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Putra IGNE, Daly M, Sutin A, Steptoe A, Scholes S, Robinson E. Obesity, psychological well-being related measures, and risk of seven non-communicable diseases: evidence from longitudinal studies of UK and US older adults. Int J Obes (Lond) 2024; 48:1283-1291. [PMID: 38824226 PMCID: PMC11347379 DOI: 10.1038/s41366-024-01551-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND We examined the role of psychological well-being related measures in explaining the associations between obesity and increased risk of non-communicable diseases (NCDs: hypertension, heart disease, stroke, diabetes, arthritis, cancer, and memory-related disease) in older adults. METHODS Data were from the English Longitudinal Study of Ageing (ELSA), UK (baseline: Wave 4-2008/2009; n = 8127) and the Health and Retirement Study (HRS), US (baseline: Waves 9 and 10-2008/2010; n = 12,477). Objective body mass index was used to define obesity. A range of psychological well-being related measures (e.g., depressive symptoms, life satisfaction) was available in ELSA (n = 7) and HRS (n = 15), and an index of overall psychological well-being was developed separately in each study. NCDs were from a self-reported doctor diagnosis and/or other assessments (e.g., biomarker data) in both studies; and in ELSA, NCDs from linked hospital admissions data were examined. Longitudinal associations between obesity status, psychological well-being measures, and NCDs were examined using Cox proportional hazard models (individual NCDs) and Poisson regression (a cumulative number of NCDs). Mediation by psychological well-being related measures was assessed using causal mediation analysis. RESULTS Obesity was consistently associated with an increased prospective risk of hypertension, heart disease, diabetes, arthritis, and a cumulative number of NCDs in both ELSA and HRS. Worse overall psychological well-being (index measure) and some individual psychological well-being related measures were associated with an increased prospective risk of heart disease, stroke, arthritis, memory-related disease, and a cumulative number of NCDs across studies. Findings from mediation analyses showed that neither the index of overall psychological well-being nor any individual psychological well-being related measures explained (mediated) why obesity increased the risk of developing NCDs in both studies. CONCLUSION Obesity and psychological well-being may independently and additively increase the risk of developing NCDs.
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Affiliation(s)
- I Gusti Ngurah Edi Putra
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK.
| | - Michael Daly
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Angelina Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Andrew Steptoe
- Department of Epidemiology and Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, UK
| | - Shaun Scholes
- Department of Epidemiology and Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, UK
| | - Eric Robinson
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
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Keweloh B, Terenzi D, Froehlich E, Coricelli C, Stürmer P, Rohmann N, Wietzke-Braun P, Beckmann A, Laudes M, Park SQ. Weight loss impacts risky decisions in obesity. Clin Nutr 2024; 43:1270-1277. [PMID: 38653010 DOI: 10.1016/j.clnu.2024.04.002] [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: 04/01/2023] [Revised: 12/15/2023] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND & AIMS Risky decision making is shaped by individual psychological and metabolic state. Individuals with obesity show not only altered risk behavior, but also metabolic and psychological abnormalities. The aim of the present study was to investigate whether a substantial weight loss in individuals with severe obesity will 1) normalize their metabolic and psychological state and 2) will change their pattern of decision guidance. METHODS We assessed the effect of glycated hemoglobin (HbA1c) and mood on risk behavior in individuals with obesity (n = 62, 41 women; BMI, 46.5 ± 4.8 kg/m2; age, 44.9 ± 14.7 years) before and after 10-weeks weight loss intervention. RESULTS Results showed that this intervention reduced participants' risk behavior, which was significantly predicted by their changes in BMI. Before intervention, mood, but not HbA1c significantly predicted decisions. After the weight loss, mood no longer, but HbA1c significantly predicted decisions. CONCLUSION Our findings shed light on the psychological and metabolic mechanisms underlying altered risky decision making in severe obesity and can inform the development of strategies in the context of weight loss interventions.
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Affiliation(s)
- Beatrix Keweloh
- Department of Decision Neuroscience & Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany; German Center for Diabetes Research, 85764 München-Neuherberg, Germany; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Neuroscience Research Center, 10117, Berlin, Germany.
