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Hart EN, Palme R, Greenblatt N, Takeshita RSC. Hormonal changes in northern white-cheeked gibbons (Nomascus leucogenys) after the death of a group member. Primates 2024; 65:365-371. [PMID: 39023722 DOI: 10.1007/s10329-024-01145-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/02/2024] [Indexed: 07/20/2024]
Abstract
The small apes, gibbons and siamangs, are monogamous species with their social groups comprising of both parents and their offspring. Therefore, the loss of a member may elicit a stress response in the remaining members due to their strong bonds. Glucocorticoids (GCs) have been useful indicators of stress, but distinguishing between acute versus chronic stress may be limited when measuring these hormones alone. The adrenal hormone dehydroepiandrosterone-sulfate (DHEAS), a GC antagonist, has been implicated in the regulation of the stress response. Thus, the concomitant measurement of these hormones can help examine whether an event, such as the loss of a group member, elicited a stress response. In this brief report, we discuss the hormonal response of two zoo-housed northern white-cheeked gibbons (Nomascus leucogenys) (1 adolescent male and his mother) after the death of the adult male of the group. Baseline fecal samples were collected opportunistically from these two individuals 5 months prior, and 3 months following the death of their group member. A total of 25 samples were quantified for fecal GC metabolites (FGCMs) and DHEAS by enzyme immunoassay (EIA) to calculate the FGCMs:DHEAS ratio. Our results indicate an increase in FGCMs and FGCMs:DHEAS for the adolescent male, but not the adult female, following the death. Our findings suggest that the integration of FGCMs and DHEAS measurements can provide valuable information to interpret individual stress levels to the sudden change in the group's social structure.
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Affiliation(s)
- Emilee N Hart
- Department of Anthropology, Kent State University, Kent, USA
| | - Rupert Palme
- Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
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Noerup ES, Skorstengaard MH, Jensen AB, Guldin MB, Neergaard MA. Does advance care planning affect relatives’ healthcare-seeking behaviour? PROGRESS IN PALLIATIVE CARE 2022. [DOI: 10.1080/09699260.2022.2119326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | | | | | - Mai-Britt Guldin
- The Danish Knowledge Centre for Rehabilitation and Palliative Care, Nyborg, Denmark
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Neutrophil-to-Lymphocyte, Monocyte-to-Lymphocyte, Platelet-to-Lymphocyte Ratio and Systemic Immune-Inflammatory Index in Different States of Bipolar Disorder. Brain Sci 2022; 12:brainsci12081034. [PMID: 36009097 PMCID: PMC9405738 DOI: 10.3390/brainsci12081034] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 11/17/2022] Open
Abstract
The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammatory (SII) index, which provide a simple, rapid, inexpensive method to measure the level of inflammation, have been examined as potential inflammatory biomarkers of bipolar disorder (BD) in several studies. We conducted a case-control study recruiting 180 BD patients and 407 healthy controls. BD patients who met the inclusion criteria and were hospitalized due to BD at the psychiatry clinic of the University General Hospital of Larisa, Greece, until September 2021 were included in the study. Among them, 111 patients experienced a manic episode and 69 patients experienced a depressive episode. Data including a complete blood count were retrieved from their first admission to the hospital. Bipolar patients had a higher NLR, MLR and SII index compared to healthy controls when they were experiencing a manic episode (p < 0.001) and a depressive episode (p < 0.001). MLR was increased with large effect size only in patients expressing manic episodes. Neutrophils and NLR had the highest area under the curve with a cutoff of 4.38 and 2.15 in the ROC curve, respectively. Gender-related differences were mainly observed in the SII index, with males who were expressing manic episodes and females expressing depressive episodes having an increased index compared to healthy controls. The NLR, MLR and SII index were significantly higher in patients with BD than in healthy controls, which implies a higher grade of inflammation in BD patients.
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Lindsay EK, Creswell JD, Stern HJ, Greco CM, Walko TD, Dutcher JM, Wright AGC, Brown KW, Marsland AL. Mindfulness-based stress reduction increases stimulated IL-6 production among lonely older adults: A randomized controlled trial. Brain Behav Immun 2022; 104:6-15. [PMID: 35550854 PMCID: PMC9646928 DOI: 10.1016/j.bbi.2022.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/15/2022] [Accepted: 05/06/2022] [Indexed: 12/13/2022] Open
Abstract
Loneliness is a potent psychosocial stressor that predicts poor health and mortality among older adults, possibly in part by accelerating age-related declines in immunocompetence. Mindfulness interventions have shown promise for reducing loneliness and improving markers of physical health. In a sample of lonely older adults, this two-arm parallel trial tested whether mindfulness training enhances stimulated interleukin-6 (IL-6) production, a measure of innate immune responsivity. Lonely older adults (65-85 years; N = 190) were randomized to an 8-week Mindfulness-Based Stress Reduction (MBSR) or control Health Enhancement Program (HEP) intervention. Lipopolysaccharide (LPS)-stimulated production of IL-6 was measured in vitro by blinded outcome assessors at pre-intervention, post-intervention, and 3-month follow-up. Mixed-effects linear models tested time (pre, post, follow-up) by condition (MBSR vs. HEP) effects. As predicted, a significant time × condition effect on stimulated IL-6 production was observed across pre, post, and follow-up timepoints. Significant MBSR vs. HEP differences emerged from pre- to post-intervention (p =.009, d = 0.38) and from pre-intervention to 3-month follow-up (p =.017, d = 0.35), with larger increases in IL-6 production following MBSR compared to HEP. No study-related adverse events were reported. Results show that mindfulness training may be effective for boosting innate immunocompetence among lonely older adults. Given that immunocompetence tends to decline with age, mindfulness training may help to counteract the effects of aging and psychosocial stress on infection risk and recovery from injury.
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Brinkworth JF, Shaw JG. On race, human variation, and who gets and dies of sepsis. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2022. [PMCID: PMC9544695 DOI: 10.1002/ajpa.24527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Jessica F. Brinkworth
- Department of Anthropology University of Illinois Urbana‐Champaign Urbana Illinois USA
- Carl R. Woese Institute for Genomic Biology University of Illinois at Urbana‐Champaign Urbana Illinois USA
- Department of Evolution, Ecology and Behavior University of Illinois Urbana‐Champaign Urbana Illinois USA
| | - J. Grace Shaw
- Department of Anthropology University of Illinois Urbana‐Champaign Urbana Illinois USA
- Carl R. Woese Institute for Genomic Biology University of Illinois at Urbana‐Champaign Urbana Illinois USA
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Bidulka P, Vestergaard SV, Hlupeni A, Kjærsgaard A, Wong AYS, Langan SM, Schmidt SAJ, Lyon S, Christiansen CF, Nitsch D. Adverse outcomes after partner bereavement in people with reduced kidney function: Parallel cohort studies in England and Denmark. PLoS One 2021; 16:e0257255. [PMID: 34555018 PMCID: PMC8460004 DOI: 10.1371/journal.pone.0257255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/26/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To investigate whether partner bereavement is associated with adverse cardiovascular and kidney-related events in people with reduced kidney function. DESIGN Two parallel matched cohort studies using linked routinely collected health data. SETTING England (general practices and hospitals using linked Clinical Practice Research Datalink, Hospital Episode Statistics, and Office of National Statistics) and Denmark (hospitals and community pharmacies using the Danish National Patient, Prescription and Education Registries and the Civil Registration System). PARTICIPANTS Bereaved people with reduced kidney function (estimated glomerular filtration rate (eGFR) <60mL/min/1.73m2 (England) or hospital-coded chronic kidney disease (Denmark)) and non-bereaved people with reduced kidney function similarly defined, matched on age, sex, general practice (England), and county of residence (Denmark) and followed-up from the bereavement date of the exposed person. MAIN OUTCOME MEASURES Cardiovascular disease (CVD) or acute kidney injury (AKI) hospitalization, or death. RESULTS In people with reduced kidney function, we identified 19,820 (England) and 5,408 (Denmark) bereaved individuals and matched them with 134,828 (England) and 35,741 (Denmark) non-bereaved individuals. Among the bereaved, the rates of hospitalizations (per 1000 person-years) with CVD were 31.7 (95%-CI: 30.5-32.9) in England and 78.8 (95%-CI: 74.9-82.9) in Denmark; the rates of hospitalizations with AKI were 13.2 (95%-CI: 12.5-14.0) in England and 11.2 (95%-CI: 9.9-12.7) in Denmark; and the rates of death were 70.2 (95%-CI: 68.5-72.0) in England and 126.4 (95%-CI: 121.8-131.1) in Denmark. After adjusting for confounders, we found increased rates of CVD (England, HR 1.06 [95%-CI: 1.01-1.12]; Denmark, HR 1.10 [95%-CI: 1.04-1.17]), of AKI (England, HR 1.20 [95%-CI: 1.10-1.31]; Denmark HR 1.36 [95%-CI: 1.17-1.58]), and of death (England, HR 1.10 [95%-CI: 1.05-1.14]; Denmark HR 1.20 [95%-CI: 1.15-1.25]) in bereaved compared with non-bereaved people. CONCLUSIONS Partner bereavement is associated with an increased rate of CVD and AKI hospitalization, and death in people with reduced kidney function. Additional supportive care for this at-risk population may help prevent serious adverse events.
