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Falk JR, Gollwitzer PM, Oettingen G, Brinkmann K, Gendolla GHE. Depressive symptoms, task choice, and effort: The moderating effect of personal control on cardiac response. Psychophysiology 2024:e14635. [PMID: 38924154 DOI: 10.1111/psyp.14635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 05/14/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
Dysphoric individuals perceive mental tasks as more demanding and show increased cardiovascular responses during the performance of easy cognitive tasks. Recent research on action shielding indicates that providing individuals with personal control over their tasks can mitigate the effects of manipulated affective states on cardiovascular responses reflecting effort. We investigated whether the shielding effect of personal choice also applies to the effect of dispositional negative mood on effort. N = 125 university students with high (dysphoric) versus low (nondysphoric) depressive symptoms engaged in an easy cognitive task either by personal choice or external assignment. As expected, dysphoric individuals showed significantly stronger cardiac PEP reactivity during task performance when the task was externally assigned. Most importantly, this dysphoria effect disappeared when participants could ostensibly personally choose their task. Our findings show that the previously observed shielding effect of personal action choice against incidental affective stimulation also applies to dispositional negative affect.
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Affiliation(s)
- Johanna R Falk
- Geneva Motivation Lab, FPSE, Section of Psychology, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Peter M Gollwitzer
- Department of Psychology, New York University, New York, New York, USA
- Department of Political and Social Sciences, Zeppelin University Friedrichshafen, Friedrichshafen, Germany
| | - Gabriele Oettingen
- Department of Psychology, New York University, New York, New York, USA
- Department of Political and Social Sciences, Zeppelin University Friedrichshafen, Friedrichshafen, Germany
| | - Kerstin Brinkmann
- Geneva Motivation Lab, FPSE, Section of Psychology, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Guido H E Gendolla
- Geneva Motivation Lab, FPSE, Section of Psychology, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
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Sobolewska-Nowak J, Wachowska K, Nowak A, Orzechowska A, Szulc A, Płaza O, Gałecki P. Exploring the Heart-Mind Connection: Unraveling the Shared Pathways between Depression and Cardiovascular Diseases. Biomedicines 2023; 11:1903. [PMID: 37509542 PMCID: PMC10377477 DOI: 10.3390/biomedicines11071903] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/11/2023] [Accepted: 06/15/2023] [Indexed: 07/30/2023] Open
Abstract
Civilization diseases are defined as non-communicable diseases that affect a large part of the population. Examples of such diseases are depression and cardiovascular disease. Importantly, the World Health Organization warns against an increase in both of these. This narrative review aims to summarize the available information on measurable risk factors for CVD and depression based on the existing literature. The paper reviews the epidemiology and main risk factors for the coexistence of depression and cardiovascular disease. The authors emphasize that there is evidence of a link between depression and cardiovascular disease. Here, we highlight common risk factors for depression and cardiovascular disease, including obesity, diabetes, and physical inactivity, as well as the importance of the prevention and treatment of CVD in preventing depression and other mental disorders. Conversely, effective treatment of CVD can also help prevent depression and improve mental health outcomes. It seems advisable to introduce screening tests for depression in patients treated for cardiac reasons. Importantly, in patients treated for mood disorders, it is worth controlling CVD risk factors, for example, by checking blood pressure and pulse during routine visits. It is also worth paying attention to the mental condition of patients with CVD. This study underlines the importance of interdisciplinary co-operation.
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Affiliation(s)
| | - Katarzyna Wachowska
- Department of Adult Psychiatry, Medical Univeristy of Lodz, 90-419 Lodz, Poland
| | - Artur Nowak
- Department of Immunopathology, Medical Univeristy of Lodz, 90-419 Lodz, Poland
| | - Agata Orzechowska
- Department of Adult Psychiatry, Medical Univeristy of Lodz, 90-419 Lodz, Poland
| | - Agata Szulc
- Psychiatric Clinic of the Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Olga Płaza
- Psychiatric Clinic of the Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Piotr Gałecki
- Department of Adult Psychiatry, Medical Univeristy of Lodz, 90-419 Lodz, Poland
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Liu X, Lin W, Huang J, Cao Z, Wu M, Chen Z, Zhu W, Tan Z, Yu P, Ma J, Chen Y, Zhang Y, Wang J. Depressive symptoms, anxiety and social stress are associated with diminished cardiovascular reactivity in a psychological treatment-naive population. J Affect Disord 2023; 330:346-354. [PMID: 36871916 DOI: 10.1016/j.jad.2023.02.150] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND There is now an increasing appreciation of how psychological health can contribute to cardiovascular disease, called the mind-heart connection. A blunted cardiovascular reactivity to depression and anxiety may be responsible for the potential mechanism, however, with inconsistent results. Anti-psychological drugs have an effect on the cardiovascular system and, thus, may disturb their relationship. However, in treatment-naive individuals with psychological symptoms, no research has specifically evaluated the relationship between psychological state and cardiovascular reactivity. METHODS We included 883 treatment-naive individuals who came from a longitudinal cohort study of Midlife in the United States. Symptoms of depression, anxiety, and stress were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D), Spielberger Trait Anxiety Inventory (STAI), the Liebowitz Social Anxiety scale (LSAS) and the Perceived Stress Scale (PSS), respectively. Cardiovascular reactivity was measured using standardized, laboratory-based stressful tasks. RESULTS Treatment-naive individuals with depressive symptoms (CES-D ≥ 16), anxiety symptoms (STAI ≥ 54), and higher stress levels (PSS ≥ 27) had lower cardiovascular reactivity as assessed by systolic blood pressure (SBP) reactivity, diastolic blood pressure (DBP) reactivity and heart rate (HR) reactivity (P < 0.05). Pearson analyses showed that psychological symptoms were correlated with lower SBP reactivity, DBP reactivity, and heart rate reactivity (P < 0.05). Multivariate linear regression showed that depression and anxiety were negatively related to lower cardiovascular reactivity (SBP, DBP and HR reactivity) after full adjustments (P < 0.05). Stress was associated with reduced SBP and DBP reactivity but with a nonsignificant association with HR reactivity (P = 0.056). CONCLUSION Depression, anxiety, and stress symptoms are associated with blunted cardiovascular reactivity in treatment-naive adult Americans. These findings suggest that blunted cardiovascular reactivity is an underlying mechanism linking psychological health and cardiovascular diseases.
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Affiliation(s)
- Xiao Liu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Weichun Lin
- Department of Gastroenterology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jingjing Huang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhengyu Cao
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Maoxiong Wu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhiteng Chen
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Wengen Zhu
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Ziqi Tan
- Department of Endocrine, the Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Peng Yu
- Department of Endocrine, the Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Jianyong Ma
- Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, United States
| | - Yangxin Chen
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yuling Zhang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
| | - Jingfeng Wang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
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Keogh TM, Howard S, Gallagher S. Behavioural clusters characteristic of cardiovascular reactivity profiles relate to poorer health outcomes. Br J Health Psychol 2022; 28:513-531. [PMID: 36458587 DOI: 10.1111/bjhp.12638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/07/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVES Blunted cardiovascular reactivity is associated with a distinct behavioural profile of greater exposure to early life adversity, coupled with higher levels of behavioural disengagement and symptoms of depression. The present study sought to extend on this work by investigating if behavioural clusters with distinct patterns of reactivity were related to health and behavioural outcomes at baseline and at a 4-year follow-up. METHODS Hierarchical cluster analyses were conducted using longitudinal data drawn from the Midlife Development in the United States (MIDUS 2) Biomarker Project and the MIDUS 3 follow-up 4 years later. During MIDUS, 2 participants (N = 513) underwent a standardized stress testing protocol and had their blood pressure and heart rate monitored throughout. In addition, hierarchical cluster analyses were conducted on responses from measures of early life adversity, behavioural disengagement and depression. Binary logistic regressions were conducted to determine whether cluster membership was related to health and behavioural outcomes which were taken at both time points. RESULTS Three behavioural clusters emerged with statistically different blood pressure reactivity patterns. The cluster characterized by greater exposure to early life adversity, higher levels of behavioural disengagement and depressive symptoms, had relatively lower blood pressure reactivity patterns compared with both the exaggerated reactivity cluster and the cluster similar to the sample mean. In fully adjusted models, this cluster was associated with hypertension (p = .050) and depressed affect (p = .033), while Cluster 1 characteristic of an exaggerated blood pressure reactivity profile was associated with depressed affect (p < .001). Cluster membership did not significantly predict future health status. CONCLUSION This study extends research on behavioural clusters characteristic of reactivity profiles to demonstrate how they relate to health and behavioural outcomes during MIDUS 2.
