1
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Feenstra HMA, van Dijk EHC, Cheung CMG, Ohno-Matsui K, Lai TYY, Koizumi H, Larsen M, Querques G, Downes SM, Yzer S, Breazzano MP, Subhi Y, Tadayoni R, Priglinger SG, Pauleikhoff LJB, Lange CAK, Loewenstein A, Diederen RMH, Schlingemann RO, Hoyng CB, Chhablani JK, Holz FG, Sivaprasad S, Lotery AJ, Yannuzzi LA, Freund KB, Boon CJF. Central serous chorioretinopathy: An evidence-based treatment guideline. Prog Retin Eye Res 2024; 101:101236. [PMID: 38301969 DOI: 10.1016/j.preteyeres.2024.101236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/30/2023] [Accepted: 01/02/2024] [Indexed: 02/03/2024]
Abstract
Central serous chorioretinopathy (CSC) is a relatively common disease that causes vision loss due to macular subretinal fluid leakage and it is often associated with reduced vision-related quality of life. In CSC, the leakage of subretinal fluid through defects in the retinal pigment epithelial layer's outer blood-retina barrier appears to occur secondary to choroidal abnormalities and dysfunction. The treatment of CSC is currently the subject of controversy, although recent data obtained from several large randomized controlled trials provide a wealth of new information that can be used to establish a treatment algorithm. Here, we provide a comprehensive overview of our current understanding regarding the pathogenesis of CSC, current therapeutic strategies, and an evidence-based treatment guideline for CSC. In acute CSC, treatment can often be deferred for up to 3-4 months after diagnosis; however, early treatment with either half-dose or half-fluence photodynamic therapy (PDT) with the photosensitive dye verteporfin may be beneficial in selected cases. In chronic CSC, half-dose or half-fluence PDT, which targets the abnormal choroid, should be considered the preferred treatment. If PDT is unavailable, chronic CSC with focal, non-central leakage on angiography may be treated using conventional laser photocoagulation. CSC with concurrent macular neovascularization should be treated with half-dose/half-fluence PDT and/or intravitreal injections of an anti-vascular endothelial growth factor compound. Given the current shortage of verteporfin and the paucity of evidence supporting the efficacy of other treatment options, future studies-ideally, well-designed randomized controlled trials-are needed in order to evaluate new treatment options for CSC.
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Affiliation(s)
- Helena M A Feenstra
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Chui Ming Gemmy Cheung
- Singapore Eye Research Institution, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Timothy Y Y Lai
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong
| | - Hideki Koizumi
- Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Michael Larsen
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark; Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Giuseppe Querques
- Department of Ophthalmology, University Vita-Salute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Susan M Downes
- Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Suzanne Yzer
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mark P Breazzano
- Retina-Vitreous Surgeons of Central New York, Liverpool, NY, USA; Department of Ophthalmology & Visual Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Yousif Subhi
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ramin Tadayoni
- Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université de Paris, Paris, France
| | - Siegfried G Priglinger
- Department of Ophthalmology, Hospital of the Ludwig-Maximilians-University, Munich, Germany
| | - Laurenz J B Pauleikhoff
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands; Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Clemens A K Lange
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
| | - Anat Loewenstein
- Division of Ophthalmology, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Roselie M H Diederen
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Reinier O Schlingemann
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands; Ocular Angiogenesis Group, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - Carel B Hoyng
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jay K Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Sobha Sivaprasad
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Andrew J Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Lawrence A Yannuzzi
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA; Department of Ophthalmology, New York University Grossman School of Medicine, New York, USA; Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, New York, NY, USA
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; Department of Ophthalmology, New York University School of Medicine, New York, NY, USA
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands; Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
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2
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Çam F, Sevik MO, Aykut A, Dericioğlu V, Şahin Çam C, Şahin Ö. Dysfunctional personality beliefs and psychopathology in patients with central serous chorioretinopathy. J Fr Ophtalmol 2024; 47:103997. [PMID: 37919151 DOI: 10.1016/j.jfo.2023.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVES To assess dysfunctional personality beliefs associated with specific personality disorders (PD), as well as psychopathological symptoms and psychological distress levels in central serous chorioretinopathy (CSC) patients. MATERIAL AND METHODS This cross-sectional study included acute and chronic CSC patients and age- and sex-matched healthy volunteers. Dysfunctional personality beliefs and psychopathological symptoms assessed with Personality Belief Questionnaire-Short Form and Symptom Check List-90 Revised (SCL-90-R), respectively, were compared between CSC patients and healthy volunteers and between acute and chronic CSC patients. MAIN RESULTS Of the 55 CSC patients included in the study analysis, 21 (38.2%) had acute and 34 (61.8%) chronic CSC. Avoidant PD (13.92±3.79 vs. 12.03±3.98, P=0.012) and obsessive-compulsive PD (13.94±3.95 vs. 12.27±3.75, P=0.025) scores on the PBQ-SF were significantly higher in CSC patients than in healthy volunteers. The PBQ-SF scores were similar between acute and chronic CSC patients. CSC patients scored significantly higher on the general severity index (GSI) and all symptom dimensions except phobic anxiety and psychoticism on the SCL-90-R. In addition, scores for obsessive-compulsive, depression, interpersonal sensitivity, paranoid ideation, and GSI were significantly higher in acute than in chronic CSC patients. CONCLUSIONS This first study investigating the relationship between CSC and dysfunctional personality beliefs indicates that CSC patients have higher levels of dysfunctional beliefs related to avoidant and obsessive-compulsive PD than healthy volunteers. These findings present a new aspect of the personality profile of CSC patients and point to a target for intervention, i.e., dysfunctional beliefs, through a cognitive-psychiatric approach.
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Affiliation(s)
- F Çam
- Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey.
| | - M O Sevik
- Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey
| | - A Aykut
- Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey
| | - V Dericioğlu
- Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey
| | - C Şahin Çam
- Department of Psychiatry, Marmara University School of Medicine, Istanbul, Turkey
| | - Ö Şahin
- Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey
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3
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Lassandro NV, Nicolai M, Arnaldi G, Franceschi A, Pelliccioni P, Cantini L, Gesuita R, Faragalli A, Mariotti C. Pachychoroid spectrum disease and choriocapillary flow analysis in patients with Cushing disease: an optical coherence tomography angiography study. Graefes Arch Clin Exp Ophthalmol 2022; 260:1535-1542. [DOI: 10.1007/s00417-021-05524-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 12/12/2021] [Accepted: 12/14/2021] [Indexed: 12/01/2022] Open
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4
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Scholz P, Altay L, Sitnilska V, van Dijk EHC, Pereira AM, van Haalen FM, Akhtar I, Boon CJF, Fauser S. SALIVARY ALPHA-AMYLASE LEVELS MAY CORRELATE WITH CENTRAL SEROUS CHORIORETINOPATHY ACTIVITY. Retina 2021; 41:2479-2484. [PMID: 34292222 DOI: 10.1097/iae.0000000000003266] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate and compare the salivary alpha-amylase (sAA) activity as an indicator of the sympathetic activity and stress response in patients with central serous chorioretinopathy (CSC) and healthy control subjects. METHODS Prospective multicenter case series, including 80 CSC patients and 88 healthy control subjects. Central serous chorioretinopathy status was classified as either active or inactive, depending on the presence of subretinal fluid on optical coherence tomography. Salivary samples were collected in the morning from patients and control subjects of the main cohort and at midnight for the additional cohort. Salivary alpha-amylase activity was determined in all patients and control subjects. RESULTS Morning sAA activity was significantly higher in patients with active CSC compared with inactive CSC (P = 0.049) and to healthy control subjects (P = 0.012). There was no significant difference in sAA activity between patients with inactive CSC and control subjects (P = 1.0). Nocturnal sAA activity did not show any significant difference between patients with active CSC and either inactive CSC or control subjects (P = 0.139). CONCLUSION Morning sAA activity is increased in patients with active CSC, although diurnal rhythmicity is preserved. Measurement of sAA is easy to perform and might be an eligible tool to further investigate the relation between stress and CSC.