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Affiliation(s)
- Patrick Bidulka
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail:
| | | | - Admire Hlupeni
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Anders Kjærsgaard
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Angel Y. S. Wong
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sinéad M. Langan
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sigrun Alba Johannesdottir Schmidt
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Susan Lyon
- Kidney Transplant Recipient, and Widow of Kidney Transplant Recipient, London, United Kingdom
| | | | - Dorothea Nitsch
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Abstract
OBJECTIVE It has been suggested that adverse socioeconomic conditions "get under the skin" by eliciting a stress response that can trigger periodontal inflammation. We aimed to a) estimate the extent to which socioeconomic position (SEP) is associated with periodontal disease (PD) and proinflammatory oral immunity, and b) determine the contribution of psychosocial stress and stress hormones to these relationships. METHODS In this cross-sectional study (n = 102), participants (20-59 years old) completed financial and perceived stress questionnaires and underwent full-mouth periodontal examinations. SEP was characterized by annual household income and educational attainment. Cortisol, a biological correlate of chronic stress, was assessed in hair samples. Oral immunity was characterized by assessing oral inflammatory load and proinflammatory oral neutrophil function. Blockwise Poisson and logistic regression models were applied. RESULTS Compared with lower SEP, individuals in the middle- and higher-income categories had a significantly lower probability of PD (incidence rate ratio [IRR] = 0.5 [confidence interval {CI} = 0.3-0.7] and IRR = 0.4 [95% CI = 0.2-0.7]) and oral inflammatory load (IRR = 0.6 [95% CI = 0.3-0.8] and IRR = 0.5 [95% CI = 0.3-0.7]) and were less likely to have a proinflammatory oral immune function (odds ratio [OR] = 0.1 [95% CI = 0.0-0.7] and OR = 0.1 [95% CI = 0.0-0.9]). PD and oral immune parameters were significantly associated with financial stress and cortisol. Adjusting for financial stress and cortisol partially attenuated the socioeconomic differences in PD to IRR = 0.7 (95% CI = 0.5-0.8) and IRR = 0.6 (95% CI = 0.5-0.7) for the middle- and higher-income categories, respectively. Similar results were observed for proinflammatory immunity (OR = 0.2 [95% CI = 0.0-1.8] and OR = 0.3 [95% CI = 0.0-2.3]). CONCLUSION These findings suggest that psychosocial stress may contribute to a proinflammatory immunity that is implicated in PD pathobiology and provide insight into social-to-biological processes in oral health.
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Doku DT, Neupane S, Dobewall H, Rimpelä A. Alcohol-related mortality and all-cause mortality following bereavement in two successive generations. PLoS One 2020; 15:e0243290. [PMID: 33301516 PMCID: PMC7728282 DOI: 10.1371/journal.pone.0243290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 11/19/2020] [Indexed: 11/21/2022] Open
Abstract
Background and aim Bereavement affects the health of the bereaved both emotionally and physically. Bereavement resulting from alcohol-related death of the previous generation (parents-first generation) may increase the risk of alcohol abuse and consequently alcohol-related mortality as well as all-cause mortality in the next generation (offspring-second generation). Furthermore, these associations can be bi-directional. However, there is no conclusive evidence of these effects, and studies exploring these intergenerational effects are rare. This study investigates these associations. Methods A longitudinal data were constructed by linking participants from the Adolescent Health and Lifestyle Surveys (AHLS) from 1979 to 1997 with census and registry-based data from Statistics Finland containing the socioeconomic status of the survey participants and their parents (N = 78610) to investigate these associations. Multivariate Cox proportional hazards models were used to calculate hazard ratios with 95% confidence intervals to determine the effect of bereavement with alcohol-related mortality and all-cause mortality. Results The findings suggest that bereavement following the death of an offspring increases the risk of both alcohol-related and all-cause mortality among both parents. The magnitude of the risk of mortality following the death of an offspring is higher for mothers than for fathers. There were no clear associations of a parent’s death with an offspring’s alcohol-related or all-cause mortality. However, generally, a father’s death seems to be protective of the risk of mortality among the offspring while a mother’s alcohol-related death slightly increased the risk of alcohol-related mortality among their offspring. Conclusions These findings emphasise the role of bereavement, particularly resulting from the death of an offspring, on alcohol-related and all-cause mortality and therefore inequalities in mortality. Furthermore, the findings highlighting the need for alcohol abuse intervention and emotional support for bereaved persons following the death of an offspring.
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Affiliation(s)
- David Teye Doku
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Faculty of Social Sciences, Tampere University, Health Sciences, Tampere, Finland
- * E-mail:
| | - Subas Neupane
- Faculty of Social Sciences, Tampere University, Health Sciences, Tampere, Finland
| | - Henrik Dobewall
- Faculty of Social Sciences, Tampere University, Health Sciences, Tampere, Finland
| | - Arja Rimpelä
- Faculty of Social Sciences, Tampere University, Health Sciences, Tampere, Finland
- PERLA (Tampere Centre for Childhood, Youth and Family Research), Tampere University, Tampere, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, Pitkäniemi, Finland
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Aoki M, Okuda H, Ishihara H, Hayashi H, Ohashi T, Nishihori T, Kuze B. Hearing loss is associated with hippocampal atrophy and high cortisol/dehydroepiandrosterone sulphate ratio in older adults. Int J Audiol 2020; 60:293-299. [PMID: 33100039 DOI: 10.1080/14992027.2020.1831703] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Hearing loss (HL) has been recognised as a prodromal symptom of cognitive disorder with aging. It is still uncertain if HL leads to cognitive impairment directly or through an indirect mechanism. DESIGN Participants of this study underwent an auditory test, blood tests, and brain MRI. The atrophy rate of the hippocampus (HP) was calculated using voxel-based specific areas. A partial correlation analysis whilst controlling for the effect of age was performed to analyse the factors affecting hearing levels and HP atrophy rate (HP%). STUDY SAMPLE Thirty-six older adults with hearing impairment. RESULTS The group of participants with moderate or severe HL (n = 22) had higher cortisol/dehydroepiandrosterone sulphate (C/D) ratio, geriatric depression score (GDS) and HP% than the mild HL or normal hearing group (n = 14, p < 0.05). The HP% showed a significant positive correlation with the C/D ratio, GDS and the hearing level of high frequency (HF) (p < 0.05). The C/D ratio was positively correlated with the HP% and the hearing level of the HF (p < 0.05). CONCLUSIONS Our results suggest that the HL is associated with the atrophy of HP and high C/D ratios in older adults; however, HL may not be causally related to hippocampal atrophy.
