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Chhabria K, Selvaraj S, Refuerzo J, Truong C, Cazaban CG. Investigating the association between metabolic syndrome conditions and perinatal mental illness: a national administrative claims study. BMC Pregnancy Childbirth 2024; 24:409. [PMID: 38849738 PMCID: PMC11157911 DOI: 10.1186/s12884-024-06542-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/25/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Although the association between mental disorder and metabolic syndrome as a bidirectional relationship has been demonstrated, there is little knowledge of the cumulative and individual effect of these conditions on peripartum mental health. This study aims to investigate the association between metabolic syndrome conditions (MetS-C) and maternal mental illness in the perinatal period, while exploring time to incident mental disorder diagnosis in postpartum women. METHODS This observational study identified perinatal women continuously enrolled 1 year prior to and 1 year post-delivery using Optum's de-identified Clinformatics® Data Mart Database (CDM) from 2014 to 2019 with MetS-C i.e. obesity, diabetes, high blood pressure, high triglycerides, or low HDL (1-year prior to delivery); perinatal comorbidities (9-months prior to and 4-month postpartum); and mental disorder (1-year prior to and 1-year post-delivery). Additionally, demographics and the number of days until mental disorder diagnosis were evaluated in this cohort. The analysis included descriptive statistics and multivariable logistic regression. MetS-C, perinatal comorbidities, and mental disorder were assessed using the International Classification of Diseases, Ninth, and Tenth Revision diagnosis codes. RESULTS 372,895 deliveries met inclusion/exclusion criteria. The prevalence of MetS-C was 13.43%. Multivariable logistic regression revealed prenatal prevalence (1.64, CI = 1.59-1.70) and postpartum incident (1.30, CI = 1.25-1.34) diagnosis of mental health disorder were significantly higher in those with at least one MetS-C. Further, the adjusted odds of having postpartum incident mental illness were 1.51 times higher (CI = 1.39-1.66) in those with 2 MetS-C and 2.12 times higher (CI = 1.21-4.01) in those with 3 or more MetS-C. Young women (under the age of 18 years) were more likely to have an incident mental health diagnosis as opposed to other age groups. Lastly, time from hospital discharge to incident mental disorder diagnosis revealed an average of 157 days (SD = 103 days). CONCLUSION The risk of mental disorder (both prenatal and incident) has a significant association with MetS-C. An incremental relationship between incident mental illness diagnosis and the number of MetS-C, a significant association with younger mothers along with a relatively long period of diagnosis mental illness highlights the need for more screening and treatment during pregnancy and postpartum.
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Affiliation(s)
- Karishma Chhabria
- Division of Management Policy and Community Health, Center for Healthcare Data Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA.
- Department of Public Health, Usha Kundu MD College of Health, University of West Florida 11000 University Pkwy, Pensacola, FL, 32514, USA.
| | - Sudhakar Selvaraj
- Louis Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
- Clinical Development, Intra-Cellular Therapies, Inc., 430 East 29th Street, New York, NY, United States
| | - Jerrie Refuerzo
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Chau Truong
- Division of Management Policy and Community Health, Center for Healthcare Data Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Cecilia Ganduglia Cazaban
- Division of Management Policy and Community Health, Center for Healthcare Data Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
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Garcia-Silva J, Borrego IRS, Navarrete NN, Peralta-Ramirez MI, Águila FJ, Caballo VE. Efficacy of cognitive-behavioural therapy for lifestyle modification in metabolic syndrome: a randomised controlled trial with a 18-months follow-up. Psychol Health 2024; 39:195-215. [PMID: 35345950 DOI: 10.1080/08870446.2022.2055023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To test the efficacy of cognitive-behavioural therapy (CBT) for lifestyle modification in patients with metabolic syndrome (MetS). DESIGN 76 MetS patients completed this clinical trial, with 18 months follow-up. 45 participants from the experimental group (EG - CBT) and 31 to the control group (CG - usual care). The CBT programme was performed by a psychologist in a face-to-face group format, during 12 weekly sessions lasting 90 minutes. The intervention for the CG consisted of workshops with basic information about MetS and it's associated cardiovascular risk. MAIN OUTCOME MEASURES Efficacy of (CBT) in (MetS) patients. RESULTS Results showed reduction in weight (mean difference - MD -2.633, 95%CI [-4.322, -0.943]; p<.003), waist circumference (MD -2.944, 95%CI [-5.090, -0.798]; p<.008), body mass index (MD -0.915, 95%CI [-1.494, -0.335]; p<.003), systolic (MD -0.046, 95%CI [-0.685, -0.023]; p<.0002) diastolic blood pressure (MD -4.777, 95%CI [-7.750, -1.804]; p<.002), and cardiovascular risk score after 18 months. An increase in adherence to the Mediterranean diet and assertiveness and a reduction in anger were observed in EG. The CG did not show any significant differences. CONCLUSION The CBT focused on changes in lifestyle seems to be effective in the reduction of MetS and cardiovascular risk factors. TRIAL REGISTRATION Registered at clinicaltrials.gov (NCT02949622) - PROMETS (Multimodal Intervention Program for Patients with Metabolic Syndrome).
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Affiliation(s)
- Jaqueline Garcia-Silva
- Department of Personality, Assessment and Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
| | | | - Nuria Navarrete Navarrete
- Clinical Management Unit, Department of Internal Medicine, University Hospital Complex of Granada, Granada, Spain
| | - María Isabel Peralta-Ramirez
- Department of Personality, Assessment and Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
- CIMCYC: Centre for Mind, Brain and Behavioural Research, University of Granada, Granada, Spain
| | - Fernando Jaén Águila
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, University Hospital Complex of Granada, Granada, Spain
| | - Vicente E Caballo
- Department of Personality, Assessment and Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
- CIMCYC: Centre for Mind, Brain and Behavioural Research, University of Granada, Granada, Spain
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Zhang H, Hu L, Zheng P, Jia G. Application of wearable devices for monitoring cardiometabolic dysfunction under the exposome paradigm. Chronic Dis Transl Med 2023; 9:200-209. [PMID: 37711864 PMCID: PMC10497849 DOI: 10.1002/cdt3.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 09/16/2023] Open
Abstract
Environmental factors, including chemical/physical pollutants, as well as lifestyle and psychological factors, contribute greatly to the pathways leading to cardiometabolic diseases with a heavy disease burden and economic loss. The concept of exposomes provides a novel paradigm for combining all exposure characteristics to evaluate disease risk. A solution-like exposome requires technological support to provide continuous data to monitor vital signs and detect abnormal fluctuations. Wearable devices allow people to conveniently monitor signals during their daily routines. These new technologies empower users to more actively prevent and manage cardiometabolic disease by reviewing risk factors of the disease, especially lifestyle factors, such as sleeping time, screen time, and mental health condition. Devices with multiple sensors can monitor electrocardiography data, oxygen saturation, intraocular pressure, respiratory rate, and heart rate to enhance the exposome study and provide precise suggestions for disease prevention and management.
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Affiliation(s)
- Haodong Zhang
- Department of Occupational and Environmental Health Sciences, School of Public HealthPeking UniversityBeijingChina
| | - Lingming Hu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University)National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital)BeijingChina
| | - Pai Zheng
- Department of Occupational and Environmental Health Sciences, School of Public HealthPeking UniversityBeijingChina
| | - Guang Jia
- Department of Occupational and Environmental Health Sciences, School of Public HealthPeking UniversityBeijingChina
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Kang W, Malvaso A. Mental Health in Coronary Heart Disease (CHD) Patients: Findings from the UK Household Longitudinal Study (UKHLS). Healthcare (Basel) 2023; 11:healthcare11101364. [PMID: 37239650 DOI: 10.3390/healthcare11101364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/08/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVES Mental health conditions in patients with coronary heart disease (CHD) are closely related to clinical outcomes. Thus, this study's goal is to investigate how CHD affects general and specific aspects of mental health. METHODS We analyzed data from Wave 10 Understanding Society: the UK Household Longitudinal Study (UKHLS), which were collected between 2018 and 2019. After removing people who had missing data, there were 450 participants who indicated that they have CHD, and 6138 age- and sex-matched healthy participants indicated that they were not clinically diagnosed with CHD. RESULTS The main findings were that participants with CHD had more mental health problems, as shown by the GHQ-12 summary score (t (449) = 6.00, p < 0.001, 95% C.I. [0.20, 0.40], Cohen's d = 0.30), social dysfunction and anhedonia, (t (449) = 5.79, p < 0.001, 95% C.I. [0.20, 0.40], Cohen's d = 0.30), depression and anxiety (t (449) = 5.04, p < 0.001, 95% C.I. [0.15, 0.33], Cohen's d = 0.24), and loss of confidence (t (449) = 4.46, p < 0.001, 95% C.I. [0.11, 0.30], Cohen's d = 0.21). CONCLUSION This study implies that GHQ-12 is a valid assessment of mental health problems in CHD patients, and there is a need to consider how different aspects of mental health are affected by CHD rather than solely focusing on depression or anxiety problems alone in patients with CHD.
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Affiliation(s)
- Weixi Kang
- UK DRI Care Research and Technology Centre, Department of Brain Sciences, Imperial College London, London SW7 2BX, UK
| | - Antonio Malvaso
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
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How Does Dietary Intake Relate to Dispositional Optimism and Health-Related Quality of Life in Germline BRCA1/2 Mutation Carriers? Nutrients 2023; 15:nu15061396. [PMID: 36986126 PMCID: PMC10058690 DOI: 10.3390/nu15061396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
Background: The Mediterranean diet (MD) is an anti-inflammatory diet linked to improved health-related quality of life (HRQoL). Germline (g)BRCA1/2 mutation carriers have an increased risk of developing breast cancer and are often exposed to severe cancer treatments, thus the improvement of HRQoL is important. Little is known about the associations between dietary intake and HRQoL in this population. Methods: We included 312 gBRCA1/2 mutation carriers from an ongoing prospective randomized controlled lifestyle intervention trial. Baseline data from the EPIC food frequency questionnaire was used to calculate the dietary inflammatory index (DII), and adherence to MD was captured by the 14-item PREDIMED questionnaire. HRQoL was measured by the EORTC QLQ-C30 and LOT-R questionnaires. The presence of metabolic syndrome (MetS) was determined using anthropometric measurements, blood samples and vital parameters. Linear and logistic regression models were performed to assess the possible impact of diet and metabolic syndrome on HRQoL. Results: Women with a prior history of cancer (59.6%) reported lower DIIs than women without it (p = 0.011). A greater adherence to MD was associated with lower DII scores (p < 0.001) and reduced odds for metabolic syndrome (MetS) (p = 0.024). Women with a more optimistic outlook on life reported greater adherence to MD (p < 0.001), whereas a more pessimistic outlook on life increased the odds for MetS (OR = 1.15; p = 0.023). Conclusions: This is the first study in gBRCA1/2 mutation carriers that has linked MD, DII, and MetS to HRQoL. The long-term clinical implications of these findings are yet to be determined.