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Affiliation(s)
- Tracey M. Keogh
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory University of Limerick Limerick Ireland
- Health Research Institute University of Limerick Limerick Ireland
| | - Siobhán Howard
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory University of Limerick Limerick Ireland
- Health Research Institute University of Limerick Limerick Ireland
| | - Stephen Gallagher
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory University of Limerick Limerick Ireland
- Health Research Institute University of Limerick Limerick Ireland
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Brownlow BN. How Racism "Gets Under the Skin": An Examination of the Physical- and Mental-Health Costs of Culturally Compelled Coping. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2022; 18:576-596. [PMID: 36179058 DOI: 10.1177/17456916221113762] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Historically and contemporarily, Black Americans have been compelled to use effortful coping styles characterized by high behavioral and emotional restraint in the face of systematic racism. Lynch and colleagues have previously conceptualized a class of regulatory strategies-overcontrolled coping-characterized by emotional suppression, hypervigilance for threat, and high distress tolerance, which bear close analogy to coping styles frequently used among individuals facing chronic racial stress. However, given the inherent culture of racism in the United States, engaging in highly controlled coping strategies is often necessitated and adaptive, at least in the short term. Thus, for Black Americans this class of coping strategies is conceptualized as culturally compelled coping rather than overcontrolled coping. In the current article, I offer a critical examination of the literature and introduce a novel theoretical model-culturally compelled coping-that culturally translates selected components of Lynch's model. Cultural translation refers to considering how the meaning, function, and consequences of using overcontrolled coping strategies changes when considering how Black Americans exist and cope within a culture of systematic racism. Importantly, this model may offer broad implications for future research and treatment by contextualizing emotion regulation as a central mechanism, partially answering how racism "gets under the skin" and affects the health of Black Americans.
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Morais-Silva G, Gomes-de-Souza L, Costa-Ferreira W, Pavan JC, Crestani CC, Marin MT. Cardiovascular Reactivity to a Novel Stressor: Differences on Susceptible and Resilient Rats to Social Defeat Stress. Front Physiol 2022; 12:781447. [PMID: 35250603 PMCID: PMC8889071 DOI: 10.3389/fphys.2021.781447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Prolonged and heightened responses to stress are known factors that influence the development of mood disorders and cardiovascular diseases. Moreover, the coping strategies related to the experience of adverse events, i.e., resilience or the susceptibility to stress, are determinants for the individual risk of developing such diseases. Susceptible rats to the social defeat stress (SDS), identified by the social interaction test (SIT), show behavioral and cardiovascular alterations after SDS exposure that are not found in resilient rats. However, it is not elucidated yet how the cardiovascular system of susceptible and resilient phenotypes responds to a new stressor after SDS exposure. Thus, using the SDS exposure followed by the SIT, we evaluated heart rate, blood pressure (BP), tail skin temperature, and circulating corticosterone responses to an acute session of restraint stress in susceptible and resilient rats to SDS. Susceptible rats showed resting tachycardia and exaggerated BP response to restraint stress, while resilient rats did not present such alterations. In contrast, both phenotypes showed increased plasma corticosterone and a drop in tail skin temperature to restraint stress, which was similar to that observed in control animals. Our results revealed an increased cardiovascular reactivity in response to a new stressful stimulus in susceptible rats, which might be related to a greater risk for the development of cardiovascular diseases.
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Affiliation(s)
- Gessynger Morais-Silva
- Laboratory of Pharmacology, School of Pharmaceutical Sciences of Araraquara, São Paulo State University, Araraquara, Brazil
- Joint Graduate Program in Physiological Sciences (PIPGCF), UFSCar/UNESP, Araraquara, Brazil
| | - Lucas Gomes-de-Souza
- Laboratory of Pharmacology, School of Pharmaceutical Sciences of Araraquara, São Paulo State University, Araraquara, Brazil
- Joint Graduate Program in Physiological Sciences (PIPGCF), UFSCar/UNESP, Araraquara, Brazil
| | - Willian Costa-Ferreira
- Laboratory of Pharmacology, School of Pharmaceutical Sciences of Araraquara, São Paulo State University, Araraquara, Brazil
- Joint Graduate Program in Physiological Sciences (PIPGCF), UFSCar/UNESP, Araraquara, Brazil
| | - Jacqueline C. Pavan
- Laboratory of Pharmacology, School of Pharmaceutical Sciences of Araraquara, São Paulo State University, Araraquara, Brazil
| | - Carlos C. Crestani
- Laboratory of Pharmacology, School of Pharmaceutical Sciences of Araraquara, São Paulo State University, Araraquara, Brazil
- Joint Graduate Program in Physiological Sciences (PIPGCF), UFSCar/UNESP, Araraquara, Brazil
| | - Marcelo T. Marin
- Laboratory of Pharmacology, School of Pharmaceutical Sciences of Araraquara, São Paulo State University, Araraquara, Brazil
- Joint Graduate Program in Physiological Sciences (PIPGCF), UFSCar/UNESP, Araraquara, Brazil
- *Correspondence: Marcelo T. Marin,
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7
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Keogh TM, Howard S, Gallagher S. Early Life Adversity and Blunted Cardiovascular Reactivity to Acute Psychological Stress: The Role of Current Depressive Symptoms. Psychosom Med 2022; 84:170-178. [PMID: 34654025 DOI: 10.1097/psy.0000000000001024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The pathways underlying the early life adversity and cardiovascular reactivity association remain unclear. The current study examined the role of current depressive symptoms on this relationship. METHODS Mediation analyses were conducted using data from 639 participants drawn from the Midlife Development in the United States 2 Biomarker Project. Responses were derived from the Childhood Trauma Questionnaire and Center for Epidemiologic Studies Depression Scale. Participants had their systolic and diastolic blood pressure (SBP, DBP) and heart rate monitored throughout a standardized stress testing protocol. RESULTS The association between early life adversity and reactivity was mediated by current depressive symptoms; all adversity factors were linked to higher levels of current depressive symptoms, which, in turn, were associated with lower cardiovascular reactivity. For emotional abuse, this was noted for SBP (β = -0.06 [95% confidence interval {CI}, -0.13 to -0.01]) and DBP (β = -0.04 [-0.07 to -0.01]), physical abuse (SBP: β = -0.05 [-0.11 to -0.01]; DBP: β = -0.03 [-0.06 to -0.01]), sexual abuse (SBP: β = -0.04 [-0.09 to -0.01]; DBP: β = -0.02 [-0.05 to -0.01]), emotional neglect (SBP: β = -0.04 [-0.09 to -0.01]; DBP: β = -0.02 [-0.05 to -0.01]), physical neglect (SBP: β = -0.09 [-0.17 to -0.02]; DBP: β = -0.05 [-0.09 to -0.02]), and total Childhood Trauma Questionnaire score (SBP: β = -0.02 [-0.03 to -0.00]; DBP: β = -0.01 [-0.02 to -0.00]). CONCLUSIONS The present findings extend research and demonstrate that depression is an underlying mechanism linking early life adversity and blunted cardiovascular reactivity.
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Affiliation(s)
- Tracey M Keogh
- From the Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory (Keogh, Howard, Gallagher), and Health Research Institute (Keogh, Howard, Gallagher), University of Limerick, Castletroy, Limerick, Ireland
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Massardo T, Quintana JC, Jaimovich R, Sáez CG, Risco L, Liberman C, Araya AV, Galleguillos T, Castro-Mora G, Pereira J. Regional Brain Perfusion Is Associated with Endothelial Dysfunction Markers in Major Depressive Disorder. Neuropsychobiology 2021; 80:214-224. [PMID: 32726779 DOI: 10.1159/000508110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 04/20/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is an important independent risk factor for cardiovascular disease. Cumulative data suggest that depressive patients exhibit derangement in regional cerebral blood flow (rCBF), although underlying mechanisms remain mostly unknown. Endothelial dysfunction (ED), defined as different forms of abnormal endothelial activity, plays a key role in the pathogenesis of vascular disease. ED is associated with several clinical conditions characterized by high cardiovascular risk. Diverse ED markers have been found in mood disorders. PURPOSE To evaluate the association between rCBF and peripheral ED markers in MDD patients, at baseline and after selective serotonin receptor inhibitors (SSRIs) therapy. PATIENTS AND METHODS Twenty-seven untreated unipolar MDD patients in their first episode were evaluated with the Hamilton Depression Rating Scale (HAM-D) and brain perfusion SPECT at baseline and after 2 months of SSRIs. Statistical Parametric Mapping (SPM) was employed to evaluate rCBF; circulating endothelial cells (CECs), plasma soluble intercellular adhesion molecule (sICAM), and high-sensitivity C-reactive protein (hsCRP) were used as independent covariates. RESULTS Baseline CECs and sICAM were increased in MDD patients compared with matching controls (p = 0.0001) and hsCRP (p = 0.03). HAM-D scores (21 items) and CECs diminished after SSRI therapy in MDD patients (p < 0.0001). There was a significant rCBF decrease, mainly in deep central structures. HAM-D change was associated with rCBF decrease at the left amygdala, right striatum levels, and Brodmann area 25. CEC change was associated with rCBF at deep brain level and sICAM with large rCBF areas at the left caudate and tectum; hsCRP was associated, to a lesser extent, with the left dorsal striatum and mesencephalic tectum. CONCLUSION ED markers in patients with MDD are associated with significant changes in rCBF which are features of depression. These findings suggest that systemic damage/activation of the endothelium may contribute to the abnormal rCBF observed in MDD patients.