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Affiliation(s)
- Mitsuhiro Aoki
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Gifu City, Japan.,Center for Healthcare Information Technology (C-HiT), Tokai National Higher Education and Research System, Nagoya City, Japan
| | - Hiroshi Okuda
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Gifu City, Japan
| | - Hiromasa Ishihara
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Gifu City, Japan
| | - Hisamitsu Hayashi
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Gifu City, Japan
| | - Toshimitsu Ohashi
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Gifu City, Japan
| | - Takesumi Nishihori
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Gifu City, Japan
| | - Bunya Kuze
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Gifu City, Japan
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Hopf D, Eckstein M, Aguilar-Raab C, Warth M, Ditzen B. Neuroendocrine mechanisms of grief and bereavement: A systematic review and implications for future interventions. J Neuroendocrinol 2020; 32:e12887. [PMID: 32754965 DOI: 10.1111/jne.12887] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 05/26/2020] [Accepted: 06/14/2020] [Indexed: 12/20/2022]
Abstract
Bereavement is associated with many negative behavioural, psychological and physiological consequences and leads to an increased risk of mortality and morbidity. However, studies specifically examining neuroendocrine mechanisms of grief and bereavement have yet to be reviewed. This systematic review is a synthesis of the latest evidence in this field and aims to draw conclusions about the implications of neurobiological findings on the development of new interventions. PRISMA guidelines for systematic reviews were used to search for articles assessing neuroendocrine correlates of grief. Findings were qualitatively summarised. The National Heart, Lung, and Blood Institute Study Assessment Tool was used to assess the quality of the included studies. Out of 460 papers, 20 met the inclusion criteria. However, most were of fair quality only. As a neuroendocrine marker, the majority of the studies reported cortisol as the outcome measure and found elevated mean cortisol levels, flattened diurnal cortisol slopes and higher morning cortisol in bereaved subjects. Cortisol alterations were moderated by individual differences such as emotional reaction to grief, depressive symptoms, grief severity, closeness to the deceased and age or gender. Research on neuroendocrine mechanisms of grief is still in its early stages regarding grief measures and the use and timing of neuroendocrine assessments. Most of the studies focus on cortisol as outcome, and only limited data exist on other biomarkers such as oxytocin. Future research might consider assessing a broader range of neuroendocrine markers and use longitudinal designs with a focus on the psychobiological reactions to loss. Based on this, individually tailored psychosocial interventions, possibly in the palliative care context, might be developed to prevent prolonged grief disorder.
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Affiliation(s)
- Dora Hopf
- Institute of Medical Psychology, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Monika Eckstein
- Institute of Medical Psychology, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Corina Aguilar-Raab
- Institute of Medical Psychology, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Marco Warth
- Institute of Medical Psychology, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
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Trevisan C, Grande G, Vetrano DL, Maggi S, Sergi G, Welmer AK, Rizzuto D. Gender Differences in the Relationship Between Marital Status and the Development of Frailty: A Swedish Longitudinal Population-Based Study. J Womens Health (Larchmt) 2020; 29:927-936. [DOI: 10.1089/jwh.2019.8095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Caterina Trevisan
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Giulia Grande
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Davide Liborio Vetrano
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Centro Medicina dell'Invecchiamento, IRCCS Fondazione Policlinico “A. Gemelli” and Catholic University of Rome, Rome, Italy
| | - Stefania Maggi
- National Research Council, Neuroscience Institute - Aging Branch, Padova, Italy
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | - Anna-Karin Welmer
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Allied Health Professionals, Function Area Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Seiler A, von Känel R, Slavich GM. The Psychobiology of Bereavement and Health: A Conceptual Review From the Perspective of Social Signal Transduction Theory of Depression. Front Psychiatry 2020; 11:565239. [PMID: 33343412 PMCID: PMC7744468 DOI: 10.3389/fpsyt.2020.565239] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 10/28/2020] [Indexed: 12/11/2022] Open
Abstract
Losing a spouse is considered one of the most stressful life events a person can experience. Particularly in the immediate weeks and months after the loss, bereavement is associated with a significantly increased risk of morbidity and mortality. Despite an abundance of research aimed at identifying risk factors for adverse health outcomes following marital death, the mechanisms through which mental and physical health problems emerge following bereavement remain poorly understood. To address this issue, the present review examines several pathways that may link bereavement and health, including inflammation and immune dysregulation, genetic and epigenetic changes, gut microbiota activity, and biological aging. We then describe how these processes may be viewed from the perspective of the Social Signal Transduction Theory of Depression to provide a novel framework for understanding individual differences in long-term trajectories of adjustment to interpersonal loss. Finally, we discuss several avenues for future research on psychobiological mechanisms linking bereavement with mental and physical health outcomes.
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Affiliation(s)
- Annina Seiler
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
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Abstract
OBJECTIVE Using an integrative view of psychology, neuroscience, immunology, and psychophysiology, the present review of literature curates the findings that have had an impact on the field of bereavement research and shaped its development. METHODS Beginning with pivotal systematic descriptions of medical and psychological responses to the death of a loved one by Lindemann in the mid-1940s, this selective review integrates findings in bereavement research from studies that investigate medical outcomes after loss, their psychological predictors, and biopsychosocial mechanisms. RESULTS Morbidity and mortality after the death of a loved one have long been a topic of research. Early researchers characterized somatic and psychological symptoms and studied immune cell changes in bereaved samples. More recent research has repeatedly demonstrated increased rates of morbidity and mortality in bereaved samples, as compared with married controls, in large epidemiological studies. Recent developments also include the development of criteria for prolonged grief disorder (also termed complicated grief). Newer methods, including neuroimaging, have observed that the greatest impact of the death of a loved one is in those who have the most severe psychological grief reactions. Research addressing the mechanisms tying bereavement to medical outcomes is relatively scarce, but differences in rumination, in inflammation, and in cortisol dysregulation between those who adapt well and those who do not have been offered with some evidence. CONCLUSIONS Recommendations to propel the field forward include longitudinal studies to understand differences between acute reactions and later adaptation, comparing samples with grief disorders from those with more typical responses, and integrating responses in brain, mind, and body.
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Pan H, Hu R. Grief Experience Patterns Among Older Adults in Rural China: A Latent Profile Analysis. OMEGA-JOURNAL OF DEATH AND DYING 2019; 83:898-913. [PMID: 31455155 DOI: 10.1177/0030222819870408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present work sought to explore grief patterns among Chinese older people in rural areas as well as the factors influencing the diverse bereavement results. Participants were 352 older residents who lived in rural areas in China. Latent profile analysis was used to identify subtypes of class membership in combing complicated grief, depression, anxiety, and meaning in life. One-way analysis of variance, chi-square analysis, and multinomial regression analysis were performed together to examine the predictor best distinguishing between classes. The latent profile analysis model best fitting the data was a three-class solution comprised of adaptive (n = 235; 66.8%), moderate maladaptive (n = 83; 23.6%), and severe maladaptive groups (n = 34; 9.7%). Compared to the severe maladaptive and moderate maladaptive groups, participants in the adaptive group had better physical functioning. Participants in the moderate maladaptive group had longer bereavement duration than those in the severe maladaptive group. Future replication is desirable for validating these subgroups.