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Ji S, Chen Y, Zhou Y, Cao Y, Li X, Ding G, Tang F. Association between anxiety and metabolic syndrome: An updated systematic review and meta-analysis. Front Psychiatry 2023; 14:1118836. [PMID: 36873213 PMCID: PMC9978147 DOI: 10.3389/fpsyt.2023.1118836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Objective Previous studies have demonstrated an association between anxiety and metabolic syndrome (MetS). However, the association is still controversial. This updated meta-analysis aimed to reanalyze the association between anxiety and MetS. Methods We comprehensively searched PubMed, Embase and Web of Science for all related studies published before January 23, 2023. Observational studies that informed effect size with 95% confidence interval (CI) for the association between anxiety and MetS were included. According to heterogeneity between studies, fixed or random effects models were applied to calculate the pooled effect size. Publication bias was examined by funnel plots. Results The research included 24 cross-sectional studies: 20 studies used MetS as the dependent variable with a pooled OR of 1.07 (95% CI: 1.01-1.13) and four studies used anxiety as the dependent variable with a pooled OR of 1.14 (95% CI: 1.07-1.23). Three cohort studies were found: two studies detected the association of baseline anxiety with the risk of MetS, one of the studies demonstrated a significant association, but a similar result was not found in another study; one study showed no significant association between baseline MetS and the risk of anxiety. Conclusion Cross-sectional studies indicated an association between anxiety and MetS. The results from cohort studies are still inconsistent and limited. More large-scale prospective studies are needed to further reveal the causal relationship of anxiety with MetS.
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Affiliation(s)
- Shuang Ji
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Weifang Medical University and Shandong Institute of Neuroimmunology, Jinan, China
| | - Yujiao Chen
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Weifang Medical University and Shandong Institute of Neuroimmunology, Jinan, China
| | - Yuying Zhou
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Weifang Medical University and Shandong Institute of Neuroimmunology, Jinan, China
| | - Yiting Cao
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Weifang Medical University and Shandong Institute of Neuroimmunology, Jinan, China
| | - Xiao Li
- Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
- Department of Clinical Pharmacy, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Guoyong Ding
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Fang Tang
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Weifang Medical University and Shandong Institute of Neuroimmunology, Jinan, China
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
- Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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Association of pessimism with cardiovascular events and all-cause mortality. Prog Cardiovasc Dis 2023; 76:91-98. [PMID: 36462555 DOI: 10.1016/j.pcad.2022.11.018] [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] [Received: 11/26/2022] [Accepted: 11/26/2022] [Indexed: 12/05/2022]
Abstract
Poor psychological health is associated with Takotsubo cardiomyopathy, cardiac syndrome X, coronary microcirculatory dysfunction, peripheral artery disease, or spontaneous coronary artery dissection. Data regarding pessimism, cardiovascular disease (CVD) events and mortality and all-cause mortality remained inconclusive. This systematic review and meta-analysis aim to provide an overview of the association between pessimism, CVD outcomes and mortality. A systematic search of electronic databases was conducted from inception through July 2022 for studies evaluating pessimism and adverse outcomes. A total of 17 studies published between 1966 and July 2022 met our inclusion criteria, for a total of 232,533 individuals. Pooled hazard ratios were calculated in random-effects meta-analyses. Based on pooled analysis of adjusted HRs, pessimism was associated with adjusted HR of 1.13 (95% CI 1.07-1.19) for all-cause mortality with minimal heterogeneity (I2 = 28.5%). Based on pooled analysis of adjusted HRs, pessimism was associated with adjusted HR of 1.30 (95% CI 0.43-3.95) for CHD mortality, adjusted HR of 1.41 (95% CI 1.05-1.91) for CVD mortality, and adjusted HR of 1.43 (95% CI 0.64-3.16) for stroke. In conclusion, pessimism seems to be significantly associated with a higher risk for and poorer outcomes from CVD events than optimistic styles. There are genetic and other bases for these life approaches, but behavioral, cognitive and meditative interventions can modify patients' level of pessimism, hopefully leading to better medical outcomes. Testing this theory would yield highly useful and practical data for clinical care.
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Gao P, Snyder M. Exposome-wide Association Study for Metabolic Syndrome. Front Genet 2021; 12:783930. [PMID: 34950191 PMCID: PMC8688998 DOI: 10.3389/fgene.2021.783930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peng Gao
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, United States
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Kwak Y, Kim Y. Differences in Health-Related Quality of Life of Adults with Cardiovascular or Metabolic Diseases Compared to the General Population. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:1352-1360. [PMID: 34568173 PMCID: PMC8426760 DOI: 10.18502/ijph.v50i7.6624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/11/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND We aimed to compare demographic, health-related characteristics, and quality of life between adults with cardiovascular or metabolic diseases and the general population. METHODS Data from 25,712 adults assessed on the Korea National Health and Nutrition Examination Survey V & VI (2010-2013) were analyzed for differences in health-related quality of life. RESULTS The corrected EuroQol-5 Dimension score mean among participants with cardiovascular or metabolic diseases was significantly lower than for the general population across all five dimensions (P<0.001). Individuals with cardiovascular disease had lower quality of life than those with metabolic diseases. CONCLUSION Adults with cardiovascular or metabolic diseases reported lower health-related quality of life in all domains when compared to adults in the general population. Therefore, interventions and management to improve quality of life among patients with cardiovascular or metabolic diseases are necessary.
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Affiliation(s)
- Yeunhee Kwak
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Yoonjung Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
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Caccamo F, Stefani I, Pinton A, Sava V, Carlon R, Marogna C. The evaluation of anxiety, depression and Type D personality in a sample of cardiac patients. COGENT PSYCHOLOGY 2020. [DOI: 10.1080/23311908.2020.1835382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- F. Caccamo
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padua, Italy
| | - I. Stefani
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padua, Italy
| | - A. Pinton
- Rehabilitation Cardiology Unit of the Cittadella Hospital (SS 4 District of ULSS 6 Euganea), Padua, Italy
| | - V. Sava
- Rehabilitation Cardiology Unit of the Cittadella Hospital (SS 4 District of ULSS 6 Euganea), Padua, Italy
| | - R. Carlon
- Rehabilitation Cardiology Unit of the Cittadella Hospital (SS 4 District of ULSS 6 Euganea), Padua, Italy
| | - C. Marogna
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padua, Italy
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How Do Positive Psychological Constructs Affect Physical Activity Engagement Among Individuals at High Risk for Chronic Health Conditions? A Qualitative Study. J Phys Act Health 2020; 17:977-986. [PMID: 32887852 DOI: 10.1123/jpah.2019-0295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 05/18/2020] [Accepted: 07/19/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Positive psychological constructs (eg, optimism, positive affect) may help people engage in physical activity, though the details of these relationships and their directionality have not been studied in depth in people with cardiovascular risk factors. The objectives of this study were to use qualitative research to explore the relationships of positive psychological constructs with physical activity among people with metabolic syndrome. METHODS Participants with metabolic syndrome and low physical activity from an academic medical center completed semistructured phone interviews about associations between physical activity and positive psychological constructs, and perceptions about benefits, motivation, and barriers to physical activity. RESULTS The participants (n = 21) were predominantly older (mean age = 63 y) white (95.2%) women (61.9%). Engaging in physical activity was commonly associated with enjoyment, energy, relaxation, accomplishment, and determination. Experiencing positive psychological constructs like enjoyment, energy, connectedness, optimism, and determination also helped them engage in physical activity. Perceived benefits, facilitators, and barriers of physical activity engagement were noted. CONCLUSIONS The participants at high risk for chronic diseases described many specific positive psychological constructs that both promote and result from physical activity. Testing ways to increase positive psychological constructs may be a novel way to help people at high risk of chronic diseases become more active.