| | - Damiano Terenzi
- Department of Decision Neuroscience & Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany; German Center for Diabetes Research, 85764 München-Neuherberg, Germany; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Neuroscience Research Center, 10117, Berlin, Germany; Institut de Neurosciences de la Timone, Aix-Marseille Université, CNRS UMR 7289, Marseille, France
| | - Eva Froehlich
- Department of Decision Neuroscience & Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Neuroscience Research Center, 10117, Berlin, Germany
| | - Carol Coricelli
- Department of Decision Neuroscience & Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany; German Center for Diabetes Research, 85764 München-Neuherberg, Germany; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Neuroscience Research Center, 10117, Berlin, Germany; Institut Lyfe Research and Innovation Center, 69139 Écully, France
| | - Paula Stürmer
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Internal Medicine 1, University of Kiel, 24105 Kiel, Germany; Institute of Epidemiology, University of Kiel, 24105 Kiel, Germany
| | - Nathalie Rohmann
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Internal Medicine 1, University of Kiel, 24105 Kiel, Germany; Institute of Diabetes and Clinical Metabolic Research, University Medical Centre, 24105 Kiel, Germany
| | - Perdita Wietzke-Braun
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Internal Medicine 1, University of Kiel, 24105 Kiel, Germany
| | - Alexia Beckmann
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Internal Medicine 1, University of Kiel, 24105 Kiel, Germany
| | - Matthias Laudes
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Internal Medicine 1, University of Kiel, 24105 Kiel, Germany; Institute of Diabetes and Clinical Metabolic Research, University Medical Centre, 24105 Kiel, Germany
| | - Soyoung Q Park
- Department of Decision Neuroscience & Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany; German Center for Diabetes Research, 85764 München-Neuherberg, Germany; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Neuroscience Research Center, 10117, Berlin, Germany
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Putra IGNE, Daly M, Sutin A, Steptoe A, Robinson E. The psychological legacy of past obesity and early mortality: evidence from two longitudinal studies. BMC Med 2023; 21:448. [PMID: 37974151 PMCID: PMC10655273 DOI: 10.1186/s12916-023-03148-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND We test a novel 'weight scarring' hypothesis which suggests that past obesity is associated with impairments in current psychological well-being and this increases risk of negative physical health outcomes associated with obesity. Across two nationally representative studies, we tested whether past obesity is associated with current psychological outcomes and whether these psychological outcomes explain the association between past obesity and subsequent early mortality. METHODS Data were from the National Health and Nutrition Examination Survey (NHANES) (n = 29,047) and the Health and Retirement Study (HRS) (n = 11,998). Past obesity was defined based on maximum lifetime weight in NHANES and the highest weight from past study waves in the HRS. Across both studies, current depressive symptoms were analysed. A set of 10 additional well-being measures were combined to produce an 'index of impaired well-being' in HRS. Subsequent all-cause mortality was examined using National Deaths Index records in NHANES and household interviews in HRS. Linear or logistic regression, Cox proportional hazard regression, and causal mediation models were used. RESULTS We found that past obesity was associated with greater current depressive symptoms after controlling for current weight status and in analyses limited to those who were no longer classified as having obesity in NHANES (β = 0.17; 95% CI: 0.13, 0.22) and HRS (β = 0.20; 95% CI: 0.08, 0.31). In HRS, past obesity was also associated with a range of current negative psychological outcomes, including an index of impaired psychological well-being (β = 0.16; 95% CI: 0.05, 0.27). Past obesity was associated with a higher risk of early mortality in both NHANES and HRS (HR = 1.31; 95% CI: 1.16, 1.48 and HR = 1.34; 95% CI: 1.20, 1.50, respectively). Depressive symptoms explained 6% (95% CI: 0.01, 0.10) and 5% (95% CI: 0.01, 0.09) of the association between past obesity and premature mortality in NHANES and HRS, respectively. Impaired psychological well-being partly mediated the association between past obesity and premature mortality by 10% (95% CI: 0.04, 0.16) in HRS. CONCLUSIONS Our findings suggest that there may be a psychological legacy of past obesity that is associated with raised mortality risk. Ensuring people with obesity receive psychological support even after experiencing weight loss may be important.
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Affiliation(s)
- I Gusti Ngurah Edi Putra
- Department of Psychology, Institute of Population Health, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK.
| | - Michael Daly
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Angelina Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, USA
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, UK
| | - Eric Robinson
- Department of Psychology, Institute of Population Health, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK
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Romero-Rebollar C, García-Gómez L, Báez-Yáñez MG, Gutiérrez-Aguilar R, Pacheco-López G. Adiposity affects emotional information processing. Front Psychol 2022; 13:879065. [PMID: 36225672 PMCID: PMC9549075 DOI: 10.3389/fpsyg.2022.879065] [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: 02/18/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Obesity is a worldwide epidemic associated with severe health and psychological wellbeing impairments expressed by an increased prevalence of affective disorders. Emotional dysfunction is important due to its effect on social performance. The aim of the present narrative review is to provide a general overview of human research exploring emotional information processing in overweight and obese people. Evidence suggests that obesity is associated with an attenuation of emotional experience, contradictory findings about emotion recognition, and scarce research about automatic emotional information processing. Finally, we made some concluding considerations for future research on emotional information processing in overweight and obese people.
