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Vasiliadis HM, Pitrou I, Grenier S, Berbiche D, Hudon C. Psychological Distress, Cognition, and Functional Disability Trajectory Profiles of Aging in Primary Care Older Adults. Clin Gerontol 2023; 46:819-831. [PMID: 35387578 DOI: 10.1080/07317115.2022.2060158] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To identify profiles of aging by combining psychological distress, cognition and functional disability, and their associated factors. METHODS Data were drawn from the Étude sur la Santé des Aînés-Services study and included 1585 older adults. Sociodemographic, psychosocial, lifestyle and health factors were informed from structured interviews. Group-based multi-trajectory modeling and multinomial logistic regression were used to identify aging profiles and correlates. Sampling weights were applied to account for the sampling plan. RESULTS The weighted sample size was 1591. Three trajectories were identified: a favorable (79.0%), intermediate (14.5%), and severe scenario (6.5%). Factors associated with the severe scenario were older age, male gender, lower education, the presence of anxiety disorders, low physical activity, and smoking. Membership in the intermediate scenario was associated with daily hassles, physical disorders, anxiety and depression, antidepressant/psychotherapy use, low physical activity, and no alcohol use. High social support was protective against less favorable profiles. CONCLUSIONS Symptoms of anxiety and depression and high burden of physical disorders were associated with less favorable trajectories. Modifiable lifestyle factors have a significant effect on healthy aging. CLINICAL IMPLICATIONS Assessment and management of anxio-depressive symptoms are important in older adults. Clinical interventions including access to psychotherapy and promotion of healthier lifestyles should be considered.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Charles-Le Moyne Research Center, Longueuil, Quebec, Canada
| | - Isabelle Pitrou
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Charles-Le Moyne Research Center, Longueuil, Quebec, Canada
| | - Sébastien Grenier
- Department of Psychology, University of Montreal, Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Quebec, Canada
| | - Djamal Berbiche
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Charles-Le Moyne Research Center, Longueuil, Quebec, Canada
| | - Carol Hudon
- School of Psychology (Laval University), CERVO Brain Research Centre, and VITAM Research Centre, Quebec, Quebec, Canada
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Bakouni H, Ouimet MC, Desjardins S, Forget H, Vasiliadis HM. Childhood abuse/neglect and temporal patterns in late-life anxiety. Aging Ment Health 2022; 27:973-982. [PMID: 35612883 DOI: 10.1080/13607863.2022.2076204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Anxiety has been associated with childhood abuse/neglect, but this relationship and its mechanisms are poorly documented in older adults. This study examined the association between childhood abuse/neglect and late-life anxiety temporal patterns (i.e. absence, remission, incidence, persistence), testing for mediators. METHODS Data were derived for 724 French-speaking community-living older adults participating in the Étude sur la santé des ainés - Services study with available information at baseline and 4-year follow-up. Past-month anxiety was based on a cutoff score ≥5 on a French translation of the 7-item Generalized Anxiety Disorder at interviews. Questions on childhood abuse/neglect (e.g. psycho-emotional, physical, sexual) were administered. Adjusted multinomial regression analyses and mediation bootstrapping models were used. Tested mediators included traumatic events (excluding childhood abuse/neglect), daily hassles, psychological resilience, and cortisol activity. RESULTS The absence, remission, incidence and persistence of anxiety was found in 45.3%, 25.3%, 8.7% and 20.7% of the sample, respectively. Participants with incident and persistent late-life anxiety experienced more childhood abuse/neglect. Participants with persistent anxiety also reported lower psychological resilience. The association between childhood abuse/neglect with anxiety incidence was mediated by daily hassles, while its association with anxiety persistence was mediated by daily hassles and psychological resilience. CONCLUSION Past childhood abuse/neglect was associated with late-life anxiety incidence and persistence, with psychological resilience and daily hassles potentially explaining this relationship. Further research should focus on ascertaining the clinical applications of psychosocial and biological profiles in informing the prevention and personalized treatment of anxiety in older adults.
