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Neyazi A, Mohammadi AQ, Neyazi M, Timilsina S, Padhi BK, Griffiths MD. Hypertension, depression, and health-related quality of life among hospitalized patients in Afghanistan. J Hum Hypertens 2024; 38:529-537. [PMID: 38684866 DOI: 10.1038/s41371-024-00914-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
In recent decades, hypertension has become the foremost risk factor for disability-adjusted life years (DALYs). The present study investigated the relationship between quality of life, depression, and hypertension among hospitalized patients in Afghanistan. A cross-sectional survey was administered from September 3, 2022, to February 2, 2023, in the Herat and Mazar-e-Sharif provinces of Afghanistan (N = 2059). The prevalence of depression symptoms was 65.8%, and hypertension was 20.9%. Multiple regression analysis indicated that moderate physical functioning, poor role-physical, higher bodily pain, poor general health, poor social functioning, lower role-emotional, and poor mental health significantly predicted depression. Multiple regression analysis indicated that moderate quality of life, poor physical functioning, higher bodily pain, lower energy/fatigue, and depression significantly predicted hypertension. The findings of the present study offer valuable insights for healthcare providers, policymakers, and researchers in developing targeted interventions and policies to enhance the well-being of individuals facing the challenges of depression and hypertension. The prevalence of hypertension and depression was high among patients in the Herat and Mazar-e-Sharif provinces of Afghanistan. Patients with hypertension had poor mental and physical quality of life. Hospitals should therefore implement regular screening for depression and offer psychological counseling for vulnerable patients with hypertension.
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Affiliation(s)
- Ahmad Neyazi
- Afghanistan Center for Epidemiological Studies, Herat, Afghanistan.
| | | | - Mehrab Neyazi
- Afghanistan Center for Epidemiological Studies, Herat, Afghanistan
| | | | - Bijaya Kumar Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Mark D Griffiths
- Department of Psychology, Nottingham Trent University, Nottingham, UK
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Nkoka O, Munthali-Mkandawire S, Mwandira K, Nindi P, Dube A, Nyanjagha I, Mainjeni A, Malava J, Amoah AS, McLean E, Stewart RC, Crampin AC, Price AJ. Association between physical multimorbidity and common mental health disorders in rural and urban Malawian settings: Preliminary findings from Healthy Lives Malawi long-term conditions survey. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002955. [PMID: 38574079 PMCID: PMC10994288 DOI: 10.1371/journal.pgph.0002955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/03/2024] [Indexed: 04/06/2024]
Abstract
In low-income Africa, the epidemiology of physical multimorbidity and associated mental health conditions is not well described. We investigated the multimorbidity burden, disease combinations, and relationship between physical multimorbidity and common mental health disorders in rural and urban Malawi using early data from 9,849 adults recruited to an on-going large cross-sectional study on long-term conditions, initiated in 2021. Multimorbidity was defined as having two or more measured (diabetes, hypertension) or self-reported (diabetes, hypertension, disability, chronic pain, HIV, asthma, stroke, heart disease, and epilepsy) conditions. Depression and anxiety symptoms were measured using the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item General Anxiety Disorder scale (GAD-7) and defined by the total score (range 0-27 and 0-21, respectively). We determined age-standardized multimorbidity prevalence and condition combinations. Additionally, we used multiple linear regression models to examine the association between physical multimorbidity and depression and anxiety symptom scores. Of participants, 81% were rural dwelling, 56% were female, and the median age was 30 years (Inter Quartile Range 21-43). The age-standardized urban and rural prevalence of multimorbidity was 14.1% (95% CI, 12.5-15.8%) and 12.2% (95% CI, 11.6-12.9%), respectively. In adults with two conditions, hypertension, and disability co-occurred most frequently (18%), and in those with three conditions, hypertension, disability, and chronic pain were the most common combination (23%). Compared to adults without physical conditions, having one (B-Coefficient (B) 0.79; 95% C1 0.63-0.94%), two- (B 1.36; 95% CI 1.14-1.58%), and three- or more- physical conditions (B 2.23; 95% CI 1.86-2.59%) were associated with increasing depression score, p-trend <0.001. A comparable 'dose-response' relationship was observed between physical multimorbidity and anxiety symptom scores. While the direction of observed associations cannot be determined with these cross-sectional data, our findings highlight the burden of multimorbidity and the need to integrate mental and physical health service delivery in Malawi.