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Affiliation(s)
| | - Leonor García-Gómez
- School of Psychology, Intercontinental University (UIC), Mexico City, Mexico
- Department of Research on Smoking and COPD, National Institute of Respiratory Diseases (INER) Ismael Cosío Villegas, Mexico City, Mexico
| | - Mario G. Báez-Yáñez
- Radiology Department, University Medical Center Utrecht, Utrecht, Netherlands
| | - Ruth Gutiérrez-Aguilar
- Division of Research, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
- Laboratory of Metabolic Diseases: Obesity and Diabetes, Hospital Infantil de México “Federico Gómez”, Mexico City, Mexico
| | - Gustavo Pacheco-López
- Health Sciences Department, Metropolitan Autonomous University (UAM), Lerma, Mexico
- *Correspondence: Gustavo Pacheco-López,
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Conradson HE, Hayden KA, Russell‐Mayhew S, Raffin Bouchal S, King‐Shier K. Positive psychological well‐being in women with obesity: A scoping review of qualitative and quantitative primary research. Obes Sci Pract 2022; 8:691-714. [DOI: 10.1002/osp4.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 03/30/2022] [Accepted: 04/06/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - K. Alix Hayden
- Libraries & Cultural Resources University of Calgary Calgary Alberta Canada
| | - Shelly Russell‐Mayhew
- Counselling Psychology Werklund School of Education University of Calgary Calgary Alberta Canada
| | | | - Kathryn King‐Shier
- Faculty of Nursing Department of Community Health Sciences University of Calgary Calgary Alberta Canada
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Fritsch J, Feil K, Weyland S, Schmidt D, Jekauc D. Effectivity of a mHealth intervention for individuals with obesity: a study protocol for a controlled intervention study. BMC Sports Sci Med Rehabil 2021; 13:112. [PMID: 34535188 PMCID: PMC8446725 DOI: 10.1186/s13102-021-00337-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/06/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Obesity is considered an epidemic problem with an increasing number of individuals affected. The physical and psychological complaints associated with obesity point to the importance of implementing effective interventions. Innovative mHealth applications appear to be promising in helping provide a continuous and flexible support during the intervention. Since research on mHealth interventions is still relatively sparse, the main goal of the current study is to assess the effectiveness of an mHealth obesity intervention in terms of weight reduction, health behaviours as well as health-related quality of life. In addition, the study aims to investigate various psychological explicit and implicit processes associated with physical activity behaviour. METHODS The study includes quantitative and qualitative methods. Regarding the quantitative methods, the goal is to recruit up to 450 individuals at baseline in different obesity centres across Germany with some of these centres offering an mHealth intervention. All individuals who agree to take part in the mHealth intervention will be assigned to the intervention group, while all other individuals will be assigned to the control group. The mHealth obesity intervention consists of three stays at an obesity centre, with approximately six months between stays during which patients are supported by the digital platform CASPAR. The study includes three measurements with a baseline measurement and two follow-up measurements, one after six months and one after twelve months. To assess the effectiveness of the intervention, body weight, physical activity behaviour, eating behaviour as well as health related quality of life will be assessed. In addition, motivation, intentions, self-efficacy, enjoyment, and habit will be used to assess the psychological processes related with physical activity behaviour. A multivariate analysis of variance with repeated measurement and latent growth curve models will be used to compare the development of the variables within the two groups. In relation to the qualitative methods, interviews with individuals of the intervention group will be conducted to shed light on the applicability, acceptance, and usability of the mHealth intervention. DISCUSSION This study may provide a valuable insight into the potential of mHealth obesity interventions and the psychological processes related to physical activity behaviour. Trial registration The trial has been registered with the German Register of Clinical Studies (DRKS) on June 30, 2021 under the registration number: DRKS00024836.
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Affiliation(s)
- Julian Fritsch
- Institute for Sport and Sport Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
| | - Katharina Feil
- Institute for Sport and Sport Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Susanne Weyland
- Institute for Sport and Sport Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Detlef Schmidt
- Institute for Sport and Sport Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Darko Jekauc
- Institute for Sport and Sport Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
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Sierra I, Senín-Calderón C, Roncero M, Perpiñá C. The Role of Negative Affect in Emotional Processing of Food-Related Images in Eating Disorders and Obesity. Front Psychol 2021; 12:723732. [PMID: 34497567 PMCID: PMC8419244 DOI: 10.3389/fpsyg.2021.723732] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/29/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study was to analyze differences in the emotional processing (valence, arousal, and dominance) of food-related information in patients with eating disorders (ED), patients with obesity, and healthy women. Moreover, the mediator role of negative affect and the moderating role of the diagnostic group (ED vs. non-ED) were analyzed. METHOD The sample consisted of 94 women (39 with eating disorders, 19 with obesity, and 36 healthy participants). MEASURES International Affective Picture System (IAPS) food picture exposure task; Self-Assessment Manikin Analog-Visual Scale (SAM) appraising Arousal, Valence, and Dominance; Eating Attitudes Test (EAT-26); Positive and Negative Affect Schedule (PANAS). RESULTS Patients with purging symptomatology rated food images as more unpleasant than healthy women. Patients with purging and restrictive eating symptomatology showed higher levels of arousal and less dominance over the emotions experienced, compared to patients with obesity and healthy women. The mediation analysis showed that negative affect mediated the relationship between eating symptomatology (EAT-26) and the Valence of food images, as well as the control over the emotions experienced when viewing food images (Dominance). For the moderation analysis participants were regrouped into two groups (ED patients vs. non-ED patients). The direct relationship between eating symptomatology and food image valence was moderated by the diagnostic group. However, the group did not moderate the direct relationship between the EAT-26 and dominance over experienced emotions, or the indirect effect on eating symptomatology through negative affect. These results show the relevance of negative affect in the emotional processing of food-related information, and they support an eating disorder-disordered eating dimensional perspective.
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Affiliation(s)
- Irene Sierra
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Valencia, Spain
| | | | - María Roncero
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Valencia, Spain
| | - Conxa Perpiñá
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Valencia, Spain
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DuPont CM, Wright AGC, Manuck SB, Muldoon MF, Jennings JR, Gianaros PJ. Is stressor-evoked cardiovascular reactivity a pathway linking positive and negative emotionality to preclinical cardiovascular disease risk? Psychophysiology 2020; 58:e13741. [PMID: 33278305 DOI: 10.1111/psyp.13741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/06/2020] [Accepted: 11/10/2020] [Indexed: 11/28/2022]
Abstract
Stressor-evoked cardiovascular reactivity, trait positive emotionality, and negative emotionality are all associated with cardiovascular disease. It is unknown, however, whether cardiovascular reactivity may constitute a pathway by which trait positive or negative emotionality relates to disease risk. Accordingly, this study modeled the cross-sectional relationships between trait positive and negative emotionality, stressor-evoked cardiovascular reactivity, and severity of a subclinical vascular marker of cardiovascular risk, carotid artery intima-media thickness (CA-IMT). The sample consisted of healthy, midlife adults free from clinical cardiovascular disease (N = 286; ages 30-54; 50% female). Trait positive and negative emotionality were measured by three questionnaires. Heart rate and blood pressure reactivity were assessed across three stressor tasks. CA-IMT was assessed by ultrasonography. Latent factors of positive and negative emotionality, blood pressure reactivity, heart rate reactivity, and CA-IMT were created using structural equation modeling. Greater negative emotionality was marginally associated with more CA-IMT (β = .21; p = .049), but lower blood pressure reactivity (β = -.19; p = .03). However, heightened blood pressure (β = .21; p = .03), but not heart rate reactivity (β = -.05; p = .75), associated with greater CA-IMT. Positive emotionality was uncorrelated with cardiovascular reactivity (blood pressure: β = -.04; p = .61; heart rate: β = .16; p = .11) and CA-IMT (β = .16; p = .07). Although trait negative emotionality associates with a known marker of cardiovascular disease risk, independent of positive emotionality, it is unlikely to occur via a stressor-evoked cardiovascular reactivity pathway.