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Affiliation(s)
- Haimin Pan
- School of Sociology and Anthropology, Xiamen University, Xiamen, China
| | - Rong Hu
- School of Sociology and Anthropology, Xiamen University, Xiamen, China
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Wu PH, Lin MY, Huang TH, Lin YT, Hung CC, Yeh YC, Kuo HT, Chiu YW, Hwang SJ, Tsai JC, Carrero JJ. Depression amongst patients commencing maintenance dialysis is associated with increased risk of death and severe infections: A nationwide cohort study. PLoS One 2019; 14:e0218335. [PMID: 31194838 PMCID: PMC6564035 DOI: 10.1371/journal.pone.0218335] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/30/2019] [Indexed: 02/02/2023] Open
Abstract
Background Depression is common in dialysis patients, but the clinical impact of this condition is poorly defined. Methods Out of 57,703 patients starting dialysis during 2000–2007 recorded in the National Health Insurance Research Database of Taiwan, we identified 2,475 patients with a clinical diagnosis of depression, and compared them with 1:5 age- and sex-matched patients without a depression diagnosis (n = 12,375). Patients were followed up for hospitalisation due to severe infections, major adverse cardiovascular events (MACE) and death. Multivariable Cox regression and competing risk analyses (accounting for death when appropriate) were used to estimate risk associations. Results Patients with depression had a higher frequency of comorbidities. During a mean follow-up of 3.2 years, 1,140 severe infections, 806 MACE, and 1,121 deaths were recorded. Compared to controls, patients with depression were at increased risk of death (adjusted hazard ratio 1.24; 95%CI 1.16–1.33). Patients with depression were also at higher risk of severe (1.14; 1.06–1.22) and fatal infections (death within 30 days, 1.22; 1.09–1.35), attributed mainly to sepsis (1.19; 1.08–1.31), septic shock (1.36; 1.13–1.62) and pneumonia (1.19; 1.07–1.33). Conversely, no association was observed between depression and the MACE risk (1.04; 0.94–1.15). Conclusion Dialysis patients with depression are associated with increased risk of infections and death.
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Affiliation(s)
- Ping-Hsun Wu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Yen Lin
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Teng-Hui Huang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Ting Lin
- Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Family Medicine, Kaohsiung Municipal Hsiao–Kang Hospital, Kaohsiung, Taiwan
| | - Chi-Chih Hung
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Chun Yeh
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Tien Kuo
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail: (JCT); (HTK)
| | - Yi-Wen Chiu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shang-Jyh Hwang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jer-Chia Tsai
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail: (JCT); (HTK)
| | - Juan-Jesus Carrero
- Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet, Stockholm, Sweden
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16
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Abstract
OBJECTIVE Bereavement is associated with increased risk for morbidity and all-cause mortality across epidemiological, meta-analytic, and case-control studies. The body of research examining the association between bereavement and immune function, beginning in 1977, has yet to be reviewed. The current systematic review clarifies these findings, identifies limitations of the diverse literature, and suggests a model and directions for future research. METHODS The PRISMA guidelines for systematic reviews were used to synthesize 41 years of research. Compared with a meta-analysis, a systematic review is appropriate given the heterogeneous nature of the studies. We used the National Heart, Lung, and Blood Institute Study Quality Assessment Tool to assess the quality of select studies. RESULTS Thirty-three publications met inclusion criteria. Most studies support the association between bereavement and maladaptive changes in immune parameters in adults, with mixed findings on bereavement-related changes in cellular immunity. A handful of recent, good-quality studies show bereaved people demonstrate higher levels of systemic inflammation, maladaptive immune cell gene expression, and lower antibody response to vaccination compared with nonbereaved controls. Individual differences in psychological response to bereavement (e.g., depression, grief) seem to influence the association between bereavement and immune function. CONCLUSIONS Research examining the association between bereavement and biomarkers of immune function is heterogeneous in methods and quality. Despite these limitations, there is evidence supporting maladaptive changes in immune function after bereavement. The research area would benefit from longitudinal research with larger sample sizes, advanced immunological methods, and incorporating measures of psychological responses to bereavement. The field is poised to refine and scale up its investigation of this common and important phenomenon.
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Münzel T, Sørensen M, Gori T, Schmidt FP, Rao X, Brook FR, Chen LC, Brook RD, Rajagopalan S. Environmental stressors and cardio-metabolic disease: part II-mechanistic insights. Eur Heart J 2018; 38:557-564. [PMID: 27460891 PMCID: PMC5381593 DOI: 10.1093/eurheartj/ehw294] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 06/02/2016] [Indexed: 12/17/2022] Open
Abstract
Environmental factors can act as facilitators of chronic non-communicable diseases. Ambient noise and air pollution collectively outrank all other environmental risk factors in importance, contributing to over 75% of the disease and disability burden associated with known environmental risk factors. In the first part of this review, we discussed the global burden and epidemiologic evidence supporting the importance of these novel risk factors as facilitators of cardiometabolic disease. In this part, we will discuss pathophysiological mechanisms responsible for noise and air pollution-mediated effects. Akin to traditional cardiovascular risk factors, a considerable body of evidence suggests that these environmental agents induce low-grade inflammation, oxidative stress, vascular dysfunction, and autonomic nervous system imbalance, thereby facilitating the development of diseases such as hypertension and diabetes. Through their impact on traditional risk factors and via additional novel mechanisms, environmental risk factors may have much larger impact on cardiovascular events than currently appreciated. In the second part of this review, we discuss deficiencies and gaps in knowledge and opportunities for new research.
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Affiliation(s)
- Thomas Münzel
- Center for Cardiology, Cardiology I, Angiology and Intensive Care Medicine, University Medical Center Mainz and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany
| | - Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Tommaso Gori
- Center for Cardiology, Cardiology I, Angiology and Intensive Care Medicine, University Medical Center Mainz and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany
| | - Frank P Schmidt
- Center for Cardiology, Cardiology I, Angiology and Intensive Care Medicine, University Medical Center Mainz and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany
| | - Xiaoquan Rao
- Division of Cardiovascular Medicine, University of Maryland Medical Center, 110 South Paca Street, Suite 7-100, Baltimore, MD 21201, USA
| | - Frank R Brook
- Air Quality Research Division, Environment and Climate Change Canada, Toronto, Canada.,Processes Research Section Environment and Climate Change Canada, Canada
| | - Lung Chi Chen
- Department of Environmental Medicine, New York University, New York, USA
| | - Robert D Brook
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, USA
| | - Sanjay Rajagopalan
- Division of Cardiovascular Medicine, University of Maryland Medical Center, 110 South Paca Street, Suite 7-100, Baltimore, MD 21201, USA
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18
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Santacroce A, Wastesson JW, Höhn A, Christensen K, Oksuzyan A. Gender differences in the use of anti-infective medications before and after widowhood: a register-based study. J Epidemiol Community Health 2018; 72:526-531. [PMID: 29459377 DOI: 10.1136/jech-2017-210114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/14/2018] [Accepted: 01/31/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND Recent findings suggest that bereavement due to spousal loss is associated with a decline in general immune functions, and thus to increased susceptibility to infections among widowed individuals. The present study aims to investigate whether spousal loss weakens immune defences more among men than among women using a 5% random sample of the total Danish population, and anti-infective medication use as a proxy for immune response. METHODS We followed 6076 Danish individuals (67% women) aged ≥50 from 5 years before and up to 5 years after widowhood to examine changes in prescriptions of anti-infectives for systemic use. RESULTS Women used more anti-infective drugs both before and after spousal loss (women: OR= 1.31; 95% CI 1.21 to 1.42). The age-related changes in the use of anti-infective medications in the period before widowhood were similar to that in the period after widowhood among both men and women. Also, age-related changes in the use of anti-infective medications were similar in both genders. CONCLUSIONS The present study shows that individuals are more likely to use anti-infective medication after being widowed than before being widowed, but this change is likely to be related to increasing age and it is similar in both genders.
