Change in positive affect during outpatient cardiac rehabilitation predicts vital exhaustion in patients with coronary heart disease

Levels of depression and life exhaustion in the open population of the middle urbanized Siberian city: gender differences

AIM

The aim of the study was to determine the levels of depression and life exhaustion in men and women of the open urban population in the age range.

MATERIALS AND METHODS

A single-stage epidemiological study was conducted among people of both sexes aged 25-64 in Tyumen. A representative sample was formed from the electoral lists of citizens by the method of "random numbers" - 2000 men and women with a response among men 85.0%, among women - 70.3%. The study of depression was conducted according to the algorithms of the program of the world health organization "MONICA-psychosocial".

RESULTS

The prevalence of depression in the Tyumen population and in the age and sex groups showed a predominance of the average level over the high, in the age categories 25-34 and 35-44 years - significantly higher prevalence of high levels of depression in women. The higher prevalence of the average level of men and women IN the open population was determined to be relatively high. The average level of LIFE significantly prevails in women in the older age categories and in the population as a whole, the high level of LIFE - at the age of 25-34 years in women and at the age of 55-64 years in men.

CONCLUSION

Therefore, in the open population of the middle-urbanized Siberian city there is a need to form an integrated approach to the prevention of non-infectious diseases, especially cardiovascular diseases, as it is established that prevention programs lead to a reduction in the burden of depression and, and effective approaches to the prevention of psycho-emotional States at the level of individual communities include school-oriented programs to teach positive thinking among the population, starting from a young age.

From Vitality to Vital Exhaustion and Other States of "Tense Tiredness": A New Biopsychosocial Risk Domain

Fatigue is a common prodromal symptom for various medical conditions, including acute myocardial infarction. Fatigue is also the core component of vital exhaustion, which consists of a specific triad: excessive fatigue, increased irritability, and feelings of demoralization. In this issue of Psychosomatic Medicine, Frestad and Prescott present a meta-analysis of 16 studies, involving 53,337 participants, which found vital exhaustion to be associated with an increased risk of incident coronary heart disease (CHD) and recurrent cardiac events among individuals with established CHD. After discussing methodological limitations of the studies included in this meta-analysis, we describe these findings in terms of a larger genre of risk that is biopsychosocial in origin and tied to two types of tiredness: "calm tiredness" and "tense tiredness." The former is regenerative, while the latter enhances disease risk. We propose that besides vital exhaustion, other symptoms of negative affect may combine with tiredness to produce increased clinical risk, such as the presence of depressed mood, an inability to relax or recover after work, and symptoms of burnout. We further propose that vital exhaustion can be considered as part of a larger paradigm, ranging from a positive state of vitality to a negative state of exhaustion of vitality. We conclude this editorial by emphasizing the importance of improving vitality and the need to clarify biobehavioral mechanisms that play a role in the association between vital exhaustion and adverse CHD outcomes. New interventions are needed that target reducing exhaustion and improving vitality for individuals at high risk of CHD.