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Affiliation(s)
- Caitlin M DuPont
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen B Manuck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matthew F Muldoon
- Heart and Vascular Institute, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - J Richard Jennings
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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Piccolo M, Milos G, Bluemel S, Schumacher S, Müller-Pfeiffer C, Fried M, Ernst M, Martin-Soelch C. Effects of hunger on mood and affect reactivity to monetary reward in women with obesity - A pilot study. PLoS One 2020; 15:e0232813. [PMID: 32428002 PMCID: PMC7237012 DOI: 10.1371/journal.pone.0232813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 04/22/2020] [Indexed: 11/18/2022] Open
Abstract
Worldwide, nearly 3 million people die every year because of being overweight or obese. Although obesity is a metabolic disease, behavioral aspects are important in its etiology. Hunger changes the rewarding potential of food in normal-weight controls. In obesity, impairments related to reward processing are present, but it is not clear whether these are due to mental disorders more common among this population. Therefore, in this pilot study, we aimed at investigating whether fasting influence mood reactivity to reward in people with obesity. Women with obesity (n = 11, all mentally healthy) and normal weight controls (n = 17) were compared on a computerized monetary reward task (the wheel of fortune), using self-reports of mood and affect (e.g., PANAS and mood evaluation during the task) as dependent variables. This task was done in 2 satiety conditions, during fasting and after eating. Partially, in line with our expectation of a reduced affect and mood reactivity to monetary reward in participants with obesity accentuated by fasting, our results indicated a significant within-group difference across time (before and after the task), with monetary gains significantly improving positive affect in healthy controls (p>0.001), but not in individuals with obesity (p = 0.32). There were no significant between-group differences in positive affect before (p = 0.328) and after (p = 0.70) the task. In addition, women with obesity, compared to controls, reported more negative affect in general (p < 0.05) and less mood reactivity during the task in response to risky gains (p < 0.001) than healthy controls. The latter was independent of the level of satiety. These preliminary results suggest an impairment in mood reactivity to monetary reward in women with obesity which is not connected to the fasting state. Increasing the reinforcing potential of rewards other than food in obesity may be one target of intervention in order to verify if that could reduce overeating.
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Affiliation(s)
- Mayron Piccolo
- Unit of Clinical and Health Psychology, University of Fribourg, Fribourg, Switzerland
| | - Gabriella Milos
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sena Bluemel
- Division of Gastroenterology and Hepatology, University Hospital of Zurich, Zurich, Switzerland
| | - Sonja Schumacher
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christoph Müller-Pfeiffer
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Fried
- Division of Gastroenterology and Hepatology, University Hospital of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, Zurich, Switzerland
| | - Monique Ernst
- Section on Neurobiology of Fear and Anxiety, National Institutes of Mental Health, Bethesda, Maryland, United States America
| | - Chantal Martin-Soelch
- Unit of Clinical and Health Psychology, University of Fribourg, Fribourg, Switzerland
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Herhaus B, Ullmann E, Chrousos G, Petrowski K. High/low cortisol reactivity and food intake in people with obesity and healthy weight. Transl Psychiatry 2020; 10:40. [PMID: 32066711 PMCID: PMC7026436 DOI: 10.1038/s41398-020-0729-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/04/2020] [Accepted: 01/13/2020] [Indexed: 01/09/2023] Open
Abstract
Increased food intake, termed "comfort eating", is a pathologic coping mechanism in chronic stress. Cortisol reactivity under stress is a potent predictor of stress-induced eating behavior affecting the body mass index (BMI). However, cortisol reactivity and food intake under stress in people with obesity has not been evaluated. The aim of this study was to investigate the effect of high/low cortisol reactivity on food intake in people with obesity and healthy weight test controls, following standardized stress induction and a resting condition. Thirty-six men and women with obesity (BMI: 33.00 ± 3.23 kg/m²), as well as 36 age- and gender-matched healthy weight controls (BMI: 21.98 ± 1.81 kg/m²) were categorized into high cortisol reactors (HCR) and low cortisol reactors (LCR) in the Trier Social Stress Test (TSST). Following the TSST and a resting condition, the food intake of all participants was recorded in a standardized laboratory meal. Obese HCR demonstrated a significantly higher food intake than LCR (t (34) = -2.046, p ≤ 0.05). However, there were no significant differences between HCR and LCR in the healthy weight controls (p = 0.26). In addition, HCR of the people with obesity showed lower values in the emotion coping strategy of cognitive reappraisal than obese LCR (t (32) = 2.087, p ≤ 0.05). In conclusion, the magnitude of the cortisol reactivity to stress predicts stress-induced food intake in people with obesity, but not in the healthy weight controls. Limited use of cognitive reappraisal in emotion regulation in the obese HCR may be a marker of vulnerability to stress-induced eating.