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Affiliation(s)
- Adriana Santacroce
- Dipartimento di Scienze Statistiche, Sapienza Università di Roma, Rome, Italy
| | - Jonas W Wastesson
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Andreas Höhn
- Department of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense C, Denmark.,Max Planck Institute for Demographic Research, Rostock, Germany
| | - Kaare Christensen
- Department of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense C, Denmark.,Max-Planck Odense Center on the Biodemography of Aging, University of Southern Denmark, Odense C, Denmark.,Danish Aging Research Center, Odense C, Denmark
| | - Anna Oksuzyan
- Max Planck Institute for Demographic Research, Rostock, Germany
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Abstract
This chapter explores the reasoning behind using the vaccination model to examine the influence of psychosocial factors on immunity. It then briefly discusses the mechanics of the vaccination response and the protocols used in psychoneuroimmunology vaccine research, before giving examples from the research literature of the studies examining relationships such as the association between stress and vaccination response. It also explores the ways the vaccination model can be used to answer key questions in psychoneuroimmunology, such as the following: "Does it matter when stressful life events occur relative to when the vaccine is received?" "What are the effects of prior exposure to the antigen?" "Do other psychosocial factors influence vaccine response besides stress?" Finally, it briefly considers the mechanisms underlying psychosocial factors and vaccination response associations and the future research needed to understand these better, and indeed to use current and future knowledge to improve and enhance vaccine responses in key at-risk populations.
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Affiliation(s)
- Anna C Whittaker
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
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20
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Einiö E, Moustgaard H, Martikainen P, Leinonen T. Does the risk of hospitalisation for ischaemic heart disease rise alreadybeforewidowhood? J Epidemiol Community Health 2017; 71:599-605. [DOI: 10.1136/jech-2016-207987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 12/15/2016] [Accepted: 02/10/2017] [Indexed: 12/26/2022]
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21
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Ge F, Pietromonaco PR, DeBuse CJ, Powers SI, Granger DA. Concurrent and prospective associations between HPA axis activity and depression symptoms in newlywed women. Psychoneuroendocrinology 2016; 73:125-132. [PMID: 27494071 PMCID: PMC5048568 DOI: 10.1016/j.psyneuen.2016.07.217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/21/2016] [Accepted: 07/21/2016] [Indexed: 11/17/2022]
Abstract
We investigated the extent to which individual differences in activity of the hypothalamic pituitary adrenal axis (HPA) are associated with depressive symptoms among newlywed couples. Participants were 218 couples (M age 28.4 years; 94% White) who provided 5 saliva samples (later assayed for cortisol and DHEA-S) before and after participation in a discussion of a major area of disagreement in their relationship. Depressive symptoms were assessed initially, and approximately 19- and 37-months later. Results revealed an interactive effect suggesting that concordant levels of cortisol and DHEA-S (either both high or both low) were concurrently and prospectively associated with higher depression scores. Interestingly, this interactive effect was observed for wives only - not for husbands. These observations underscore contemporary theoretical assumptions that the expression of the association between HPA activity and depression is dependent on factors related to the interaction between characteristics of the person and features of the social environment, and moderated by co-occurring variation in endocrine milieu.
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Affiliation(s)
- Fiona Ge
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, 01003, USA
| | - Paula R Pietromonaco
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, 01003, USA.
| | - Casey J DeBuse
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, 01003, USA
| | - Sally I Powers
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, 01003, USA
| | - Douglas A Granger
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, 01003, USA
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22
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Vitlic A, Lord JM, Taylor AE, Arlt W, Bartlett DB, Rossi A, Arora-Duggal N, Welham A, Heald M, Oliver C, Carroll D, Phillips AC. Neutrophil function in young and old caregivers. Br J Health Psychol 2015; 21:173-89. [DOI: 10.1111/bjhp.12156] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 07/17/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Ana Vitlic
- School of Sport, Exercise and Rehabilitation Sciences; University of Birmingham; UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research; University of Birmingham; UK
| | - Janet M. Lord
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research; University of Birmingham; UK
- School of Immunity and Infection; University of Birmingham; UK
| | - Angela E. Taylor
- Centre for Endocrinology Diabetes and Metabolism (CEDAM); University of Birmingham; UK
| | - Wiebke Arlt
- Centre for Endocrinology Diabetes and Metabolism (CEDAM); University of Birmingham; UK
| | - David B. Bartlett
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research; University of Birmingham; UK
- School of Immunity and Infection; University of Birmingham; UK
| | - Alessandra Rossi
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research; University of Birmingham; UK
- School of Immunity and Infection; University of Birmingham; UK
| | - Niharika Arora-Duggal
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research; University of Birmingham; UK
- School of Immunity and Infection; University of Birmingham; UK
| | - Alice Welham
- School of Psychology; University of Birmingham; UK
| | - Mary Heald
- School of Psychology; University of Birmingham; UK
| | - Chris Oliver
- School of Psychology; University of Birmingham; UK
| | - Douglas Carroll
- School of Sport, Exercise and Rehabilitation Sciences; University of Birmingham; UK
| | - Anna C. Phillips
- School of Sport, Exercise and Rehabilitation Sciences; University of Birmingham; UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research; University of Birmingham; UK
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23
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Shirtcliff EA, Dismukes AR, Marceau K, Ruttle PL, Simmons JG, Han G. A dual-axis approach to understanding neuroendocrine development. Dev Psychobiol 2015. [PMID: 26220016 DOI: 10.1002/dev.21337] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This introduction sets out to present a series of paper about a novel perspective regarding stress and sex hormones, or what the authors within this special issue term "coupling" of hypothalamic-pituitary-adrenal and--gonadal axes. This view postulates that these axes do not necessarily operate in opposition, but can operate together as evidenced empirically as a positive within-person association between stress hormones like cortisol or sex hormones like testosterone. A wealth of papers within the special issue demonstrate positive coupling across acute, diurnal, basal, and longitudinal timeframes and across several different types of contexts. Reviews were meant to challenge whether this was physiologically plausible. Consistently, sophisticated statistical models were utilized in order to show a template for how to model positive coupling and to ensure that coupling was a within-person phenomenon. We cautiously considered positive coupling until the consistency of observing coupling was robust enough for us to consider challenging the prevailing oppositional view of these axes. We do so to acknowledge that there are contexts, moments and stages in which the function of these axes should work together: for example when contexts are both stressful and challenging or at developmental stages (like adolescence) in which the youth must grow up despite the storm and stress of youth. We hope that by putting forward a functional dual-axis approach, the field will be able to consider when and how these axes work together.