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Emery RL, Levine MD, Creswell KG, Wright AGC, Marsland AL, Matthews KA, Flory JD, Manuck SB. Impulsivity and midlife cardiometabolic risk: The role of maladaptive health behaviors. Health Psychol 2020; 39:642-654. [PMID: 32378961 PMCID: PMC8363173 DOI: 10.1037/hea0000884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The present study evaluated distinct facets of impulsivity related to cardiometabolic risk (CMR) to identify specific behavioral mechanisms driving these relationships. METHOD Community adults (N = 1,295) between 30 and 54 years old (53% female, 84% White) completed a battery of impulsivity measures, reported their engagement in health behaviors over the past week (i.e., cigarette smoking, alcohol use, physical activity, and dietary intake), and were assessed for CMR factors (i.e., blood pressure, insulin resistance, adiposity, and blood lipids). Structural equation modeling was used to estimate previously established hierarchical models of distinct facets of impulsivity and CMR. Indirect effects through the observed health behaviors were examined for each association between the latent impulsivity factors identified and the latent CMR factor. RESULTS Neuroticism/negative emotionality was the only latent impulsivity factor directly related to heightened CMR (β = 0.09, 95% confidence interval [CI] [0.01, 0.16], p = .020). Extraversion/positive emotionality indirectly related to lower CMR through greater physical activity (β = -0.04, 95% CI [-0.06, -0.02], p < .001), and measures of inhibition (β = 0.02, 95% CI [0.001, 0.04], p = .045) and delay discounting (β = 0.08, 95% CI [0.001, 0.15], p = .049) indirectly related to CMR through saturated fat intake. CONCLUSIONS These findings indicate that distinct facets of impulsivity differentially relate to CMR through varied behavioral pathways and identify physical activity and saturated fat intake as being particularly important health behaviors to target when tailoring treatment approaches to the unique behavioral characteristics of individuals high on certain facets of impulsivity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Gentile C, Ditto B, Deschamps A, D'Antono B. Parasympathetic Response Patterns are Associated with Metabolic Syndrome Among Older Women but Not Men. Ann Behav Med 2020; 53:515-526. [PMID: 30113625 PMCID: PMC6499413 DOI: 10.1093/abm/kay063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Little is known about the role of physiological stress responses in metabolic syndrome (MetS). Purpose To examine whether patterns of autonomic response to psychological stress are associated with MetS and whether this association is moderated by sex Methods 1121 men and women (Mage = 65.3 ± 6.77 years) with and without coronary artery disease (CAD) underwent an anger recall stressor task. Heart rate and heart-rate variability (HRV; HF, LF/HF) were assessed. Clusters of participants showing similar patterns of response across baseline, stress, and recovery periods were created using ACECLUS and FASTCLUS in SAS. Logistic regressions included clusters and interaction between clusters and sex as independent variables, controlling for relevant covariates. ANCOVAs were conducted in secondary analyses utilizing a continuous composite representation of MetS. Results Men and women showing greater tonic and phasic HR elevations were more likely to meet MetS criteria (OR = 1.45, [95% CI = 1.02–2.07], p = .037). HF-HRV cluster interacted significantly with sex (p < .001) to predict MetS. In women, those with significant parasympathetic withdrawal to stress and poor recovery were more likely to have MetS than women with a more moderate response (OR = 2.56, [95% CI = 1.23–5.41], p = .013). Women who displayed stress-related parasympathetic activation were also at greater risk of MetS (OR = 2.30, [95% CI = 1.30–4.07], p = .004). Results using a continuous measure of MetS were generally consistent with these findings. Conclusion Among older participants with CAD or other noncardiovascular disease, hyperreactivity to stress was associated with greater prevalence of MetS, particularly in women. Consistent with emerging literature, women who showed blunting or activation of parasympathetic responses to stress were similarly at greater risk.
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Affiliation(s)
- Christina Gentile
- Research Center, Montreal Heart Institute, Montreal, Canada Psychology Department, Université de Montréal, Canada
| | - Blaine Ditto
- Department of Psychology, McGill University, Montreal, Canada
| | - Alain Deschamps
- Chief, Department of Anesthesiology, Montreal Heart Institute, Montreal, Canada
| | - Bianca D'Antono
- Research Center, Montreal Heart Institute, Montreal, Canada Psychology Department, Université de Montréal, Canada
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Efectos de la rehabilitación cardiaca en el paciente cardiovascular con ansiedad y depresión. REVISTA COLOMBIANA DE CARDIOLOGÍA 2020. [DOI: 10.1016/j.rccar.2019.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Xu YE, Chopik WJ. Identifying Moderators in the Link Between Workplace Discrimination and Health/Well-Being. Front Psychol 2020; 11:458. [PMID: 32256433 PMCID: PMC7092632 DOI: 10.3389/fpsyg.2020.00458] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 02/27/2020] [Indexed: 12/18/2022] Open
Abstract
The stress that arises from workplace discrimination can have a large impact on an employee's work attitude, their work and life satisfaction, and oftentimes whether or not they stay in a job. Workplace discrimination can also have a considerable influence on employees' short- and long-term health. However, less is known about the factors that might mitigate or exacerbate the effects of discrimination on health. The current study focused not only on the links between workplace discrimination and health, and but also on the effects of potential moderators of the discrimination-health link (i.e., perceived control, Big Five personality traits, optimism, and coworker/supervisor support). People with high neuroticism, high extraversion and high agreeableness were more negatively affected by workplace discrimination than those low on neuroticism, extraversion, and agreeableness. Perceived control was found to be a protective factor, such that those high in perceived control had fewer chronic illnesses in the context of high levels of workplace discrimination.
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Affiliation(s)
| | - William J. Chopik
- Department of Psychology, Michigan State University, East Lansing, MI, United States
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Thomas MC, Kamarck TW, Wright AGC, Matthews KA, Muldoon MF, Manuck SB. Hostility Dimensions and Metabolic Syndrome in a Healthy, Midlife Sample. Int J Behav Med 2020; 27:475-480. [PMID: 32030598 DOI: 10.1007/s12529-020-09855-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Evidence links trait hostility with components of the metabolic syndrome (MetS), a clustering of cardiometabolic risk factors, but which hostility dimensions (e.g., expressive or cognitive hostility) relate to MetS are not well known. Further, there may be age and sex differences in the extent to which hostility dimensions relate to MetS. The present study evaluated associations between dimensions of hostility and the metabolic syndrome and its individual components as well as the moderating effects of sex and age. METHODS In a cross-sectional sample of 478 employed adults, a principal component analysis from common trait hostility questionnaires yielded a two-factor solution: expressive hostility (anger and aggression) and cognitive hostility (cynicism). Each of these two components of hostility was examined as predictors of each of two aggregated MetS outcomes: a dichotomous measure of MetS, based upon the NCEP-ATP III definition, and a continuous measure based upon the average of standardized scores for each component; and they were examined as predictors of individual MetS components as well. RESULTS Expressive hostility was associated with MetS severity (b = 0.110, p = 0.04) and waist circumference (b = 2.75, p = 0.01). Moderation analyses revealed that elevated expressive hostility was associated with elevated waist circumference in women but not men. Cognitive hostility was not related to any metabolic syndrome component or aggregated outcome, and no moderation was observed. CONCLUSIONS Among multiple individual components and two aggregated scores, only trait dispositions to expressed hostile affect and behavior were associated with MetS severity and waist circumference. The effects were small but statistically significant. The association between cognitive hostility and metabolic syndrome measures may not be robust in a large sample of healthy, midlife adults.
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Affiliation(s)
- Mark C Thomas
- University of Pittsburgh, Pittsburgh, PA, 15260, USA
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Scheier MF, Carver CS. Dispositional optimism and physical health: A long look back, a quick look forward. ACTA ACUST UNITED AC 2019; 73:1082-1094. [PMID: 30525784 DOI: 10.1037/amp0000384] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Dispositional optimism is the generalized, relatively stable tendency to expect good outcomes across important life domains. This article provides a representative review of 30 years of research on dispositional optimism and physical well-being. Assessment of optimism is described, along with data regarding its stability. A review of the research linking optimism and physical health is then presented. Included in the review are initial studies suggesting that optimism and physical well-being might be linked as well as more recent, larger scale epidemiological studies that make the point more emphatically. Also considered are potential pathways-behavioral, biological, and social-that might explain these associations. The article concludes with a brief look to the future, describing several issues and questions that still need to be answered. These questions include the relationship of optimism and pessimism to each other (and the implications of that relationship for physical well-being), the origins of optimism and pessimism, and interventions that might be implemented to reduce the negative impact of a pessimistic outlook. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Fluoxetine Attenuated Anxiety-Like Behaviors in Streptozotocin-Induced Diabetic Mice by Mitigating the Inflammation. Mediators Inflamm 2019; 2019:4315038. [PMID: 31396018 PMCID: PMC6664488 DOI: 10.1155/2019/4315038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/18/2019] [Accepted: 04/28/2019] [Indexed: 12/22/2022] Open
Abstract
Patients with diabetes mellitus (DM) showed an increased risk of anxiety. High anxiety levels are also shown to increase stress of diabetic patients, which may contribute to poor clinical outcomes. The mechanisms underlying the development of anxiety disorders in diabetic patients remain unknown. As a result, there are no available treatments yet. Here, we tested the hypothesis that glial cells in the hippocampal area of DM mice might be responsible for their anxiety-like behaviors. Furthermore, we postulated that treatment with antidepressant, fluoxetine, could reduce anxiety behaviors and prevent the dysregulation of glial cells (oligodendrocyte and astrocyte) in DM mice. Diabetic mice were administered a single injection of streptozotocin (STZ), followed by treatment with fluoxetine. Mice were then tested on Y maze, open field, dark and light transition, and elevated plus maze tests to measure the status of anxiety and cognition. After completing these behavioral tests, mice were sacrificed and western blot was used to detect the oligodendrocyte and astrocyte maker proteins in hippocampal tissues. Emphasis was directed towards adult oligodendrocyte precursor cells (OPCs) and their marker protein to measure their proliferation and differentiation. We found that fluoxetine could effectively mitigate the level of anxiety and attenuate the cognitive dysfunction in diabetic mice. Meanwhile, fluoxetine inhibited astrocyte activation in mice exposed to STZ, prevented the loss of myelin basic protein (MBP), and affected the function of OPCs in these diabetic mice. The results suggested that the changes of these glial cells in the brains of diabetic mice might be related to the high anxiety levels and cognitive deficit in DM mice. Fluoxetine could ameliorate the high anxiety level and prevent cognitive deficit via inhibiting astrocyte activation and repairing the oligodendrocyte damage.