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Affiliation(s)
- Teresa Massardo
- Nuclear Medicine Section, Department of Medicine, University of Chile Clinical Hospital, Santiago, Chile
| | - Juan Carlos Quintana
- Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Jaimovich
- Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia G Sáez
- Department of Hematology-Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Risco
- Universitary Psychiatric Clinic, University of Chile Clinical Hospital, Santiago, Chile
| | - Claudio Liberman
- Endocrinology Section, Department of Medicine, University of Chile Clinical Hospital, Santiago, Chile
| | - Aída Verónica Araya
- Endocrinology Section, Department of Medicine, University of Chile Clinical Hospital, Santiago, Chile
| | - Tamara Galleguillos
- Universitary Psychiatric Clinic, University of Chile Clinical Hospital, Santiago, Chile
| | - Gabriel Castro-Mora
- Nuclear Medicine Section, Department of Medicine, University of Chile Clinical Hospital, Santiago, Chile
| | - Jaime Pereira
- Department of Hematology-Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,
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Nelson BW, Sheeber L, Pfeifer JH, Allen NB. Affective and Autonomic Reactivity During Parent-Child Interactions in Depressed and Non-Depressed Mothers and Their Adolescent Offspring. Res Child Adolesc Psychopathol 2021; 49:1513-1526. [PMID: 34142271 PMCID: PMC8483768 DOI: 10.1007/s10802-021-00840-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 12/28/2022]
Abstract
Depression presents risks that are profound and intergenerational, yet research on the association of depression with the physiological processes that might be associated with impaired mental and physical health has only recently been contextualized within the family environment. Participants in this multi-method case-control study were 180 mother-adolescent dyads (50% mothers with a history of depression treatment and current depressive symptoms). In order to examine the association between maternal depression and affective and autonomic reactivity amongst these mothers and their adolescent offspring we collected self-reported measures of positive and negative affect, as well as measures of cardiovascular and electrodermal autonomic activity, during mother-adolescent interaction tasks. Findings indicated that depressed mothers and their adolescent offspring exhibited greater self-reported negative affect reactivity during a problem-solving interaction and blunted (i.e., low) sympathetic activity as measured via skin conductance level across both interaction tasks. These effects remained significant after controlling for a range of potential covariates, including medication use, sex, age, adolescents own mental health symptoms, and behavior of the other interactant, along with correcting for multiple comparisons. Findings indicate that depressed mothers and their adolescent offspring both exhibit patterns of affect and physiology during interactions that are different from those of non-depressed mothers and their offspring, including increased negative affect reactivity during negative interactions and blunted sympathetic activity across both positive and negative interactions. These findings have potential implications for understanding the role of family processes in the intergenerational transmission of risk for depressive disorders.
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Affiliation(s)
- Benjamin W Nelson
- Department of Psychology, University of Oregon, Eugene, OR, USA.
- Oregon Research Institute, Eugene, OR, USA.
- School of Medicine, University of Washington, Seattle, WA, USA.
- Department of Psychology, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA.
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Calvi A, Fischetti I, Verzicco I, Belvederi Murri M, Zanetidou S, Volpi R, Coghi P, Tedeschi S, Amore M, Cabassi A. Antidepressant Drugs Effects on Blood Pressure. Front Cardiovasc Med 2021; 8:704281. [PMID: 34414219 PMCID: PMC8370473 DOI: 10.3389/fcvm.2021.704281] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 06/28/2021] [Indexed: 11/16/2022] Open
Abstract
Individuals suffering from depressive disorders display a greater incidence of hypertension compared with the general population, despite reports of the association between depression and hypotension. This phenomenon may depend, at least in part, on the use of antidepressant drugs, which may influence blood pressure through different effects on adrenergic and serotoninergic pathways, as well as on histaminergic, dopaminergic, and cholinergic systems. This review summarizes extant literature on the effect of antidepressant drugs on blood pressure. Selective serotonin reuptake inhibitors are characterized by limited effects on autonomic system activity and a lower impact on blood pressure. Thus, they represent the safest class—particularly among elderly and cardiovascular patients. Serotonin–norepinephrine reuptake inhibitors, particularly venlafaxine, carry a greater risk of hypertension, possibly related to greater effects on the sympathetic nervous system. The norepinephrine reuptake inhibitor reboxetine is considered a safe option because of its neutral effects on blood pressure in long-term studies, even if both hypotensive and hypertensive effects are reported. The dopamine–norepinephrine reuptake inhibitor bupropion can lead to blood pressure increases, usually at high doses, but may also cause orthostatic hypotension, especially in patients with cardiovascular diseases. The norepinephrine–serotonin modulators, mirtazapine and mianserin, have minimal effects on blood pressure but may rarely lead to orthostatic hypotension and falls. These adverse effects are also observed with the serotonin-reuptake modulators, nefazodone and trazodone, but seldomly with vortioxetine and vilazodone. Agomelatine, the only melatonergic antidepressant drug, may also have limited effects on blood pressure. Tricyclic antidepressants have been associated with increases in blood pressure, as well as orthostatic hypotension, particularly imipramine. Oral monoamine–oxidase inhibitors, less frequently skin patch formulations, have been associated with orthostatic hypotension or, conversely, with hypertensive crisis due to ingestion of tyramine-containing food (i.e., cheese reaction). Lastly, a hypertensive crisis may complicate antidepressant treatment as a part of the serotonin syndrome, also including neuromuscular, cognitive, and autonomic dysfunctions. Clinicians treating depressive patients should carefully consider their blood pressure status and cardiovascular comorbidities because of the effects of antidepressant drugs on blood pressure profiles and potential interactions with antihypertensive treatments.
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Affiliation(s)
- Anna Calvi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Ilaria Fischetti
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Ignazio Verzicco
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Martino Belvederi Murri
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Stamatula Zanetidou
- Research Group on Mental and Physical Health of the Elderly (ARISMA), Bologna, Italy
| | - Riccardo Volpi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Pietro Coghi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Stefano Tedeschi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics, and Infant-Maternal Science, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Aderville Cabassi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
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Abstract
OBJECTIVE Decades of research suggest that there may be important ethnic differences in the hemodynamic mechanisms that co-determine arterial blood pressure, the primary diagnostic index of hypertension. In general, studies have observed that, compared with European Americans (EAs), African Americans (AAs) exhibit higher total peripheral resistance (TPR), an important summative index of peripheral vascular constriction. In contrast, EAs have been reliably shown to exhibit greater cardiac output (CO), which is directly linked to left ventricle and overall cardiac blood flow. We have previously proposed that elevated basal TPR, in particular, represents one component of the cardiovascular conundrum, characterized, paradoxically, by elevated resting heart rate variability among AAs relative to EAs. The present meta-analysis and systematic review of the literature sought to extend this previous work by establishing the magnitude of the empirically implied ethnic differences in resting TPR and CO. METHODS A search of the literature yielded 140 abstracts on differences in TPR between AAs and EAs; 40 were included. Sample sizes, means, and standard deviations for baseline TPR with samples that included EAs and AAs were collected, and Hedges g was computed. RESULTS Findings indicated that AAs had higher baseline TPR than did EAs (Hedges g = 0.307, SE = 0.043, confidence interval= 0.224 to 0.391, p < .001). In addition, EAs had higher resting CO than did AAs (Hedges g = -0.214, SE = 0.056, confidence interval = -0.324 to -0.104, p < .001). CONCLUSIONS We discuss the present findings in the context of the role of elevated TPR in the deleterious effects of high blood pressure specifically for AAs.
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12
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Bair A, Marksteiner J, Falch R, Ettinger U, Reyes Del Paso GA, Duschek S. Features of autonomic cardiovascular control during cognition in major depressive disorder. Psychophysiology 2020; 58:e13628. [PMID: 32621782 DOI: 10.1111/psyp.13628] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 11/27/2022]
Abstract
Previous research has suggested reduced parasympathetic cardiac regulation during cognitive activity in major depressive disorder (MDD). However, little is known about possible abnormalities in sympathetic control and cardiovascular reactivity. This study aimed to provide a comprehensive analysis of autonomic cardiovascular control in the context of executive functions in MDD. Thirty six MDD patients and 39 healthy controls participated. Parameters of sympathetic (pre-ejection period, PEP) and parasympathetic control (high and low frequency heart rate variability, HF HRV, LF HRV; and baroreflex sensitivity, BRS) as well as RR interval were obtained at rest and during performance of executive function tasks (number-letter task, n-back task, continuous performance test, and Stroop task). Patients, as compared to controls, exhibited lower HF HRV and LF HRV during task execution and smaller shortenings in PEP and RR interval between baseline and tasks. They displayed longer reaction times during all conditions of the tasks and more omission errors and false alarms on the continuous performance test. In the total sample, on-task HF HRV, LF HRV and BRS, and reactivity in HF HRV, LF HRV, and PEP, were positively associated with task performance. As performance reduction arose independent of executive function load of the tasks, the behavioral results reflect impairments in attention and processing speed rather than executive dysfunctions in MDD. Abnormalities in cardiovascular control during cognition in MDD appear to involve both divisions of the autonomic nervous system. Low tonic parasympathetic control and blunted sympathetic reactivity imply reduced physiological adjustment resources and, by extension, provide suboptimal conditions for cognitive performance.
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Affiliation(s)
- Angela Bair
- Institute of Psychology, UMIT - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Josef Marksteiner
- Department of Psychiatry, County Hospital of Hall in Tirol, Hall in Tirol, Austria
| | - Reingard Falch
- Department of Psychiatry, County Hospital of Hall in Tirol, Hall in Tirol, Austria
| | | | | | - Stefan Duschek
- Institute of Psychology, UMIT - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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13
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Orthostatic hypotension and health-related quality of life among community-living older people in Korea. Qual Life Res 2019; 29:303-312. [PMID: 31515746 DOI: 10.1007/s11136-019-02295-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the association of orthostatic hypotension (OH) with health-related quality of life (HRQoL) in older people living in the community. METHODS A cross-sectional design was used. A total of 217 participants aged 65 and older were classified as having OH if their systolic or diastolic blood pressure showed a drop of ≥ 20 mmHg systolic blood pressure or ≥ 10 mmHg diastolic blood pressure, respectively, within 3 min of standing. Participants provided demographic and medical information and responded to questionnaires about their HRQoL (EuroQoL-5D-3L), as well as depression, anxiety, cognitive function, and recent physical activities. RESULTS The number of participants with OH was 117, and those without OH numbered 100. The mean HRQoL levels were 0.56 (SD 0.29) in the OH group and 0.74 (SD 0.25) in the non-OH group (p < .001). Participants with OH were more likely to be older, women, and smokers. These participants had fewer years of education, a greater history of stroke and hypertension, and a greater number of comorbidities. The absence of OH, a higher physical activity level, a lower degree of depression, an absence of stroke history, and younger age were all significant determinants of greater HRQoL. CONCLUSIONS The level of HRQoL of older people with OH was significantly lower than that of older people without. The presence of OH was an independent determinant of HRQoL in older adults after adjusting for covariates. This finding suggests that strategies for relieving OH could improve HRQoL in affected older adults.