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Affiliation(s)
| | - Andrew R Dismukes
- Human Development Family Studies, Iowa State University, Ames, IA, 50011
| | | | | | - Julian G Simmons
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, 3071
| | - Georges Han
- Department of Psychology, University of California, Davis, CA, 95616
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Lucas SJ, Breen L, Phillips AC. Exercising our brains, muscles and cells to fight the ageing process. Sci Prog 2015; 98:413-5. [PMID: 26790179 PMCID: PMC10365453 DOI: 10.3184/003685015x14467218232110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Samuel J.E. Lucas
- School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Leigh Breen
- School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Anna C. Phillips
- School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
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25
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Assareh AA, Sharpley CF, McFarlane JR, Sachdev PS. Biological determinants of depression following bereavement. Neurosci Biobehav Rev 2014; 49:171-81. [PMID: 25541460 DOI: 10.1016/j.neubiorev.2014.12.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 11/13/2014] [Accepted: 12/07/2014] [Indexed: 12/28/2022]
Abstract
There is considerable variability among people in their response to bereavement. While most people adapt well to bereavement, some develop exaggerated and/or pathological responses and may meet criteria for a major depressive episode. Many studies have investigated the effect of psychosocial factors on bereavement outcome but biological factors have not received much attention, hence the focus of this paper. The biological factors studied to date in relation to bereavement outcomes include genetic polymorphisms, neuroendocrine factors, and immunologic/inflammatory markers. In addition, animal studies have shown the alterations of brain neurotransmitters as well as changes in the plasma levels of the neurotrophic growth factors under the influence of peer loss. Recent studies have also investigated the biological basis of stress resilience, and have found a few genetic polymorphisms and potential biomarkers as protective factors in the face of adversity. Longitudinal studies that include data collection prior to, and also after, bereavement and which chart both biological and psychological measures are needed to develop profiles for the prediction of response to bereavement and personalised interventions.
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Affiliation(s)
- Amelia A Assareh
- Collaborative Research Network for Mental Health and Well-being, University of New England, Armidale, Australia.
| | - Christopher F Sharpley
- Collaborative Research Network for Mental Health and Well-being, University of New England, Armidale, Australia; Brain-Behaviour Research Group, University of New England, Armidale, Australia
| | - James R McFarlane
- Collaborative Research Network for Mental Health and Well-being, University of New England, Armidale, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
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26
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Duggal NA, Upton J, Phillips AC, Hampson P, Lord JM. Depressive symptoms post hip fracture in older adults are associated with phenotypic and functional alterations in T cells. IMMUNITY & AGEING 2014; 11:25. [PMID: 25628751 PMCID: PMC4307912 DOI: 10.1186/s12979-014-0025-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 12/06/2014] [Indexed: 01/10/2023]
Abstract
Background Ageing is accompanied by reduced immunity, termed immunesenescence. The immune system does not act in isolation and is sensitive to both psychological and physical stress. Hip fracture is a common physical stressor in older adults with a high incidence of new onset depression, which relates to poorer prognosis. We therefore set out to examine the possible synergistic effects of physical stress (hip fracture) and psychological stress (depressive symptoms) on the aged immune system. Results T cell phenotype and function was assessed in 101 hip fracture patients (81 female) 6 weeks after hip fracture and 43 healthy age-matched controls (26 female). 38 fracture patients had depressive symptoms at 6 weeks. T cell frequency (p = .01) and numbers (p = .003) were both lower in depressed hip fracture patients compared to healthy controls. The frequency of senescent CD28-ve (p = .001), CD57+ve (p = .001), KLRG1+ve (p = .03) CD8 T cells, as well as senescent CD28-ve CD4+ve (p = .01) and CD57+ve CD4+ve (p = .003) T cells were higher in depressed hip fracture patients compared with healthy controls and the frequency of CD28-ve CD8 T cells was also higher when compared to patients with hip fracture alone (p = .01). Additionally, activated CD69+ve (p = .005) and HLADR+ve (p < .001) CD8 T cells, were also higher in depressed hip fracture patients compared to healthy controls. On examining cytokine production by activated T cells, a significant increase in TNFα (p = .03) and IL6 (p = .04) production was observed in CD4 T cells from hip fracture patients with depressive symptoms compared to healthy controls. Conclusions As none of the patients in the study had a prior history of depression, our data suggest that the development of depressive symptoms in hip fracture patients is associated with altered T cell phenotype and increased pro-inflammatory function which is not seen in patients who do not develop depression after hip fracture. Treating depressive symptoms promptly in hip fracture patients may therefore improve immunity and outcomes in these patients. Electronic supplementary material The online version of this article (doi:10.1186/s12979-014-0025-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Niharika Arora Duggal
- School of Immunity and Infection, University of Birmingham, Birmingham, B15 2TT UK ; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research and, University of Birmingham, Birmingham, B15 2TT UK
| | - Jane Upton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT UK
| | - Anna C Phillips
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research and, University of Birmingham, Birmingham, B15 2TT UK ; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT UK
| | - Peter Hampson
- School of Immunity and Infection, University of Birmingham, Birmingham, B15 2TT UK ; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research and, University of Birmingham, Birmingham, B15 2TT UK
| | - Janet M Lord
- School of Immunity and Infection, University of Birmingham, Birmingham, B15 2TT UK ; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research and, University of Birmingham, Birmingham, B15 2TT UK
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27
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Zisook S, Iglewicz A, Avanzino J, Maglione J, Glorioso D, Zetumer S, Seay K, Vahia I, Young I, Lebowitz B, Pies R, Reynolds C, Simon N, Shear MK. Bereavement: course, consequences, and care. Curr Psychiatry Rep 2014; 16:482. [PMID: 25135781 DOI: 10.1007/s11920-014-0482-8] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This paper discusses each of several potential consequences of bereavement. First, we describe ordinary grief, followed by a discussion of grief gone awry, or complicated grief (CG). Then, we cover other potential adverse outcomes of bereavement, each of which may contribute to, but are not identical with, CG: general medical comorbidity, mood disorders, post-traumatic stress disorder, anxiety, and substance use.
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Affiliation(s)
- Sidney Zisook
- Department of Psychiatry, University of California, 3350 La Jolla Village Dr, San Diego, CA, 92161-116A, USA,
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28
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Vitlic A, Khanfer R, Lord JM, Carroll D, Phillips AC. Bereavement reduces neutrophil oxidative burst only in older adults: role of the HPA axis and immunesenescence. IMMUNITY & AGEING 2014; 11:13. [PMID: 25191511 PMCID: PMC4154898 DOI: 10.1186/1742-4933-11-13] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 08/22/2014] [Indexed: 11/24/2022]
Abstract
Background The effect of the chronic stress of bereavement on immunity is poorly understood. Previous studies have demonstrated negative effects on immunity in older adults, and those who report higher depressive symptoms. The aim of the present study was to compare the effect of bereavement on neutrophil function in healthy young and old adults, also assessing serum levels of the stress hormones, cortisol and dehydroepiandrosterone sulphate (DHEAS). 41 young (mean age 32 years) and 52 older adults (mean age 72 years), bereaved and non-bereaved, took part in the study. They completed questionnaires on socio-demographic and health behaviour characteristics, as well as psychosocial variables, and provided a blood sample for analysis of neutrophil function (phagocytosis and reactive oxygen species (ROS) production) and stress hormone analysis. Results Bereaved participants in both age groups reported more symptoms of depression and anxiety than controls and scored moderately highly on bereavement-specific questionnaires for these symptoms. Despite this, young bereaved participants showed robust neutrophil function when compared to age-matched non-bereaved controls, and comparable stress hormone levels, while reduced neutrophil ROS production and raised stress hormone levels (cortisol:DHEAS ratio) were seen in the older bereaved group compared to their age-matched controls. Conclusions Reduced neutrophil function among older bereaved participants may be the result of the inability to maintain stress hormone balance, specifically the cortisol:DHEAS ratio.
