The Mindfulness Meditation Effect on States of Anxiety,
Depression, Stress and Quality of Life
Pedro Morais
, Ana P. Pinheiro
, Miguel S. Fonseca
and Carla Quintão
LIBPhys, NOVA School of Science and Technology, NOVA University of Lisbon, Lisbon, Portugal
Faculty of Psychology, University of Lisbon, Lisbon, Portugal
Center for Mathematics and Applications, NOVA School of Science and Technology,
NOVA University of Lisbon, Lisbon, Portugal
NOVA School of Science and Technology - Department of Physics, NOVA University of Lisbon, Lisbon, Portugal
Keywords: Mindfulness, Anxiety, Depression, Stress, Quality-of-Life.
Abstract: Purpose: This paper aims to study how mindfulness meditation can be used to prevent, or improve, states of
anxiety, depression, stress and loss of quality of life. Although this model of meditation has been associated
with a healthier life, there is a need for scientific evidence-based on longitudinal results. Methods: Twenty-
five volunteers, asymptomatic of psychological distress, participated in this research project attending a
Mindfulness-Based Stress Reduction (MBSR) course. The status of each individual was assessed for 18
weeks, with three scales: World Health Organization Quality of Life (WHOQOL), Profile of Mood States
(POMS) and Depression, Anxiety and Stress Scale (DASS). There were four evaluation periods:
Pre/Peri/Post-MBSR course and a fourth follow-up, after two months. Results: Comparing the beginning to
the end of the MBSR course, a significant reduction was observed in mean results of self-reported anxiety: -
66.0% (p<0.001), stress: -52.0% (p<0.001), depression: -51.0% (p<0.001) and Total Mood Disturbance
(TMD): -19.0% (p<0.001), as well as an increase in quality of life: 11.2% (p<0.001). Conclusion: The current
values suggest that the practice of mindfulness meditation, characterized by self-regulation of attention, can
be used as a proactive way to prevent and respond to psychopathological disorders.
Being healthy is much more than not being sick
(World Health Organization, 2014), involving daily
physical and mental well-being. The modern society,
of which we are part of, imposes increasing personal
responsibilities, an increasingly demanding
professional activity and a constant connection to the
technological world. New obligations arise daily,
preventing a timely response to problems. There is no
room to rest and the mind tends to walk into a state of
stress. This vulnerable and unhealthy way of life is
evidenced by a study published by the OCDE in
which more than 80 million Europeans suffer from
mental health problems (OECD, 2018). The search
for a healthy and effective alternative, without using
drugs, becomes a real demand. Mindfulness
meditation comes as part of the solution to this type
of disorder. It consists of a mental self-regulation
technique of controlling attention and, consequently,
the individual’s well-being. Mindfulness, which
underlies the principle of observing without
judgment, calms the mind, acting not only from the
therapeutic point of view but mainly by preventing or
aiding a treatment of mental disorders that affect a
large part of the population. This type of meditation
has evolved worldwide with very significant results
in the quality of life of its followers. There is a
growing number of practitioners and countries such
as England (Education et al., n.d.), Portugal (João
Carvalho das Neves, João Pargana, 2019), Australia
(Dobkin & Hutchinson, 2013) and the USA where
Mindfulness has already become a curricular
Morais, P., Pinheiro, A., Fonseca, M. and Quintão, C.
The Mindfulness Meditation Effect on States of Anxiety, Depression, Stress and Quality of Life.
DOI: 10.5220/0010854900003123
In Proceedings of the 15th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2022) - Volume 5: HEALTHINF, pages 573-582
ISBN: 978-989-758-552-4; ISSN: 2184-4305
2022 by SCITEPRESS Science and Technology Publications, Lda. All rights reserved
discipline (Weare, 2018) and also used as medical
care (Vos & Vitali, 2018)(Kemper et al.,
2016)(Mouzinho et al., 2018).
Several meta-analyses demonstrated positive
effects of mindfulness meditation on stress, anxiety
and depression (Spijkerman et al., 2016)(Li et al.,
2017). Furthermore, by comparing Mindfulness to
other types of meditation, such as Yoga, the first was
shown to produce clearly superior effects (Virgili,
2015). Studies at various universities advise
Mindfulness meditation as an effective method for
calming stress levels among the student population
(Galante et al., 2018). Nevertheless, the benefits of
this practice need to be ascertained (Galante et al.,
2016). Clinical situations such as chronic pain or low
back pain (Hilton et al., 2017) might be relieved with
the aid of Mindfulness (Anheyer et al., 2017).