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14
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Li J, Yang Y, Zhu Y, Zhou L, Han Y, Yin T, Cheng Z, Zhang G, Shen Y, Chen J. Towards characterizing the regional cerebral perfusion in evaluating the severity of major depression disorder with SPECT/CT. BMC Psychiatry 2018; 18:70. [PMID: 29562903 PMCID: PMC5863480 DOI: 10.1186/s12888-018-1654-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 03/08/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a common mental disorder worldwide, but now there is a lack of clinically effective assessment and management of MDD. In this study, we used technetium-99 m ethylcysteinate dimer ([99mTc]ECD) SPECT/CT to characterize the regional cerebral blood flow (rCBF) status of MDD patients, and to explore an objective image assessment model of MDD which is non- or minimally-invasive, convenient and accurate in a clinical setting. METHODS The severity of MDD was assessed by three trained psychiatrists, based on scores obtained from HAMD and HAMA. [99mTc]ECD rCBF SPECT/CT was performed in 20 healthy controls and 74 unipolar MDD patients before receiving the treatment. The CT attenuation-corrected SPECT images data were automatically registered, analyzed simultaneously by 3D-SSP and eZIS. RESULTS The mean score of HAMD and HAMA in the MDD patients was 25.49 ± 6.00, and 23.12 ± 5.83, respectively. There was a positive correlation between two scores. The MDD women had higher HAMD scores than MDD men. The decreased rCBF of MDD patients in frontal lobes (bilateral B11, B47 and right B4, B6, B10, B46), temporal lobe (right B21, B41, B42) and cingulated cortex (bilateral B24, B33), while their increased rCBF in occipital lobe (bilateral B17, B19 and left B18). Additionally, the depression severity was negatively correlated with decreased rCBF in left ventral anterior cingulate cortex B24, and was positively correlated with decreased rCBF in left inferior prefrontal gyrus B47 and increased rCBF in right associative visual cortex B19. The anxiety severity was negatively correlated with decreased rCBF in left subgenual cortex B25. CONCLUSIONS Although the mechanism underlying the correlation is not yet fully understood, our findings indicated that the rCBF SPECT/CT may provide an objective assessment for MDD severity. It might be used monitoring therapeutic efficacy in the management of MDD.
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Affiliation(s)
- Jinming Li
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China ,0000 0004 1758 2270grid.412632.0Department of Nuclear Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei Province 430060 China
| | - Yuan Yang
- 0000 0004 0368 7223grid.33199.31Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Yuankai Zhu
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Liqiang Zhou
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Yunfeng Han
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Tao Yin
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Zhaoting Cheng
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Guopeng Zhang
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Yanxia Shen
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Jing Chen
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, China.
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15
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Haj Kheder S, Heller J, Bär JK, Wutzler A, Menge BA, Juckel G. Autonomic dysfunction of gastric motility in major depression. J Affect Disord 2018; 226:196-202. [PMID: 28992583 DOI: 10.1016/j.jad.2017.09.049] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 08/14/2017] [Accepted: 09/24/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patients suffering from major depressive disorder (MDD) often complain about somatic symptoms. Cardiac complaints have been examined predominantly. However, gastrointestinal complaints are also reported frequently and are associated with worse outcomes. The research concerning changes in gastric motility of these patients is rather sparse. The aim of our study was to determine dysfunction of gastric motility and gastrointestinal symptoms in MDD. The duration and severity of MDD were examined regarding its influence over gastric emptying. METHODS Gastric emptying was determined by a 13C-acetate breath test in patients with MDD (n = 29) and healthy control subjects (n = 51). Prior to this, depressive illness was operationalized using external and self-assessment scales (HAMD-21, MADRS, BDI, CGI). Whether the severity or duration of MDD influenced the gastric emptying parameters was examined using Spearman's correlation. In addition, autonomic complaints were recorded by means of an ANS score. Each ANS score item was determined using a Mann-Whitney U or Kruskal-Wallis test concerning the gastric emptying parameters. RESULTS There was a significant difference in the parameters of the maximum gastric emptying rate (Tmax) and gastric half emptying time T1/2b between patients with MDD and healthy control subjects (Tmax 66.21min vs 53.35min, p < 0.006, T1/2b 207.59min vs 133.27min, p < 0.005). There was a significant negative correlation between Tmax and the severity of MDD determined with the depression rating scales BDI (Spearman's rank - 0.521, p = 0.013) and HAMD-21 (r - 0.384, p = 0.048). No correlation was found between the duration of MDD and the maximum gastric emptying rate (r - 0.125, p = 0.519) and gastric half emptying time (r - 0.62, p = 0.749). CONCLUSION Gastrointestinal motility is significantly impaired in patients with MDD compared to healthy control subjects. Autonomic complaints were indicated frequently in MDD patients. The duration of MDD had no influence over the time of gastric emptying. There was a significant negative correlation between the severity of MDD and Tmax, indicating that the Tmax was reached earlier with the progression of MDD. The slowing of gastric motility in MDD patients is likely a result of a dysfunction of the autonomic nervous system.
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Affiliation(s)
- S Haj Kheder
- Department of Medicine II, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
| | - J Heller
- LWL-Clinic for Forensic Psychiatry, Herne, Germany
| | - J K Bär
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - A Wutzler
- Department of Medicine II, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - B A Menge
- Department of Medicine I, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - G Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
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16
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Park JH. Vascular Contributions to Late Life Depression. Curr Behav Neurosci Rep 2017. [DOI: 10.1007/s40473-017-0128-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Hoffmann A, Ettinger U, Reyes del Paso GA, Duschek S. Executive function and cardiac autonomic regulation in depressive disorders. Brain Cogn 2017; 118:108-117. [DOI: 10.1016/j.bandc.2017.08.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 08/03/2017] [Accepted: 08/09/2017] [Indexed: 11/28/2022]
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18
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Lucas-Thompson RG, Lunkenheimer ES, Granger DA. Adolescent Conflict Appraisals Moderate the Link Between Marital Conflict and Physiological Stress Reactivity. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2017; 27:173-188. [PMID: 28498527 DOI: 10.1111/jora.12264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The goal of this study was to advance understanding of how adolescent conflict appraisals contribute uniquely, and in combination with interparental conflict behavior, to individual differences in adolescent physiological reactivity. Saliva samples were collected from 153 adolescents (52% female; ages 10-17 years) before and after the Trier Social Stress Test. Saliva was assayed for cortisol and alpha-amylase. Results revealed interactive effects between marital conflict and conflict appraisals. For youth who appraised parental conflict negatively (particularly as threatening), negative marital conflict predicted dampened reactivity; for youth who appraised parental conflict less negatively, negative marital conflict predicted heightened reactivity. These findings support the notion that the family context and youth appraisals of family relationships are linked with individual differences in biological sensitivity to context.
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Affiliation(s)
| | | | - Douglas A Granger
- Arizona State University
- Johns Hopkins University
- University of Nebraska
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19
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Duschek S, Hoffmann A, Reyes Del Paso GA. Affective impairment in chronic low blood pressure. J Psychosom Res 2017; 93:33-40. [PMID: 28107890 DOI: 10.1016/j.jpsychores.2016.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 11/21/2016] [Accepted: 12/10/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Physical complaints such as faintness, dizziness, cold limbs and headaches have been well-established in chronic low blood pressure (hypotension). This study investigated the occurrence of adverse emotional states and the symptoms of depression in this condition. As autonomic dysregulation, particularly diminished sympathetic tone, is believed to be involved in the etiology of hypotension, the impact of different facets of autonomic cardiovascular control on mood and depressive symptoms was also explored. METHODS Forty individuals with chronic hypotension and forty normotensive control persons were presented with the Mood Scale and Beck Depression Inventory. Stroke volume, cardiac output, pre-ejection period, Heather index and aortic peak blood flow velocity were recorded under resting conditions as indices of beta-adrenergic inotropic drive. Respiratory sinus arrhythmia and baroreflex sensitivity were additionally obtained. RESULTS Hypotensive individuals scored markedly higher on both questionnaire scales than controls, indicating an adversely affected emotional state and more severe depressive symptoms. In the entire sample, cardiac output, Heather index, and aortic peak blood flow velocity correlated negatively with the questionnaire scores; according to regression analysis, the Heather index explained the largest proportion of test score variance. CONCLUSION Although hypotension does not constitute a serious medical condition, the findings of an adverse affective state and increased burden with depressive symptoms corroborate the view that it can have a considerable impact on wellbeing and quality of life. The correlations of the beta-adrenergic indices with the questionnaire scales indicate that cardiac sympathetic regulation plays a key role in the psychophysiological mediation of hypotension-related mood impairment.
