Effects of seasonal mood changes on seasonal variations in coronary heart disease: role of immune system, infection, and inflammation

Seasonal variations in mood and behavior associate with common chronic diseases and symptoms in a population-based study

The purpose of this study was to assess how seasonality is associated with some of the most common non-communicable diseases (NCDs) in the general Finnish population. The global seasonality score (GSS) was used to measure the magnitude of seasonality in 4689 participants, in addition to which they reported the extent to which the seasonal variations in mood and behavior were experienced as a problem. Regression models and the odds ratios were adopted to analyze the associations adjusted for a range of covariates. Seventy percent of the participants had seasonal variations in sleep duration, social activity, mood, or energy level, and forty percent those in weight and appetite. Angina pectoris and depression were significantly associated with seasonality throughout the analysis. Hypertension, high cholesterol levels, diabetes, other (than rheumatoid) joint diseases and other (than depressive) psychological illnesses were significantly associated with experiencing a problem due to the seasonal variations, with an increase in the GSS, and with seasonal affective disorder and its subsyndromal form. The co-occurrence of the seasonal variations in mood and behavior with certain common NCDs warrants future research to have insights into the etiology and potentially shared pathways and mechanisms of action.

Specific personality traits and coping styles predict affective symptoms in early post acute coronary syndrome inpatients

OBJECTIVE

Affective symptoms have adverse effects in hospital and long-term cardiac outcomes of post Acute Coronary Syndrome (ACS) patients. This study aims to identify personality traits and maladaptive coping strategies that could predict affective symptoms in early post-ACS patients.

METHODS

Seventy patients undergoing revascularization procedures were examined within a week after their admission by means of the Hospital Anxiety-Depression Scale. Personality was analyzed through the Type D Personality Scale and the Coping Inventory for Stressful Situation. Multiple logistic regression analysis was used to determine independent predictors of anxiety and depressed mood.

RESULTS

A high rate of depressive and anxious symptoms was found and 76% of patients resulted Type D personality. Depression was associated with b-blocker therapy, Type D personality, and specific coping strategies. Unmarried status, low education, unstable angina, Type D personality, emotion, and avoidance oriented coping independently predicted anxiety.

CONCLUSION

These findings underlie the importance of assessment for Type D personality and coping strategies that could be useful to identify post-ACS patients at higher risk for affective symptoms. Using these brief instruments, as sensitive screening measures, we investigated the prevalence of depressive and anxiety symptoms in patients with ACS, we identified personality traits and coping strategies used to manage stress and estimated independent predictors of affectivity disorders after ACS.

Increased health risk in subjects with high self-reported seasonality

BACKGROUND

Seasonal variations in mood and behaviour, termed seasonality, are commonly reported in the general population. As a part of a large cross-sectional health survey in Hordaland, Norway, we investigated the relationship between seasonality, objective health measurements and health behaviours.

METHODOLOGY/PRINCIPAL FINDINGS

A total of 11,545 subjects between 40-44 years old participated, completing the Global Seasonality Score, measuring seasonality. Waist/hip circumference, BMI and blood pressure were measured, and blood samples were analyzed for total cholesterol, HDL cholesterol, triglycerides and glucose. Subjects also completed a questionnaire on miscellaneous health behaviours (exercise, smoking, alcohol consumption). Hierarchical linear regression analyses were used to investigate associations between seasonality and objective health measurements, while binary logistic regression was used for analysing associations between seasonality and health behaviours. Analyses were adjusted for sociodemographic factors, month of questionnaire completion and sleep duration. Seasonality was positively associated with high waist-hip-ratio, BMI, triglyceride levels, and in men high total cholesterol. Seasonality was negatively associated with HDL cholesterol. In women seasonality was negatively associated with prevalence of exercise and positively associated with daily cigarette smoking.

CONCLUSIONS/SIGNIFICANCE

High seasonality was associated with objective health risk factors and in women also with health behaviours associated with an increased risk for cardiovascular disease.

Effect of seasonal variation on the clinical course of chronic hepatitis B

BACKGROUND

Seasonal variation in immunity has been found in healthy individuals and in association with some diseases. It is still unknown whether seasonal variation affects the clinical course of chronic hepatitis B. Our aim in this study was to explore the effect of seasonal variation on the clinical course of chronic hepatitis B.

METHODS

The flare and remission time of chronic hepatitis B were observed in patients with hepatitis B virus (HBV) infection. All patients enrolled were followed up at least every 3 months for a mean follow-up time of 24.0 (range, 12-60) months. Seasonal decomposition was employed to analyze the relationship between seasonal variation and flares, remission, and hepatitis B e antigen (HBeAg) seroconversion in chronic hepatitis B patients during follow-up.