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Affiliation(s)
- Benedict Herhaus
- Medical Psychology and Medical Sociology, Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medicine Mainz, Mainz, Germany.
| | - Enrico Ullmann
- Department of Medicine, Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Leipzig, Germany
- School of Medical Biology, South Ural State University, Chelyabinsk, Russia
| | - George Chrousos
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Katja Petrowski
- Medical Psychology and Medical Sociology, Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medicine Mainz, Mainz, Germany
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Insatisfacción corporal y calidad de vida : contribución a la ocurrencia de conductas alimentarias anómalas en administrativos hospitalarios. ACTA COLOMBIANA DE PSICOLOGIA 2020. [DOI: 10.14718/acp.2020.23.1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
El objetivo del presente estudio consistió en evaluar la capacidad predictiva de variables como el índice de masa corporal (IMC), la imagen corporal, el afecto positivo y negativo, las actitudes hacia la gente obesa y la calidad de vida (CV) sobre las conductas alimentarias anómalas del personal administrativo del sector salud en la Ciudad de México, además de conocer las diferencias entre los sexos y del IMC en las variables de estudio. En total, participaron 181 trabajadores administrativos, divididos según su IMC (normo peso, sobrepeso, obesidad), que completaron una hoja de datos generales y cuestionarios de autor reporte. En general, se encontró que la insatisfacción de la imagen corporal, aunada a la percepción de vitalidad y bienestar físico, podría explicar en parte la presencia del comportamiento alimentario anómalo, el cual favorece a la ganancia excesiva de peso corporal. Adicionalmente, se observaron diferencias significativas entre los sexos en el afecto positivo, además de diferencias entre el grupo con obesidad y el grupo normo peso en insatisfacción corporal, afecto negativo, funcionamiento físico, rol físico y funcionamiento social.
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Positive and negative affect as predictors of social functioning in Spanish children. PLoS One 2018; 13:e0201698. [PMID: 30071086 PMCID: PMC6072041 DOI: 10.1371/journal.pone.0201698] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 07/20/2018] [Indexed: 12/22/2022] Open
Abstract
The aim of this study was to analyze the relationship between affect in its two commonly used theoretical categories, positive affect (PA) and negative affect (NA), and social functioning dimensions (school performance, family relationships, peer relationships and home duties/self-care). The sample comprised 390 students of primary education aged 8–11 years (M = 9.39; SD = 1.15). The short-form of the Positive and Negative Affect Schedule for children (PANAS-C-SF) and the Child and Adolescent Social Adaptive Functioning Scale (CASAFS) were used. Student’s t tests indicated that those reporting high levels on all the social functioning dimensions also reported significantly higher levels of PA than peers who reported low levels; by contrast, students reporting high levels of social functioning reported significantly lower levels of NA than peers who reported low levels. Similarly, logistic regression analyses showed that an increase in PA increased probability of high levels of social functioning, and that an increase in NA decreased the probability of presenting high levels of social functioning dimensions, with the exception of school performance. These results expand the PA and NA relationship with social functioning reported in adults to Spanish children, which is potentially of interest in the fields of Education and Psychology.
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Abstract
Statins are used widely in primary and secondary prevention of cardiovascular disease; a treatment effect that has long been thought to be due to their cholesterol-lowering properties. However, statins also have a wide range of anti-inflammatory effects independent of their lipid-lowering mechanisms. In depression, low-grade inflammation is a replicated finding, and several studies have shown antidepressant properties of diverse anti-inflammatory drugs. Large observational studies have suggested reduced risks of depression amongst those taking statins, an effect that is thought to be explained by the anti-inflammatory properties of this class of drugs. Also, preliminary randomized controlled trials (RCTs) have indicated that statins may have adjunctive antidepressant effects when used as add-on treatment to selective serotonin reuptake inhibitors (SSRIs). However, the RCTs were small and limited by low generalizability, and some early observational studies have pointed towards potential neuropsychiatric adverse effects of statin treatment. Nevertheless, based on the good tolerability and general safety of the statins, researchers are currently investigating the potential antidepressant properties of these agents. The present review aims to give an overview on the potential antidepressant effects of statins based on their anti-inflammatory properties, covering topics such as safety versus treatment effects, potential mechanisms of action and the possibility of targeted treatment (precision medicine).