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Zhao F, Lin Y, Zhai L, Gao C, Zhang J, Ye Q, Zaslawski CJ, Ma F, Wang Y, Liang C. Effects of cardiac rehabilitation qigong exercise in patients with stable coronary artery disease undergoing phase III rehabilitation: A randomized controlled trial (with video). JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2018. [DOI: 10.1016/j.jtcms.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Bergmann N, Ballegaard S, Krogh J, Bech P, Hjalmarson Å, Gyntelberg F, Faber J. Chronic psychological stress seems associated with elements of the metabolic syndrome in patients with ischaemic heart disease. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 77:513-519. [DOI: 10.1080/00365513.2017.1354254] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Natasha Bergmann
- Department of Endocrinology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
- Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | | | - Jesper Krogh
- Department of Endocrinology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Per Bech
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Hillerød, Denmark
| | - Åke Hjalmarson
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Finn Gyntelberg
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jens Faber
- Department of Endocrinology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Kozela M, Pająk A, Micek A, Besala A, Kubinova R, Malyutina S, Tamosiunas A, Pikhart H, Peasey A, Nikitin Y, Marmot M, Bobak M. Impact of perceived control on all-cause and cardiovascular disease mortality in three urban populations of Central and Eastern Europe: the HAPIEE study. J Epidemiol Community Health 2017; 71:771-778. [PMID: 28515210 PMCID: PMC5537505 DOI: 10.1136/jech-2017-208992] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/03/2017] [Accepted: 04/20/2017] [Indexed: 01/10/2023]
Abstract
Background Inverse associations between perceived control and cardiovascular disease (CVD) have been reported in studies from Western Europe and the USA. To assess this relationship across different populations, we investigated the association between perceived control and all-cause and CVD mortality in three population-based cohorts of Eastern European countries. Methods We analysed data from a prospective cohort study in random population samples in Krakow (Poland), Novosibirsk (Russia) and six Czech towns. Baseline survey included structured questionnaire and objective examination in a clinic. Perceived control was assessed using an 11-item scale developed by the MacArthur Foundation Programme on Successful Midlife. Information on vital status was obtained from death registers. Effect of perceived control on mortality was assessed using Cox proportional hazards models. Results A total of 2377 deaths (1003 from CVD) occurred among 27 249 participants over a median 7-year follow-up. In the Czech and Polish cohorts, perceived control was inversely associated with mortality; the adjusted HRs for the lowest versus highest control quintiles were 1.71 (1.34 to 2.19) in men and 1.63 (1.14 to 2.35) in women for all-cause mortality and 2.31 (1.48 to 3.59) and 5.50 (2.14 to 14.13) for CVD deaths. There was no association between perceived control and mortality in Russia; the adjusted HRs for all-cause mortality were 1.03 (0.79 to 1.34) in men and 1.29 (0.82 to 2.02) in women. Conclusions Low perceived control was associated with increased risk of all-cause and CVD mortality in Czech and Polish cohorts but not in Russia. It is possible that this inconsistency may partly reflect a different sociocultural understanding of the concept of control in Russia.
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Affiliation(s)
- Magdalena Kozela
- Chair of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Andrzej Pająk
- Chair of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Micek
- Chair of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Besala
- Chair of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | | | - Sofia Malyutina
- Institute of Internal and Preventive Medicine, Novosibirsk, Russia.,Novosibirsk State Medical University, Novosibirsk, Russia
| | - Abdonas Tamosiunas
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Hynek Pikhart
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Anne Peasey
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Yuri Nikitin
- Institute of Internal and Preventive Medicine, Novosibirsk, Russia
| | - Michael Marmot
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
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Tang F, Wang G, Lian Y. Association between anxiety and metabolic syndrome: A systematic review and meta-analysis of epidemiological studies. Psychoneuroendocrinology 2017; 77:112-121. [PMID: 28027497 DOI: 10.1016/j.psyneuen.2016.11.025] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 11/11/2016] [Accepted: 11/18/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Epidemiological studies have repeatedly investigated the association between anxiety and metabolic syndrome (MetS). However, the results have been inconsistent. We performed a meta-analysis of observational studies to summarize the evidence regarding the relation of anxiety and MetS risk. METHODS We performed a systematic literature search of all studies published in PubMed and EMBASE from its inception to June 2016. Cross-sectional and cohort studies that reported an association between the two conditions in adults were included. Data on prevalence, incidence, unadjusted or adjusted odds ratio (OR), and 95% CI were extracted or provided independently by the authors. Random effects model was used to report the pooled OR. The I2 statistic was used to assess heterogeneity. Egger's test and Begger's test were used to evaluate the publication bias. RESULTS The search yielded 18 cross-sectional studies and two cohort studies. The pooled finding from cross-sectional studies showed that anxiety had a significant positive association with MetS (OR 1.07, 95% CI 1.01-1.12), with moderate heterogeneity (I2=45.7%, P=0.018). Findings from two cohort studies indicated that the association between anxiety and MetS was insignificant. CONCLUSION Our results suggest that there is an association between anxiety and MetS. In individuals with MetS anxiety should be detected and managed. Further prospective studies are needed to explore the bidirectional association between anxiety and MetS.
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Affiliation(s)
- Fang Tang
- Health Management Center, Qianfoshan Hospital Affiliated to Shandong University, Jinan, China
| | - Gangpu Wang
- Department of General Surgery, The Fourth Hospital of Jinan City, Jinan, China
| | - Ying Lian
- Department of Case Administration, Qianfoshan Hospital Affiliated to Shandong University, Jinan, China.
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Puig-Perez S, Hackett RA, Salvador A, Steptoe A. Optimism moderates psychophysiological responses to stress in older people with Type 2 diabetes. Psychophysiology 2016; 54:536-543. [PMID: 28000236 PMCID: PMC5396342 DOI: 10.1111/psyp.12806] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 11/14/2016] [Indexed: 12/21/2022]
Abstract
Optimism is thought to be beneficial for health, and these effects may be mediated through modifications in psychophysiological stress reactivity. Type 2 diabetes (T2D) is associated with reduced cardiovascular responses to stress and heightened cortisol over the day. This study assessed the relationships between optimism, stress responsivity, and daily cortisol output in people with T2D. A total of 140 participants with T2D were exposed to laboratory stress. Heart rate (HR), systolic (SBP), diastolic blood pressure (DBP), and cortisol were measured throughout the session. Cortisol output over the day was also assessed. Optimism and self‐reported health were measured using the revised Life Orientation Test and the Short Form Health Survey. Optimism was associated with heightened SBP and DBP stress reactivity (ps < .047) and lower daily cortisol output (p = .04). Optimism was not related to HR, cortisol stress responses, or the cortisol awakening response (ps > .180). Low optimism was related to poorer self‐reported physical and mental health (ps < .01). Optimism could have a protective role in modulating stress‐related autonomic and neuroendocrine dysregulation in people with T2D.
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Affiliation(s)
- S Puig-Perez
- Department of Psychobiology and IDOCAL, Laboratory of Social Cognitive Neuroscience, University of Valencia, Valencia, Spain
| | - R A Hackett
- Department of Epidemiology and Public Health, University College London, London, UK
| | - A Salvador
- Department of Psychobiology and IDOCAL, Laboratory of Social Cognitive Neuroscience, University of Valencia, Valencia, Spain
| | - A Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
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Azar KMJ, Koliwad S, Poon T, Xiao L, Lv N, Griggs R, Ma J. The Electronic CardioMetabolic Program (eCMP) for Patients With Cardiometabolic Risk: A Randomized Controlled Trial. J Med Internet Res 2016; 18:e134. [PMID: 27234480 PMCID: PMC4902854 DOI: 10.2196/jmir.5143] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 01/22/2016] [Accepted: 02/21/2016] [Indexed: 01/16/2023] Open
Abstract
Background Effective lifestyle interventions targeting high-risk adults that are both practical for use in ambulatory care settings and scalable at a population management level are needed. Objective Our aim was to examine the potential effectiveness, feasibility, and acceptability of delivering an evidence-based Electronic Cardio-Metabolic Program (eCMP) for improving health-related quality of life, improving health behaviors, and reducing cardiometabolic risk factors in ambulatory care high-risk adults. Methods We conducted a randomized, wait-list controlled trial with 74 adults aged ≥18 years recruited from a large multispecialty health care organization. Inclusion criteria were (1) BMI ≥35 kg/m2 and prediabetes, previous gestational diabetes and/or metabolic syndrome, or (2) BMI ≥30 kg/m2 and type 2 diabetes and/or cardiovascular disease. Participants had a mean age of 59.7 years (SD 11.2), BMI 37.1 kg/m2 (SD 5.4) and were 59.5% female, 82.4% white. Participants were randomized to participate in eCMP immediately (n=37) or 3 months later (n=37). eCMP is a 6-month program utilizing video conferencing, online tools, and pre-recorded didactic videos to deliver evidence-based curricula. Blinded outcome assessments were conducted at 3 and 6 months postbaseline. Data were collected and analyzed between 2014 and 2015. The primary outcome was health-related quality of life. Secondary outcomes included biometric cardiometabolic risk factors (eg, body weight), self-reported diet and physical activity, mental health status, retention, session attendance, and participant satisfaction. Results Change in quality of life was not significant in both immediate and delayed participants. Both groups significantly lost weight and reduced waist circumference at 6 months, with some cardiometabolic factors trending accordingly. Significant reduction in self-reported anxiety and perceived stress was seen in the immediate intervention group at 6 months. Retention rate was 93% at 3 months and 86% at 6 months post-baseline. Overall eCMP attendance was high with 59.5-83.8% of immediate and delayed intervention participants attending 50% of the virtual stress management and behavioral lifestyle sessions and 37.8-62.2% attending at least 4 out of 7 in-person physical activity sessions. The intervention received high ratings for satisfaction. Conclusions The technology-assisted eCMP is a feasible and well-accepted intervention and may significantly decrease cardiometabolic risk among high-risk individuals. Trial Registration Clinicaltrials.gov NCT02246400; https://clinicaltrials.gov/ct2/show/NCT02246400 (Archived by WebCite at http://www.webcitation.org/6h6mWWokP)
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Affiliation(s)
- Kristen M J Azar
- Sutter Health Research, Development and Dissemination, Walnut Creek, CA, United States.