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Affiliation(s)
- Owen Nkoka
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Kondwani Mwandira
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Providence Nindi
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Albert Dube
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | | | - Angella Mainjeni
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Jullita Malava
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Abena S. Amoah
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Estelle McLean
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Robert C. Stewart
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Division of Psychiatry, Centre for Clinical Brain Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Amelia C. Crampin
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Alison J. Price
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Ali NH, Al‐Kuraishy HM, Al‐Gareeb AI, Albuhadily AK, Hamad RS, Alexiou A, Papadakis M, Saad HM, Batiha GE. Role of brain renin-angiotensin system in depression: A new perspective. CNS Neurosci Ther 2024; 30:e14525. [PMID: 37953501 PMCID: PMC11017442 DOI: 10.1111/cns.14525] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/26/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
Depression is a mood disorder characterized by abnormal thoughts. The pathophysiology of depression is related to the deficiency of serotonin (5HT), which is derived from tryptophan (Trp). Mitochondrial dysfunction, oxidative stress, and neuroinflammation are involved in the pathogenesis of depression. Notably, the renin-angiotensin system (RAS) is involved in the pathogenesis of depression, and different findings revealed that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may be effective in depression. However, the underlying mechanism for the role of dysregulated brain RAS-induced depression remains speculative. Therefore, this review aimed to revise the conceivable role of ACEIs and ARBs and how these agents ameliorate the pathophysiology of depression. Dysregulation of brain RAS triggers the development and progression of depression through the reduction of brain 5HT and expression of brain-derived neurotrophic factor (BDNF) and the induction of mitochondrial dysfunction, oxidative stress, and neuroinflammation. Therefore, inhibition of central classical RAS by ARBS and ACEIs and activation of non-classical RAS prevent the development of depression by regulating 5HT, BDNF, mitochondrial dysfunction, oxidative stress, and neuroinflammation.
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Affiliation(s)
- Naif H. Ali
- Department of Internal MedicineMedical CollegeNajran UniversityNajranKSA
| | - Hayder M. Al‐Kuraishy
- Department of Clinical Pharmacology and Medicine, College of MedicineMustansiriyah UniversityBaghdadIraq
| | - Ali I. Al‐Gareeb
- Department of Clinical Pharmacology and Medicine, College of MedicineMustansiriyah UniversityBaghdadIraq
| | - Ali K. Albuhadily
- Department of Clinical Pharmacology and Medicine, College of MedicineMustansiriyah UniversityBaghdadIraq
| | - Rabab S. Hamad
- Biological Sciences DepartmentCollege of Science, King Faisal UniversityAl AhsaSaudi Arabia
- Central LaboratoryTheodor Bilharz Research InstituteGizaEgypt
| | - Athanasios Alexiou
- University Centre for Research & Development, Chandigarh UniversityMohaliPunjabIndia
- Department of Science and EngineeringNovel Global Community Educational FoundationHebershamNew South WalesAustralia
- AFNP MedWienAustria
| | - Marios Papadakis
- Department of Surgery IIUniversity Hospital Witten‐Herdecke, University of Witten‐HerdeckeWuppertalGermany
| | - Hebatallah M. Saad
- Department of Pathology, Faculty of Veterinary MedicineMatrouh UniversityMatrouhEgypt
| | - Gaber El‐Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary MedicineDamanhour UniversityDamanhourAlBeheiraEgypt
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Johnson LF, Kassanjee R, Folb N, Bennett S, Boulle A, Levitt NS, Curran R, Bobrow K, Roomaney RA, Bachmann MO, Fairall LR. A model-based approach to estimating the prevalence of disease combinations in South Africa. BMJ Glob Health 2024; 9:e013376. [PMID: 38388163 PMCID: PMC10884267 DOI: 10.1136/bmjgh-2023-013376] [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: 07/10/2023] [Accepted: 11/12/2023] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The development of strategies to better detect and manage patients with multiple long-term conditions requires estimates of the most prevalent condition combinations. However, standard meta-analysis tools are not well suited to synthesising heterogeneous multimorbidity data. METHODS We developed a statistical model to synthesise data on associations between diseases and nationally representative prevalence estimates and applied the model to South Africa. Published