However, the temporal sequence in evaluations is
required. Some approaches already address this need,
such as the Mindfulness study of 104 international
students at the University of Amsterdam being
collected during four meditation course sessions (de
Bruin et al., 2015).
Notwithstanding, a longitudinal study addressing
different aspects of well-being and mental health is
missing. There are several articles published based on
WHOQOL survey. In a study conducted at a
university hospital in Seoul, the effects of
Mindfulness meditation on 50 nurses were evaluated.
With an 8-week course, they found significant
improvements in nurses’ quality of life and increased
positive emotional states (Chang et al., 2016). A
meta-analysis of 96 studies with 7647 participants
also found positive outcomes of the MBSR course on
volunteer’s quality of life (de Vibe et al., 2017) and
relief of depressive symptoms (Manh Dang et al.,
2018). Identical results, with clear improvements in
the health status of each individual, were also
revealed using POMS (Evans et al., 2018)(Garland et
al., 2007) and DASS (McConville et al.,
2017)(Kolahkaj & Zargar, 2015) surveys. The studies
compared the states pre and post-course and revealed
reductions in depression, which are more significant
on anxiety and even more on stress.
Most papers published in this area only perform
comparative studies between test and control groups
in a single moment, disregarding the dynamics of the
emotional states and the intrinsic nature of training,
which demands continued practice (Tang et al.,
2015). It is expected that after the participation in the
MBSR course, psychological changes occur in the
individual, providing a more positive life approach
without known negative collateral damage. However,
it is important to assess until when the effects persist.
The main objectives of this study were to specify
the contribution of the current practice of
Mindfulness meditation to the prevention and
management of mood dysregulation such as anxiety,
depression and/or stress. Three different surveys
(DASS, POMS and WHOQOL-100) were used to
evaluate the well-being subjects evolution.
Longitudinal monitoring was carried out over 18
weeks, through 4 collection sessions, and the
existence of only one test group was characterized in
the first session and kept as the baseline for the
subsequent sessions.
The present study is based on the administration of a
Mindfulness-Based Stress Reduction (MBSR) course
to 30 individuals and its evaluation was performed
over 18 weeks. Through a longitudinal approach, with
records from 4 sessions, three scales assessed the
current Quality of Life (QoL) of the participants, their
mood state and the levels of depression, anxiety and
2.1 Participants Recruitment and
Sample Characterization
The participant’s selection was made in a Portuguese
University where this research work took place.
Recruitment began with the dissemination of posters
through Facebook and sent via e-mail to all faculty
members, students and employees. Through a QR
code/link, those who were interested, were provided
access to a Web page with more detailed information
such as the instructor’s name, the sessions scheduled
and the attribution of a certificate to all those who
successfully completed it. For 15 days, an online
mini-survey was active, allowing to pre-select the
candidates. All those who did not belong to this
academic environment already had training in
Mindfulness or were not available to attend the entire
course were excluded. The page registered 279
accesses with 35 applications, resulting in the
rejection of 5 individuals (1 did not belong to the
university, 3 already had Mindfulness training and 1
did not have full availability to attend the course).
Subsequently, during the MBSR course, 5 individuals
gave up (2 for health issues and 3 without
justification), so the final population considered for
this study was composed of 25 individuals (mean age
= 26.0, SD = 7.1, 9 male) (Table 1).
HEALTHINF 2022 - 15th International Conference on Health Informatics
Table 1: Sample characterization.
<20 3 1 2 3 0 0
20-25 10 5 5 10 0 0
25-30 8 2 6 4 2 2
≥30 4 1 3 1 3 0
2.2 Mindfulness-based Stress
Reduction Course
The MBSR training is specifically targeted to
situations of stress, anxiety and depression(Grossman
et al., 2004). It was developed to be trained in 8
lessons of 2 hours and 30 minutes each, one per week.
In the 6
week, an intensive training session was
prepared, usually on a Sunday, in a silent regime of
"retreat", putting into practice the knowledge already
acquired (Table 2).
Table 2: Plan for MBSR Training Course.