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Affiliation(s)
- Hamzah Bakouni
- Faculté de Médecine et Des Sciences De La Santé, Université de Sherbrooke, Longueuil, Quebec, Canada.,Centre de recherche Charles-Le Moyne, Longueuil, Quebec, Canada
| | - Marie Claude Ouimet
- Faculté de Médecine et Des Sciences De La Santé, Université de Sherbrooke, Longueuil, Quebec, Canada.,Centre de recherche Charles-Le Moyne, Longueuil, Quebec, Canada
| | | | - Helen Forget
- Université du Québec en Outaouais, Gatineau, Canada
| | - Helen-Maria Vasiliadis
- Faculté de Médecine et Des Sciences De La Santé, Université de Sherbrooke, Longueuil, Quebec, Canada.,Centre de recherche Charles-Le Moyne, Longueuil, Quebec, Canada
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Self-affirmation training can relieve negative emotions by improving self-integrity among older adults. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02201-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Hormonal and Subjectively Perceived Stress of the Emergency Physicians of the Airborne Rescue Service. J Clin Psychol Med Settings 2021; 28:771-780. [PMID: 33594632 PMCID: PMC8590658 DOI: 10.1007/s10880-021-09767-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 11/22/2022]
Abstract
Due to their work activities, emergency physicians are regularly exposed to exceptional mental and physical situations. In order to prevent stress-related illnesses, the triggers of hormonal and subjectively perceived stress must be understood better. On a sample of emergency physicians from two air rescue services (N = 80), the cortisol awakening response (CAR) was determined on flight rescue days, clinic days, and days off. Pearson correlations showed significant connections between the CAR on flight rescue days and individual scales of the Trier Inventory for Chronic Stress (TICS) and the Perceived Stress Scale (PSS). The results indicate that a lower subjective stress level is associated with higher levels of hormonal stress. Stepwise regression analyses showed a significant influence of the number of professional years, subjectively perceived stress, pressure to succeed, and social isolation. The results suggest that the hormonal stress burden of emergency physicians is in a complex relationship with perceived strain.
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Bakouni H, Ouimet MC, Forget H, Vasiliadis HM. Temporal patterns of anxiety disorders and cortisol activity in older adults. J Affect Disord 2020; 277:235-243. [PMID: 32836030 DOI: 10.1016/j.jad.2020.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/01/2020] [Accepted: 08/05/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Studies focusing on anxiety temporal patterns and cortisol activity in older adults are scarce. The objectives of this study were to examine in older adults the relationship between anxiety temporal patterns and cortisol activity and ascertain the presence of sex differences. METHODS Data were retrieved from the Étude sur la santé des ainés - Services study in Quebec and included N = 762 community living adults aged ≥ 65 years having participated in interviews at baseline (T1) and at 4 years follow-up (T2). A standardized questionnaire, based on DSM-5 criteria, was used to ascertain in the past 6 months the presence of anxiety (absence, remission, incidence, persistence). Cortisol activity during the interview and cortisol concentration on a regular day (at T2) were the dependent variables. Adjusted multivariable linear regression models, stratified by sex, were used. RESULTS Results showed higher cortisol activity during the interview in participants with anxiety in remission (Beta: 2.59; 95% CI: 0.62 , 4.57), specifically in males, and lower activity in participants with persistent anxiety (Beta: -3.97; 95% CI: -7.05, -0.88). Cortisol concentration on a regular day was higher in males reporting incident anxiety (Beta: 8.07; 95% CI: 2.39 , 13.76). LIMITATIONS The convenience sample with losses to follow-up may have led to a potential selection bias. CONCLUSION Anxiety temporal patterns were associated with cortisol activity profiles in older adults with sex being a significant moderator. Future studies are recommended to ascertain the longitudinal changes in cortisol activity and anxiety temporal patterns, which may further inform personalized treatment of anxiety.
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Affiliation(s)
- Hamzah Bakouni
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, Quebec, Canada; Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Longueuil, Quebec, Canada
| | - Marie Claude Ouimet
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, Quebec, Canada; Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Longueuil, Quebec, Canada
| | - Helen Forget
- Université du Québec en Outaouais, Gatineau, Canada
| | - Helen-Maria Vasiliadis
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, Quebec, Canada; Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Longueuil, Quebec, Canada.