and unpublished data were reviewed, and meta-regression analysis was conducted to assess pairwise associations between 10 conditions: arthritis, asthma, chronic obstructive pulmonary disease (COPD), depression, diabetes, HIV, hypertension, ischaemic heart disease (IHD), stroke and tuberculosis. The national prevalence of each condition in individuals aged 15 and older was then independently estimated, and these estimates were integrated with the ORs from the meta-regressions in a statistical model, to estimate the national prevalence of each condition combination. RESULTS The strongest disease associations in South Africa are between COPD and asthma (OR 14.6, 95% CI 10.3 to 19.9), COPD and IHD (OR 9.2, 95% CI 8.3 to 10.2) and IHD and stroke (OR 7.2, 95% CI 5.9 to 8.4). The most prevalent condition combinations in individuals aged 15+ are hypertension and arthritis (7.6%, 95% CI 5.8% to 9.5%), hypertension and diabetes (7.5%, 95% CI 6.4% to 8.6%) and hypertension and HIV (4.8%, 95% CI 3.3% to 6.6%). The average numbers of comorbidities are greatest in the case of COPD (2.3, 95% CI 2.1 to 2.6), stroke (2.1, 95% CI 1.8 to 2.4) and IHD (1.9, 95% CI 1.6 to 2.2). CONCLUSION South Africa has high levels of HIV, hypertension, diabetes and arthritis, by international standards, and these are reflected in the most prevalent condition combinations. However, less prevalent conditions such as COPD, stroke and IHD contribute disproportionately to the multimorbidity burden, with high rates of comorbidity. This modelling approach can be used in other settings to characterise the most important disease combinations and levels of comorbidity.
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Affiliation(s)
- Leigh F Johnson
- Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, Cape Town, South Africa
| | - Reshma Kassanjee
- Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, Cape Town, South Africa
| | | | | | - Andrew Boulle
- Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, Cape Town, South Africa
- Department of Health, Western Cape Provincial Government, Cape Town, South Africa
| | - Naomi S Levitt
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Robyn Curran
- Knowledge Translation Unit, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Kirsty Bobrow
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Rifqah A Roomaney
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa
| | - Max O Bachmann
- Norwich Medical School, University of East Anglia, Faculty of Medicine and Health Sciences, Norwich, UK
| | - Lara R Fairall
- Knowledge Translation Unit, University of Cape Town, Cape Town, Western Cape, South Africa
- King's Global Health Institute, King's College London, London, UK
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Odame EA, Atandoh PH, Mamudu L, Adzrago D, Tagoe I, Sulley S, Boms M, Tetteh-Bator E, McNeel TS, Williams F. Associations of depression with hypertension and citizenship among U.S. adults: A cross-sectional study of the interactions of hypertension and citizenship. Prev Med Rep 2023; 36:102523. [PMID: 38116249 PMCID: PMC10728450 DOI: 10.1016/j.pmedr.2023.102523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023] Open
Abstract
With the increasing prevalence of hypertension-related cardiovascular deaths and depression, this study examined the associations of depression with hypertension, citizenship status, and interaction of hypertension and citizenship status among U.S. adults. Data from the 2015-2018 National Health Interview Survey (NHIS), including 63,985 individuals, were analyzed. Depression status was the outcome, with hypertension and U.S. citizenship status as the main independent variables. Using odds ratio (OR) estimates, we evaluated the associations between hypertension and depression, and citizenship status. The result indicates that a higher proportion of U.S. adults with hypertension reported depression compared to those who did not have hypertension (42.9 % vs. 37.5 %). In terms of U.S. citizenship status, a higher proportion of U.S. citizens reported depression than non-citizens (39.6 % vs. 31.6 %). However, non-citizens with hypertension were more likely to report depression compared to U.S. citizens without hypertension (OR = 1.46; 95 % CI = 1.15, 1.86). While hypertension marginally increased the odds of depression among the general U.S. population, being a non-U.S. citizen with hypertension significantly increased the risk of depression by 46 %. The findings imply that the healthy immigrant paradox, in the context of hypertension-depression prevention and control, may not apply to non-citizens with hypertension. We therefore recommend community-based screenings and more tailored interventions to address these health disparities while taking into consideration the unique cultural norms, behaviors and healthcare barriers encountered by specific immigrant communities.