Mindfulness-Based Stress Reduction
of the
Introduction to Mindfulness 2.5 21
Perception 2.5 22
Mindfulness of breath & body in motion 2.5 23
Learning about our patterns of stress
2.5 24
Dealing with stress: Using Mindfulness to
respond instead of to react
2.5 25
Stressful communications and
interpersonal Mindfulness
2.5 26
(Silent retreat) 6.0 26
Lifestyle choices: Take care of me 2.5 27
Keep Mindfulness alive 1.5 28
2.3 Online Surveys
The DASS, POMS and WHOQOL-100 inquiries
were implemented through the Google Forms
platform, collecting and pre-processing data. After
the application submission, the selected volunteers
received an SMS with a random alphanumeric 6
digits, corresponding to their personal and non-
transferable identification. Personal data privacy is
guaranteed using HTTPS protocol and this code
authentication without any other identification.
In the four sessions scheduled, the DASS and
POMS surveys were completed, with a 15-minute
completion time. To avoid a time overload in the
collection session, the WHOQOL-100 survey,
estimated at 25 minutes, were answered online later,
on the day itself. The surveys were answered at
different stages of the academic calendar (Table 3).
Table 3: School Calendar during the 4 sessions surveys.
Session Date (last 2 weeks) Academic calendar
May School days
June Exams
July Special period of exams/
Paper submissions
- August Summer holidays (full
September School days
2.3.1 Depression, Anxiety and Stress Scale
The DASS, adapted to Portuguese with 21 questions
(Pais-Ribeiro et al., 2004) and answered from 0 to 3,
was developed for adults in order to evaluate a set of
emotions and feelings, lived in the last week, and
grouped in three basic structures: Anxiety, depression
and stress. The issues related to anxiety include
subjective experiences, skeletal muscle effects,
autonomic system arousal and situational anxiety.
Depression encompasses discouragement, lack of
interest or involvement, inertia, self-depreciation and
devaluation of life. Finally, stress encompasses
irritability, nervous excitement, impatience,
restlessness, and difficulty in relaxing. The healthiest
individual will get a final score of 0 progressing to a
maximum of 42, evolving from "Normal" to
"Medium," "Moderate," "Severe," and "Extremely
Severe". Although each state has a maximum value of
42, its classification varies according to each state
analysis (Figure 1).
2.3.2 Profile of Mood States
POMS is an easy-to-respond and easy-to-use
assessment instrument that evaluates mood states and
psychological well-being (McNair et al., 1971). In the
Portuguese adaptation (Faro Viana et al., 2012) 42
adjectives were used, identifying six state factors:
Stress/Anxiety is represented by an increase of
tension; Depression/Melancholy describes the
emotional state of sadness, loneliness, unhappiness
and discouragement; Hostility/Anger depicts a mood
of anger or dislike of others; Vigor/Activity
the state of energy and physical and
The Mindfulness Meditation Effect on States of Anxiety, Depression, Stress and Quality of Life
Figure 1: Qualitative/Quantitative Classification for Anxiety, Depression and Stress, using DASS scale.
psychological vigor; Fatigue/Inertia expresses a state
of fatigue, inertia and reduced energy; and finally
Confusion/Disorientation corresponds to a low
lucidity and confused state. All questions were
presented online, and evaluate the person status
during the last week, on a scale of 0 to 4
(0="Nothing", 1="A little", 2="Moderately", 3="Fair"
and 4="Many"). The final mood state is calculated
through the sum of the states of tension, depression,
hostility, fatigue and confusion, from which the state
of vigor is subtracted. To avoid a negative final result,
the value 100 is added to the sum. This TMD is
represented by the final value obtained. A lower value
represents a more positive mood state.
2.3.3 Quality of Life
The WHOQOL survey is intended to assess the
quality of life of an individual, taking into account his
"perception and position in life in a cultural context
and system of values in which he lives and in relation
to his goals, expectations, standards and concerns"
(World Health Organization, 1998). The WHOQOL-
100 consists of 100 questions adapted to the
Portuguese population assessing the physical,
psychological, independence, social relations,
personal environment and spirituality/beliefs.
Responses are given based on the individual
experience during the past two weeks. The first 42
questions are related to positive feelings of happiness
and contentment. The rating ranges from "Nothing"
to "Too Much". The daily activities are assessed with
13 questions with a score of "Nothing" to
"Completely", checking whether the subject
experienced or was able to do certain things such as
washing themselves or eating. The third phase
includes 34 questions to evaluate if the individual felt
satisfied, happy or well with various aspects of their
life, ranging from "Very dissatisfied" to "Very
satisfied". The 5
analysis phase includes 4 questions
about the daily activities that take the most time and
energy, varying the classification between
"Nothing/Very dissatisfied" to "Completely/Very
satisfied". Next, there are four more questions
assessing an individual's physical ability to
accomplish what they need to do by ranking "Very
Bad/Not at All/Very Dissatisfied" and "Very
Good/Very Satisfied". Finally, the last four questions
address personal beliefs and spirituality, with the
responses varying between "Nothing" and "Many".