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Kozela M, Bobak M, Besala A, Micek A, Kubinova R, Malyutina S, Denisova D, Richards M, Pikhart H, Peasey A, Marmot M, Pająk A. The association of depressive symptoms with cardiovascular and all-cause mortality in Central and Eastern Europe: Prospective results of the HAPIEE study. Eur J Prev Cardiol 2016; 23:1839-1847. [PMID: 27154591 PMCID: PMC5089224 DOI: 10.1177/2047487316649493] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/22/2016] [Indexed: 11/16/2022]
Abstract
Background Studies in western populations have shown a positive association between depression and cardiovascular disease (CVD) and all-cause mortality. The association with depressive symptoms seems to be graded, rather than limited to the presence versus the absence of depression. Evidence from populations with potentially different patterns of confounders helps to address the consistency of these findings. The objective of the study was to investigate the association between depressive symptoms and all-cause and CVD mortality in populations of Central and Eastern Europe. Study design This was a prospective cohort study. Methods A total of 24,542 participants aged 45–69 years, randomly selected from populations of Novosibirsk (Russia), Krakow (Poland) and six Czech towns, were included. Depressive symptoms, assessed by the 20-item Center for Epidemiologic Studies Depression (CES-D) scale, were used as both continuous and categorical variables. Data on deaths were obtained from local or national death registers. Associations between depression and mortality were assessed using Cox proportional hazards models. Results Over a median of 7 years, 2091 deaths from all causes and 850 CVD deaths occurred in the cohorts. There was a graded association between CES-D score and mortality; the hazard ratio (HR) of CVD mortality for a 1 SD increase in CES-D was 1.20 (95% confidence interval (CI): 1.16–1.24) in men and 1.23 (95% CI: 1.12–1.35) in women; for all-cause mortality, the HRs were 1.13 (95% CI: 1.09–1.18) and 1.17 (95% CI: 1.10–1.25), respectively. The results were similar across countries. Conclusions Depressive symptoms predicted CVD and all-cause mortality independently of a wide range of potential confounders. The association followed a gradient and increased mortality risks were associated with scores below the cut-offs that are commonly used to define ‘depression’.
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Affiliation(s)
- Magdalena Kozela
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Agnieszka Besala
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Micek
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | | | - Sofia Malyutina
- Institute of Internal and Preventive Medicine, Novosibirsk, Russia.,Novosibirsk State Medical University, Novosibirsk, Russia
| | - Diana Denisova
- Institute of Internal and Preventive Medicine, Novosibirsk, Russia
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Hynek Pikhart
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Anne Peasey
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Michael Marmot
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
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Optimism and pessimism are related to different components of the stress response in healthy older people. Int J Psychophysiol 2015; 98:213-21. [DOI: 10.1016/j.ijpsycho.2015.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 08/28/2015] [Accepted: 09/01/2015] [Indexed: 11/30/2022]
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Kinley DJ, Lowry H, Katz C, Jacobi F, Jassal DS, Sareen J. Depression and anxiety disorders and the link to physician diagnosed cardiac disease and metabolic risk factors. Gen Hosp Psychiatry 2015; 37:288-93. [PMID: 25896947 DOI: 10.1016/j.genhosppsych.2015.03.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 03/30/2015] [Accepted: 03/31/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE There has been increasing interest in the relationship between cardiac and metabolic conditions with mental illness. Many studies have found associations between these conditions and depression but results with anxiety disorders have been mixed. We explore these relationships in a nationally representative survey using physician diagnoses of physical conditions and DSM-IV psychiatric disorders. METHODS Data came from the nationally representative German Health Survey (N=4181, age 18-65). Physician diagnoses of angina, myocardial infarction, congestive heart, hypertension, dyslipidemia, diabetes, and obesity were examined in relation to depression and anxiety disorders, which were assessed through a modified version of the Composite International Diagnostic Interview. Multiple logistic regression analyses were used to examine the associations between these conditions. RESULTS After adjusting for sociodemographics, psychiatric comorbidity, and substance use, having an anxiety disorder was associated with increased odds of cardiac conditions and metabolic risk factors with odds ratios ranging from 1.3 to 3.3. Depression was not associated with any of the conditions but was associated with poor medical compliance for health conditions on two outcomes measured. Anxiety was also associated with reduced medical compliance for one health behaviour measured. CONCLUSION Anxiety disorders, but not depression, were associated with metabolic and cardiac conditions in our sample. Both conditions were related to some aspects of poor self-care for health conditions and therefore may be linked to negative outcomes.
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Affiliation(s)
- D Jolene Kinley
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Helen Lowry
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Saschetchewan, Canada
| | - Cara Katz
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Frank Jacobi
- Department of Psychology, Technical University of Dresden, Dresden, Saxony, Germany
| | - Davinder S Jassal
- Section of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jitender Sareen
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
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Abstract
Patients with cardiovascular disease (CVD) commonly have syndromal major depression, and depression has been associated with an increased risk of morbidity and mortality. Prevalence of depression is between 17% and 47% in CVD patients. Pharmacologic and psychotherapeutic interventions have long been studied, and in general are safe and somewhat efficacious in decreasing depressive symptoms in patients with CVD. The impact on cardiac outcomes remains unclear. The evidence from randomized controlled clinical trials indicates that antidepressants, especially selective serotonin uptake inhibitors, are overwhelmingly safe, and likely to be effective in the treatment of depression in patients with CVD. This review describes the prevalence of depression in patients with CVD, the physiological links between depression and CVD, the treatment options for affective disorders, and the clinical trials that demonstrate efficacy and safety of antidepressant medications and psychotherapy in this patient population. Great progress has been made in understanding potential mediators between major depressive disorder and CVD—both health behaviors and shared biological risks such as inflammation.
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Affiliation(s)
- Nicole Mavrides
- Department of Psychiatry and Behavioral Sciences, Center on Aging, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Center on Aging, University of Miami Miller School of Medicine, Miami, Florida, USA
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Mavrides N, Nemeroff CB. Treatment of affective disorders in cardiac disease. DIALOGUES IN CLINICAL NEUROSCIENCE 2015; 17:127-40. [PMID: 26246788 PMCID: PMC4518697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Patients with cardiovascular disease (CVD) commonly have syndromal major depression, and depression has been associated with an increased risk of morbidity and mortality. Prevalence of depression is between 17% and 47% in CVD patients. Pharmacologic and psychotherapeutic interventions have long been studied, and in general are safe and somewhat efficacious in decreasing depressive symptoms in patients with CVD. The impact on cardiac outcomes remains unclear. The evidence from randomized controlled clinical trials indicates that antidepressants, especially selective serotonin uptake inhibitors, are overwhelmingly safe, and likely to be effective in the treatment of depression in patients with CVD. This review describes the prevalence of depression in patients with CVD, the physiological links between depression and CVD, the treatment options for affective disorders, and the clinical trials that demonstrate efficacy and safety of antidepressant medications and psychotherapy in this patient population. Great progress has been made in understanding potential mediators between major depressive disorder and CVD--both health behaviors and shared biological risks such as inflammation.
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Affiliation(s)
- Nicole Mavrides
- Department of Psychiatry and Behavioral Sciences, Center on Aging, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Center on Aging, University of Miami Miller School of Medicine, Miami, Florida, USA
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Ortiz MS, Myers HF, Dunkel Schetter C, Rodriguez CJ, Seeman TE. Psychosocial Predictors of Metabolic Syndrome among Latino Groups in the Multi-Ethnic Study of Atherosclerosis (MESA). PLoS One 2015; 10:e0124517. [PMID: 25906072 PMCID: PMC4408074 DOI: 10.1371/journal.pone.0124517] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 03/15/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We sought to determine the contribution of psychological variables to risk for metabolic syndrome (MetS) among Latinos enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA), and to investigate whether social support moderates these associations, and whether inflammatory markers mediate the association between psychological variables and MetS. RESEARCH DESIGN AND METHODS Cross-sectional analyses at study baseline were conducted with a national Latino cohort (n = 1,388) that included Mexican Americans, Dominican Americans, Puerto Rican Americans and Central/South Americans. Hierarchical logistic regression analyses were conducted to test the effects of psychosocial variables (chronic stress, depressive symptoms, and social support) on MetS. In addition, separate subgroup-specific models, controlling for nationality, age, gender, socioeconomic position, language spoken at home, exercise, smoking and drinking status, and testing for the effects of chronic stress, depressive symptoms and inflammation (IL-6, CRP, fibrinogen) in predicting risk for MetS were conducted. RESULTS In the overall sample, high chronic stress independently predicted risk for MetS, however this association was found to be significant only in Mexican Americans and Puerto Rican Americans. Social support did not moderate the associations between chronic stress and MetS for any group. Chronic stress was not associated with inflammatory markers in either the overall sample or in each group. CONCLUSIONS Our results suggest a differential contribution of chronic stress to the prevalence of MetS by national groups.
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Affiliation(s)
- Manuel S. Ortiz
- Department of Psychology, Universidad de La Frontera, Temuco, Chile
- * E-mail:
| | - Hector F. Myers
- Center for Medicine, Health & Society and Psychology, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Christine Dunkel Schetter
- Department of Psychology, University of California Los Angeles, Los Angeles, California, United States of America
| | - Carlos J. Rodriguez
- Division of Public Health Sciences, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Teresa E. Seeman
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America
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Susin N, de Melo Boff R, Ludwig MWB, Feoli AMP, da Silva AG, Macagnan FE, da Silva Oliveira M. Predictors of adherence in a prevention program for patients with metabolic syndrome. J Health Psychol 2015; 21:2156-67. [PMID: 25805660 DOI: 10.1177/1359105315572451] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The study objectives were (1) comparison of baseline characteristics between individuals with metabolic syndrome, adhering/not adhering to a primary prevention program modificação do estilo de vida e risco cardiovascular; and (2) determination of risk factors for program adherence. The sample included 127 participants with mean age (±standard deviation) of 49.58 (±7.77) years, participating in the modificação do estilo de vida e risco cardiovascular between 2010 and 2012. Results show that program adherence predictors were age (odds ratio: 1.134, 95% confidence interval: 1.106-1.833); practicing physical exercise (odds ratio: 1.322, 95% confidence interval: 1.115-7.589); self-efficacy for regular eating habits (odds ratio: 2.044, 95% confidence interval: 1.184-3.377); low binge eating scores (odds ratio: 1.922, 95% confidence interval: 1.118-3.974); and low isolation and depression scores (odds ratio: 0.721, 95% confidence interval: 0.322-0.917).