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Affiliation(s)
- Paula Scholz
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
| | - Lebriz Altay
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
| | - Vasilena Sitnilska
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
| | - Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, Netherlands
| | - Alberto M Pereira
- Department of Medicine, Division of Endocrinology, and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, Netherlands
| | - Femke M van Haalen
- Department of Medicine, Division of Endocrinology, and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, Netherlands
| | - Isha Akhtar
- Department of Ophthalmology, University of Cologne, Experimental Immunology of the Eye, Cologne, Germany
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, Netherlands
- Department of Ophthalmology, Academic Medical Center, Amsterdam, the Netherlands; and
| | - Sascha Fauser
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
- F. Hoffmann-La Roche, Basel, Switzerland
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5
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Fukita S, Kawasaki H, Yamasaki S. Does Behavior Pattern Influence Blood Pressure in the Current Cultural Context of Japan? IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:701-709. [PMID: 34183919 PMCID: PMC8219619 DOI: 10.18502/ijph.v50i4.5994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Type A behavior pattern has been presented as a risk for coronary heart disease and defined as a psychological-behavioral construct. This study aimed to identify the influence of type A behavior pattern on blood pressure in the current cultural context of Japan. Methods: This study utilized a cross-sectional design. Self-administered questionnaires were distributed to community residents aged 40–59 yr in western Japan from Aug to Sep 2017. The data included participant’s demographic information (including socioeconomic variables); information related to blood pressure, type A behavior pattern, psychological factors, and health-related behaviors. Logistic regression was used to identify the influence of type A behavior pattern on systolic blood pressure after adjusting for behavioral, psychological, and socioeconomic factors. Results: The sample included 362 participants with a mean age of 51.5 years (SD = 5.96); 148 (41.2%) men. A logistic regression demonstrated that type A behavior pattern was negatively associated with systolic blood pressure (OR = 0.43, 95% CI [0.22, 0.83]) after adjusting for sex and age. Similar results were observed after adjusting for other covariates. Conclusion: There may be a negative association between type A behavior pattern and systolic blood pressure among adults living in the current cultural context of Japan.
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Affiliation(s)
- Susumu Fukita
- Faculty of Nursing & Medical Care, Keio University, Tokyo, Japan.,Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiromi Kawasaki
- Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoko Yamasaki
- Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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6
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van Rijssen TJ, van Dijk EHC, Yzer S, Ohno-Matsui K, Keunen JEE, Schlingemann RO, Sivaprasad S, Querques G, Downes SM, Fauser S, Hoyng CB, Piccolino FC, Chhablani JK, Lai TYY, Lotery AJ, Larsen M, Holz FG, Freund KB, Yannuzzi LA, Boon CJF. Central serous chorioretinopathy: Towards an evidence-based treatment guideline. Prog Retin Eye Res 2019; 73:100770. [PMID: 31319157 DOI: 10.1016/j.preteyeres.2019.07.003] [Citation(s) in RCA: 272] [Impact Index Per Article: 54.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 07/11/2019] [Accepted: 07/14/2019] [Indexed: 12/17/2022]
Abstract
Central serous chorioretinopathy (CSC) is a common cause of central vision loss, primarily affecting men 20-60 years of age. To date, no consensus has been reached regarding the classification of CSC, and a wide variety of interventions have been proposed, reflecting the controversy associated with treating this disease. The recent publication of appropriately powered randomised controlled trials such as the PLACE trial, as well as large retrospective, non-randomised treatment studies regarding the treatment of CSC suggest the feasibility of a more evidence-based approach when considering treatment options. The aim of this review is to provide a comprehensive overview of the current rationale and evidence with respect to the variety of interventions available for treating CSC, including pharmacology, laser treatment, and photodynamic therapy. In addition, we describe the complexity of CSC, the challenges associated with treating CSC, and currently ongoing studies. Many treatment strategies such as photodynamic therapy using verteporfin, oral mineralocorticoid antagonists, and micropulse laser treatment have been reported as being effective. Currently, however, the available evidence suggests that half-dose (or half-fluence) photodynamic therapy should be the treatment of choice in chronic CSC, whereas observation may be the preferred approach in acute CSC. Nevertheless, exceptions can be considered based upon patient-specific characteristics.
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Affiliation(s)
- Thomas J van Rijssen
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Suzanne Yzer
- Department of Ophthalmology, Rotterdam Eye Hospital, Rotterdam, the Netherlands
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan
| | - Jan E E Keunen
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Reinier O Schlingemann
- Department of Ophthalmology, Amsterdam University Medical Center, University of Amsterdam, the Netherlands; Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre 162, London, United Kingdom
| | - Giuseppe Querques
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute University, Milan, Italy
| | - Susan M Downes
- Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, West Wing, Oxford, United Kingdom
| | - Sascha Fauser
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany; F. Hoffmann-La Roche, Basel, Switzerland
| | - Carel B Hoyng
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Jay K Chhablani
- Smt. Kanuri Santhamma Retina Vitreous Centre, L.V. Prasad Eye Institute, Kallam Anji Reddy Campus, Banjara Hills, Hyderabad, India
| | - Timothy Y Y Lai
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong; 2010 Retina & Macula Centre, Tsim Sha Tsui, Kowloon, Hong Kong
| | - Andrew J Lotery
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Michael Larsen
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark; Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA; Department of Ophthalmology, New York University School of Medicine, New York, NY, USA
| | - Lawrence A Yannuzzi
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA; Department of Ophthalmology, New York University School of Medicine, New York, NY, USA
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands; Department of Ophthalmology, Amsterdam University Medical Center, University of Amsterdam, the Netherlands.
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7
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Haalen FM, Dijk EH, Andela CD, Dijkman G, Biermasz NR, Pereira AM, Boon CJ. Maladaptive personality traits, psychological morbidity and coping strategies in chronic central serous chorioretinopathy. Acta Ophthalmol 2019; 97:e572-e579. [PMID: 30378259 DOI: 10.1111/aos.13952] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/26/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE 'Type A' behavioural characteristics and psychosocial stress have traditionally been associated with chronic central serous chorioretinopathy (cCSC). However, a characteristical personality profile could not be identified in these patients and the presumed association with stress is subject to controversy, due to a lack of convincing studies using validated measuring instruments. In this study, we aimed to assess maladaptive personality traits, psychological morbidity and coping strategies in patients with cCSC, in order to identify potentially modifiable psychosocial aspects which could be used in support to current standard treatment. METHODS A cross-sectional study in a cohort of 86 patients with cCSC using validated questionnaires. Findings were compared to both Dutch population reference data and reference data from patients treated for Cushing's disease. RESULTS Maladaptive personality traits were not more prevalent in patients with cCSC than in the general population, and psychological morbidity was not increased. Patients with cCSC were shown to make more use of passive coping, active coping and seeking social support. Interestingly, personality, psychological morbidity and coping characteristics of patients with cCSC were more comparable to features of patients treated for Cushing's disease than to population-based data. CONCLUSION Maladaptive personality traits such as type A behavioural characteristics are not more prevalent in patients with cCSC. Patients with cCSC make more use of certain coping strategies, which could be addressed by psychosocial care to improve self-management. Further research is needed establish whether the course of disease can be improved by altering coping and reducing 'stress'.