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Affiliation(s)
- Ana Vitlic
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK ; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
| | - Riyad Khanfer
- City Hospital Eye Accident and Emergency Department, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Janet M Lord
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK ; School of Immunity and Infection, University of Birmingham, Birmingham, UK
| | - Douglas Carroll
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Anna C Phillips
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK ; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
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Müller L, Pawelec G. Aging and immunity - impact of behavioral intervention. Brain Behav Immun 2014; 39:8-22. [PMID: 24315935 DOI: 10.1016/j.bbi.2013.11.015] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 11/06/2013] [Accepted: 11/21/2013] [Indexed: 12/16/2022] Open
Abstract
Immune responses to pathogens to which they were not previously exposed are commonly less effective in elderly people than in young adults, whereas those to agents previously encountered and overcome in earlier life may be amplified. This is reflected in the robust finding in many studies that the proportions and numbers of naïve B and T cells are lower and memory cells higher in the elderly. In addition to the "extrinsic" effects of pathogen exposure, "intrinsic" events such as age-associated differences in haematopoeitic stem cells and their niches in the bone marrow associated with differences in cell maturation and output to the periphery are also observed. In the case of T cells, the "intrinsic" process of thymic involution, beginning before puberty, further contributes to reducing the production of naïve T cells. Like memory T cell populations, innate immune cells may be increased in number but decreased in efficacy on a per-cell basis. Thus, superimposed on chronological age alone, remodelling of immunity as a result of interactions with the environment over the life course is instrumental in shaping immune status in later life. In addition to interactions with pathogens, host microbiome and nutrition, exercise and stress, and many other extrinsic factors are crucial modulators of this "immunosenescence" process. In this review, we briefly outline the observed immune differences between younger and older people, and discuss the possible impacts of behavioral variations thereon.
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Affiliation(s)
- Ludmila Müller
- Max Planck Institute for Human Development, Lentzeallee 94, D-14195 Berlin, Germany.
| | - Graham Pawelec
- Center for Medical Research, University of Tübingen, Waldhörnlestr. 22, D-72072 Tübingen, Germany
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Vitlic A, Lord JM, Phillips AC. Stress, ageing and their influence on functional, cellular and molecular aspects of the immune system. AGE (DORDRECHT, NETHERLANDS) 2014; 36:9631. [PMID: 24562499 PMCID: PMC4082590 DOI: 10.1007/s11357-014-9631-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 02/11/2014] [Indexed: 05/29/2023]
Abstract
The immune response is essential for keeping an organism healthy and for defending it from different types of pathogens. It is a complex system that consists of a large number of components performing different functions. The adequate and controlled interaction between these components is necessary for a robust and strong immune response. There are, however, many factors that interfere with the way the immune response functions. Stress and ageing now consistently appear in the literature as factors that act upon the immune system in the way that is often damaging. This review focuses on the role of stress and ageing in altering the robustness of the immune response first separately, and then simultaneously, discussing the effects that emerge from their interplay. The special focus is on the psychological stress and the impact that it has at different levels, from the whole system to the individual molecules, resulting in consequences for physical health.
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Affiliation(s)
- Ana Vitlic
- />School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT England UK
- />MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, England UK
| | - Janet M. Lord
- />MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, England UK
- />School of Immunity and Infection, University of Birmingham, Birmingham, England UK
| | - Anna C. Phillips
- />School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT England UK
- />MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, England UK
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Duggal NA, Beswetherick A, Upton J, Hampson P, Phillips AC, Lord JM. Depressive symptoms in hip fracture patients are associated with reduced monocyte superoxide production. Exp Gerontol 2014; 54:27-34. [PMID: 24512764 DOI: 10.1016/j.exger.2014.01.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 01/23/2014] [Accepted: 01/31/2014] [Indexed: 12/15/2022]
Abstract
Ageing is accompanied by reduced functioning of the immune system, termed immunesenescence which is associated with increased risk of infection and mortality. However the immune system does not operate in isolation and can be modified by many environmental factors, including stress. In this study we determined whether physical stress (hip fracture) and psychological distress (depressive symptoms) had additive effects upon the aged immune system, specifically on monocyte numbers and function. We assessed immune function in 101 hip fracture patients (81 female) 6weeks and 6months after injury and 43 healthy age matched controls (28 females). Thirty-eight of the hip fracture group were found to be depressed at the 6week sampling. No differences in peripheral monocyte count, distribution of monocyte subsets or TNFα secretion were observed between hip fracture patients and healthy controls. However we observed significantly reduced superoxide production in response to Escherichia coli in the monocytes of hip fracture patients who developed depressive symptoms compared with non-depressed hip fracture patients (p=0.002) or healthy controls (p=0.008) 6weeks after the fracture which remained decreased 6months following injury. In previous studies we have shown an effect of depression on neutrophil superoxide generation in hip fracture patients, suggesting a particular susceptibility of this aspect of immune cell function to psychological stress.
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Affiliation(s)
- Niharika Arora Duggal
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Amy Beswetherick
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK
| | - Jane Upton
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Peter Hampson
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Anna C Phillips
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Janet M Lord
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK.
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Tsukamoto K, Machida K. Effects of psychological stress on neutrophil phagocytosis and bactericidal activity in humans — a meta-analysis. Int J Psychophysiol 2014; 91:67-72. [DOI: 10.1016/j.ijpsycho.2013.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 11/11/2013] [Accepted: 12/02/2013] [Indexed: 11/25/2022]
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Richardson VE, Bennett KM, Carr D, Gallagher S, Kim J, Fields N. How Does Bereavement Get Under the Skin? The Effects of Late-Life Spousal Loss on Cortisol Levels. J Gerontol B Psychol Sci Soc Sci 2013; 70:341-7. [DOI: 10.1093/geronb/gbt116] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 10/09/2013] [Indexed: 11/13/2022] Open
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Abstract
Bereavement is a common experience in adults aged 60 and older. Loss of a loved one usually leads to acute grief characterized by yearning and longing, decreased interest in ongoing activities, and frequent thoughts of the deceased. For most, acute grief naturally evolves into a state of integrated grief, where the bereaved is able to reengage with everyday activities and find interest or pleasure. About 7 % of bereaved older adults, however, will develop the mental health condition of Complicated Grief (CG). In CG, the movement from acute to integrated grief is derailed, and grief symptoms remain severe and impairing. This article reviews recent publications on the diagnosis of CG, risk factors for the condition and evidenced-based treatments for CG. Greater attention to CG detection and treatment in older adults is needed.
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Duggal NA, Upton J, Phillips AC, Hampson P, Lord JM. Depressive symptoms are associated with reduced neutrophil function in hip fracture patients. Brain Behav Immun 2013; 33:173-82. [PMID: 23876747 PMCID: PMC3781604 DOI: 10.1016/j.bbi.2013.07.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Revised: 07/04/2013] [Accepted: 07/13/2013] [Indexed: 01/20/2023] Open
Abstract
Hip fracture is a common trauma in older adults with a high incidence of depression, which relates to poorer prognosis including increased risk of infection. Ageing is accompanied by reduced immunity, termed immunesenescence, resulting in increased susceptibility to infection. We examined whether physical trauma (hip fracture) and psychological distress (depressive symptoms) had additive effects upon the aged immune system that might contribute to poor outcomes after injury. Neutrophil function was assessed in 101 hip fracture patients (81 female) 6 weeks and 6 months after injury and 43 healthy age-matched controls (28 female). Thirty eight fracture patients had depressive symptoms at 6 weeks. No difference in neutrophil phagocytosis of Escherichia coli was observed between controls and hip fracture patients, but superoxide production was significantly reduced in hip fracture patients with depressive symptoms compared with patients without symptoms (p=.001) or controls (p=.004) at 6 weeks. Superoxide production improved 6 months following fracture to the level seen in controls. We detected elevated serum cortisol, reduced dehydroepiandrosterone sulphate (DHEAS) and an increased cortisol:DHEAS ratio in fracture patients with depressive symptoms compared with patients without depressive symptoms or controls at 6 weeks and 6 months after injury. Serum IL6, TNFα and IL10 were higher among patients with depressive symptoms at 6 weeks. The cortisol:DHEAS ratio and IL6 levels related to depressive symptom scores but not to neutrophil function. In conclusion, depressive symptoms related to poorer neutrophil function after hip fracture, but this was not driven by changes in stress hormone or cytokine levels.