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Affiliation(s)
- Nathália Susin
- Pontífícia Universidade Católica do Rio Grande do Sul (PUCRS), Brazil
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Keen L, Turner AD, Mwendwa D, Callender C, Campbell A. Depressive symptomatology and respiratory sinus arrhythmia in a non-clinical sample of middle-aged African Americans. Biol Psychol 2015; 108:56-61. [PMID: 25796340 DOI: 10.1016/j.biopsycho.2015.03.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 03/07/2015] [Accepted: 03/09/2015] [Indexed: 12/25/2022]
Abstract
Decreased heart rate variability and depression are both independent risk factors for cardiac mortality in clinical and non-clinical samples. The purpose of the current study is to examine the hypothesis that severity of depressive symptomatology is inversely associated with respiratory sinus arrhythmia (RSA) in a non-clinical sample of African Americans. The sample included 77 African Americans with a mean age of 48.4 (SD = 11.7). Participants completed the Beck Depression Inventory-II (BDI-II) and a 5-min resting baseline measurement of RSA was collected. The BDI-II total score was positively associated with RSA (β = .334, p = .008). Given the unexpected direction of the association, we separated the BDI-II into cognitive and somatic affective subscales to identify which construct was driving the relationship. The somatic affective, was related to RSA (β = .328, p = .010), but not the cognitive subscale. Given this unexpected positive result, future research should further examine the nature of the relationship between depressive symptomatology and RSA in African Americans, as the relationship may vary based on levels of depressive symptomatology.
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Affiliation(s)
- Larry Keen
- Virginia State University, Department of Psychology, Petersburg, VA, United States.
| | - Arlener D Turner
- Center of Excellence on Disparities in HIV and Aging, Rush Alzheimer's Disease Center, Chicago, IL, United States.
| | - Denee Mwendwa
- Howard University, Department of Psychology, Washington, DC, United States.
| | - Clive Callender
- Howard University, School of Medicine, Washington, DC, United States; National Minority Organ and Tissue Transplant Program, Washington, DC, United States.
| | - Alfonso Campbell
- Howard University, Department of Psychology, Washington, DC, United States.
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Deak T, Quinn M, Cidlowski JA, Victoria NC, Murphy AZ, Sheridan JF. Neuroimmune mechanisms of stress: sex differences, developmental plasticity, and implications for pharmacotherapy of stress-related disease. Stress 2015; 18:367-80. [PMID: 26176590 PMCID: PMC4813310 DOI: 10.3109/10253890.2015.1053451] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The last decade has witnessed profound growth in studies examining the role of fundamental neuroimmune processes as key mechanisms that might form a natural bridge between normal physiology and pathological outcomes. Rooted in core concepts from psychoneuroimmunology, this review utilizes a succinct, exemplar-driven approach of several model systems that contribute significantly to our knowledge of the mechanisms by which neuroimmune processes interact with stress physiology. Specifically, we review recent evidence showing that (i) stress challenges produce time-dependent and stressor-specific patterns of cytokine/chemokine expression in the CNS; (ii) inflammation-related genes exhibit unique expression profiles in males and females depending upon individual, cooperative or antagonistic interactions between steroid hormone receptors (estrogen and glucocorticoid receptors); (iii) adverse social experiences incurred through repeated social defeat engage a dynamic process of immune cell migration from the bone marrow to brain and prime neuroimmune function and (iv) early developmental exposure to an inflammatory stimulus (carageenin injection into the hindpaw) has a lasting influence on stress reactivity across the lifespan. As such, the present review provides a theoretical framework for understanding the role that neuroimmune mechanisms might play in stress plasticity and pathological outcomes, while at the same time pointing toward features of the individual (sex, developmental experience, stress history) that might ultimately be used for the development of personalized strategies for therapeutic intervention in stress-related pathologies.
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Affiliation(s)
- Terrence Deak
- Behavioral Neuroscience Program, Department of Psychology, Binghamton University-SUNY, Binghamton, NY 13902-6000
- Address correspondence to: Terrence Deak, Ph.D., , Phone: 607-777-5918
| | - Matt Quinn
- Laboratory of Signal Transduction, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina 27709
| | - John A. Cidlowski
- Laboratory of Signal Transduction, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina 27709
| | - Nicole C. Victoria
- Neuroscience Institute, Georgia State University, Petit Science Center, PO Box 5030, Atlanta, GA 30302-5030
| | - Anne Z. Murphy
- Neuroscience Institute, Georgia State University, Petit Science Center, PO Box 5030, Atlanta, GA 30302-5030
| | - John F. Sheridan
- The Ohio State University College of Dentistry and Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH 43210
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ZhiQing Z, XinXing W, Jingbo G, Rui Z, Xiujie G, Yun Z, Lei W, Xue L, LingJia Q. Effects of HIP in protection of HSP70 for stress-induced cardiomyocytes injury and its glucorticoid receptor pathway. Cell Stress Chaperones 2014; 19:865-75. [PMID: 24789270 PMCID: PMC4389846 DOI: 10.1007/s12192-014-0510-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 03/26/2014] [Accepted: 03/27/2014] [Indexed: 01/16/2023] Open
Abstract
Moderate levels of stress can be beneficial to health, while stress overload can cause injury or contribute to diseases. Despite a number of studies of adaptation or stress damage, the mechanisms of adaptation and stress damage remain far from clear. The effect and mechanisms of adaptation on cardiomyocytes damage caused by stress overload are discussed in this study. Data showed that mild repeated stress mitigated stress overload-induced cardiomyocyte injury both in an animal model of restraint stress and in H9C2 cells with GC (glucocorticoid) treatment. HSP70, HIP expression and interaction between HSP70 and HIP increased during adaptation induced by mild stress both in animals and H9C2 cells. Overexpression or inhibition of HSP70 in H9C2 cells with pCDNA-3.1-Hsp70 or KNK437 (HSP70 inhibitor) showed that HSP70 can protect H9C2 cells from GC-induced cell damage. A luciferase assay showed that Hsp70 plays its protective role through inhibition of GR transcription activity dependent on the interaction with HIP. These results indicated that HSP70 may promote adaptation with its interacting protein HIP, and increased levels of HSP70 and its interacting protein HIP during adaptation may play a protective role on stress-overload-induced cardiomyocyte injury.
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MESH Headings
- Adaptation, Physiological
- Animals
- Benzhydryl Compounds/pharmacology
- Cell Line
- Disease Models, Animal
- Glucocorticoids/toxicity
- HSP70 Heat-Shock Proteins/antagonists & inhibitors
- HSP70 Heat-Shock Proteins/genetics
- HSP70 Heat-Shock Proteins/metabolism
- Heart Diseases/genetics
- Heart Diseases/metabolism
- Heart Diseases/pathology
- Heart Diseases/prevention & control
- Hydrocortisone/blood
- Male
- Molecular Chaperones/genetics
- Molecular Chaperones/metabolism
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/metabolism
- Myocytes, Cardiac/pathology
- Pyrrolidinones/pharmacology
- RNA Interference
- Rats, Wistar
- Receptors, Glucocorticoid/agonists
- Receptors, Glucocorticoid/genetics
- Receptors, Glucocorticoid/metabolism
- Restraint, Physical
- Signal Transduction/drug effects
- Stress, Psychological/complications
- Stress, Psychological/genetics
- Stress, Psychological/metabolism
- Stress, Psychological/pathology
- Time Factors
- Transfection
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Affiliation(s)
- Zhang ZhiQing
- />Institute of Health & Environmental Medicine, Tianjin, 300050 People’s Republic of China
| | - Wang XinXing
- />Institute of Basic Medical Sciences, Beijing, 100850 People’s Republic of China
| | - Gong Jingbo
- />Institute of Basic Medical Sciences, Beijing, 100850 People’s Republic of China
| | - Zhan Rui
- />Institute of Basic Medical Sciences, Beijing, 100850 People’s Republic of China
| | - Gao Xiujie
- />Institute of Health & Environmental Medicine, Tianjin, 300050 People’s Republic of China
| | - Zhao Yun
- />Institute of Basic Medical Sciences, Beijing, 100850 People’s Republic of China
| | - Wu Lei
- />Institute of Health & Environmental Medicine, Tianjin, 300050 People’s Republic of China
| | - Leng Xue
- />Institute of Medical Equipment, Tianjin, 300161 People’s Republic of China
| | - Qian LingJia
- />Institute of Basic Medical Sciences, Beijing, 100850 People’s Republic of China
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Gentile C, Dragomir AI, Solomon C, Nigam A, D’Antono B. Sex Differences in the Prediction of Metabolic Burden from Physiological Responses to Stress. Ann Behav Med 2014; 49:112-27. [DOI: 10.1007/s12160-014-9639-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Pogosova N, Saner H, Pedersen SS, Cupples ME, McGee H, Höfer S, Doyle F, Schmid JP, von Känel R. Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology. Eur J Prev Cardiol 2014; 22:1290-306. [PMID: 25059929 DOI: 10.1177/2047487314543075] [Citation(s) in RCA: 161] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 06/20/2014] [Indexed: 12/18/2022]
Abstract
A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.