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Affiliation(s)
- Femke M. Haalen
- Department of Medicine Division of Endocrinology and Center for Endocrine Tumors Leiden University Medical Center Leiden the Netherlands
| | - Elon H.C. Dijk
- Department of Ophthalmology Leiden University Medical Center Leiden the Netherlands
| | - Cornelie D. Andela
- Department of Medicine Division of Endocrinology and Center for Endocrine Tumors Leiden University Medical Center Leiden the Netherlands
| | - Greet Dijkman
- Department of Ophthalmology Leiden University Medical Center Leiden the Netherlands
| | - Nienke R. Biermasz
- Department of Medicine Division of Endocrinology and Center for Endocrine Tumors Leiden University Medical Center Leiden the Netherlands
| | - Alberto M. Pereira
- Department of Medicine Division of Endocrinology and Center for Endocrine Tumors Leiden University Medical Center Leiden the Netherlands
| | - Camiel J.F. Boon
- Department of Ophthalmology Leiden University Medical Center Leiden the Netherlands
- Department of Ophthalmology Amsterdam University Medical Center University of Amsterdam Amsterdam the Netherlands
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Rossi A, Grasso-Cladera A, Luarte N, Riillo A, Parada FJ. The brain/body-in-the-world system is cognitive science’s study object for the twenty-first century / El sistema cerebro/cuerpo-en-el-mundo es el objeto de estudio de la ciencia cognitiva en el siglo XXI. STUDIES IN PSYCHOLOGY 2019. [DOI: 10.1080/02109395.2019.1596704] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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9
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Klein E, Bieck SM, Bloechle J, Huber S, Bahnmueller J, Willmes K, Moeller K. Anticipation of difficult tasks: neural correlates of negative emotions and emotion regulation. Behav Brain Funct 2019; 15:4. [PMID: 30885230 PMCID: PMC6421679 DOI: 10.1186/s12993-019-0155-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 03/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Difficult cognitive tasks are often associated with negative feelings. This can be already the case for the mere anticipation of having to do a difficult task. For the case of difficult math tasks, it was recently suggested that such a negative emotional response may be exclusive to highly math-anxious individuals. However, it is also conceivable that negative emotional responses simply reflect that math is perceived as difficult. Here we investigated whether non-math-anxious individuals also experience negative emotional responses when anticipating to do difficult math tasks. METHODS We compared brain activation following the presentation of a numerical cue indicating either difficult or easy upcoming proportion magnitude comparison tasks. RESULTS Comparable to previous results for highly math-anxious individuals we observed a network associated with negative emotions to be activated in non-math-anxious individuals when facing cues indicating a difficult upcoming task. Importantly, however, math anxiety scores did not predict the neural response. Furthermore, we observed activation in areas associated with processes of cognitive control areas such as anterior cingulate cortex, which were suggested to play a key role in emotion regulation. CONCLUSION Activation in the emotion processing network was observed when anticipating an upcoming difficult (math) task. However, this activation was not predicted by individual' degree of math anxiety. Therefore, we suggest that negative emotional responses to difficult math tasks might be a rather common reaction not specific to math-anxious individuals. Whether or not this initial negative response impairs math performance, however, might depend on the ability to regulate those emotions effectively.
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Affiliation(s)
- Elise Klein
- Leibniz-Institut für Wissensmedien, Tübingen, Germany.,LEAD Graduate School and Research Network, University of Tuebingen, Tübingen, Germany
| | - Silke M Bieck
- Leibniz-Institut für Wissensmedien, Tübingen, Germany. .,LEAD Graduate School and Research Network, University of Tuebingen, Tübingen, Germany.
| | - Johannes Bloechle
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tübingen, Germany
| | - Stefan Huber
- Leibniz-Institut für Wissensmedien, Tübingen, Germany
| | - Julia Bahnmueller
- Leibniz-Institut für Wissensmedien, Tübingen, Germany.,LEAD Graduate School and Research Network, University of Tuebingen, Tübingen, Germany.,Department of Psychology, University of Tuebingen, Tübingen, Germany
| | - Klaus Willmes
- Department of Neurology, University Hospital, RWTH Aachen University, Aachen, Germany
| | - Korbinian Moeller
- Leibniz-Institut für Wissensmedien, Tübingen, Germany.,LEAD Graduate School and Research Network, University of Tuebingen, Tübingen, Germany.,Department of Psychology, University of Tuebingen, Tübingen, Germany
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10
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Abu el-Asrar AM. Central Serous Chorioretinopathy Complicating Systemic Corticosteroid Therapy. Eur J Ophthalmol 2018; 7:297-300. [PMID: 9352287 DOI: 10.1177/112067219700700317] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose. To present evidence that systemic corticosteroid therapy may cause central serous chorioretinopathy. Methods. A 20-year-old male with idiopathic thrombocytopenic purpura was examined during systemic treatment with corticosteroids (100 mg daily). Results. The patient had central serous chorioretinopathy. Spontaneous recovery accompanied discontinuation of the steroid treatment. Conclusions. This case provides further evidence that Cortisol may play a role in the development of central serous chorioretinopathy.
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Affiliation(s)
- A M Abu el-Asrar
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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11
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12
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Abstract
PURPOSE To evaluate choroidal thickness (CT) in patients with Cushing syndrome (CS) with enhanced depth imaging optical coherence tomography. METHODS Twenty-eight patients with CS and 38 healthy volunteers were enrolled in this observational cross-sectional study. Patients with newly diagnosed CS who have been admitted to Erciyes University Department of Endocrinology in 3 years time interval were compared with age- and sex-matched healthy volunteers. Choroidal thickness was measured at the fovea and 2 points nasal and 2 points temporal to the fovea with 500-μm intervals each. RESULTS Choroidal thickness measurements were higher in patients with CS than in the control group at all examination points; however, the difference was found to be significant at the center of the fovea (367.8 ± 94.4 μm vs. 329 ± 90.5 μm) and 1,000 μm temporal to the fovea. Choroidal thickness measurements were significantly higher in adrenocorticotrophic hormone (ACTH)-dependent CS group than in the control group at all measurement points (CT at fovea 388.2 ± 92.4 μm vs. 329.1 ± 90.5 μm). All CT measurements were found to be correlated with ACTH levels. CONCLUSION Cushing syndrome is associated with increased CT. The ACTH-dependent CS may increase CT more than ACTH-independent CS. This effect may be directly related to ACTH itself or increased plasma cortisol levels or both.
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Competition, testosterone, and adult neurobehavioral plasticity. PROGRESS IN BRAIN RESEARCH 2016; 229:213-238. [PMID: 27926439 DOI: 10.1016/bs.pbr.2016.05.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Motivation in performance is often measured via competitions. Winning a competition has been found to increase the motivation to perform in subsequent competitions. One potential neurobiological mechanism that regulates the motivation to compete involves sex hormones, such as the steroids testosterone and estradiol. A wealth of studies in both nonhuman animals and humans have shown that a rise in testosterone levels before and after winning a competition enhances the motivation to compete. There is strong evidence for acute behavioral effects in response to steroid hormones. Intriguingly, a substantial testosterone surge following a win also appears to improve an individual's performance in later contests resulting in a higher probability of winning again. These effects may occur via androgen and estrogen pathways modulating dopaminergic regions, thereby behavior on longer timescales. Hormones thus not only regulate and control social behavior but are also key to adult neurobehavioral plasticity. Here, we present literature showing hormone-driven behavioral effects that persist for extended periods of time beyond acute effects of the hormone, highlighting a fundamental role of sex steroid hormones in adult neuroplasticity. We provide an overview of the relationship between testosterone, motivation measured from objective effort, and their influence in enhancing subsequent effort in competitions. Implications for an important role of testosterone in enabling neuroplasticity to improve performance will be discussed.