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Affiliation(s)
- Emmanuel A. Odame
- Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Paul H. Atandoh
- Department of Mathematics, Mercer University, Macon, GA, USA
| | - Lohuwa Mamudu
- Department of Public Health, California State University, Fullerton, CA, USA
| | - David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Ishmael Tagoe
- Division of Health Services, College of Nursing and Advanced Health Professions, The Chicago School of Professional Psychology, IL, USA
| | - Saanie Sulley
- National Healthy Start Association, Washington, DC, USA
| | - Maureen Boms
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Erasmus Tetteh-Bator
- Department of Mathematics and Statistics, College of Arts and Sciences, University of South Florida, Tampa, FL, USA
| | | | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Shaphe MA, Alshehri MM, Alfaifi B, Aljahni MA, Esht V, Malik S, Bautista MJ, Alqahtani AS, Ahmad A, Khan A, Aafreen A, Khan AR. Assessment of Risk Factors and the Relationship between Hypothyroidism with Hypertension in Diabetes Mellitus Patients: A Cross-Sectional Community-Based Study. J Pers Med 2023; 13:1231. [PMID: 37623480 PMCID: PMC10455546 DOI: 10.3390/jpm13081231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/13/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
(1) Background: hypertension (HTN) and diabetes mellitus (DM) represent two widely noncommunicable diseases that are prevalent globally, and they often correlate with chronic health issues. There has been an acknowledged connection between diabetes, hypertension, and hypothyroidism for quite some time. However, the extent of thyroid dysfunction among the diabetic population is not uniform and significantly differs across different research studies. This study was conducted with the objective of identifying the risk factors associated with hypothyroidism as well as assessing the relationship between hypothyroidism and hypertension in patients with diabetes. (2) Materials and Methods: Participants aged 18 years and above were included in this study, while pregnant women were excluded. Trained health professionals measured sociodemographic, behavioural, food practices, and anthropometric information about the participants. Each respondent sought medical advice regarding their health, and a face-to-face interview enabled them to express concern about the likelihood of being diagnosed with diabetes mellitus and hypertension. (3) Results: The study encompassed 640 participants, with an average age of 49.20 ± 13.0 years. Among these participants, 65.5% were female, and 34.5% were male. Of the total, 31.25% were diagnosed with diabetes mellitus, and 18.75% had hypertension. Interestingly, co-occurrence of both conditions was observed in 9.68% of the population. A comparison of thyroid function and indicators of blood sugar levels yielded consistent results across the different patient groups. Specifically, for diabetes mellitus (DM) patients, the average levels were 3.4 ± 9.8 pg/mL for fT3, 0.9 ± 0.7 ng/dL for fT4, 3.3 ± 6.2 μiU/mL for TSH, 153.1 ± 68.0 mg/dL for fasting plasma glucose (FPG), 213.2 ± 97.2 mg/dL for postprandial glucose (PPG), and 8.3 ± 3.2% for HbA1c. (4) Conclusion: It is concluded that patients with hypertension had a significant prevalence of diabetes mellitus. Subclinical hypothyroid subjects must be frequently screened for hypertension. Of 120 individuals with hypertension, 45 (37.5%) were also diagnosed with diabetes. This co-occurrence was significantly higher in subjects aged over 50 years (26.7%), in the lower socio-economic class (18.5%), and among those who were married (14.7%). Additionally, patients with hypertension exhibited a high prevalence of diabetes across different educational backgrounds and occupations, with the highest prevalence among postgraduates (37.5%) and professionals (24.0%), respectively. These findings highlight the need for an integrated approach to the management of hypertension and diabetes, particularly in high-risk demographics.