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Affiliation(s)
- Stefan Duschek
- UMIT - University of Health Sciences Medical Informatics and Technology, Institute of Psychology, Austria.
| | - Alexandra Hoffmann
- UMIT - University of Health Sciences Medical Informatics and Technology, Institute of Psychology, Austria
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20
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Yuenyongchaiwat K, Baker IS, Sheffield D. Symptoms of anxiety and depression are related to cardiovascular responses to active, but not passive, coping tasks. ACTA ACUST UNITED AC 2016; 39:110-117. [PMID: 27828668 PMCID: PMC7111443 DOI: 10.1590/1516-4446-2016-1935] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 06/01/2016] [Indexed: 12/02/2022]
Abstract
Objective: Anxiety and depression have been linked to blunted blood pressure (BP) and heart rate (HR) reactions to mental stress tests; however, most studies have not included indices of underlying hemodynamics nor multiple stress tasks. This study sought to examine the relationships of anxiety and depression with hemodynamic responses to acute active and passive coping tasks. Methods: A total of 104 participants completed the Hospital Anxiety and Depression Scales and mental arithmetic, speech, and cold pressor tasks while BP, HR, total peripheral resistance, and cardiac output (CO) were assessed. Results: After adjustment for traditional risk factors and baseline cardiovascular activity, depression scores were negatively associated with systolic BP, HR, and CO responses to the mental arithmetic task, while anxiety scores were inversely related to the systolic BP response to mental arithmetic. Conclusion: High anxiety or depression scores appear to be associated with blunted cardiac reactions to mental arithmetic (an active coping task), but not to the cold pressor test or speech tasks. Future research should further examine potential mechanisms and longitudinal pathways relating depression and anxiety to cardiovascular reactivity. Clinical trial registration number: TCTR20160208004
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Affiliation(s)
| | - Ian S Baker
- Centre for Psychological Research, Faculty of Education, Health and Sciences, University of Derby, United Kingdom
| | - David Sheffield
- Centre for Psychological Research, Faculty of Education, Health and Sciences, University of Derby, United Kingdom
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21
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Hamilton JL, Alloy LB. Atypical reactivity of heart rate variability to stress and depression across development: Systematic review of the literature and directions for future research. Clin Psychol Rev 2016; 50:67-79. [PMID: 27697746 DOI: 10.1016/j.cpr.2016.09.003] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 07/29/2016] [Accepted: 09/17/2016] [Indexed: 11/26/2022]
Abstract
Heart rate variability has received growing attention in the depression literature, with several recent meta-analyses indicating that lower resting heart rate variability is associated with depression. However, the role of fluctuations in heart rate variability (or reactivity) in response to stress in depression remains less clear. The present review provides a systematic examination of the literature on heart rate variability reactivity to a laboratory-induced stressor task and depression, including 26 studies of reactivity in heart rate variability and clinical depression, remitted (or history of) depression, and subthreshold depression (or symptom-level depression) among adults, adolescents, and children. In addition to reviewing the findings of these studies, methodological considerations and conceptual gaps in the literature are addressed. We conclude by highlighting the importance of investigating the potential transactional relationship between heart rate variability reactivity and depression and possible mechanisms underlying this relationship.
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Affiliation(s)
- Jessica L Hamilton
- Temple University, Department of Psychology, 1701 N. 13th St., Philadelphia, PA 19122, United States.
| | - Lauren B Alloy
- Temple University, Department of Psychology, 1701 N. 13th St., Philadelphia, PA 19122, United States
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22
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Silvia PJ, Mironovová Z, McHone AN, Sperry SH, Harper KL, Kwapil TR, Eddington KM. Do depressive symptoms "blunt" effort? An analysis of cardiac engagement and withdrawal for an increasingly difficult task. Biol Psychol 2016; 118:52-60. [PMID: 27174723 PMCID: PMC4956535 DOI: 10.1016/j.biopsycho.2016.04.068] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 04/21/2016] [Accepted: 04/27/2016] [Indexed: 01/29/2023]
Abstract
Research on depression and effort has suggested "depressive blunting"-lower cardiovascular reactivity in response to challenges and stressors. Many studies, however, find null effects or higher reactivity. The present research draws upon motivational intensity theory, a broad model of effort that predicts cases in which depressive symptoms should increase or decrease effort. Because depressive symptoms can influence task-difficulty appraisals-people see tasks as subjectively harder-people high in depressive symptoms should engage higher effort at objectively easier levels of difficulty but also quit sooner. A sample of adults completed a mental effort challenge with four levels of difficulty, from very easy to difficult-but-feasible. Depressive symptoms were assessed with the CESD and DASS; effort-related cardiac activity was assessed via markers of contractility (e.g., the cardiac pre-ejection period [PEP]) obtained with impedance cardiography. The findings supported the theory's predictions. When the task was relatively easier, people high in depressive symptoms showed higher contractility (shorter PEP), consistent with greater effort. When the task was relatively harder, people high in depressive symptoms showed diminished contractility, consistent with quitting. The results suggest that past research has been observing a small part of a larger trajectory of trying and quitting, and they illustrate the value of a theoretically grounded analysis of depressive symptoms and effort-related cardiac activity.
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Affiliation(s)
- Paul J Silvia
- Department of Psychology, University of North Carolina at Greensboro, United States.
| | - Zuzana Mironovová
- Department of Psychology, University of North Carolina at Greensboro, United States
| | - Ashley N McHone
- Department of Psychology, University of North Carolina at Greensboro, United States
| | - Sarah H Sperry
- Department of Psychology, University of North Carolina at Greensboro, United States
| | - Kelly L Harper
- Department of Psychology, University of North Carolina at Greensboro, United States
| | - Thomas R Kwapil
- Department of Psychology, University of North Carolina at Greensboro, United States
| | - Kari M Eddington
- Department of Psychology, University of North Carolina at Greensboro, United States
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23
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Cardiac Vagal Control and Depressive Symptoms in Response to Negative Emotional Stress. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016. [DOI: 10.1007/5584_2016_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register]
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24
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Role of peripheral vascular resistance for the association between major depression and cardiovascular disease. J Cardiovasc Pharmacol 2016; 65:299-307. [PMID: 25469807 PMCID: PMC4415957 DOI: 10.1097/fjc.0000000000000187] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Major depression and cardiovascular diseases are 2 of the most prevalent health problems in Western society, and an association between them is generally accepted. Although the specific mechanism behind this comorbidity remains to be elucidated, it is clear that it has a complex multifactorial character including a number of neuronal, humoral, immune, and circulatory pathways. Depression-associated cardiovascular abnormalities associate with cardiac dysfunctions and with changes in peripheral resistance. Although cardiac dysfunction in association with depression has been studied in detail, little attention was given to structural and functional changes in resistance arteries responsible for blood pressure control and tissue perfusion. This review discusses recent achievements in studies of depression-associated abnormalities in resistance arteries in humans and animal experimental models. The changes in arterial structure, contractile and relaxing functions associated with depression symptoms are discussed, and the role of these abnormalities for the pathology of major depression and cardiovascular diseases are suggested.
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25
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Robertson SMC, Swickert RJ, Connelly K, Galizio A. Physiological reactivity during autobiographical narratives in older adults: the roles of depression and anxiety. Aging Ment Health 2016; 19:689-97. [PMID: 25289681 DOI: 10.1080/13607863.2014.962010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Physiological reactivity (PR) describes the change in physiological functioning (e.g., heart rate, blood pressure, pulse pressure) that occurs after the induction of a stressful task. This study aims to understand the influence of mental health symptoms on patterns of PR during autobiographical narratives in an older adult sample. METHOD Eighty older adults completed self-report measures regarding their symptoms of depression and anxiety. Next, their blood pressure was recorded while they completed two verbal autobiographical narratives. RESULTS During the positive narrative, anxiety was positively associated with increased PR while depression was negatively associated with PR. During the negative narrative, a significant interaction occurred whereby anxiety was significantly positively associated with PR for those participants low in depression. DISCUSSION The above results are explained in the context of the Tripartite Model of Depression and Anxiety, which predicts different patterns of PR as a function of mental health symptoms. Limitations and future directions are also discussed.
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26
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Puig-Perez S, Villada C, Pulopulos MM, Hidalgo V, Salvador A. How are neuroticism and depression related to the psychophysiological stress response to acute stress in healthy older people? Physiol Behav 2016; 156:128-36. [PMID: 26780150 DOI: 10.1016/j.physbeh.2016.01.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/12/2016] [Accepted: 01/13/2016] [Indexed: 01/07/2023]
Abstract
Neuroticism and depressive symptomatology have been related to a heightened and diminished physiological stress response, which may partly explain their negative relationship with health and wellbeing. Identifying factors that may increase disease vulnerability is especially relevant in older people, whose physiological systems decline. With this in mind, we investigated the influence of neuroticism and depression on the psychophysiological stress response in healthy older people (from 55 to 76years old). A total of 36 volunteers were exposed to a stressful task (Trier Social Stress Test, TSST), while 35 volunteers performed a control non-stressful task. The physiological stress response was assessed through measures of cortisol, alpha-amylase, heart rate (HR). Our results showed that, neuroticism was not related to physiological stress response. However, depression was related to higher cortisol response and lower HR reactivity in the stress condition. In summary, emotional states such as depressive mood seem to amplify the cortisol stress response and reduce the cardiovascular response, whereas more stable dispositions such as neuroticism did not affect stress response in older people. These findings confirm, in healthy older people, the adverse effects of depression, acting on different subsystems of the stress response.