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Setrouk E, Hubault B, Vankemmel F, Zambrowski O, Nazeyrollas P, Delemer B, Durlach V, Ducasse A, Arndt C. Circadian disturbance and idiopathic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 2016; 254:2175-2181. [DOI: 10.1007/s00417-016-3378-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 04/17/2016] [Accepted: 05/02/2016] [Indexed: 12/29/2022] Open
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Tsai DC, Huang CC, Chen SJ, Chou P, Chung CM, Chan WL, Huang PH, Lin SJ, Chen JW, Leu HB. Increased risk of erectile dysfunction among males with central serous chorioretinopathy -- a retrospective cohort study. Acta Ophthalmol 2013; 91:666-71. [PMID: 22998678 DOI: 10.1111/j.1755-3768.2012.02528.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Central serous chorioretinopathy (CSCR) mostly affects middle-aged men and has been associated with stress and hypercortisolism. We hypothesized that some factors prone to inducing CSCR could also have a harmful effect on erectile function. This study aimed to investigate the risk of subsequent erectile dysfunction after CSCR using Taiwan National Health Insurance Research Database. METHODS The study cohort (n = 1220) consisted of newly diagnosed CSCR men aged 19-64 years between 1999 and 2007, and men matched for age, monthly income and time of enrolment were randomly selected as the control group (n = 10870). Cox proportional hazard regressions were performed to calculate the hazard ratios (HR) of clinically diagnosed erectile dysfunction (including organic origin and/or psychogenic origin) for the two groups. Erectile dysfunction-free survival analysis was assessed using a Kaplan-Meier method. RESULTS Twenty-five patients (2.0%) from the CSCR cohort and 103 (0.9%) from the control group were diagnosed erectile dysfunction clinically during a mean observation period of 4.3 years. Patients with CSCR had a significantly higher incidence of erectile dysfunction diagnosis than those without CSCR (p < 0.001). After adjusting for age, geographic location, chronic comorbidities and medication habits, patients with CSCR were found to have a 2.22-fold [95% confidence interval (CI), 1.42-3.46] higher hazard ratio of a subsequent erectile dysfunction diagnosis than the matched controls. The adjusted HR for organic and psychogenic erectile dysfunction were 2.14 (95% CI: 1.34-3.44) and 3.83 (95% CI: 1.47-10.01), respectively. CONCLUSIONS Central serous chorioretinopathy was independently associated with an increased risk of being diagnosed with erectile dysfunction.
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Affiliation(s)
- Der-Chong Tsai
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, TaiwanDepartment of Ophthalmology, National Yang-Ming University Hospital, Taipei, TaiwanInstitute of Pharmacology, National Yang-Ming University, Taipei, TaiwanCardiovascular Research Center, School of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Medical Research and Education, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Ophthalmology, Taipei Veterans General Hospital, Taipei, TaiwanInstitute of Biomedical Sciences, Academia Sinica, Taipei, TaiwanHealthcare and Management Center, Taipei Veterans General Hospital, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
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Song C, Ikei H, Lee J, Park BJ, Kagawa T, Miyazaki Y. Individual differences in the physiological effects of forest therapy based on Type A and Type B behavior patterns. J Physiol Anthropol 2013; 32:14. [PMID: 24088391 PMCID: PMC3851594 DOI: 10.1186/1880-6805-32-14] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 09/24/2013] [Indexed: 11/28/2022] Open
Abstract
Background In recent years, the physiological relaxation effects of natural environments have been widely exploited, and although individual differences in the effects of forest therapy are known, assessment methods have not been clearly established. This study used a classification based on Type A and Type B behavior patterns to explain individual differences in physiological responses to forest environments. Methods We performed physiological experiments in 44 forest and urban (controls) areas. In total, 485 male university students (age, 21.8 ± 1.6 years) participated in the study. The subjects were asked to visit forest or urban environments randomly and observe each landscape for 15 min. The subjects’ pulse rates and blood pressures were tested to evaluate their physiological responses. The Kwansei Gakuin daily life questionnaire was used to identify Type A and Type B behavior patterns in subjects. Results The pulse rate was significantly lower in the Type B group after exposure to forest areas than after exposure to urban areas, whereas no significant difference was observed in the Type A group. In addition, the pulse rate was significantly lower in the low scoring subjects in the Type B group, which was consistent with changes in their diastolic blood pressure. Conclusions These results suggest that individual differences in pulse rate and blood pressure in response to forest environments can be explained by Type A and Type B behavior patterns.
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Affiliation(s)
- Chorong Song
- Center for Environment, Health and Field Science, Chiba University, Chiba, Japan.
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Abstract
Animal research has well established that a link exists between variations in corticosteroids and the proneness to excess body fat accumulation. Accordingly, it is known that adrenalectomy is an efficient approach to counteract weight gain in most animal models of obesity. In humans, the association between variations in corticosteroids, its stress-related environmental effects and the predisposition to obesity is more difficult to demonstrate. In this paper, we propose that this relationship is accentuated by globalization and modernization which favour a labour context imposing additional stress and changes in life habits promoting a positive energy balance. Our main hypothesis is that the increase in knowledge-based work, and the decrease of quality and duration of sleep both induce an increase in cortisolaemia and glycaemia instability, which results in an increase in food intake, a reduction in energy expenditure and body fat gain. The authors of this paper believe that, from a socioeconomic perspective, globalization leads every nation of the world in conflict with itself and may consequently represent a real problem. On one hand, there are preoccupations related to productivity and money making. On the other hand, people have to adopt a daily lifestyle leading to hyperphagia and decreased energy expenditure in order to maintain their economic competitiveness.
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Affiliation(s)
- L Huneault
- Department of Social and Preventive Medicine, Laval University, Quebec City, Quebec, Canada
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Wang Y, Winters JM. Modeling the adaptive pathophysiology of essential hypertension. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2011; 2011:1029-1032. [PMID: 22254488 DOI: 10.1109/iembs.2011.6090239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This paper proposes an adaptive neuro-fuzzy model to study the pathophysiology of essential hypertension. Using diverse inputs such as risk factors, physical relations and medical interventions, and states that include both transient and resting states for key physiological variables (blood pressure, total peripheral resistance), it can roughly predict both real-time and long-term blood pressure change for a robust range of inputs. Although it was tuned using published population data, it can be applied to specific individuals to estimate the risks of hypertension with different life experience.
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Affiliation(s)
- Yu Wang
- Department of Bioengineering , University of California, San Diego, La Jolla, CA, USA.
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Del Giudice M, Ellis BJ, Shirtcliff EA. The Adaptive Calibration Model of stress responsivity. Neurosci Biobehav Rev 2010; 35:1562-92. [PMID: 21145350 DOI: 10.1016/j.neubiorev.2010.11.007] [Citation(s) in RCA: 816] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2010] [Revised: 11/15/2010] [Accepted: 11/18/2010] [Indexed: 02/05/2023]
Abstract
This paper presents the Adaptive Calibration Model (ACM), an evolutionary-developmental theory of individual differences in the functioning of the stress response system. The stress response system has three main biological functions: (1) to coordinate the organism's allostatic response to physical and psychosocial challenges; (2) to encode and filter information about the organism's social and physical environment, mediating the organism's openness to environmental inputs; and (3) to regulate the organism's physiology and behavior in a broad range of fitness-relevant areas including defensive behaviors, competitive risk-taking, learning, attachment, affiliation and reproductive functioning. The information encoded by the system during development feeds back on the long-term calibration of the system itself, resulting in adaptive patterns of responsivity and individual differences in behavior. Drawing on evolutionary life history theory, we build a model of the development of stress responsivity across life stages, describe four prototypical responsivity patterns, and discuss the emergence and meaning of sex differences. The ACM extends the theory of biological sensitivity to context (BSC) and provides an integrative framework for future research in the field.
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Affiliation(s)
- Marco Del Giudice
- Center for Cognitive Science, Department of Psychology, University of Turin, Via Po 14, 10123 Torino, Italy.