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Abstract
Supplemental Digital Content is available in the text. Objectives: The ICU is a complex and stressful environment and is associated with significant psychologic morbidity for patients and their families. We sought to determine whether salivary cortisol, a physiologic measure of acute stress, was associated with subsequent psychologic distress among family members of ICU patients. Design: This is a prospective, observational study of family members of adult ICU patients. Setting: Adult medical and surgical ICU in a tertiary care center. Subjects: Family members of ICU patients. Interventions: Participants provided five salivary cortisol samples over 24 hours at the time of the patient ICU admission. The primary measure of cortisol was the area under the curve from ground; the secondary measure was the cortisol awakening response. Outcomes were obtained during a 3-month follow-up telephone call. The primary outcome was anxiety, measured by the Hospital Anxiety and Depression Scale-Anxiety. Secondary outcomes included depression and posttraumatic stress disorder. Measurements and Main Results: Among 100 participants, 92 completed follow-up. Twenty-nine participants (32%) reported symptoms of anxiety at 3 months, 15 participants (16%) reported depression symptoms, and 14 participants (15%) reported posttraumatic stress symptoms. In our primary analysis, cortisol level as measured by area under the curve from ground was not significantly associated with anxiety (odds ratio, 0.94; p = 0.70). In our secondary analysis, however, cortisol awakening response was significantly associated with anxiety (odds ratio, 1.08; p = 0.02). Conclusions: Roughly one third of family members experience anxiety after an ICU admission for their loved one, and many family members also experience depression and posttraumatic stress. Cortisol awakening response is associated with anxiety in family members of ICU patients 3 months following the ICU admission. Physiologic measurements of stress among ICU family members may help identify individuals at particular risk of adverse psychologic outcomes.
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Preston KL, Schroeder JR, Kowalczyk WJ, Phillips K, Jobes ML, Dwyer M, Vahabzadeh M, Lin JL, Mezghanni M, Epstein DH. End-of-day reports of daily hassles and stress in men and women with opioid-use disorder: Relationship to momentary reports of opioid and cocaine use and stress. Drug Alcohol Depend 2018; 193:21-28. [PMID: 30336389 PMCID: PMC6239924 DOI: 10.1016/j.drugalcdep.2018.08.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/10/2018] [Accepted: 08/14/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Stress can be validly assessed "live" or by a summary evaluation of the very recent past. Using smartphone-based ecological momentary assessment (EMA) combined with end-of-day (EOD) entries, we assessed the association between daily hassles, stressful events and use of opioids and cocaine, in opioid- and cocaine-using men and women. METHODS For up to 16 weeks, 161 outpatients in opioid-agonist treatment who reported cigarette smoking carried smartphones on which they reported stressful events (SEs) and drug use (DU) and completed an EOD questionnaire to report hassles encountered throughout the day, current perceived stress, cigarettes/day, and current mood. We compared EOD responses on days with and without SE and DU reports and on days when thrice-weekly urine drug screens indicated opioid or cocaine use or abstinence. RESULTS Participants (N = 161) made 11,544 EOD entries; EMA SEs were reported on 861 (7.5%) days, and DUs on 1685 (14.6%) days. The most frequently reported hassles in EOD entries were "not enough money" (31.4% of daily reports) and maintaining abstinence (18.7%). Total EOD hassles showed small but statistically significant associations [odds ratios (95% CIs)] with EMA SEs [1.09 (1.06-1.13)], DUs [1.08 (1.06-1.10)], and urine-positive opioid [1.06 (1.04-1.09)] and cocaine [1.03 (1.00-1.06)] results. Men and women had similar rates (mean/day (SD)) of hassles: men 2.25 (3.55); women 2.55 (3.76) (F1,159 = 0.53, p = 0.47). CONCLUSIONS Daily hassles, reported at the end of the day, are associated with both same-day stressful events and drug use. Monitoring hassles and devising specific coping strategies might be useful therapeutic targets.