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Affiliation(s)
- Nana Pogosova
- Federal Health Center and Department of Internal Disease Prevention, National Research Center for Preventive Medicine, Russia
| | - Hugo Saner
- Cardiovascular Prevention, Rehabilitation and Sports Medicine, Bern University Hospital, Switzerland
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Denmark Department of Cardiology, Odense University Hospital, Denmark
| | - Margaret E Cupples
- UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University, Belfast, UK
| | - Hannah McGee
- Division of Population Health Sciences (Psychology), Royal College of Surgeons in Ireland, Ireland
| | - Stefan Höfer
- Medical Psychology, Innsbruck Medical University, Austria
| | - Frank Doyle
- Division of Population Health Sciences (Psychology), Royal College of Surgeons in Ireland, Ireland
| | - Jean-Paul Schmid
- Cardiology Clinic, Tiefenauspital, Bern University Hospital, Switzerland
| | - Roland von Känel
- Department of Neurology, Bern University Hospital, Switzerland Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland
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Shim MJ, Kang YJ. Relationships between Metabolic Syndrome Component and Depression, Stress. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2014. [DOI: 10.15324/kjcls.2014.46.2.68] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Moon-Jung Shim
- Department of Clinical Laboratory Science, Ansan University, Ansan 426-701, Korea
| | - Yun-Jung Kang
- Department of Health Science, Dankook University Graduate School, Cheonan 330-714, Korea
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Innes KE, Selfe TK. Meditation as a therapeutic intervention for adults at risk for Alzheimer's disease - potential benefits and underlying mechanisms. Front Psychiatry 2014; 5:40. [PMID: 24795656 PMCID: PMC4005947 DOI: 10.3389/fpsyt.2014.00040] [Citation(s) in RCA: 45] [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: 11/19/2013] [Accepted: 03/31/2014] [Indexed: 12/12/2022] Open
Abstract
Alzheimer's disease (AD) is a chronic, progressive, brain disorder that affects at least 5.3 million Americans at an estimated cost of $148 billion, figures that are expected to rise steeply in coming years. Despite decades of research, there is still no cure for AD, and effective therapies for preventing or slowing progression of cognitive decline in at-risk populations remain elusive. Although the etiology of AD remains uncertain, chronic stress, sleep deficits, and mood disturbance, conditions common in those with cognitive impairment, have been prospectively linked to the development and progression of both chronic illness and memory loss and are significant predictors of AD. Therapies such as meditation that specifically target these risk factors may thus hold promise for slowing and possibly preventing cognitive decline in those at risk. In this study, we briefly review the existing evidence regarding the potential utility of meditation as a therapeutic intervention for those with and at risk for AD, discuss possible mechanisms underlying the observed benefits of meditation, and outline directions for future research.
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Affiliation(s)
- Kim E. Innes
- Department of Epidemiology, West Virginia University, Morgantown, WV, USA
- Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, Charlottesville, VA, USA
| | - Terry Kit Selfe
- Department of Epidemiology, West Virginia University, Morgantown, WV, USA
- Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, Charlottesville, VA, USA
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Nekouei ZK, Yousefy A, Doost HTN, Manshaee G, Sadeghei M. Structural Model of psychological risk and protective factors affecting on quality of life in patients with coronary heart disease: A psychocardiology model. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2014; 19:90-8. [PMID: 24778660 PMCID: PMC3999613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 11/08/2013] [Accepted: 12/01/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Conducted researches show that psychological factors may have a very important role in the etiology, continuity and consequences of coronary heart diseases. This study has drawn the psychological risk and protective factors and their effects in patients with coronary heart diseases (CHD) in a structural model. It aims to determine the structural relations between psychological risk and protective factors with quality of life in patients with coronary heart disease. MATERIALS AND METHODS The present cross-sectional and correlational studies were conducted using structural equation modeling. The study sample included 398 patients of coronary heart disease in the university referral Hospital, as well as other city health care centers in Isfahan city. They were selected based on random sampling method. Then, in case, they were executed the following questionnaires: Coping with stressful situations (CISS- 21), life orientation (LOT-10), general self-efficacy (GSE-10), depression, anxiety and stress (DASS-21), perceived stress (PSS-14), multidimensional social support (MSPSS-12), alexithymia (TAS-20), spiritual intelligence (SQ-23) and quality of life (WHOQOL-26). RESULTS The results showed that protective and risk factors could affect the quality of life in patients with CHD with factor loadings of 0.35 and -0.60, respectively. Moreover, based on the values of the framework of the model such as relative chi-square (CMIN/DF = 3.25), the Comparative Fit Index (CFI = 0.93), the Parsimony Comparative Fit Index (PCFI = 0.68), the Root Mean Square Error of Approximation (RMSEA = 0.07) and details of the model (significance of the relationships) it has been confirmed that the psychocardiological structural model of the study is the good fitting model. CONCLUSION This study was among the first to research the different psychological risk and protective factors of coronary heart diseases in the form of a structural model. The results of this study have emphasized the necessity of noticing the psychological factors in primary prevention by preventive programs and in secondary prevention by rehabilitation centers to improve the quality of life of the people with heart diseases.
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Affiliation(s)
- Zohreh Khayyam Nekouei
- Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran
| | - Alireza Yousefy
- Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Taher Neshat Doost
- Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran
| | - Gholamreza Manshaee
- Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran
| | - Masoumeh Sadeghei
- Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran
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Boylan JM, Ryff CD. High anger expression exacerbates the relationship between age and metabolic syndrome. J Gerontol B Psychol Sci Soc Sci 2013; 70:77-82. [PMID: 24077742 DOI: 10.1093/geronb/gbt092] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Building on prior work linking high anger expression to poor health, this cross-sectional study addressed whether anger expression exacerbated age-related risk for metabolic syndrome in a national sample of adults, known as MIDUS (Midlife in the United States). METHOD Respondents reported anger expression via survey assessments and completed an overnight clinic visit. RESULTS Unadjusted metabolic syndrome prevalence was 40.6%. Men, less educated individuals, and those who reported not getting regular physical activity were at significantly higher risk for metabolic syndrome. Anger expression did not predict higher risk for metabolic syndrome in main effects models, but it moderated the relationship between age and metabolic syndrome. Age-associated risk for metabolic syndrome was significant only for adults with high anger expression. DISCUSSION Among older adults, anger expression predicted higher prevalence of metabolic syndrome. Older adults reporting low anger expression had metabolic syndrome rates comparable to younger adults. Results highlight that failing to show the frequently observed decline in anger expression with age may have pernicious health concomitants.
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Affiliation(s)
| | - Carol D Ryff
- Department of Psychology, and Institute on Aging, University of Wisconsin-Madison
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Zhang YY, Wang ZR. Role of psychological factors in pathogenesis of ulcerative colitis. Shijie Huaren Xiaohua Zazhi 2013; 21:1823-1827. [DOI: 10.11569/wcjd.v21.i19.1823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Ulcerative colitis (UC) is a chronic inflammatory disease of the colon of unknown etiology. Multiple factors induce the occurrence and development of UC. Among these factors, psychological factors play an important role. As psychoneuroimmunology concept is gradually being accepted, it is currently believed that emotion can affect immune function through the nervous system. Recent studies suggest that psychological stress can be involved in alterations in intestinal inflammation by changing brain-gut axis function, exciting vegetative nerve, releasing neurotransmitters and altering bacterial-mucosal interactions. This paper reviews recent advances in understanding the role of psychological factors in the pathogenesis of UC and emphasizes the ways for the development of therapeutic psychological interventions.
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Abstract
OBJECTIVES To investigate the impact of anxiety on the prognosis of coronary artery disease (CAD) in patients of Chinese Han ethnicity and to explore the correlation between anxiety and the severity of coronary atherosclerosis. METHODS Between June 2007 and May 2009, 1007 hospitalized patients with CAD diagnosed by coronary angiography were recruited. The anxiety symptoms were investigated within 2 days after coronary angiography or percutaneous coronary intervention, using the Zung Self-Rating Anxiety Scale. The severity of coronary atherosclerosis was assessed using the modified Gensini score. One and a half years after discharge, the participants were evaluated at the outpatient clinic or by telephone. The primary outcome was the composite of all-cause death and nonfatal myocardial infarction (MI). RESULTS A total of 917 (91.1%) patients were evaluated during a mean follow-up period of 17 months. Thirty-five deaths (26 of cardiovascular and 9 of other causes) and 5 nonfatal MIs occurred. The Zung Self-Rating Anxiety Scale score assessed during hospitalization was significantly and independently associated with the Gensini score (β = 1.35, p < .001). Adjusted Cox proportional hazards models showed that anxiety symptoms predicted all-cause death and nonfatal MI (adjusted hazard ratio = 2.43, 95% confidence interval = 1.24-4.75, p = .009). CONCLUSIONS Anxiety was independently associated with the severity of coronary atherosclerosis and predicted worse outcome in patients with CAD of Chinese Han ethnicity.
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43
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Mavrides N, Nemeroff C. Treatment of depression in cardiovascular disease. Depress Anxiety 2013; 30:328-41. [PMID: 23293051 DOI: 10.1002/da.22051] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 12/06/2012] [Accepted: 12/08/2012] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Depression in patients with Cardiovascular Disease (CVD) is extremely common, with a prevalence of 17-47%, and is associated with increased risk of morbidity and mortality. Treatment of depression has been hypothesized to reduce cardiac mortality. Pharmacologic and psychotherapeutic interventions have been studied and appear to be safe and in some studies effective in reducing depressive symptoms in patients with cardiac disease. The impact on cardiac outcomes remains unclear. This review briefly focuses on the prevalence of depression in patients with CVD, the physiological links between depression and CVD, and largely is concerned with the clinical trials that seek to demonstrate efficacy and safety of antidepressant medications and psychotherapy in this patient population. METHODS PubMed and PsycINFO databases were searched through July 2012. Publications were included if they were in English, a review article, or a clinical trial in the CVD population with comorbid depression. The search was completed with key words of antidepressants, CVD, coronary artery syndrome, SSRIs, depression, treatment of depression, post-MI (where MI is myocardial infarction), major depression, and cardiac disease. Trials were included if the patients were above the age of 18, both male and female genders, and had cardiac comorbidity. No trials were excluded. RESULTS A total of 61 articles and/or book chapters were included. The majority were from North America and Europe. There were 7 clinical trials of tricyclic antidepressants (TCAs), one of TCAs and bupropion, and 10 trials of selective serotonin reuptake inhibitors (SSRIs). We also evaluated five trials involving psychotherapeutic techniques and/or collaborative care. CONCLUSIONS There is considerable evidence from randomized controlled clinical trials that antidepressants, especially SSRIs, are safe in the treatment of major depression in patients with CVD. Although efficacy has been demonstrated in some, but not all, trials for both antidepressants and certain psychotherapies, large, well-powered trials are urgently needed. There are virtually no data available on predictors of antidepressant response in depressed patients with CVD. Whether successful treatment of depression is associated with a reduction in cardiac morbidity and mortality remains unknown.