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Hudetz JA, Hoffmann RG, Patterson KM, Byrne AJ, Iqbal Z, Gandhi SD, Warltier DC, Pagel PS. Preoperative Dispositional Optimism Correlates With a Reduced Incidence of Postoperative Delirium and Recovery of Postoperative Cognitive Function in Cardiac Surgical Patients. J Cardiothorac Vasc Anesth 2010; 24:560-7. [DOI: 10.1053/j.jvca.2010.01.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Indexed: 12/12/2022]
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Zakir SM, Shukla M, Simi ZUR, Ahmad J, Sajid M. Serum cortisol and testosterone levels in idiopathic central serous chorioretinopathy. Indian J Ophthalmol 2010; 57:419-22. [PMID: 19861741 PMCID: PMC2812758 DOI: 10.4103/0301-4738.57143] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Context: The preferential occurrence of idiopathic central serous chorioretinopathy (ICSC) in males with a typical Type A personality and behavior and a relative absence in females is a possible indicator towards the role of serum cortisol and /or the male sex hormone testosterone. Aims: To study levels of cortisol and testosterone in ICSC. Settings and Design: Case-control study in a tertiary care teaching hospital. Materials and Methods: The study was conducted on 23 cases of ICSC. Twelve patients with unilateral sudden painless loss of vision of less than one month duration served as controls. Serum cortisol and testosterone levels at 8.00 a.m. were estimated by radioimmunoassay in both groups. Statistical analysis used: Statistical analysis was done using SPSS 13.0 software. Independent Sample t-test was applied to analyze statistical significance between the two groups. Results: Mean age of patients with ICSC was 37.1 ± 9.7 years and 96% of the patients were males. Mean serum cortisol levels were significantly higher (P=0.002) in patients with ICSC i.e., 495.02 ± 169.47 nano moles/liter (nmol/L) as compared to controls i.e., 362.25 ± 51.54 nmol/L. Mean serum testosterone levels were 3.85 ± 1.81 nano grams/ml (ngm/ml) and 4.23 ± 1.89 ngm/ml in cases and controls respectively and the difference was not statistically significant (P=0.58). Conclusions: ICSC is associated with elevated 8.00 a.m. serum cortisol levels. However, mean serum testosterone levels in both patients of ICSC and controls were within normal range.
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Affiliation(s)
- Shaik M Zakir
- Retina Service, Institute of Ophthalmology, Aligarh Muslim University, Aligarh, India.
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Ferrara DC, Calucci D, Oréfice J, Magalhães ÉP, Oréfice F, Costa RA. Proposed physiopathological mechanisms and potential therapeutic targets for central serous chorioretinopathy. EXPERT REVIEW OF OPHTHALMOLOGY 2008. [DOI: 10.1586/17469899.3.5.553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kanbara K, Fukunaga M, Mutsuura H, Takeuchi H, Kitamura K, Nakai Y. An exploratory study of subgrouping of patients with functional somatic syndrome based on the psychophysiological stress response: its relationship with moods and subjective variables. Psychosom Med 2007; 69:158-65. [PMID: 17289824 DOI: 10.1097/psy.0b013e3180312cac] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To study the characteristics and subjective estimations of subgroups of patients with functional somatic syndrome (FSS). A characteristic in patients with FSS was reportedly hyporeactivity in the psychophysiological stress response (PSR). METHODS The PSR was measured in 59 FSS patients and 41 healthy controls. Autonomic lability scores (ALSs) of six psychophysiological measurements on PSR were calculated. Cluster analysis using the ALSs was performed in the FSS group. A discriminant analysis was also performed to identify the criterion of the subgrouping. Factor analysis scores of the six ALSs, and moods and subjective variables were compared between the subgroups. RESULTS Cluster analysis divided the FSS patients into two clusters. Three groups (low-lability, high-lability, and control groups) were compared. All factor scores of autonomic lability significantly differed between the low- and high-lability groups, and between the low-lability and control groups. The mood scores were higher in the high-lability group than in the low-lability group. The duration of suffering was significantly longer in the high-lability group than in the low-lability group. The distributions of symptoms and diagnosis did not significantly differ between the subgroups. CONCLUSIONS We have tentatively verified that there are two subgroups based on the autonomic lability among FSS patients, which were independent of the type of symptoms and diagnostic category. Autonomic lability is an important axis in the multiaxial diagnosis of FSS.
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Affiliation(s)
- Kenji Kanbara
- Department of Psychosomatic Medicine, Kansai Medical University, 10-15, Fumizono-cho, Moriguchi-shi, Osaka, Japan.
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Sakaguchi K, Oki M, Honma S, Hasegawa T. Influence of relationship status and personality traits on salivary testosterone among Japanese men. PERSONALITY AND INDIVIDUAL DIFFERENCES 2006. [DOI: 10.1016/j.paid.2006.04.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ahad MA, Chua CN, Evans NM. Central serous chorioretinopathy associated with testosterone therapy. Eye (Lond) 2006; 20:503-5. [PMID: 15846380 DOI: 10.1038/sj.eye.6701905] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Girdler SS, Jammer LD, Shapiro D. Hostility, testosterone, and vascular reactivity to stress: effects of sex. Int J Behav Med 2006; 4:242-63. [PMID: 16250731 DOI: 10.1207/s15327558ijbm0403_4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This study investigated the association of personality with cardiovascular stress reactivity (CVR) in men and women. Also, the degree to which testosterone and estradiol reactivity were related to personality and CVR measures was examined. Twenty-six men and 44 women completed the Cook-Medley Hostility Scale, the Beck Depression Inventory, and the Spielberger Trait Anxiety Inventory before speech, Stroop, and math stress. Testosterone (men) and estradiol (subset of women) were sampled once after an initial rest period and again after the last stressor. Cardiovascular reactivity, including cardiac output and total peripheral resistance (TPR), was assessed during stressors. For men, testosterone increased significantly with stress, and testosterone reactivity to stressors was significantly correlated with hostility. However, stepwise multiple regression revealed that hostility was the only independent predictor of CVR to speech, math, and Stroop stress in men, accounting for 13%-32% of the variance in TPR. Baseline systolic blood pressure explained 22% of the variance in TPR reactivity to speech preparation. No evidence was obtained to suggest that hostility, depressive mood, or anxiety predicted CVR in women, and estradiol did not show stress-sensitive effects. These data provide evidence that increased vascular reactivity may be one mechanism linking hostility to increased cardiovascular mortality in men and support the notion that hostility may have different implications for CVR in women.
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Affiliation(s)
- S S Girdler
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA
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D'Antono B, Moskowitz DS, Miners C, Archambault J. Gender and communal trait differences in the relations among social behaviour, affect arousal, and cardiac autonomic control. J Behav Med 2005; 28:267-79. [PMID: 16015461 DOI: 10.1007/s10865-005-4663-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2004] [Indexed: 12/19/2022]
Abstract
To examine the relation between social behaviour and vagal activity, the communal behaviour of healthy college men (N = 33) and women (N = 33) was manipulated while monitoring heart rate (HR) and respiratory sinus arrhythmia (RSA). The subjects were classified as low or high on communal trait. Communal behaviour was manipulated by having the subjects behave in an agreeable or quarrelsome manner in scripted role-plays. HR, RSA and self-report arousal were obtained during or immediately following baseline, experimental and relaxation periods. 2 (Gender) x 2 (Communal Trait; low/high) x 2 (Condition; agreeable/quarrelsome) ANCOVAs were performed. Men had lower RSA values when behaving in a quarrelsome fashion than agreeable and lower RSA values than women in the quarrelsome condition. In the latter condition, low communal men reported more arousal than other groups. Strong but opposite associations between RSA and affect arousal were observed in low communal men and woman. Men, especially more quarrelsome (less communal) men exhibited weaker vagal control during arousing social situations.