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Affiliation(s)
- Ole Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital, Skovagervej 2, 8240, Risskov, Denmark. .,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. .,Mental Health Centre Copenhagen, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Christiane Gasse
- National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark.,iPSYCH, The Lundbeck Initiative for Integrated Research in Psychiatry, Aarhus, Denmark
| | - Michael Berk
- Deakin University, School of Medicine, IMPACT Strategic Research Centre, Geelong, VIC, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,The Florey Institute for Neuroscience and Mental Health, Parkville, VIC, Australia.,Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Søren Dinesen Østergaard
- Psychosis Research Unit, Aarhus University Hospital, Skovagervej 2, 8240, Risskov, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Liu Z, Huang J, Qian D, Chen F, Xu J, Li S, Jin L, Wang X. Does Low Body Mass Index Matter? Relationship between Body Mass Index and Subjective Well-Being among Long-Lived Women over 95 Years of Age. J Nutr Health Aging 2016; 20:99-105. [PMID: 26812504 DOI: 10.1007/s12603-015-0556-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To examine the relationship between body mass index (BMI) and subjective well-being (SWB) among long-lived women over 95 years of age and evaluate whether this relationship is mediated by functional ability. DESIGN Retrospective cohort study. SETTING Data from the Rugao longevity cohort, a population-based study in Rugao, China. PARTICIPANTS A sample of 342 long-lived women (mean age 97.4 ± 2.1, range 95-107) whose SWB and other covariates were available were included in this study. MEASUREMENTS BMI was calculated as weight in kilograms divided by height in meters-squared (kg/m(2)). SWB was measured by life satisfaction (LS), positive affect (PA), negative affect (NA) and affect balance (AB). Functional ability was assessed by the Katz Index of Activities of Daily Living (ADL). RESULTS According to BMI classification standards for China, the underweight group had lower levels of LS than the normal and overweight groups (28.62 vs. 30.51 and 31.57, respectively; p<.05). Correlation analysis showed that BMI was significantly related to LS (r = 0.166, p<.01). The strength of the BMI and LS association was diminished when ADL was included in the general linear regression models. Mediation analysis revealed that ADL mediated this relationship (effect size = 22.6%). We did not observe significant associations of BMI with other SWB components (PA, NA, and AB). CONCLUSION For long-lived women, low BMI, rather than elevated BMI, is an indicator of poor psychological well-being. The findings call for public health awareness about low body weight in long-lived women, especially in those with physical disabilities when focusing on quality of life.
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Affiliation(s)
- Z Liu
- Xiaofeng Wang, School of Life Sciences, Fudan University, 220 Handan Rd., Shanghai 200433, China. Tel+86 21 65643714; Fax: +86 21 65642426; E-mail address:
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van der Burg JW, Sen S, Chomitz VR, Seidell JC, Leviton A, Dammann O. The role of systemic inflammation linking maternal BMI to neurodevelopment in children. Pediatr Res 2016; 79:3-12. [PMID: 26375474 PMCID: PMC4888781 DOI: 10.1038/pr.2015.179] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 07/01/2015] [Indexed: 11/09/2022]
Abstract
Children of obese mothers are at increased risk of developmental adversities. Maternal obesity is linked to an inflammatory in utero environment, which, in turn, is associated with neurodevelopmental impairments in the offspring. This is an integrated mechanism review of animal and human literature related to the hypothesis that maternal obesity causes maternal and fetal inflammation, and that this inflammation adversely affects the neurodevelopment of children. We propose integrative models in which several aspects of inflammation are considered along the causative pathway linking maternal obesity with neurodevelopmental limitations.
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Affiliation(s)
- Jelske W. van der Burg
- Department of Health and Life Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Sarbattama Sen
- Department of Pediatrics and Mother Infant Research Institute, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts, USA
- Jean Mayer Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Virginia R. Chomitz
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Jaap C. Seidell
- Department of Health and Life Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Alan Leviton
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Olaf Dammann
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Perinatal Epidemiology Unit, Hannover Medical School, Hannover, Germany
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Park AE, Huynh P, Schell AM, Baker LA. Relationship between obesity, negative affect and basal heart rate in predicting heart rate reactivity to psychological stress among adolescents. Int J Psychophysiol 2015; 97:139-44. [PMID: 26049136 PMCID: PMC4685043 DOI: 10.1016/j.ijpsycho.2015.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 05/20/2015] [Accepted: 05/27/2015] [Indexed: 11/29/2022]
Abstract
Reduced cardiovascular responses to psychological stressors have been found to be associated with both obesity and negative affect in adults, but have been less well studied in children and adolescent populations. These findings have most often been interpreted as reflecting reduced sympathetic nervous system response, perhaps associated with heightened baseline sympathetic activation among the obese and those manifesting negative affect. However, obesity and negative affect may themselves be correlated, raising the question of whether they both independently affect cardiovascular reactivity. The present study thus examined the separate effects of obesity and negative affect on both cardiovascular and skin conductance responses to stress (e.g., during a serial subtraction math task) in adolescents, while controlling for baseline levels of autonomic activity during rest. Both obesity and negative affect had independent and negative associations with cardiovascular reactivity, such that reduced stress responses were apparent for obese adolescents and those with high levels of negative affect. In contrast, neither obesity nor negative affect was related to skin conductance responses to stress, implicating specifically noradrenergic mechanisms rather than sympathetic mechanisms generally as being deficient. Moreover, baseline heart rate was unrelated to obesity in this sample, which suggests that heightened baseline of sympathetic activity is not necessary for the reduced cardiovascular reactivity to stress.