Quality of life is then assessed quantitatively in all
these six domains, from 1 to 5. The higher the result
obtained, the more quality of life an individual has.
This survey was completed only in the first, third and
fourth sessions, with no data collection occurring on
the second (Peri-MBSR). This decision occurred
since filling this questionnaire is very time-
consuming, and the major goal of the survey is to
evaluate the changes before, after the course, and
after two months.
2.4 Statistical Analysis
The statistical analysis was performed using a linear
mixed-effects model. This approach is particularly
appropriate to process longitudinal data with missing
values. This model considers the independent effects
of interest (fixed effects) and the variations that may
occur (random effects). The model included one
random effect (subjects) and one fixed effect
(sessions). The analysis was performed using
FITLME command of Matlab (MathWorks, 2020).
The completed command was: lme = fitlme (tbl,
formula), where tbl is the data table, previously
structured in an adequate format, and
The data related to DASS and POMS surveys in the
four sessions (21 and 42 questions respectively), and
the WHOQOL-100 survey (100 questions in 3
sessions), in a total of 13.800 responses, were
processed. The datasets were labeled with "Pre",
"Peri", "Post" and "Follow-Up", corresponding to
"Pre-Course", "During Course", “Post-Course" and
"2 Months after Course".
HEALTHINF 2022 - 15th International Conference on Health Informatics
Figure 2: DASS survey averaged results for Anxiety, Depression and Stress (from 0 to 42), from session 1 (S1) to session 4
(S4), for the global sample. The error bars represent the standard deviation.
Table 4: DASS survey results (mean; standard deviation, SD, and p-value) for anxiety, depression and stress (from 0 to 42),
for the entire sample.
DASS Survey
Pre-MBSR (S1) Peri-MBSR (S2) Post-MBSR (S3) Follow-up MBSR (S4)
Mean SD Mean SD p(S1-S2) Mean SD p(S1-S3) Mean SD p(S1-S4)
Anxiety 10.3 ± 1.5 6.8 ± 0.9 < 0.01 3.5 ± 0.7 < 0.001 6.2 ± 1.5 < 0.01
Depression 10.4 ± 1.7 7.6 ± 1.2 0.07 5.1 ± 1.0 < 0.001 7.4 ± 1.6 < 0.05
Stress 19.6 ± 1.3 15.8 ± 1.2 < 0.05 9.4 ± 1.3 < 0.001 12.9 ± 2.1 < 0.001
3.1 DASS Survey
When considering the global sample, the DASS
survey revealed a general improvement in all
assessment parameters. The average state of
depression dropped from the first session to the
following from a qualitative grade of "Medium" to
"Normal". Anxiety also exhibited the same pattern
being reduced from "Moderate" to "Normal". Self-
reported stress also decreased between the first and
second sessions from "Moderate" to "Medium" and
then to "Normal" in the remaining two sessions.
These findings indicate that the Mindfulness course
does influence the parameters measured in the DASS
survey (Figure 2). In Table 4 we present separate
results for anxiety, depression, and stress, as well as
the p-values obtained when data from session 1 was
compared with data from the other 3 sessions. It is
worth noting that only one contrast did not reach
statistically significant, i.e., p≥0.05 (Depression:
session 1 against session 2). Since DASS included
both qualitative and quantitative discrimination
(Figure 1), it allowed the creation of two subgroups
of participants, one with low ("Normal" or
"Medium") and the other with high levels
("Moderate", "Severe" or "Extremely severe"). The
overall results obtained indicate the existence of 14
subjects with “Moderate” to “Extremely Severe”
levels of anxiety, 7 with depression and 14 with stress
(Table 5). Comparing the first (Pre-MBSR) with the
third session (Post-MBSR), 12 out of 14 (85.7%)
subjects lowered their anxiety state to "Normal" or
Table 5: Evaluation of Anxiety, Depression and Stress
using DASS data in subjects who presented high levels of
these conditions in the first session.