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Affiliation(s)
- Niharika Arora Duggal
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Jane Upton
- School of Sport and Exercise Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Anna C. Phillips
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK
- School of Sport and Exercise Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Peter Hampson
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Janet M. Lord
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK
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Rogers MAM, Greene MT, Young VB, Saint S, Langa KM, Kao JY, Aronoff DM. Depression, antidepressant medications, and risk of Clostridium difficile infection. BMC Med 2013; 11:121. [PMID: 23647647 PMCID: PMC3651296 DOI: 10.1186/1741-7015-11-121] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 03/20/2013] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND An ancillary finding in previous research has suggested that the use of antidepressant medications increases the risk of developing Clostridium difficile infection (CDI). Our objective was to evaluate whether depression or the use of anti-depressants altered the risk of developing CDI, using two distinct datasets and study designs. METHODS In Study 1, we conducted a longitudinal investigation of a nationally representative sample of older Americans (n = 16,781), linking data from biennial interviews to physician and emergency department visits, stays in hospital and skilled nursing facilities, home health visits, and other outpatient visits. In Study 2, we completed a clinical investigation of hospitalized adults who were tested for C. difficile (n = 4047), with cases testing positive and controls testing negative. Antidepressant medication use prior to testing was ascertained. RESULTS The population-based rate of CDI in older Americans was 282.9/100,000 person-years (95% confidence interval (CI)) 226.3 to 339.5) for individuals with depression and 197.1/100,000 person-years for those without depression (95% CI 168.0 to 226.1). The odds of CDI were 36% greater in persons with major depression (95% CI 1.06 to 1.74), 35% greater in individuals with depressive disorders (95% CI 1.05 to 1.73), 54% greater in those who were widowed (95% CI 1.21 to 1.95), and 25% lower in adults who did not live alone (95% CI 0.62 to 0.92). Self-reports of feeling sad or having emotional, nervous or psychiatric problems at baseline were also associated with the later development of CDI. Use of certain antidepressant medications during hospitalization was associated with altered risk of CDI. CONCLUSIONS Adults with depression and who take specific anti-depressants seem to be more likely to develop CDI. Older adults who are widowed or who live alone are also at greater risk of CDI.
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Affiliation(s)
- Mary A M Rogers
- Department of Internal Medicine, University of Michigan, 016-440E NCRC, Ann Arbor, MI 48109-2800, USA.
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Stark J, Tulassay Z, Lengyel G, Szombath D, Székács B, Adler I, Marczell I, Nagy-Répas P, Dinya E, Rácz K, Békési G. Increased total scavenger capacity in rats fed corticosterone and cortisol on lipid-rich diet. ACTA PHYSIOLOGICA HUNGARICA 2013; 100:84-88. [PMID: 23232702 DOI: 10.1556/aphysiol.99.2012.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND In our earlier studies both corticosterone and cortisol had antioxidant effect in vitro. OBJECTIVES Our aim was to clarify whether corticosterone and cortisol oral administration results in beneficial antioxidant changes in Sprague-Dawley adult male rats in vivo. METHODS Experimental animals were fed a lipid rich diet and treated with corticosterone or cortisol in the drinking fluid. Control group was fed only lipid rich diet with untreated drinking water. The untreated group was feda normal diet with untreated water. Total scavenger capacity (TSC) was measured before and after 4 weeks of treatment in blood samples using a chemiluminometric assay. RESULTS Both corticosterone and cortisol treatment caused increased TSC. The control group and the untreated group showed no significant changes in TSC. CONCLUSION Our results support the hypothesis that corticosterone and cortisol administration can improve the antioxidant status not only in vitro but also in vivo.
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Affiliation(s)
- J Stark
- Semmelweis University 2nd Department of Medicine, Faculty of Medicine Budapest Hungary
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Psychoneuroendocrine interventions aimed at attenuating immunosenescence: a review. Biogerontology 2013; 14:9-20. [DOI: 10.1007/s10522-012-9412-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 12/20/2012] [Indexed: 12/18/2022]
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Buckley T, Sunari D, Marshall A, Bartrop R, McKinley S, Tofler G. Physiological correlates of bereavement and the impact of bereavement interventions. DIALOGUES IN CLINICAL NEUROSCIENCE 2012. [PMID: 22754285 PMCID: PMC3384441 DOI: 10.31887/dcns.2012.14.2/tbuckley] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The death of a loved one is recognized as one of life's greatest stresses, with reports of increased mortality and morbidity for the surviving spouse or parent, especially in the early months of bereavement. The aim of this paper is to review the evidence to date to identify physiological changes in the early bereaved period, and evaluate the impact of bereavement interventions on such physiological responses, where they exist. Research to date suggests that bereavement is associated with neuroendocrine activation (cortisol response), altered sleep (electroencephalography changes), immune imbalance (reduced T-lymphocyte proliferation), inflammatory cell mobilization (neutrophils), and prothrombotic response (platelet activation and increased vWF-ag) as well as hemodynamic changes (heart rate and blood pressure), especially in the early months following loss. Additional evidence suggests that bereavement interventions have the potential to be of value in instances where sleep disturbance becomes a prolonged feature of complicated grief, but have limited efficacy in maintaining immune function in the normal course of bereavement.
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Abstract
Complicated grief (CG) is a disorder marked by intense and persistent yearning for the deceased, in addition to other criteria. The present article reviews what is known about the immunologic and neuroimaging biomarkers of both acute grief and CG, Attachment theory and cognitive stress theory are reviewed as they pertain to bereavement, as is the biopsychosocial model of CG. Reduced immune cell function has been replicated in a variety of bereaved populations. The regional brain activation to grief cues frequently includes the dorsal anterior cingulate cortex and insula, and also the posterior cingulate cortex. Using theory to point to future research directions, we may eventually learn which biomarkers are helpful in predicting CG, and its treatment.
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Affiliation(s)
- Mary-Frances O'Connor
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA.
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Khanfer R, Carroll D, Lord JM, Phillips AC. Reduced neutrophil superoxide production among healthy older adults in response to acute psychological stress. Int J Psychophysiol 2012; 86:238-44. [PMID: 23041234 DOI: 10.1016/j.ijpsycho.2012.09.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 06/12/2012] [Accepted: 09/27/2012] [Indexed: 12/11/2022]
Abstract
Ageing is associated with higher morbidity and mortality, and declining immune function, termed immunesenescence. The present study examined the effects of an acute laboratory psychological stress task on innate immunity, specifically neutrophil function, among older adults. The two functional assays used were phagocytosis of Escherichia coli and stimulated superoxide production. Participants were 17 (11 female) older adults (mean age 75.7, SD=7.06 years). Blood samples to determine neutrophil function by flow cytometry were taken at the end of resting baseline, during an acute stress task and during recovery. The stress task was an 8-minute time-pressured mental arithmetic challenge with social evaluation. There was a significant reduction in neutrophil superoxide production, p=.017, η(2)(p)=.240, associated with the stress task relative to baseline, but no effect on phagocytosis. The results of this study could contribute to explaining the increased risk of infection in older adults, particularly those subject to frequent stress exposures. Future research is needed to explore the underlying mechanisms of acute stress effects on human neutrophil function in older adults in greater detail.
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Affiliation(s)
- Riyad Khanfer
- School of Sport and Exercise Sciences, University of Birmingham, UK
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