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Affiliation(s)
- Sara Puig-Perez
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Avd. Blasco Ibáñez, 21, 46010 Valencia, Spain.
| | - Carolina Villada
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Avd. Blasco Ibáñez, 21, 46010 Valencia, Spain
| | - Matias M Pulopulos
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Avd. Blasco Ibáñez, 21, 46010 Valencia, Spain
| | - Vanesa Hidalgo
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Avd. Blasco Ibáñez, 21, 46010 Valencia, Spain
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Avd. Blasco Ibáñez, 21, 46010 Valencia, Spain
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Wang MY, Chiu CH, Lee HC, Su CT, Tsai PS. Cardiovascular Reactivity in Patients With Major Depressive Disorder With High- or Low-Level Depressive Symptoms. Biol Res Nurs 2015; 18:221-9. [DOI: 10.1177/1099800415596227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Depression increases the risk of adverse cardiac events. Cardiovascular reactivity is defined as the pattern of cardiovascular responses to mental stress. An altered pattern of cardiovascular reactivity is an indicator of subsequent cardiovascular disease. Because depression and adverse cardiac events may have a dose-dependent association, this study examined the differences in cardiovascular reactivity to mental stress between patients with major depressive disorder (MDD) with high depression levels and those with low depression levels. Moreover, autonomic nervous system regulation is a highly plausible biological mechanism for the pattern of cardiovascular reactivity to mental stress. The association between cardiovascular reactivity and parameters of heart rate variability (HRV), an index for quantifying autonomic nervous system activity modulation, was thus examined. This study included 88 patients with MDD. HRV was measured before stress induction. The Stroop Color and Word Test and mirror star-tracing task were used to induce mental stress. We observed no significant association between depressive symptom level and any of the cardiovascular reactivity parameters. Cardiovascular reactivity to mental stress was comparable between patients with MDD with high-level depressive symptoms and those with low-level depressive symptoms. After adjusting for confounding variables, the high-frequency domain of HRV was found to be an independent predictor of the magnitude of heart rate reactivity (β = −.33, p = .002). In conclusion, the magnitude of cardiovascular reactivity may be independent of depression severity in patients with MDD. The autonomic regulation of cardiovascular responses to mental stress primarily influences heart rate reactivity in patients with MDD.
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Affiliation(s)
- Mei-Yeh Wang
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, New Taipei City, Taiwan
| | - Chen-Huan Chiu
- Department of Community Psychiatry, Taipei City Psychiatric Center, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry & Sleep Center, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chien-Tien Su
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Pei-Shan Tsai
- Graduate Institutes of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Sleep Science Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Nursing, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan
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Reklaitiene R, Grazuleviciene R, Dedele A, Virviciute D, Vensloviene J, Tamosiunas A, Baceviciene M, Luksiene D, Sapranaviciute-Zabazlajeva L, Radisauskas R, Bernotiene G, Bobak M, Nieuwenhuijsen MJ. The relationship of green space, depressive symptoms and perceived general health in urban population. Scand J Public Health 2014; 42:669-76. [DOI: 10.1177/1403494814544494] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims:To assess the relationship between green space proximity, use of green space and depressive symptoms and perceived general health among a random sample men and women. Methods: Cross-sectional study of a population-based sample of 6,944 45–72 year old Kaunas city residents. Self-reported questionnaires provided information on sociodemographic variables, health behaviours, depressive symptoms and poor and very poor perceived general health. Residential proximity to green spaces was defined as living less than 300 m, within interval of 300–999 m, and equal or more than 1 km from a park. The use of the park was divided into two categories: no park use or use <4hrs/week and use of the park ≥4 h/week. The study received approval from the Kaunas Regional Research Ethics Committee. Multiple logistic regression assessed the associations controlling for confounding variables. Results: The prevalence of depressive symptoms and poor and or very poor perceived general health was higher in women than in men. The association between the use of the park and residential proximity to the park revealed that women living >300 m from a green space and who used the space ≥4 h/week showed higher odds 1.92 (1.11–3.3) and 1.68 (0.81–3.48) of depressive symptoms and poor and very poor perceived general health as compared to those who used the park <4 hrs/week and residential proximity was >300 m. Conclusions: The results of our study confirmed an association between use of the green space, residential proximity, and depressive symptoms and poor and very poor perceived general health among women only.
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Affiliation(s)
- Regina Reklaitiene
- Lithuanian University of Health Sciences, Academy of Medicine, Institute of Cardiology, Kaunas, Lithuania
| | | | - Audrius Dedele
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Dalia Virviciute
- Lithuanian University of Health Sciences, Academy of Medicine, Institute of Cardiology, Kaunas, Lithuania
| | - Jone Vensloviene
- Lithuanian University of Health Sciences, Academy of Medicine, Institute of Cardiology, Kaunas, Lithuania
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Abdonas Tamosiunas
- Lithuanian University of Health Sciences, Academy of Medicine, Institute of Cardiology, Kaunas, Lithuania
| | - Migle Baceviciene
- Lithuanian University of Health Sciences, Academy of Medicine, Institute of Cardiology, Kaunas, Lithuania
| | - Dalia Luksiene
- Lithuanian University of Health Sciences, Academy of Medicine, Institute of Cardiology, Kaunas, Lithuania
| | | | - Ricardas Radisauskas
- Lithuanian University of Health Sciences, Academy of Medicine, Institute of Cardiology, Kaunas, Lithuania
| | - Gailute Bernotiene
- Lithuanian University of Health Sciences, Academy of Medicine, Institute of Cardiology, Kaunas, Lithuania
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Mark J Nieuwenhuijsen
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain, Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain, CIBER Epidemiologia y Salud Publica (CIBERESP), Spain
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A Review of the Etiology, Asssociated Comorbidities, and Treatment of Orthostatic Hypotension. Am J Ther 2013; 20:279-91. [DOI: 10.1097/mjt.0b013e31828bfb7f] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lin HP, Lin HY, Lin WL, Huang ACW. Effects of stress, depression, and their interaction on heart rate, skin conductance, finger temperature, and respiratory rate: sympathetic-parasympathetic hypothesis of stress and depression. J Clin Psychol 2011; 67:1080-91. [PMID: 21905026 DOI: 10.1002/jclp.20833] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We examined effects of stress, depression, and their interaction on sympathetic-parasympathetic responses, including percentage heart rate (PHR), percentage skin conductance (PSC), percentage finger temperature (PTEMP), and percentage respiratory rate (PRESPR). Participants were categorized into normal, low-risk, and high-risk depression groups under stress or no-stress by measuring psychophysiological responses. Stress increased PHR and PSC and decreased PTEMP. Depression negatively correlated with PHR and PTEMP. PSC and PTEMP were significantly dependent on and positively correlated with depression. PTEMP was significantly affected by the stress and depression interaction. Stress affects sympathetic, rather than parasympathetic, activity. Depression and the interaction between stress and depression initially associated with the sympathetic division and are then correlated with parasympathetic activity. A sympathetic-parasympathetic hypothesis and its clinical implications are discussed.
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Affiliation(s)
- Hsiao-Pei Lin
- Department of Psychology, Fo Guang University, Taiwan
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A review of orthostatic blood pressure regulation and its association with mood and cognition. Clin Auton Res 2011; 22:99-107. [PMID: 21948454 DOI: 10.1007/s10286-011-0145-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2010] [Accepted: 08/24/2011] [Indexed: 10/17/2022]
Abstract
AIMS This paper will review literature that examines the psychological and neuropsychological correlates of orthostatic blood pressure regulation. RESULTS The pattern of change in systolic blood pressure in response to the shift from supine to upright posture reflects the adequacy of orthostatic regulation. Orthostatic integrity involves the skeletal muscle pump, neurovascular compensation, neurohumoral effects and cerebral flow regulation. Various physiological states and disease conditions may disrupt these mechanisms. Clinical and subclinical orthostatic hypotension has been associated with impaired cognitive function, decreased effort, reduced motivation and increased hopelessness as well as dementia, diabetes mellitus, and Parkinson's disease. Furthermore, inadequate blood pressure regulation in response to orthostasis has been linked to increased depression and anxiety as well as to intergenerational behavioral sequalae. CONCLUSIONS Identifying possible causes and consequences of subclinical and clinical OH are critical in improving quality of life for both children and older adults.
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Hawkins MAW, Stewart JC, Fitzgerald GJ, Kim S. Combined effect of depressive symptoms and hostility on autonomic nervous system function. Int J Psychophysiol 2011; 81:317-23. [PMID: 21851841 DOI: 10.1016/j.ijpsycho.2011.07.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 07/25/2011] [Accepted: 07/29/2011] [Indexed: 12/30/2022]
Abstract
Depression and hostility have been separately related to indicators of sympathetic hyperactivation and parasympathetic hypoactivation. We examined the associations of depressive symptoms, hostility, and their interaction with pre-ejection period (PEP) and high frequency heart rate variability (HRV), specific indices of sympathetic and parasympathetic cardiac control, respectively. Healthy, young adults (N=120) completed questionnaires assessing depressive symptoms and hostility and underwent autonomic testing. Although main effects were not observed, a depressive symptoms×hostility interaction was detected for PEP (β=.25, p=.01). Simple slope analyses revealed that hostility was negatively related to PEP among individuals with low depressive symptoms but was not associated with PEP among those with mild-to-moderate depressive symptoms. No interaction effect was detected for high frequency HRV. Our findings suggest that depressive symptoms may moderate the link between hostility and sympathetic activation such that hostility is accompanied by sympathetic hyperactivation only when depressive symptoms are minimal.