Anxiety ≥10 14 9 2 4
Depression ≥ 14 7 5 2 4
Stress ≥ 19 14 6 1 6
"Medium". The same pattern was observed for
depression in 5 out of 7 (71.4%) subjects and for
stress in 13 out of 14 subjects (92.9%). This indicates
that post-training changes were enhanced in
participants who presented more extreme anxiety and
stress scores in the baseline assessment. Considering
the results in a globally, at the end of MBSR course,
92% of participants (25) reported "Normal" or
"Medium" levels of anxiety, 92% of depression and
96% of stress.
3.2 POMS Survey
The POMS states are evaluated with a score ranging
from 0 to 4. The tension, hostility, vigor, fatigue and
depression are calculated considering the sum of 6
questions each, being 0 to 24 the possible range
obtained for each state. The depression score is
obtained based on 12 questions varying from 0 to 48.
The Mindfulness Meditation Effect on States of Anxiety, Depression, Stress and Quality of Life
Figure 3: POMS survey averaged results for Tension, Hostility, Fatigue, Confusion, Vigor (from 0 to 24), Depression (from
0 to 48) and TMD (from 76 to 244). The error bars represent the standard deviation.
Table 6: POMS survey results (mean; standard deviation, SD, and p-value) for Tension, Depression, Hostility, Fatigue,
Confusion, Vigor and Total Mood Disturbance for the global sample.
POMS Survey
Pre-MBSR (S1) Peri-MBSR (S2) Post-MBSR (S3) Follow-up MBSR (S4)
Mean SD Mean SD p(S1-S2) Mean SD p(S1-S3) Mean SD p(S1-S4)
Tension 12.2 ± 0.7 9.0 ± 0.7 <0.001 6.5 ± 0.8 < 0.001 8.1 ± 1.2 < 0.001
Depression 13.4 ± 2.0 9.4 ± 1.3 < 0.01 6.8 ± 1.4 < 0.001 8.4 ± 1.9 < 0.001
Hostility 7.5 ± 0.7 6.3 ± 0.8 0.18 4.2 ± 0.7 < 0.001 3.9 ± 0.8 < 0.001
Fatigue 12.2 ± 1.1 8.9 ± 1.1 < 0.01 6.0 ± 1.1 < 0.001 9.1 ± 1.6 < 0.01
Confusion 9.2 ± 1.0 7.3 ± 0.7 < 0.01 6.3 ± 0.7 < 0.001 6.2 ± 0.9 < 0.001
Vigor 13.9 ± 0.8 14.1 ± 0.8 0.78 16.0 ± 0.8 < 0.05 15.3 ± 1.0 0.06
TMD 140.6 ± 5.0 126.8 ± 4.1 < 0.01 113.9 ± 4.4 < 0.001 120.3 ± 5.9 < 0.001
Considering the global sample, the results
comparison from Pre-MBSR to Post-MBSR sessions
revealed an increase in the vigor level (15.1%) and an
expressive reduction in the remaining states: Tension
-46.7%, Depression -49.3%, Hostility -44.0%,
Fatigue -50.8% and Confusion -31.5% (Figure 3).
This changing pattern was also verified in the
intermediate stage of the MBRS course from the first
to the second session. The comparison of the third
session with the fourth session revealed a general
reduction trend in negative mood states (Table 6 and
Figure 3). Finally, the comparison of the TMD index
from the Pre-MBSR to Post-MBSR session showed a
reduction of -19.0%. We also performed a global
statistical analysis similar to the one described for the
DASS survey. When comparing each session with the
first one (Table 6) only three contrasts did not reach
statistical significance, i.e. hostility from the first to
the second session and vigor from the first to the
second and fourth session.
3.3 WHOQOL-100 Survey
The WHOQOL-100 survey comprises 100 questions
ranging from 1 to 5. Each evaluation is performed
through 4 answers, with five levels each, resulting in
a minimum value of 4 and a maximum value of 20.
Compared to previous surveys, the scale
interpretation must be reversed, that is, the quality of
life is considered higher as the value increases.
Regarding the analysis of individual states (Table 7
and Figure 4) an improvement from the Pre-MBSR to
the Post-MBSR was observed at all levels: Physical
(15.8%), Psychological (15.7%); Independence
(15.2%), Social Relationships (9.9%), Environment
(9.4%), and Spirituality (9.6%). The final state
Quality-of-Life that integrates all previous ones
HEALTHINF 2022 - 15th International Conference on Health Informatics
Figure 4: WHOQOL-100 survey averaged results for physical, psychological, independence, social relationships,
environment, spirituality and quality-of-life items (from 4 to 20). The error bars represent the standard deviation.