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Affiliation(s)
- Andres E Park
- Department of Psychology, Seeley G. Mudd Building Room 501, University of Southern California, 3620 South McClintock Ave., Los Angeles, CA 90007, United States
| | - Pauline Huynh
- Department of Psychology, Seeley G. Mudd Building Room 501, University of Southern California, 3620 South McClintock Ave., Los Angeles, CA 90007, United States
| | - Anne M Schell
- Department of Psychology, Occidental College, 1600 Campus Rd, Los Angeles, CA 90041, United States.
| | - Laura A Baker
- Department of Psychology, Seeley G. Mudd Building Room 501, University of Southern California, 3620 South McClintock Ave., Los Angeles, CA 90007, United States
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Affiliation(s)
- Michael Berk
- IMPACT Strategic Research Centre, Deakin University, Melbourne, Australia Department of Psychiatry, Orygen Research Centre, and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Lesley Berk
- Mental Health and Wellbeing Strategic Research Centre, School of Psychology, Deakin University, Melbourne, Australia Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Tim Denton
- School of Medicine, Deakin University, Geelong, Australia Barwon Medicare Local, Geelong, Australia
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Moylan S, Berk M, Dean OM, Samuni Y, Williams LJ, O'Neil A, Hayley AC, Pasco JA, Anderson G, Jacka FN, Maes M. Oxidative & nitrosative stress in depression: why so much stress? Neurosci Biobehav Rev 2014; 45:46-62. [PMID: 24858007 DOI: 10.1016/j.neubiorev.2014.05.007] [Citation(s) in RCA: 268] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/17/2014] [Accepted: 05/13/2014] [Indexed: 12/29/2022]
Abstract
Many studies support a crucial role for oxidative & nitrosative stress (O&NS) in the pathophysiology of unipolar and bipolar depression. These disorders are characterized inter alia by lowered antioxidant defenses, including: lower levels of zinc, coenzyme Q10, vitamin E and glutathione; increased lipid peroxidation; damage to proteins, DNA and mitochondria; secondary autoimmune responses directed against redox modified nitrosylated proteins and oxidative specific epitopes. This review examines and details a model through which a complex series of environmental factors and biological pathways contribute to increased redox signaling and consequently increased O&NS in mood disorders. This multi-step process highlights the potential for future interventions that encompass a diverse range of environmental and molecular targets in the treatment of depression.
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Affiliation(s)
- Steven Moylan
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; Barwon Health, Geelong, Victoria, Australia.
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; Florey Institute for Neuroscience and Mental Health University of Melbourne, Parkville, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, Victoria, Australia; University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville 3052, Australia; Barwon Health, Geelong, Victoria, Australia; Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Olivia M Dean
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; Florey Institute for Neuroscience and Mental Health University of Melbourne, Parkville, Victoria, Australia; University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville 3052, Australia
| | - Yuval Samuni
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Lana J Williams
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville 3052, Australia
| | - Adrienne O'Neil
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, Victoria, Australia
| | - Amie C Hayley
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Julie A Pasco
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; Northwest Academic Centre, University of Melbourne, St. Albans, Victoria, Australia
| | | | - Felice N Jacka
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; Department of Psychiatry, Chulalongkorn University, Faculty of Medicine, Bangkok, Thailand; Department of Psychiatry, State University of Londrina, Londrina, Brazil
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Vincent A, Clauw D, Oh TH, Whipple MO, Toussaint LL. Decreased physical activity attributable to higher body mass index influences fibromyalgia symptoms. PM R 2014; 6:802-7. [PMID: 24534101 DOI: 10.1016/j.pmrj.2014.02.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 01/03/2014] [Accepted: 02/13/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Although previous studies report associations between increased body mass index (BMI) and fibromyalgia symptoms, there is uncertainty as to whether this relationship is driven by physical factors, psychological factors, or both. OBJECTIVE To assess these relationships in a clinical sample of patients with fibromyalgia. DESIGN Cross-sectional study. SETTING Tertiary care facility. PATIENTS A total of 686 patients from an existing national fibromyalgia registry. METHODS Patients completed a demographic form and self-report questionnaires including the Fibromyalgia Impact Questionnaire-Revised (FIQ-R), the Medical Outcomes Study Short Form-36 (SF-36), the Brief Pain Inventory (BPI), and the 30-item Profile of Mood States (30-item POMS). MAIN OUTCOME MEASUREMENTS FIQ-R overall impact subscale. RESULTS BMI was significantly correlated with fibromyalgia impact (P < .001). The relationship between BMI and fibromyalgia impact was almost fully accounted for by physical factors and not by psychological factors. CONCLUSIONS Despite patient report that pain hinders physical activity, clinicians who encounter patients with fibromyalgia, particularly patients with increased BMI, should be cognizant of the need to invest time and resources to counsel patients on physical factors (ie, physical activity) that could improve the patients' symptom experience.
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Affiliation(s)
- Ann Vincent
- Fibromyalgia and Chronic Fatigue Clinic, Mayo Clinic, 200 First Street SW, Rochester, MN 55902(∗).
| | - Daniel Clauw
- Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI(†)
| | - Terry H Oh
- Fibromyalgia and Chronic Fatigue Clinic, Mayo Clinic, Rochester, MN(‡)
| | - Mary O Whipple
- Fibromyalgia and Chronic Fatigue Clinic, Mayo Clinic, Rochester, MN(§)
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Vilhena E, Pais-Ribeiro J, Silva I, Cardoso H, Mendonça D. Predictors of quality of life in Portuguese obese patients: a structural equation modeling application. J Obes 2014; 2014:684919. [PMID: 24693421 PMCID: PMC3945172 DOI: 10.1155/2014/684919] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 12/23/2013] [Accepted: 12/24/2013] [Indexed: 01/26/2023] Open
Abstract
Living with obesity is an experience that may affect multiple aspects of an individual's life. Obesity is considered a relevant public health problem in modern societies. To determine the comparative efficacy of different treatments and to assess their impact on patients' everyday life, it is important to identify factors that are relevant to the quality of life of obese patients. The present study aims to evaluate, in Portuguese obese patients, the simultaneous impact of several psychosocial factors on quality of life. This study also explores the mediating role of stigma in the relationship between positive/negative affect and quality of life. A sample of 215 obese patients selected from the main hospitals in Portugal completed self-report questionnaires to assess sociodemographic, clinical, psychosocial, and quality of life variables. Data were analysed using structural equation modeling. The model fitted the data reasonably well, CFI = 0.9, RMSEA = 0.06. More enthusiastic and more active patients had a better quality of life. Those who reflect lower perception of stigma had a better physical and mental health. Partial mediation effects of stigma between positive affect and mental health and between negative affect and physical health were found. The stigma is pervasive and causes consequences for psychological and physical health.