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Affiliation(s)
- Mohammad Abu Shaphe
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (M.M.A.); (B.A.); (V.E.); (S.M.); (M.J.B.)
| | - Mohammed M. Alshehri
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (M.M.A.); (B.A.); (V.E.); (S.M.); (M.J.B.)
| | - Bushra Alfaifi
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (M.M.A.); (B.A.); (V.E.); (S.M.); (M.J.B.)
| | - Mohammed A Aljahni
- Physical Education Department, Jazan University, Jazan 45142, Saudi Arabia;
| | - Vandana Esht
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (M.M.A.); (B.A.); (V.E.); (S.M.); (M.J.B.)
| | - Shazia Malik
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (M.M.A.); (B.A.); (V.E.); (S.M.); (M.J.B.)
| | - Marissa J Bautista
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (M.M.A.); (B.A.); (V.E.); (S.M.); (M.J.B.)
| | - Abdulfattah S. Alqahtani
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Ausaf Ahmad
- Department of Community Medicine, IIMS&R, Integral University, Lucknow 226026, India;
| | - Ashfaque Khan
- Department of Physiotherapy, Integral University, Lucknow 226026, India; (A.K.); (A.A.)
| | - Aafreen Aafreen
- Department of Physiotherapy, Integral University, Lucknow 226026, India; (A.K.); (A.A.)
| | - Abdur Raheem Khan
- Department of Physiotherapy, Integral University, Lucknow 226026, India; (A.K.); (A.A.)
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Fontes MAP, Marins FR, Patel TA, de Paula CA, Dos Santos Machado LR, de Sousa Lima ÉB, Ventris-Godoy AC, Viana ACR, Linhares ICS, Xavier CH, Filosa JA, Patel KP. Neurogenic Background for Emotional Stress-Associated Hypertension. Curr Hypertens Rep 2023; 25:107-116. [PMID: 37058193 PMCID: PMC10103037 DOI: 10.1007/s11906-023-01235-7] [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] [Accepted: 01/31/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE OF REVIEW The response to natural stressors involves both cardiac stimulation and vascular changes, primarily triggered by increases in sympathetic activity. These effects lead to immediate flow redistribution that provides metabolic support to priority target organs combined with other key physiological responses and cognitive strategies, against stressor challenges. This extremely well-orchestrated response that was developed over millions of years of evolution is presently being challenged, over a short period of time. In this short review, we discuss the neurogenic background for the origin of emotional stress-induced hypertension, focusing on sympathetic pathways from related findings in humans and animals. RECENT FINDINGS The urban environment offers a variety of psychological stressors. Real or anticipatory, emotional stressors may increase baseline sympathetic activity. From routine day-to-day traffic stress to job-related anxiety, chronic or abnormal increases in sympathetic activity caused by emotional stressors can lead to cardiovascular events, including cardiac arrhythmias, increases in blood pressure and even sudden death. Among the various alterations proposed, chronic stress could modify neuroglial circuits or compromise antioxidant systems that may alter the responsiveness of neurons to stressful stimuli. These phenomena lead to increases in sympathetic activity, hypertension and consequent cardiovascular diseases. The link between anxiety, emotional stress, and hypertension may result from an altered neuronal firing rate in central pathways controlling sympathetic activity. The participation of neuroglial and oxidative mechanisms in altered neuronal function is primarily involved in enhanced sympathetic outflow. The significance of the insular cortex-dorsomedial hypothalamic pathway in the evolution of enhanced overall sympathetic outflow is discussed.
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Affiliation(s)
- Marco Antônio Peliky Fontes
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil.