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Affiliation(s)
- Misty A W Hawkins
- Department of Psychology, Indiana University–Purdue University Indianapolis, IN 46202, USA.
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Schwerdtfeger A, Rosenkaimer AK. Depressive symptoms and attenuated physiological reactivity to laboratory stressors. Biol Psychol 2011; 87:430-8. [PMID: 21679744 DOI: 10.1016/j.biopsycho.2011.05.009] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 05/04/2011] [Accepted: 05/30/2011] [Indexed: 11/17/2022]
Abstract
There is evidence that depressive symptoms are associated with attenuated physiological reactivity to active stressors. However, it is not known whether blunted reactivity in depressed individuals is stressor-specific. We examined cardiovascular and electrodermal reactivity in non-clinical participants with varying levels of depressive symptoms to different active and passive stressors. Depressive symptoms were inversely related to both blood pressure and skin conductance reactivity during a public speaking task and the viewing of the speech video. However, no effects were found during a cold pressor task. Together these findings suggest that depressive symptoms are related to attenuated sympathetic nervous system reactivity in response to self-relevant stressors.
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PHILLIPS ANNAC. Blunted as well as exaggerated cardiovascular reactivity to stress is associated with negative health outcomes1. JAPANESE PSYCHOLOGICAL RESEARCH 2011. [DOI: 10.1111/j.1468-5884.2011.00464.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Successful holistic management of type 2 diabetes with depression: a very personal story. Holist Nurs Pract 2011; 25:88-96. [PMID: 21325909 DOI: 10.1097/hnp.0b013e31820de840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We used illness narrative methods to evaluate the retrospective illness story of a bereaved woman who has recovered from type 2 diabetes and depression with comorbid hypertension, hyperlipidemia, vertigo, and obesity. Her spoken illness story was obtained with a single interview question: What happened? Our findings show that the patient searched for and found personal meaning in her illness. The finding of meaning in her illness appears to have supported her efforts to adopt more positive health beliefs and health behaviors. Although she received excellent health care throughout her illness, she attributes her return to good health to spiritual growth. We discuss the practice implications of this patient's illness story for clinicians who seek new insights into patients who have complex illness stories.
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Phillips AC. Blunted cardiovascular reactivity relates to depression, obesity, and self-reported health. Biol Psychol 2011; 86:106-13. [DOI: 10.1016/j.biopsycho.2010.03.016] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Revised: 02/15/2010] [Accepted: 03/21/2010] [Indexed: 12/25/2022]
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Nugent AC, Bain EE, Thayer JF, Sollers JJ, Drevets WC. Heart rate variability during motor and cognitive tasks in females with major depressive disorder. Psychiatry Res 2011; 191:1-8. [PMID: 21129936 PMCID: PMC3032348 DOI: 10.1016/j.pscychresns.2010.08.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Revised: 08/24/2010] [Accepted: 08/24/2010] [Indexed: 12/30/2022]
Abstract
Research indicates that major depressive disorder (MDD) is associated with alterations in autonomic control, particularly cardiac control as measured by heart rate variability (HRV). In this preliminary study, we investigated the neural correlates of autonomic control by measuring both HRV and associated brain activity during the performance of mildly stressful tasks. Medically healthy female subjects with MDD (N=10) and healthy controls (N=7) underwent H(2)(15)O-positron emission tomography (PET) and electrocardiographic ECG recording while performing a handgrip motor task and an n-back task. Indices of HRV were calculated and correlated with regional cerebral blood flow (rCBF). Differences in the rCBF and HRV correlations between depressed and healthy subjects were evident in both the medial and lateral orbital cortices. In addition, these areas appeared to be involved in different facets of autonomic control with regard to sympathetic or parasympathetic dominance of cardiac control. These results are consistent with the known roles of networks within the orbital cortex in both autonomic control and the pathophysiology of MDD.
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Affiliation(s)
- Allison Carol Nugent
- Section on Neuroimaging in Mood Disorders, NIMH/NIH, Bethesda, MD 20892-1030, USA.
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38
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Taylor CB. Depression, heart rate related variables and cardiovascular disease. Int J Psychophysiol 2010; 78:80-8. [DOI: 10.1016/j.ijpsycho.2010.04.006] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 04/07/2010] [Accepted: 04/14/2010] [Indexed: 11/16/2022]
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Habituation–sensitization of cardiovascular reactivity to repeated stress in smokers and non-smokers: An anthropometrically matched trial. Int J Psychophysiol 2010; 76:34-9. [DOI: 10.1016/j.ijpsycho.2010.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 01/28/2010] [Accepted: 02/01/2010] [Indexed: 11/20/2022]
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Ward EC, Clark LO, Heidrich S. African American Women's beliefs, coping behaviors, and barriers to seeking mental health services. QUALITATIVE HEALTH RESEARCH 2009; 19:1589-601. [PMID: 19843967 PMCID: PMC2854663 DOI: 10.1177/1049732309350686] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Little is known about African American women's beliefs about mental illness. In this qualitative study we employed the Common Sense Model (CSM) to examine African American women's beliefs about mental illness, coping behaviors, barriers to treatment seeking, and variations in beliefs, coping, and barriers associated with aging. Fifteen community-dwelling African American women participated in individual interviews. Dimensional analysis, guided by the CSM, showed that participants believed general, culturally specific, and age-related factors can cause mental illness. They believed mental illness is chronic, with negative health outcomes. Participants endorsed the use of prayer and counseling as coping strategies, but were ambivalent about the use of medications. Treatment-seeking barriers included poor access to care, stigma, and lack of awareness of mental illness. Few age differences were found in beliefs, coping behaviors, and barriers. Practice and research implications are discussed.
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Disturbed stress responses in women with polycystic ovary syndrome. Psychoneuroendocrinology 2009; 34:727-35. [PMID: 19150179 DOI: 10.1016/j.psyneuen.2008.12.001] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Revised: 12/05/2008] [Accepted: 12/05/2008] [Indexed: 11/20/2022]
Abstract
BACKGROUND We analyzed the neuroendocrine and immune cell responses to psychosocial stress in PCOS patients compared to BMI-matched healthy controls. METHODS Responses to public speaking stress were analyzed in 32 PCOS patients and 32 BMI-matched healthy controls. At baseline, during, and 10- and 45-min after stress, state anxiety, cardiovascular responses, cortisol, ACTH, as well as circulating leukocyte subpopulations were analyzed, together with hsCRP and serum IL-6 concentrations. RESULTS In response to public speaking stress, both groups showed significant but comparable increases in state anxiety, and blood pressure (all p<0.001; time effects). The ACTH and cortisol stress responses were significantly enhanced in PCOS (both p<0.05; interaction effect). In addition, heart rate was significantly higher in PCOS (p<0.05; group effect). PCOS patients displayed a reduced upregulation of IL-6 levels in response to stress (p<0.05; interaction effect). Baseline levels of circulating leukocyte subpopulations, IL-6 and hsCRP concentrations did not differ between BMI-matched controls and PCOS patients. PCOS patients were characterized by markedly increased psychological distress. CONCLUSIONS PCOS patients showed enhanced HPA-axis and heart rate reactivity as well as a reduced upregulation of IL-6 in response to stress. The altered stress reactivity in PCOS patients may constitute a link between depression, overweight, and the cardiovascular and diabetes risks associated with the diagnosis.
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Salomon K, Clift A, Karlsdóttir M, Rottenberg J. Major depressive disorder is associated with attenuated cardiovascular reactivity and impaired recovery among those free of cardiovascular disease. Health Psychol 2009; 28:157-65. [PMID: 19290707 DOI: 10.1037/a0013001] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine cardiovascular reactivity and recovery to laboratory stress among a naturalistic sample of individuals diagnosed with major depressive disorder (MDD) and healthy control participants. Prospective evidence suggests that MDD confers risk for cardiovascular disease equal to or greater than the risk associated with depressed mood. Enhanced cardiovascular reactivity has been proposed as a mechanism explaining increased risk, but data are inconsistent as to whether depressed individuals exhibit enhanced or attenuated reactivity. Further, few studies have examined appraisal and recovery differences. DESIGN Participants diagnosed with MDD (N = 25) and healthy control participants (N = 25) engaged in a cardiovascular reactivity protocol including 2 tasks, each followed by a brief recovery period. MAIN OUTCOME MEASURES Blood pressure, heart rate, pre-ejection period, cardiac output and total peripheral resistance were assessed. Appraisals of tasks were assessed prior to each task. RESULTS Depressed participants exhibited significantly less systolic blood pressure, heart rate, and cardiac output reactivity during speech, less heart rate reactivity during mirror tracing, and less heart rate recovery after speech and mirror tracing than controls. Depressed participants appraised the tasks as more demanding, threatening, and stressful and reported being less able to cope than controls. Appraisals were related to heart rate reactivity, but appraisals did not mediate the relationship between depression group and reactivity. CONCLUSION Impaired recovery rather than exaggerated cardiovascular reactivity may partially explain the increased prospective cardiovascular disease risk in depressed individuals.
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Affiliation(s)
- Kristen Salomon
- Cardiovascular Psychophysiology Laboratory, University of South Florida, Tampa, FL 33620, USA.