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Affiliation(s)
- Kenzie L. Preston
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224,Correspondence Kenzie L. Preston, Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, phone: 443.740.2326, fax: 443.740.2318,
| | | | - William J. Kowalczyk
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224,Present address: Hartwick College, Department of Psychology, Oneonta, NY, 13820
| | - Karran. Phillips
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224
| | - Michelle L. Jobes
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224
| | - Megan Dwyer
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224
| | - Massoud Vahabzadeh
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224
| | - Jia-Ling Lin
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224
| | - Mustapha Mezghanni
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224
| | - David H. Epstein
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224
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Sang YM, Wang LJ, Mao HX, Lou XY, Zhu YJ. The association of short-term memory and cognitive impairment with ghrelin, leptin, and cortisol levels in non-diabetic and diabetic elderly individuals. Acta Diabetol 2018; 55:531-539. [PMID: 29492658 DOI: 10.1007/s00592-018-1111-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Accepted: 01/29/2018] [Indexed: 01/02/2023]
Abstract
AIMS This study assessed short-term memory and biochemical indicators with the levels of ghrelin, leptin, and cortisol between cognitive impairment and normal older adults with or without diabetes. METHODS We enrolled 286 older adults (aged 65-85 years) with or without diabetes from the local community. Short-term memory was assessed using pictures of common objects; cognitive functioning was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The physiological indexes assessed were plasma levels of fasting ghrelin and leptin, ghrelin level at 2_h after breakfast, 24-h urinary cortisol value, body mass index, and plasma cortisol levels at 8:00 a.m., 4:00 p.m., and 12:00 p.m. RESULTS In both non-diabetic and diabetic subjects, short-term memory was significantly lower in the impaired cognition group (5.99 ± 2.90 in non-diabetic subjects and 4.71 ± 2.14 in diabetic subjects) than in the normal cognition group (8.14 ± 2.23 in non-diabetic subjects and 7.82 ± 3.37 in diabetic subjects). Baseline ghrelin level was significantly lower in the impaired cognition group (9.07 ± 1.13 ng/mL in non-diabetic subjects and 7.76 ± 1.34 ng/mL in diabetic subjects) than in the normal cognition group (10.94 ± 1.53 ng/mL in non-diabetic subjects and 9.93 ± 1.76 ng/mL in diabetic subjects); plasma cortisol levels at 8:00 a.m., 4:00 p.m., and 12:00 p.m. were significantly higher in the impaired cognition group than in the normal cognition group, while no significant difference was observed in plasma levels of fasting leptin between different groups. CONCLUSIONS Fasting plasma ghrelin and cortisol levels may be markers of cognitive decline and memory loss. It is possible that adjusting their levels may have a therapeutic effect, and this should be investigated in future studies.
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Affiliation(s)
- Yu Ming Sang
- Department of Endocrinology, Jinhua Central Hospital, Jinhua, Zhejiang province, China.
| | - Li Jun Wang
- Department of Psychology, Zhejiang Normal University, Jinhua, China
| | - Hong Xian Mao
- Department of Endocrinology, Jinhua Central Hospital, Jinhua, Zhejiang province, China
| | - Xue Yong Lou
- Department of Endocrinology, Jinhua Central Hospital, Jinhua, Zhejiang province, China
| | - Yi Jun Zhu
- The Central Laboratory, Jinhua Central Hospital, Jinhua, Zhejiang province, China
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Rosnick CB, Wetherell JL, White KS, Andreescu C, Dixon D, Lenze EJ. Cognitive-behavioral therapy augmentation of SSRI reduces cortisol levels in older adults with generalized anxiety disorder: A randomized clinical trial. J Consult Clin Psychol 2016; 84:345-52. [PMID: 26881447 DOI: 10.1037/a0040113] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Elevated cortisol in stress and aging, such as has been seen in late-life anxiety disorders, is postulated to accelerate cognitive and physiological decline in this large and increasing population. Selective serotonin-reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) are both effective treatments for generalized anxiety disorder (GAD) in older adults. On the other hand, there is very little research examining the effect of combining these therapies on peak cortisol levels. For the current analyses, we examined the effectiveness of CBT augmentation on peak cortisol levels in older adults diagnosed with GAD. METHODS The sample consisted of 42 individuals with late-life GAD who received an acute course of the SSRI escitalopram and then entered a 16-week randomized phase. Twenty-one participants were randomized to receive 16 sessions of CBT in addition to continuing escitalopram and the remaining 21 participants continued on escitalopram without CBT. Generalized estimating equations were performed to assess the effectiveness of CBT augmentation on peak cortisol levels (30 min after waking). RESULTS Older adults with GAD who received both escitalopram and CBT demonstrated a significant reduction in peak cortisol levels at posttreatment compared to the group who received escitalopram without CBT augmentation. CONCLUSIONS CBT augmentation of SSRI treatment reduced peak cortisol levels for older adults with GAD. Since persistently high cortisol levels in aging are thought to increase age-related cognitive and medical problems, our findings suggest that there may be a benefit to health and cognition of CBT augmentation for late-life anxiety disorders.
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Affiliation(s)
| | | | - Kamila S White
- Department of Psychology, University of Missouri-St. Louis
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - David Dixon
- Department of Psychiatry, Washington University School of Medicine
| | - Eric J Lenze
- Department of Psychiatry, Washington University School of Medicine
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Abstract
Anxiety disorders are highly prevalent among the elderly and are associated with increased disability, poor quality of life, and cognitive impairment. Despite this high prevalence and associated morbidities, anxiety disorders in late life are underreported and understudied. In this article, we discuss the epidemiology, disease presentation, and current treatment of anxiety disorders in older adults. We also discuss limitations in the current understanding of such disorders in this population, as well as future research directions that may reveal the mechanisms and rationale for treatment regimens for anxiety disorders in late life. We present material on the application of the Research Domain Criteria (RDoC) model to geriatric anxiety. Finally, we describe optimal management strategies of anxiety disorders.