Table 7: WHOQOL survey results (mean; standard deviation, SD, and p-value) for physical, psychology, independence, social
relationships, environment and spirituality items, in the global sample.
WHOQOL-100 Survey
Pre-MBSR (S1) Post-MBSR (S3) Follow-up MBSR (S4)
Mean SD Mean SD p(S1-S3) Mean SD p(S1-S4)
Physical 13.3 ± 0.4 15.7 ± 0.5 < 0.001 15.4 ± 0.5 < 0.001
Psychological 13.4 ± 0.6 15.5 ± 0.5 < 0.001 15.5 ± 0.6 < 0.001
Independence 15.1 ± 0.5 17.4 ± 0.4 < 0.001 17.5 ± 0.4 < 0.001
Social Relationships 14.1 ± 0.7 15.5 ± 0.6 < 0.05 15.0 ± 0.6 0.06
Environment 14.9 ± 0.4 16.3 ± 0.3 < 0.001 16.1 ± 0.4 < 0.001
Spirituality 13.6 ± 0.9 14.9 ± 0.7 < 0.05 15.0 ± 0.9 < 0.05
Quality-of-Life 14.3 ± 0.4 15.9 ± 0.3 < 0.001 15.9 ± 0.4 < 0.001
presented, in average, an increase of 11.2%. A linear
fixed-effects model revealed a global states p<0.05.
When comparing each session with the first one
(Table 7), only one did not reach statistical
significance (‘social relationships’; S4; p>0.05).
The results presented in the previous section shed
light on the temporal changes of mood and quality of
life parameters in participants enrolled in
Mindfulness meditation practice. An 11.2% in an
individual's Quality-of-Life was observed before and
after training. Furthermore, meditation practice was
associated with a decrease in the state of anxiety (-
66.0%), depression (-51.0%) and TMD (-19.0%).
Finally, stress also presented a significant reduction
post-practice, i.e., -52.0% (Table 8; Figure 5). This
longitudinal, randomized and actively controlled
study has been carried along for 18 weeks, showing a
gradual change between sessions. Regarding the
fourth session, which took place two months after the
end of the course, participants presented a trend of
regression to values close to the second session.
These results point to functional changes that regress
when the subjects stop the practice of this meditation
technique. This indicates the benefits of continued
Mindfulness meditation as an effective method for
mind calming, improving quality of life and
increasing positive emotional states. It should be
noted that the sample is mainly composed of
university students who experienced an increased
overload in the second evaluation of July, a period of
academic evaluations (Table 3). Nonetheless, even in
this stressful moment, the results revealed an evident
improvement in the subject’s well-being. Given this
limitation, it is likely that the results of the third
The Mindfulness Meditation Effect on States of Anxiety, Depression, Stress and Quality of Life
session are even more relevant to the individual's
well-being. Together, the findings of the current study
suggest that the daily practice of Mindfulness
meditation contributes to reducing depression,
anxiety, stress, TMD, and to increase QoL.
Mindfulness meditation benefits well-being,
potentially preventing clinical mood disturbances that
affect a large part of the population.
Table 8: Survey resume evolution of Quality-of-life,
Anxiety, Depression, Stress and TMD.
QoL WHOQOL 64.4 n.a. 74.4 74.4
24.5 16.2 8.3 14.8
Depression 24.8 18.1 12.1 17.6
Stress 46.7 37.6 22.4 30.7
TMD POMS 38.5 30.2 22.6 26.4
Funding: The authors acknowledge the financial
support of the Fundação para a Ciência e Tecnologia,
through its project UIDB/FIS/04559/2020.
Ethics Approval: Ethical approval for this research
was obtained from the Ethics Committee of NOVA
School of Science and Technology - NOVA
University of Lisbon, Portugal. The study was
performed following the ethical standards of the 1964
Helsinki Declaration and its later amendments.
Consent to Participate and Publication: Informed
consent was obtained from all subjects included in
this study.
Conflict of Interest: The authors declare that there is
no conflict of interest regarding the publication of this
The authors thank LIBPhys, Laboratory for
Instrumentation, Biomedical Engineering and
Radiation Physics, from NOVA School of Science
and Technology, for the equipment, laboratory and all
conditions provided.
Figure 5: Final states evolution in radar graph for Anxiety, Depression, Stress, TMD and QoL.
HEALTHINF 2022 - 15th International Conference on Health Informatics
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