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Affiliation(s)
- Bianca D'Antono
- Department of Psychosomatic Medicine, Montreal Heart Institute, 5000 Belanger Street East, Montreal, Quebec, Canada. biancad'
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Shusterman V, Barnea O. Sympathetic nervous system activity in stress and biofeedback relaxation. ACTA ACUST UNITED AC 2005; 24:52-7. [PMID: 15825846 DOI: 10.1109/memb.2005.1411349] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Mansuetta CC, Mason JO, Swanner J, Feist RM, White MF, Thomley ML, McGwin G, Emond TL. An association between central serous chorioretinopathy and gastroesophageal reflux disease. Am J Ophthalmol 2004; 137:1096-100. [PMID: 15183795 DOI: 10.1016/j.ajo.2004.01.054] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2004] [Indexed: 11/29/2022]
Abstract
PURPOSE To explore a clinically observed association between central serous chorioretinopathy (CSC) and gastroesophageal reflux disease (GERD) DESIGN: A retrospective case-control study. PARTICIPANTS AND CONTROLS Sixty-nine consecutive patients diagnosed with CSC were compared with a control group of 55 non-CSC patients. METHODS The records of 69 patients with CSC were retrospectively reviewed and compared with the records of 55 controls. All patients and controls were examined in a referral setting. RESULTS Patients with CSC were significantly more likely to have GERD compared with controls (odds ratio 6.05; 95% confidence interval 2.14-17.11; P =.0003). Central serous chorioretinopathy patients were also more likely than controls to have used oral corticosteroid medications (odds ratio 16.30; 95% confidence interval 2.09-127.33; P =.0006) and antacid/antireflux medications (odds ratio 15.00; 95% confidence interval 1.91-117.58; P =.001). CONCLUSIONS This study identifies an association between CSC and GERD. There are biochemical factors common to both diseases that support this association, giving further insight into the pathogenesis of CSC.
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Affiliation(s)
- Cheri C Mansuetta
- University of Alabama at Birmingham, Department of Ophthalmology, USA
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Dickerson SS, Kemeny ME. Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research. Psychol Bull 2004; 130:355-91. [PMID: 15122924 DOI: 10.1037/0033-2909.130.3.355] [Citation(s) in RCA: 3372] [Impact Index Per Article: 168.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This meta-analysis reviews 208 laboratory studies of acute psychological stressors and tests a theoretical model delineating conditions capable of eliciting cortisol responses. Psychological stressors increased cortisol levels; however, effects varied widely across tasks. Consistent with the theoretical model, motivated performance tasks elicited cortisol responses if they were uncontrollable or characterized by social-evaluative threat (task performance could be negatively judged by others), when methodological factors and other stressor characteristics were controlled for. Tasks containing both uncontrollable and social-evaluative elements were associated with the largest cortisol and adrenocorticotropin hormone changes and the longest times to recovery. These findings are consistent with the animal literature on the physiological effects of uncontrollable social threat and contradict the belief that cortisol is responsive to all types of stressors.
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Affiliation(s)
- Sally S Dickerson
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
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Schwarz AM, Schächinger H, Adler RH, Goetz SM. Hopelessness is associated with decreased heart rate variability during championship chess games. Psychosom Med 2003; 65:658-61. [PMID: 12883118 DOI: 10.1097/01.psy.0000075975.90979.2a] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Clinical observations suggest that negative affects such as helplessness/hopelessness (HE/HO) may induce autonomic duration; affects were assessed for every move after reconstruction of the games. In all games compiled, 18 situation of intense confidence/optimism and 20 of intense helplessness/hopelessness were observed. RESULTS Intense affects of HE/HO were associated with decreasing HF-HRV (Fisher exact test, p =.003), increasing "nervousness" (p =.0005), decreasing "optimism" (p =.0005), and decreasing "calmness" (p =.0005). CONCLUSIONS Investigation of championship chess game players with an ELO strength > or = 2300 in a natural field setting revealed increasing HE/HO being associated with reduced HF-HRV suggestive of vagal withdrawal. Thus, our data may help link negative mood states, autonomic nervous system disturbances, and cardiac events.
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Affiliation(s)
- Alfons M Schwarz
- Department of Internal Medicine, Medical Division Lory, University of Berne Medical School, Berne, Switzerland
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Haimovici R, Rumelt S, Melby J. Endocrine abnormalities in patients with central serous chorioretinopathy. Ophthalmology 2003; 110:698-703. [PMID: 12689888 DOI: 10.1016/s0161-6420(02)01975-9] [Citation(s) in RCA: 118] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To investigate and to identify endocrine and metabolic abnormalities in patients with central serous chorioretinopathy (CSCR). DESIGN Observational case series. PARTICIPANTS Twenty-four patients with CSCR. METHODS Serum and urinary catecholamines, glucocorticoids, mineralocorticoids, serum testosterone, and thyroid-stimulating hormone (TSH) function were evaluated prospectively. RESULTS Fifty percent (12 of 24) of patients with active acute CSCR showed elevated 24-hour urine cortisol or tetrahydroaldosterone levels. Serum aldosterone levels were low in 7 of 24 (29.1%) patients. Single morning plasma catecholamine levels were elevated in 7 of 24 patients, although 24-hour urine metanephrines (catecholamine breakdown products) were normal. Serum testosterone and TSH levels were normal in nearly all (23 of 24) patients. CONCLUSION Many patients with acute CSCR have elevated 24-hour urine corticosteroids, which may contribute to the pathogenesis of the disorder. Endogenous mineralocorticoid dysfunction is a newly described feature of CSCR.
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Affiliation(s)
- Robert Haimovici
- Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts, USA
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Abstract
Central serous chorioretinopathy is a relatively common retinal disease characterized by the accumulation of subretinal fluid at the posterior pole of the fundus, creating a circumscribed area of serous retinal detachment. It typically affects young and middle-aged men with no previous medical and family history, and no systemic symptoms or signs. However, it has been noted that central serous chorioretinopathy is associated with different conditions, characterized by exposure to increased levels of endogenous or exogenous glucocorticoids. In fact, central serous chorioretinopathy has been described in patients with endogenous Cushing's syndrome. It is also prevalent in patients with type-A behavior, and following stressful events, and pregnancy probably represents a risk factor for central serous chorioretinopathy; these conditions are characterized by endogenous hypercortisolism. In addition, many cases of central serous chorioretinopathy have been described during or following treatment with glucocorticoids, administrated by any route, for various systemic or ocular conditions. Central serous chorioretinopathy, when related to the exposure to exogenous glucocorticoids, has a less prominent male predilection, presents more often with a chronic or atypical form, and is frequently bilateral. Furthermore, treatment of central serous chorioretinopathy with glucocorticoids was found to exacerbate the clinical picture. Based on these observations it could be suggested that glucocorticoids may be involved in the development of central serous chorioretinopathy, even though the exact pathogenic mechanism remains unclear. Glucocorticoids should not be used in the treatment of central serous chorioretinopathy and central serous chorioretinopathy should be added to the list of ocular complications of glucocorticoids.
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Bandello F, Incorvaia C, Rosa N, Parmeggiani F, Costagliola C, Sebastiani A. Bilateral central serous chorioretinopathy in a patient treated with systemic cortico-steroids for non-Hodgkin lymphoma. Eur J Ophthalmol 2002; 12:123-6. [PMID: 12022284 DOI: 10.1177/112067210201200208] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To describe the concomitant occurrence of systemic cortico-steroid treatment and the development of bilateral central serous chorioretinopathy (CSC), which promptly regressed after the reduction of the drug dosage, up to its scheduled withdrawal. METHODS Case report. RESULTS A 46-year-old white male, with a history of monolateral CSC, had a non-Hodgkin lymphoma on his right cheek. Soon after surgical excision of the tumoral lesion, he received a standard post-operative regimen of decreasing intramuscular betamethasone for 25 days, followed by 10 day's withdrawal, then cycles of intravenous cyclophosphamide and vincristine, followed by 7-day oral prednisone, repeated monthly for three months. Fluorescein angiographies at the end of the first oral cortico-steroid cycle and before starting the second, documented the occurrence of bilateral CSC and its regression, which were chronologically related respectively to the cortico-steroid administration and withdrawal. CONCLUSIONS This case further demonstrates that systemic cortico-steroids can be responsible for the occurrence of CSC. The patient's history should always be checked for any previous CSC episodes. In these subjects, periodical ophthalmoscopic examination is essential to discover early or asymptomatic steroid-related CSC patterns, to prevent complications of the disease.
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Affiliation(s)
- F Bandello
- Department of Ophthalmology, University of Ferrara, Italy.