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Pollatos O, Traut-Mattausch E, Schandry R. Differential effects of anxiety and depression on interoceptive accuracy. Depress Anxiety 2009; 26:167-73. [PMID: 19152366 DOI: 10.1002/da.20504] [Citation(s) in RCA: 191] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Feedback from the body is assumed to be altered in depression. Nevertheless, empirical studies investigating this assumed relationship remain sparse. This study aimed to examine interrelations between the ability to perceive heartbeats accurately (interoceptive awareness), depressive symptoms, and anxiety in healthy participants. METHODS A well-validated heartbeat perception task to measure interoceptive awareness together with two questionnaires indexing anxiety and depression were administered to 119 participants. RESULTS As main results we observed a negative correlation between heartbeat perception and depression. Only when focussing on high anxiety levels this negative correlation coefficient between depression and interoception remained significant. CONCLUSIONS Our results highlight the possible relationship between depressive symptoms and interoceptive awareness and may have further implications for theoretical models of anxiety disorders and their treatment. Further research is required to examine the potential consequences of altering interoceptive awareness in healthy subjects in relation to depression and anxiety.
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Affiliation(s)
- Olga Pollatos
- Clinic of Neurology, University of Munich, Munich, Germany.
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Frew AK, Drummond PD. Opposite effects of opioid blockade on the blood pressure–pain relationship in depressed and non-depressed participants. Pain 2009; 142:68-74. [DOI: 10.1016/j.pain.2008.11.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Revised: 11/14/2008] [Accepted: 11/24/2008] [Indexed: 02/04/2023]
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Stroud LR, Foster E, Papandonatos GD, Handwerger K, Granger DA, Kivlighan KT, Niaura R. Stress response and the adolescent transition: performance versus peer rejection stressors. Dev Psychopathol 2009; 21:47-68. [PMID: 19144222 PMCID: PMC2700625 DOI: 10.1017/s0954579409000042] [Citation(s) in RCA: 404] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Little is known about normative variation in stress response over the adolescent transition. This study examined neuroendocrine and cardiovascular responses to performance and peer rejection stressors over the adolescent transition in a normative sample. Participants were 82 healthy children (ages 7-12 years, n = 39, 22 females) and adolescents (ages 13-17, n = 43, 20 females) recruited through community postings. Following a habituation session, participants completed a performance (public speaking, mental arithmetic, mirror tracing) or peer rejection (exclusion challenges) stress session. Salivary cortisol, salivary alpha amylase (sAA), systolic and diastolic blood pressure (SBP, DBP), and heart rate were measured throughout. Adolescents showed significantly greater cortisol, sAA, SBP, and DBP stress response relative to children. Developmental differences were most pronounced in the performance stress session for cortisol and DBP and in the peer rejection session for sAA and SBP. Heightened physiological stress responses in typical adolescents may facilitate adaptation to new challenges of adolescence and adulthood. In high-risk adolescents, this normative shift may tip the balance toward stress response dysregulation associated with depression and other psychopathology. Specificity of physiological response by stressor type highlights the importance of a multisystem approach to the psychobiology of stress and may also have implications for understanding trajectories to psychopathology.
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Affiliation(s)
- Laura R Stroud
- Center for Behavioral Medicine, Department of Psychiatry and Human Behavior, Brown Medical School and The Miriam Hospital, CoroWest, Suite 500, 1 Hoppin Street, Providence, RI 02903, USA.
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Deley G, Lipman RD, Kannam JP, Bartolini C, Taylor JA. Stress responses and baroreflex function in coronary disease. J Appl Physiol (1985) 2008; 106:576-81. [PMID: 19095750 DOI: 10.1152/japplphysiol.91053.2008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Exaggerated pressor responses to mental stress in patients with coronary artery disease (CAD) are associated with increased risk for subsequent cardiovascular events. The integrated baroreflex gain and its mechanical and neural component were estimated and then related to the blood pressure and heart rate responses to simulated real-life stressors: mental arithmetic and public speaking. Eighteen healthy individuals (aged 61 +/- 8 yr) and 29 individuals with documented CAD but no other comorbidities (aged 59 +/- 8 yr) were studied. Heart rate and blood pressures were continuously assessed before, during preparation for, and during performance of a math task and a speech task. The assessment of beat-to-beat carotid diameters during baroreflex engagement was used to estimate the integrated baroreflex gain and its mechanical and neural component. The CAD subjects demonstrated significantly greater increases in heart rate and blood pressures for the performance of the speech task. However, there were no group differences in integrated cardiovagal baroreflex gain or either mechanical or neural baroreflex component. These findings indicate that the augmented pressor responses in CAD do not result from a generalized arterial baroreflex deficit.
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Affiliation(s)
- Gaelle Deley
- Dept. of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02114, USA
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Strodl E, Kenardy J. The 5-Item Mental Health Index Predicts the Initial Diagnosis of Nonfatal Stroke in Older Women. J Womens Health (Larchmt) 2008; 17:979-86. [DOI: 10.1089/jwh.2007.0516] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Esben Strodl
- School of Psychology and Counselling, Queensland University of Queensland, Australia
| | - Justin Kenardy
- Centre of National Research on Disability and Rehabilitation Medicine, University of Queensland, Australia
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Abstract
Depression has long had a popular link to cardiovascular disease and death. However, only during the last 15 years has scientific evidence supporting this common wisdom been available. Beginning in the early 1990s, there began to accumulate community-based epidemiological evidence that medically healthy depressed patients followed for long periods of time were at increased risk of both cardiovascular disease and cardiac death. In the mid-1990s, evidence appeared to indicate that depression following a heart attack increased the risk of death. It is now apparent that depression aggravates the course of multiple cardiovascular conditions. There are two major unanswered questions. One is whether treating depression will reduce the risk of cardiovascular disease and death. Here, preliminary, but not definitive, evidence suggests that the serotonin reuptake inhibitors may be useful. The other unanswered question regards the mechanisms that underlie this link between depression and cardiovascular disease. There is strong evidence linking platelet activation, autonomic activity, and inflammatory markers to both depression and heart disease, but why these links exist is far less clear.
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Philippsen C, Hahn M, Schwabe L, Richter S, Drewe J, Schachinger H. Cardiovascular reactivity to mental stress is not affected by alpha2-adrenoreceptor activation or inhibition. Psychopharmacology (Berl) 2007; 190:181-8. [PMID: 17111173 DOI: 10.1007/s00213-006-0597-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2006] [Accepted: 09/20/2006] [Indexed: 11/25/2022]
Abstract
RATIONALE It has been postulated that cardiovascular reactivity to mental stress varies with tonic central sympathetic nervous system activity, but pharmacological evidence is missing. OBJECTIVE To test whether modulation of central sympathetic nervous system activity by alpha2-adrenergic agonism and antagonism affects cardiovascular reactivity to mental stress. MATERIALS AND METHODS On three five-stepped dose/concentration-response study days, 12 healthy male volunteers received intravenous infusions of dexmedetomidine (alpha2-agonist, target plasma concentrations: 0.04-0.32 ng/ml), yohimbine (alpha2-antagonist, doses: 0.016-0.125 mg/kg), and placebo, respectively. During each dose step, subjects performed a 5-Choice Reaction Time Task (CRTT) and a Paced Auditory Serial Addition Task (PASAT) to induce moderate mental stress. Prestress baseline, as well as stress-induced responses of heart rate, and noninvasive finger arterial blood pressure (Finapres) were assessed. RESULTS Prestress baseline heart rate and blood pressure decreased with increasing doses of dexmedetomidine and increased with increasing doses of yohimbine. However, dexmedetomidine and yohimbine did not affect stress-induced heart-rate and blood-pressure changes. CONCLUSIONS Cardiovascular reactivity to mental stress is not related to pharmacologically manipulated tonic central sympathetic nervous system activity by alpha2-adrenergic agonists and antagonists. These results do not support the assumption that cardiovascular reactivity is an index of tonic central sympathetic nervous system activity.
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Affiliation(s)
- Christine Philippsen
- Division of Clinical Physiology, Graduate School of Psychobiology, University of Trier, Johanniterufer 15, 54290, Trier, Germany
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Abstract
Interventions that reduce the magnitude of psychobiological responses are justified, at least in part, by the notion that exaggerated responses to stress can have detrimental effects on health. The biological processes underlying the association between stress and coronary heart disease (CHD) are thought to involve haemodynamic, neuroendocrine, inflammatory and haemostatic pathways. One of the many recognised benefits of exercise is in buffering physiological responses to psychosocial stressors, which is thought to be partly mediated by sympatho-inhibitory mechanisms, although other potentially important psychobiological processes such as inflammatory, neuroendocrine and haemostatic pathways have gained little attention. Thus, the present review focuses on the role of exercise in buffering psychobiological processes, particularly in relation to pathways that are directly relevant for reducing CHD risk. There are inconsistencies in the literature regarding the effects of exercise on cardiovascular responses to stressors, which may in part be accounted for by differences in experimental design, characteristics of participants, inadequate assessment of physical fitness, and the confounding effects of acute exercise. However, new emerging evidence suggests that exercise promotes an anti-inflammatory environment and increases tissue sensitivity to glucocorticoids, which may have implications for the effects of exercise on stress-induced inflammatory pathways. Future work should focus on the efficacy of exercise for promoting anti-inflammatory pathways in relation to psychosocial stress.
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Affiliation(s)
- Mark Hamer
- Psychobiology Group, Department of Epidemiology and Public Health, University College London, London, UK.
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