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Affiliation(s)
- Estela Vilhena
- Polytechnic Institute of Cávado and Ave, 4750-810 Barcelos, Portugal
- ICBAS, University of Porto, 4050-313 Porto, Portugal
- ISPUP, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
- *Estela Vilhena:
| | - José Pais-Ribeiro
- Faculty of Psychology and Educational Sciences, University of Porto, 4200-135 Porto, Portugal
- UIPES, 1140-041 Lisbon, Portugal
| | - Isabel Silva
- University of Fernando Pessoa, 4249-004 Porto, Portugal
| | - Helena Cardoso
- UMIB/ICBAS and Hospital Santo António/CHP, 4099-001 Porto, Portugal
| | - Denisa Mendonça
- ICBAS, University of Porto, 4050-313 Porto, Portugal
- ISPUP, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
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Hayley AC, Williams LJ, Berk M, Kennedy GA, Jacka FN, Pasco JA. The relationship between excessive daytime sleepiness and depressive and anxiety disorders in women. Aust N Z J Psychiatry 2013; 47:772-8. [PMID: 23677847 DOI: 10.1177/0004867413490036] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Excessive daytime sleepiness (EDS) is a common clinical symptom that affects women more than men. However, the association of excessive sleepiness with depressive and anxiety disorders in the broader population is unclear. The aim of this study was, therefore, to examine the association between excessive daytime sleepiness as measured by the Epworth Sleepiness Scale, and depressive and anxiety disorders in a population-based sample of women. METHODS Using the Structured Clinical Interview for DSM-IV Disorders (Non-Patient) (SCID-I/NP), 944 women aged 20-97 years (median 49 years, IQR 33-65 years) were assessed for depressive and anxiety disorders as part of the Geelong Osteoporosis Study. EDS was assessed using the Epworth Sleepiness Scale (ESS, cut-off > 10). Lifestyle factors were documented by self-report, height and weight were measured, and socioeconomic status categorised according to the Index of Relative Socio-Economic Advantage and Disadvantage. RESULTS Overall, 125 (13.2%) of the women were identified with EDS. EDS was associated with an increased likelihood for both current (OR = 2.11, 95% CI 1.10-4.06) and lifetime history (OR = 1.95, 95% CI 1.28-2.97) of depressive disorders, but not anxiety disorders, independent of age and alcohol consumption. These findings were not explained by antidepressant or sedative use, body mass index, physical activity, smoking, or socioeconomic status. CONCLUSIONS These results suggest that excessive daytime sleepiness is associated with current and lifetime depressive, but not anxiety disorders. Clinically, this highlights the need to take into account the possible bidirectional relationship between depressive disorders and excessive sleepiness when assessing mental health issues in patients with EDS.
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Affiliation(s)
- Amie C Hayley
- School of Medicine, Deakin University, Geelong, Australia.
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Hayen A, Herigstad M, Pattinson KTS. Understanding dyspnea as a complex individual experience. Maturitas 2013; 76:45-50. [PMID: 23849705 DOI: 10.1016/j.maturitas.2013.06.005] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 06/05/2013] [Indexed: 02/07/2023]
Abstract
Dyspnea is the highly threatening experience of breathlessness experienced by patients with diverse pathologies, including respiratory, cardiovascular, and neuromuscular diseases, cancer and panic disorder. This debilitating symptom is especially prominent in the elderly and the obese, two growing populations in the Western world. It has further been found that women suffer more strongly from dyspnea than men. Despite optimization of disease-specific treatments, dyspnea is often inadequately treated. The immense burden faced by patients, families and the healthcare system makes improving management of chronic dyspnea a priority. Dyspnea is a multidimensional sensation that encompasses an array of unpleasant respiratory sensations that vary according to underlying cause and patient characteristics. Biopsychological factors beyond disease pathology exacerbate the perception of dyspnea, increase symptom severity and reduce quality of life. Psychological state (especially comorbid anxiety and depression), hormone status, gender, body weight (obesity) and general fitness level are particularly important. Neuroimaging has started to uncover the neural mechanisms involved in the processing of sensory and affective components of dyspnea. Awareness of biopsychological factors beyond pathology is essential for diagnosis and treatment of dyspnea. Increasing understanding the interactions between biopsychological factors and dyspnea perception will enhance the development of symptomatic treatments that specifically address each patient's most pressing needs at a specific stage in life. Future neuroimaging research can provide objective markers to fully understand the role of biopsychological factors in the perception of dyspnea in the hope of uncovering target areas for pharmacologic and non-pharmacologic therapy.
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Affiliation(s)
- Anja Hayen
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, United Kingdom.
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Malhi GS. Buds of May. Aust N Z J Psychiatry 2013; 47:405-6. [PMID: 23653058 DOI: 10.1177/0004867413486555] [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: 11/17/2022]
Affiliation(s)
- Gin S Malhi
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia
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