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Perkins SL, Kim JE, Pollack JS, Merrill PT. Clinical characteristics of central serous chorioretinopathy in women. Ophthalmology 2002; 109:262-6. [PMID: 11825806 DOI: 10.1016/s0161-6420(01)00951-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To describe the clinical features of central serous chorioretinopathy (CSC) in women and identify factors predictive of complete recovery, moderate visual loss, and prolonged duration. DESIGN Retrospective observational case series. PARTICIPANTS Eighty-four eyes in 78 women with CSC seen in our practices between 1982 and 1999. METHODS Univariate and multivariate statistical analysis. MAIN OUTCOME MEASURES Analyses of three outcome parameters: complete recovery (recovery of visual acuity and complete symptom resolution), moderate visual acuity loss (final acuity less than 20/40), and duration of symptoms greater than 5 months. RESULTS Sixty-two percent (52 of 84) achieved complete recovery over a median of 5 months (range, 2-108 months) and 88% (74 of 84) had a final vision of 20/40 or better. Patients with subretinal precipitates (P = 0.001), single occurrence (P = 0.002), absence of hormone replacement therapy (HRT) (P = 0.01), duration less than 5 months (P = 0.02), or absence of a pigment epithelial detachment (PED) (P = 0.05) were more likely to recover completely. Recurrence (P = 0.03) and lack of subretinal precipitates (P = 0.03) were associated with a final vision less than 20/40. Age older than 50 (P = 0.004) and the presence of a PED (P = 0.02) were associated with duration longer than 5 months. CONCLUSIONS In women, CSC associated with subretinal precipitates, shorter duration, single occurrence, lack of HRT use, and absence of PED is more likely to resolve completely. CSC occurring in women older than 50 or associated with PED formation is more likely to take longer to resolve.
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Affiliation(s)
- Stephen L Perkins
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226-4812, USA
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Sloan RP, Bagiella E, Shapiro PA, Kuhl JP, Chernikhova D, Berg J, Myers MM. Hostility, gender, and cardiac autonomic control. Psychosom Med 2001; 63:434-40. [PMID: 11382270 DOI: 10.1097/00006842-200105000-00012] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Although considerable evidence implicates hostility in the development of coronary artery disease (CAD), the pathogenic mechanisms remain poorly understood. We have developed a psychophysiological model that holds that altered autonomic nervous system function links psychological traits with CAD outcomes. In laboratory studies, stressors reduce high-frequency (HF) heart period variability, an index of cardiac vagal modulation. With ambulatory electrocardiographic recording, we demonstrated in a predominantly male sample that hostility was inversely associated with HF power, but only during waking hours. These findings are consistent with the hypothesis that hostile individuals experience multiple stressful interpersonal transactions each day, resulting in overall lower HF power during the day but not at night. METHODS To further evaluate this hypothesis, we screened 96 subjects using the Cook-Medley Hostility Scale and selected 15 men and 15 women representing a wide distribution of hostility. These subjects were studied in a laboratory session assessing reactivity to psychological and orthostatic challenges with continuous electrocardiographic, blood pressure, and respiration monitoring. We predicted that for men and women, hostility would be inversely related to reductions in HF power in response to challenge. RESULTS In response to mental stressors, all measures of heart period variability change were inversely related to hostility as predicted. No such relationships were found for responses to tilt. The data suggested a possible effect of gender on these relationships. CONCLUSIONS These data add to the growing body of evidence showing that hostility influences vagal modulation of the cardiovascular system and suggest that altered autonomic control is a pathogenic mechanism linking hostility and CAD.
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Affiliation(s)
- R P Sloan
- Department of Psychiatry, Columbia University, New York, NY 10032, USA.
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Smith BD, Cranford D, Green L. Hostility and caffeine: cardiovascular effects during stress and recovery. PERSONALITY AND INDIVIDUAL DIFFERENCES 2001. [DOI: 10.1016/s0191-8869(00)00097-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Seeman TE, Singer B, Wilkinson CW, McEwen B. Gender differences in age-related changes in HPA axis reactivity. Psychoneuroendocrinology 2001; 26:225-40. [PMID: 11166486 DOI: 10.1016/s0306-4530(00)00043-3] [Citation(s) in RCA: 190] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Possible differences between men and women in age-related patterns of hypothalamic-pituitary-adrenal (HPA) axis response to challenge were examined to test the hypothesis that women show greater age-related increase in HPA axis reactivity to challenge. Twenty-six younger subjects, 9 men and 17 women, ages 22-26 and 14 older subjects, 7 men and 7 women, ages 67-88 participated in the study. Patterns of change in salivary "free" cortisol were measured in response to a standardized, 30-minute cognitive challenge, administered individually to each subject beginning at 1600 h. Consistent with previous research, there was a significant main effect for age with respect to baseline cortisol: older age was associated with higher baseline cortisol (P = <0.001). Results also provide support for the hypothesized age-by-gender interaction with respect to patterns of response to challenge. There was a significant interaction with respect to maximum percentage increase over baseline (P < 0.002): among younger adults, the men exhibited greater increases whereas among the older adults, the women exhibited greater increases. A similar, though only marginally significant pattern was seen for total area under the response curve (P = 0.07). Repeated measures ANOVA confirmed the gender-by-age differences in the patterns of response (P = 0.01 for time*age*gender interaction).
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Affiliation(s)
- T E Seeman
- Division of Geriatrics, UCLA School of Medicine, Los Angeles, CA 90095-1687, USA.
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Do benzodiazepines have a role in the prevention or treatment of coronary heart disease and other major medical disorders? J Psychiatr Res 2001; 24 Suppl 2:51-6. [PMID: 1980699 DOI: 10.1016/0022-3956(90)90035-o] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Increased coronary disease rates, as well as increased all-cause mortality, in persons with high levels of hostility/anger and in persons suffering from panic disorder or phobic anxiety suggest that biological concomitants of these traits/conditions lead to major medical illnesses. Benzodiazepines have effects, e.g. blunting of stress hormone responses, that could prevent disease in persons so predisposed. It will be necessary to identify subgroups with sufficiently high absolute rates of disease risk to justify pharmacological interventions, and then to carry out controlled prevention trials to document the benefits, before such approaches can be recommended for the general population. This approach (use of drugs when other measures fail) is now standard for more traditional risk factors, such as hyperlipidemia and hypertension. In contrast to primary prevention, a stronger case can be made for the use of benzodiazepines in secondary prevention. Research has shown benzodiazepine treatment to improve control of angina and to reduce "silent ischemia", directly suggesting clinical benefits to be gained from the effects of benzodiazepines to reduce stress hormone responses. While benzodiazepines have long been prescribed for the postmyocardial infarction patient, there are no controlled clinical trials documenting such benefits. These are now clearly in order so that the use of benzodiazepines in coronary patients can be advised on a rational basis.
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Cohen S, Hamrick N, Rodriguez MS, Feldman PJ, Rabin BS, Manuck SB. The stability of and intercorrelations among cardiovascular, immune, endocrine, and psychological reactivity. Ann Behav Med 2001; 22:171-9. [PMID: 11211850 DOI: 10.1007/bf02895111] [Citation(s) in RCA: 129] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
One hundred fifteen college students were exposed to an evaluative speech task twice, separated by 2 weeks. At both sessions, we assessed cardiovascular, endocrine, immune, and psychological response at baseline and during the task. We found stability across sessions for stress-induced increases in anxiety and task engagement, heart rate, blood pressure, norepinephrine (but not epinephrine), cortisol, natural killer cell cytotoxicity, and numbers of circulating CD3+, CD8+, and CD56+ (but not CD4+ or CD19+) lymphocytes. The stable cardiovascular, immune, and endocrine reactivities were intercorrelated, providing evidence of a unified physiological stress response across these outcomes. Although stable stress-induced increases in task engagement were associated with the physiological stress responses, stress-induced anxiety was not.