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Affiliation(s)
- Nicole Mavrides
- Department of Psychiatry and Behavioral Sciences, Center on Aging, Miller School of Medicine, University of Miami, Miami, Florida
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Khayyam-Nekouei Z, Neshatdoost H, Yousefy A, Sadeghi M, Manshaee G. Psychological factors and coronary heart disease. ARYA ATHEROSCLEROSIS 2013; 9:102-11. [PMID: 23690809 PMCID: PMC3653260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Accepted: 10/14/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although psychological factors play an important role in coronary heart diseases (CHD), it seems there is a need for more researches in this respect. The present study aimed to review psychological factors, including depression, anxiety and stress related to etiology and prognosis of CHD. METHODS This was a review on medical and psychological literatures, particularly in the years 1995-2012. RESULTS As protective factor or risk factor, psychological factors play an important role in CHD. CONCLUSION Given the findings of this study, it seems necessary that we pay attention to psychological factors, as independent risk factors or protective factors for CHD.
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Affiliation(s)
- Zohreh Khayyam-Nekouei
- PhD Candidate, Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran
| | | | - Alireza Yousefy
- Associate Professor, Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Associate Professor, Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Manshaee
- Assistant Professor, Department of Psychology, Isfahan Science and Research Branch, Islamic Azad University, Isfahan, Iran
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Carpiniello B, Pinna F, Velluzzi F, Loviselli A. Mental disorders in patients with metabolic syndrome. The key role of central obesity. Eat Weight Disord 2012; 17:e259-66. [PMID: 23299201 DOI: 10.3275/8809] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The Authors sought to evaluate current prevalence of mental disorders in patients affected by metabolic syndrome compared with patients affected by central obesity alone. METHODS 186 (63.5%) patients affected by central obesity and 107 (36.5%) affected by metabolic syndrome according to ICF criteria were interviewed by means of SCID I. RESULTS Axis I current prevalence was respectively 45.7% and 44.9% among patients with central obesity and patients with metabolic syndrome, differences which were not significant. No statistically significant differences were found between groups as far as each single axis I diagnostic category was concerned. Moreover, current prevalence of any axis I, anxiety and mood disorders were independent of the number of components of metabolic syndrome. CONCLUSION metabolic syndrome is associated to an higher risk for current mental disorders, which seems to be mainly due to the strong association of central obesity to psychopathology.
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Affiliation(s)
- B Carpiniello
- Department of Public Health, Clinical and Molecular Medicine-Section of Psychiatry and Psychiatric Clinic, University of Cagliari, Cagliari, Italy.
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Edwards LE, Mezuk B. Anxiety and risk of type 2 diabetes: evidence from the Baltimore Epidemiologic Catchment Area Study. J Psychosom Res 2012; 73:418-23. [PMID: 23148808 PMCID: PMC3499773 DOI: 10.1016/j.jpsychores.2012.09.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 08/28/2012] [Accepted: 09/24/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Depression is increasingly recognized as a risk factor for type 2 diabetes, and is also commonly comorbid with anxiety. However, few studies have examined whether anxiety is predictive of diabetes risk. The objectives of this study are to examine the prospective relationship between anxiety disorders (generalized anxiety disorder, panic disorder, social phobia, and agoraphobia) and risk of type 2 diabetes over an 11-year period, and to investigate the association between anxiety and risk of diabetes-related complications among those with prevalent type 2 diabetes. METHODS Data come from the 1993/6 and 2004/5 waves of the Baltimore Epidemiologic Catchment Area Study (N=1920), a population-based prospective cohort. Anxiety disorders were assessed using the Diagnostic Interview Schedule. The prospective association between anxiety and incident type 2 diabetes was evaluated using a series of nested multivariable logistic regression models. RESULTS At baseline, 315 participants (21.8%) had an anxiety disorder. The relationship between anxiety and risk of developing type 2 diabetes was not statistically significant after controlling for demographic characteristics (Odds Ratio (OR): 1.28, 95% Confidence Interval (CI): 0.75, 2.18). There was no relationship between anxiety and diabetes risk after controlling for health behaviors and depression status (OR: 1.00, 95% CI: 0.53, 1.89). There was no significant relationship between anxiety and development of diabetes-related complications among those with prevalent type 2 diabetes (OR: 2.02, 95% CI: 0.61, 6.74). CONCLUSION Anxiety disorders are not associated with increased risk of type 2 diabetes or risk of diabetes complications among those who have diabetes.
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Affiliation(s)
- Lauren E. Edwards
- Department of Epidemiology and Community Health Virginia Commonwealth University School of Medicine
| | - Briana Mezuk
- Department of Epidemiology and Community Health Virginia Commonwealth University School of Medicine
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Personality as a risk factor for the metabolic syndrome: a systematic review. J Psychosom Res 2012; 73:326-33. [PMID: 23062804 DOI: 10.1016/j.jpsychores.2012.08.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 08/27/2012] [Accepted: 08/28/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The metabolic syndrome is a cluster of risk factors for the development of cardiovascular disease and/or type 2 diabetes. Personality can be defined as a stable set of behavioral characteristics of a person. In this review we systematically reviewed whether different personality characteristics are associated with the risk of having or developing the metabolic syndrome. METHODS Systematic review. RESULTS In total 18 studies were included. Thirteen cross-sectional analyses, and ten longitudinal analyses were grouped according to personality constructs: hostility, anger, and Type A behavior, temperament, neuroticism, and Type D personality. Conflicting evidence was reported on persons with high hostility, neuroticism, or Type D personality scores to be associated with an increased metabolic syndrome prevalence and development. All significant findings do point in the same direction: a more negative, or hostile personality type is associated with an increased prevalence of metabolic syndrome and its development over time. CONCLUSION There was no clear association between personality measures and the occurrence and development of the metabolic syndrome. There is, however, a cluster of risk factors that include the presence of the metabolic syndrome, as well as a more negative prone personality style, that both predispose to the development of coronary heart disease and diabetes. Future studies should investigate the role of personality measures in the development of these conditions, while taking into account metabolic syndrome, lifestyle and socio-demographic factors.
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Tsenkova VK, Carr D, Coe CL, Ryff CD. Anger, adiposity, and glucose control in nondiabetic adults: findings from MIDUS II. J Behav Med 2012; 37:37-46. [PMID: 23065351 DOI: 10.1007/s10865-012-9460-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Accepted: 09/26/2012] [Indexed: 11/28/2022]
Abstract
Anger has been linked to cardiovascular disease, but few studies have examined the relationship between anger and type 2 diabetes. The aim was to investigate associations among different indicators of anger expression, adiposity, and nondiabetic glucose metabolism in a national survey of adults. Participants were 939 adults without diabetes in the Midlife in the US study (MIDUS II). Glucose metabolism was characterized by fasting glucose, insulin, insulin resistance, and glycosylated hemoglobin (HbA1c). Spielberger's Anger Expression inventory was used to measure suppressed anger (anger-in), expressed anger (anger-out), and controlled anger (anger-control). We investigated the relationship between anger and glucose metabolism, and whether anger amplified the adverse relationship between body weight distribution (body mass index = BMI and waist-to-hip ratio = WHR) and glucose metabolism. Multivariate-adjusted analyses revealed an association between anger-out and both insulin and insulin resistance. As predicted, anger-in amplified the relationships between BMI and insulin and insulin resistance, while anger-out amplified the association between WHR and insulin and insulin resistance. Low anger-control was associated with higher glucose. None of the three anger measures was significantly associated with HbA1c. Our findings extend previous research on anger as a potential risk factor for type 2 diabetes by demonstrating that anger expression is associated with clinical indicators of glycemic control, especially among those with pre-existing risk due to obesity and high central adiposity.
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Affiliation(s)
- Vera K Tsenkova
- Center for Women's and Health Disparities Research, University of Wisconsin-Madison, 310N. Midvale Blvd, Madison, WI, 53706, USA,
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Abstract
The close, bidirectional relationship between depression and cardiovascular disease is well established. Major depression is associated with an increased risk of coronary artery disease and acute cardiovascular sequelae, such as myocardial infarction, congestive heart failure, and isolated systolic hypertension. Morbidity and mortality in patients with cardiovascular disease and depression are significantly higher than in patients with cardiovascular disease who are not depressed. Various pathophysiological mechanisms might underlie the risk of cardiovascular disease in patients with depression: increased inflammation; increased susceptibility to blood clotting (owing to alterations in multiple steps of the clotting cascade, including platelet activation and aggregation); oxidative stress; subclinical hypothyroidism; hyperactivity of the sympatho-adrenomedullary system and the hypothalamic-pituitary-adrenal axis; reductions in numbers of circulating endothelial progenitor cells and associated arterial repair processes; decreased heart rate variability; and the presence of genetic factors. Early identification of patients with depression who are at risk of cardiovascular disease, as well as prevention and appropriate treatment of cardiovascular disease in these patients, is an important and attainable goal. However, adequately powered studies are required to determine the optimal treatment regimen for patients with both depression and cardiovascular disorders.
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Carpiniello B, Pinna F, Pili R, Velluzzi F, Loviselli A. Mental disorders in obese patients with and without metabolic syndrome. Int J Psychiatry Med 2012; 42:369-75. [PMID: 22530399 DOI: 10.2190/pm.42.4.c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The authors sought to evaluate lifetime prevalence of mental disorders in patients affected by metabolic syndrome compared with patients affected by central obesity alone. METHODS One hundred eighty-six (63.5%) patients affected by central obesity and 107 (36.5%) affected by metabolic syndrome according to ICF criteria were interviewed by means of SCID I and SCID II. RESULTS Axis I and axis II lifetime prevalence were respectively 53.8% and 30.1% among patients with central obesity, 50.5% and 28% among patients with metabolic syndrome, differences which were not significant. No statistically significant differences were found between groups as far as each single axis I and II diagnostic category was considered. CONCLUSION Metabolic syndrome is not associated with a higher risk of mental disorders compared to central obesity alone.
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Affiliation(s)
- B Carpiniello
- Dept. of Public Health-Section of Psychiatry and Psychiatric Clinic, University of Cagliari, Italy.
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