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Lenze EJ, Hershey T, Newcomer JW, Karp JF, Blumberger D, Anger J, Doré P, Dixon D. Antiglucocorticoid therapy for older adults with anxiety and co-occurring cognitive dysfunction: results from a pilot study with mifepristone. Int J Geriatr Psychiatry 2014; 29:962-9. [PMID: 24633761 PMCID: PMC4138285 DOI: 10.1002/gps.4085] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 01/09/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVES In older adults with anxiety disorders, chronically elevated cortisol may contribute to cognitive impairment and elevated anxiety. We conducted a pilot study with mifepristone, a glucocorticoid receptor antagonist, as a potential treatment for late-life anxiety disorders and co-occurring cognitive dysfunction. METHODS Fifteen individuals 60 years and older with an anxiety disorder plus cognitive dysfunction participated in the 12-week study. In the first week, participants were randomly assigned to mifepristone 300 mg daily or placebo. In the subsequent 3 weeks, all participants received mifepristone 300 mg. Mifepristone was then discontinued, and the participants were reassessed 8 weeks later. We examined the following: (1) cognitive changes; (2) worry symptom severity; (3) safety and tolerability; and (4) salivary cortisol before, during, and after mifepristone exposure. RESULTS Overall safety, tolerability, and high retention supported the feasibility of this research. Participants with higher baseline cortisol levels (peak cortisol >6.0 ng/ml, n = 5) showed improvements in memory, executive function, and worry severity after 3-4 weeks of mifepristone with persistent memory and worry improvements 8 weeks after mifepristone discontinuation. Individuals with low-to-normal baseline cortisol (n = 8) showed little to no improvement. As expected, cortisol levels rose during mifepristone exposure and returned to pretreatment levels 8 weeks after mifepristone discontinuation. In the first week of treatment, there were no differences between placebo-treated and mifepristone-treated participants. CONCLUSION The results of this pilot study warrant further testing of antiglucocorticoid agents in late-life anxiety disorders with co-occurring cognitive dysfunction. Mifepristone is hypothesized to have benefits in patients with evidence of glucocorticoid excess. Directions for further study are discussed.
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Affiliation(s)
| | | | | | | | | | | | - Peter Doré
- Washington University School of Medicine
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Galbraith ND, Brown KE, Clifton E. A survey of student nurses' attitudes toward help seeking for stress. Nurs Forum 2014; 49:171-181. [PMID: 24392669 DOI: 10.1111/nuf.12066] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Globally, stress in student nurses may have serious implications for health, absenteeism, and attrition. Despite this, there is scant research on student nurses' attitudes toward help seeking. OBJECTIVES To examine student nurses' attitudes toward stress and help-seeking. DESIGN METHODS AND STATISTICAL ANALYSIS A cross-sectional questionnaire survey design was employed to gather data from 219 student nurses at two large U.K. universities. Two-sample chi-square tests and Fisher's exact tests were used to analyze categorical associations between responses. RESULTS Most had experienced stress before, believed the incidence within the profession was high, and would disclose their own stress to family/friends rather than to colleagues or professional institutions. The most popular outpatient treatment choice was social support; few would choose formal advice. The most common factor influencing inpatient treatment choice was confidentiality; for many, this factor would also lead them to seek distant rather than local inpatient care. Encouragingly, most would not lose confidence in a stressed colleague. CONCLUSIONS Negative attitudes toward stress and help seeking may be entrenched even before training and may have a marked influence on how/whether students seek help. Nurse employers and educators should foster more supportive and accepting attitudes toward stress in order to tackle its unwanted consequences.
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Affiliation(s)
- Niall D Galbraith
- Psychology, Department of Psychology, School of Applied Sciences, University of Wolverhampton, Wolverhampton, UK
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Cha MY, Hong HS. Effects on the Laughter Score, Cortisol and Immunoglobulin of Laughter Therapy in Middle Aged Women. ACTA ACUST UNITED AC 2013. [DOI: 10.7586/jkbns.2013.15.4.230] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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