RESULTS

A total of 2238 patients were observed in our study. Flare and HBeAg seroconversion were seldom seen in 1076 patients (48.08%) with alanine aminotransferase (ALT) levels of less than 2.0 x upper limit of normal (ULN) during follow-up (mean, 36 months). The remaining 1162 patients (51.92%) (766, HBeAg positive; 387 anti-HBeAg positive; 9 negative for both HBeAg and anti-HBeAg) with ALT levels >or=2.0 x ULN were followed longitudinally for 12 months to judge flare, remission, and HBeAg seroconversion. Flare, remission, and HBeAg seroconversion in patients with ALT levels >or=2.0 x ULN showed clear seasonal patterns (P < 0.001), with high peaks during spring, summer, and summer, respectively. An autocorrelation correlogram showed that flares, remission, and HBeAg seroconversion occurred with distinct periodicity in winter, spring, summer, and autumn.

CONCLUSIONS

Seasonal variation might affect the clinical course of chronic hepatitis B. The role of seasonal triggering factors should be further investigated.

Seasonal Variations in Health-Related Human Physical Activity

There are profound fluctuations in climate that occur within the annual cycle of seasonal changes. The severity of these changes depends on latitude of location and prevailing topography. Living creatures have evolved means of coping with seasonal extremes. Endogenous circannual cycles, at least in humans, appear to have been masked by mechanisms employed to cope with environmental changes. Physical activity levels tend to be lower in winter than in summer, mediating effects on health-related fitness. In athletes, seasonal changes are dictated by requirements of the annual programme of competitive engagements rather than an inherent circannual rhythm. Injury rates are influenced by seasonal environmental factors, notably in field sports. Season of birth has been related to susceptibility to selected morbidities, including mental ill-health. In age-restricted sports, there is a date-of-birth bias favouring those individuals born early in the competitive year. Trainers and selectors should acknowledge this trend if they are to avoid omitting gifted individuals, born later in the year, from talent development programmes.

Effects of heavy alcohol consumption on the cardiovascular system may be mediated in part by the influence of alcohol-induced depression on the immune system

The harmful effects of heavy alcohol use are well-documented and wide-ranging. Heavy drinking may cause or exacerbate cardiovascular disorders. The author suggests that effects of heavy alcohol consumption on the cardiovascular system may be mediated in part by the influence of alcohol-induced depression on the immune system. This hypothesis is based on the following data: (1) alcohol misuse may cause or exacerbate depression; (2) depressive disorders are associated with increased incidence, morbidity, and mortality of cardiovascular disorders; (3) the immune system may mediate effects of depressive disorders on the cardiovascular system. Further studies are needed to clarify the etiopathogenesis of alcohol-related disorders and develop new treatment modalities.

Stress, inflammation and cardiovascular disease

Various psychosocial factors have been implicated in the etiology and pathogenesis of certain cardiovascular diseases such as atherosclerosis, now considered to be the result of a chronic inflammatory process. In this article, we review the evidence that repeated episodes of acute psychological stress, or chronic psychologic stress, may induce a chronic inflammatory process culminating in atherosclerosis. These inflammatory events, caused by stress, may account for the approximately 40% of atherosclerotic patients with no other known risk factors. Stress, by activating the sympathetic nervous system, the hypothalamic-pituitary axis, and the renin-angiotensin system, causes the release of various stress hormones such as catecholamines, corticosteroids, glucagon, growth hormone, and renin, and elevated levels of homocysteine, which induce a heightened state of cardiovascular activity, injured endothelium, and induction of adhesion molecules on endothelial cells to which recruited inflammatory cells adhere and translocate to the arterial wall. An acute phase response (APR), similar to that associated with inflammation, is also engendered, which is characterized by macrophage activation, the production of cytokines, other inflammatory mediators, acute phase proteins (APPs), and mast cell activation, all of which promote the inflammatory process. Stress also induces an atherosclerotic lipid profile with oxidation of lipids and, if chronic, a hypercoagulable state that may result in arterial thromboses. Shedding of adhesion molecules and the appearance of cytokines, and APPs in the blood are early indicators of a stress-induced APR, may appear in the blood of asymptomatic people, and be predictors of future cardiovascular disease. The inflammatory response is contained within the stress response, which evolved later and is adaptive in that an animal may be better able to react to an organism introduced during combat. The argument is made that humans reacting to stressors, which are not life-threatening but are "perceived" as such, mount similar stress/inflammatory responses in the arteries, and which, if repetitive or chronic, may culminate in atherosclerosis.