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Affiliation(s)
- S Cohen
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA
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Ricarte J, Salvador A, Costa R, Torres M, Subirats M. Heart rate and blood pressure responses to a competitive role-playing game. Aggress Behav 2001. [DOI: 10.1002/ab.1020] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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al'Absi M, Bongard S, Lovallo WR. Adrenocorticotropin responses to interpersonal stress: effects of overt anger expression style and defensiveness. Int J Psychophysiol 2000; 37:257-65. [PMID: 10858571 DOI: 10.1016/s0167-8760(00)00108-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study evaluated the influence of overt anger expression style and defensiveness on the hypothalamic-pituitary-adrenocortical (HPA) responses to acute psychological stress. These personality traits are thought to modulate the stress cardiovascular response and influence disease risk, however, little is known about their influence on HPA responses. Forty-six young, healthy male volunteers worked on counterbalanced extended public-speaking and mental arithmetic. The sample was dichotomitized into groups low vs. high in anger-out, using Spielberger's Anger-Expression Inventory, and in defensiveness, using the Marlowe-Crown Social Desirability Scale. Serum cortisol and adrenocorticotropic hormone (ACTH) concentrations were measured before and after performing each task. Heart rate (HR) and blood pressures (BP) were obtained continuously in 2-min intervals before, during and after the tasks. Public speaking produced greater adrenocortical and cardiovascular stress responses than mental arithmetic, and the greatest increases in ACTH occurred in subjects high in anger-out and defensiveness. These preliminary findings provide evidence that a mismatch between traits of preferred anger expression style and defensive style produces pronounced adrenocorticotropic responses during socially salient stress.
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Affiliation(s)
- M al'Absi
- University of Minnesota School of Medicine, Duluth, MN 55812-2487,
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Cagnacci A, Zanni AL, Veneri MG, Menozzi R, Volpe A, Rio GD. Influence of exogenous melatonin on catecholamine levels in postmenopausal women prior and during oestradiol replacement. Clin Endocrinol (Oxf) 2000; 53:367-72. [PMID: 10971455 DOI: 10.1046/j.1365-2265.2000.01099.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE In young individuals melatonin administration reduces circulating norepinephrine. Some effects of melatonin are reduced in elderly women and are modulated by gonadal steroids. Accordingly, the influence of melatonin on catecholamine levels was investigated in postmenopausal women without and with oestradiol replacement. DESIGN Prior to and after 2 months of transdermal oestradiol (50 microg/day), women were studied on two consecutive days, on which they received placebo or 1 mg of melatonin orally in a randomised and double-blind fashion. PATIENTS Fourteen healthy postmenopausal women. MEASUREMENTS Resting levels of epinephrine and norepinephrine and their responses to both a cold stimulus, performed by placing a hand in a basin of water and ice for 2 minutes, and to 10 minutes of upright position (upright test). RESULTS Prior to oestradiol, melatonin did not modify baseline or stimulated catecholamine levels. In contrast, during oestradiol, melatonin tended to reduce, although not significantly, baseline norepinephrine levels (P = 0.053), and significantly reduced peak values (P = 0.0061) and integrated norepinephrine response (P = 0.0076) to the cold stimulus. Responses of norepinephrine to the upright test were not modified, while those of epinephrine were increased (P = 0.042). During, but not prior to oestradiol replacement, modifications induced by melatonin (melatonin day-placebo day) in the norepinephrine response to the cold (r2 = 0. 457; P = 0.0079) and the upright (r2 = 0.747; P = 0.0001) tests were linearly and inversely related to the responses of the placebo day. CONCLUSIONS Melatonin does not modulate adrenergic activity in postmenopausal women without hormone replacement therapy. Oestradiol replacement restores the capability of melatonin to modulate adrenergic activity, particularly the norepinephrine response to stimuli.
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Affiliation(s)
- A Cagnacci
- Institute of Obstetrics and Gynecology of Modena, Italy.
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Abstract
Sexual dysfunction is a well-known symptom of depression. However, it has received little, if any, attention from clinicians and researchers. A review of published literature suggests that sexual dysfunction occurs in the majority of depressed patients. It has a major impact on the quality of life of the patients. The pathophysiology of sexual dysfunction in depression involves a complex interplay of various neurotransmitters and hormones. Clinicians need to be more proactive in enquiring about sexual dysfunction in depressed patients. More information is needed about the nature, prevalence and pathophysiology of sexual dysfunction in depression. Copyright 2000 John Wiley & Sons, Ltd.
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Affiliation(s)
- Albert Michael
- Department of Psychiatry, West Suffolk Hospital, Bury St Edmunds, IP33 2QZ, UK
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Bedi M, Varshney VP, Babbar R. Role of cardiovascular reactivity to mental stress in predicting future hypertension. Clin Exp Hypertens 2000; 22:1-22. [PMID: 10685721 DOI: 10.1081/ceh-100100058] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hypertension (HT) has been known since times immemorial to be one of the major causes of morbidity and mortality. It contributes to atherosclerotic cardiovascular disease, increasing its risk 2-3 times and is also associated with dyslipidemia, insulin resistance, glucose intolerance and obesity (1). The age of onset of hypertension is now earlier than before, making it essential that early detection of people who could be future hypertensives is done. Therefore, cardiovascular reactivity to stress in predicting future hypertension becomes important. In this fast paced age most people are exposed to mental stress which is the most common and prevalent form of stress. Increase in blood pressure (BP) in response to emotional arousal is well known, but support for this hypothesis of reactivity in predicting future hypertension is limited. We are attempting here to put forth a review of the various endeavours done so far to support this hypothesis.
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Affiliation(s)
- M Bedi
- Department of Physiology, Maulana Azad Medical College, Bahadur Shah Jafar Marg, New Delhi, India
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Schultheiss OC, Campbell KL, McClelland DC. Implicit power motivation moderates men's testosterone responses to imagined and real dominance success. Horm Behav 1999; 36:234-41. [PMID: 10603287 DOI: 10.1006/hbeh.1999.1542] [Citation(s) in RCA: 121] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study tested the hypothesis that implicit power motivation moderates individuals' testosterone responses to the anticipated success in and actual outcome of a dominance contest. Salivary testosterone levels were assessed in 42 male students at the beginning of the study, after they had imagined a success in an ensuing power contest, and immediately after the contest had taken place. Contest outcome (winning or losing against a competitor on a speed-based task) was varied experimentally. Participants' power motive was assessed with a picture-story exercise, in which an assertive, personalized (p Power) component was distinguished from an altruistic, socialized (s Power) component. In contrast to all other participants, individuals high only in p Power (a) had elevated testosterone after imagining a success in a subsequent dominance contest and (b) continued to have high testosterone levels after actually winning, but not after losing, the contest.
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Affiliation(s)
- O C Schultheiss
- Department of Psychology, Harvard University, William James Hall 1518, 33 Kirkland Street, Cambridge, Massachusetts, 02138, USA.
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Filaire E, Le Scanff C, Duché P, Lac G. The relationship between salivary adrenocortical hormones changes and personality in elite female athletes during handball and volleyball competition. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 1999; 70:297-302. [PMID: 10522287 DOI: 10.1080/02701367.1999.10608048] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Salivary cortisol, androstenedione delta 4, and dehydroepiandrosterone (DHEA) in 20 elite sportswomen were measured using radioimmunoassay in samples taken 5 min before and after a handball or volleyball competition. Three psychometric tests--State Trait Anxiety Inventory, Bortner, and Questionnaire de Personnalité pour Sportifs (questionnaire of personality for sports participants)--were used to evaluate the participants' personalities. Results indicated higher concentrations of cortisol and lower concentrations of delta 4 and DHEA in handball players before and after the competition. Cortisol values increased significantly during the competition in both groups. No changes were observed in androgen levels. The state of anxiety was higher in handball players, characterized by Pattern A behavior, whereas Pattern B behavior defined the volleyball players. The results suggest that adrenocortical changes during handball and volleyball competition are influenced by the different energy systems required by the two activities, individual personality characteristics, and the athlete's anxiety level relative to winning or losing.
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Affiliation(s)
- E Filaire
- Movement Performance Laboratory, Blaise Pascal University
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