| | - Fernanda Ribeiro Marins
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Tapan A Patel
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Cristiane Amorim de Paula
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Liliane Ramos Dos Santos Machado
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Érick Bryan de Sousa Lima
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Ana Caroline Ventris-Godoy
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Ana Clara Rocha Viana
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Isadora Cristina Souza Linhares
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | | | | | - Kaushik P Patel
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
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Shamsuddin S, Davis K, Moorhouse L, Mandizvidza P, Maswera R, Dadirai T, Nyamukapa C, Gregson S, Chigogora S. Relationship between psychological distress, health behaviours and future reports of hypertension among adults in East Zimbabwe: a cohort study. Open Heart 2023; 10:e002346. [PMID: 37385733 DOI: 10.1136/openhrt-2023-002346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/16/2023] [Indexed: 07/01/2023] Open
Abstract
INTRODUCTION Extensive cross-sectional evidence has demonstrated an association between psychological distress (PD) and hypertension. However, evidence on the temporal relationship is limited, especially in low-income and middle-income countries. The role of health risk behaviours including smoking and alcohol consumption in this relationship is also largely unknown. The aim of this study was to investigate the association between PD and later development of hypertension, and how this association may have been influenced by health risk behaviours, among adults in east Zimbabwe. METHODS The analysis included 742 adults (aged 15-54 years) recruited by the Manicaland general population cohort study, who did not have hypertension at baseline in 2012-2013, and who were followed until 2018-2019. In 2012-2013, PD was measured using the Shona Symptom Questionnaire, a screening tool validated for use in Shona-speaking countries including Zimbabwe (cut-off point: 7). Smoking, alcohol consumption and use of drugs (health risk behaviours) were also self-reported. In 2018-2019, participants reported if they had diagnosed with hypertension by a doctor or nurse. Logistic regression was used to assess the association between PD and hypertension. RESULTS In 2012, 10.4% of the participants had PD. The odds of new reports of hypertension were 2.04 times greater (95% CI 1.16 to 3.59) among those with PD at baseline, after adjusting for sociodemographic and health risk behaviour variables. Female gender (adjusted odds ratio, AOR 6.89, 95% CI 2.71 to 17.53), older age (AOR 2.67, 95% CI 1.63 to 4.42), and greater wealth (AOR 2.10, 95% CI 1.04 to 4.24 more wealthy, 2.88, 95% CI 1.24 to 6.67 most wealthy) were significant risk factors for hypertension. The AOR for the relationship between PD and hypertension did not differ substantially between models with and without health risk behaviours. CONCLUSION PD was associated with an increased risk of later reports of hypertension in the Manicaland cohort. Integrating mental health and hypertension services within primary healthcare may reduce the dual burden of these non-communicable diseases.
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Affiliation(s)
- Shehla Shamsuddin
- Department of Health and Social Care, UK Government, London, UK
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Katherine Davis
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Louisa Moorhouse
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Phyllis Mandizvidza
- Manicaland Centre for Public Health Research, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Rufurwokuda Maswera
- Manicaland Centre for Public Health Research, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Tawanda Dadirai
- Manicaland Centre for Public Health Research, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Constance Nyamukapa
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- Manicaland Centre for Public Health Research, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Simon Gregson
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- Manicaland Centre for Public Health Research, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Sungano Chigogora
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
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Said B, Gharawi MO, Dallak FH, Maashi AQ, Hurissi E, Gharawi SO, Tarshi MM, Hayyan AI, Faqihi SA, AlMusawa HI, Hakami GM, Alhazmi AH. Factors Associated with Anxiety During COVID-19 Pandemic and Its Association with Hypertension in Saudi Arabia. Patient Prefer Adherence 2023; 17:905-912. [PMID: 37016675 PMCID: PMC10066885 DOI: 10.2147/ppa.s400168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/15/2023] [Indexed: 03/31/2023] Open
Abstract
Objective Patients with chronic diseases such as hypertension (HTN) are considered a vulnerable group, and they are prone to anxiety and other psychological conditions during pandemics. Very few reports discussed factors related to anxiety and how it is associated with HTN during COVID-19 pandemic. In this project, we aimed to identify the prevalence of anxiety among hypertensive patients in Saudi Arabia during the COVID-19 pandemic. Methods A cross-sectional study was conducted, and data were collected using an electronic self-administered pretested questionnaire distributed via trained data collectors. Data were analyzed using t-test and chi-test. Results A total of 2135 participants were enrolled in this study. Anxiety was reported in 5% of all participants and 8% of the hypertensive participants. Older age, marital status, higher body mass index (BMI), smoking, and Khat chewing were strongly associated with anxiety among the general population. In addition, less adherence to medication made participants with HTN significantly more anxious. Conclusion The prevalence of anxiety among hypertensive individuals is higher compared to the general population. Moreover, anxiety is significantly associated with some sociodemographic in the general population, and with less adherence to medications in hypertensive patients. Further studies with data from medical record including more variables are needed to highlight this association.
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Affiliation(s)
- Badria Said
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | | | | | - Afnan Q Maashi
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Eman Hurissi
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | | | - Melia M Tarshi
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | | | - Suzan A Faqihi
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | | | | | - Abdulaziz H Alhazmi
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
- Correspondence: Abdulaziz H Alhazmi, Jazan University, Tel +966-7329-5000, Email
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Shayani Rad M, Moohebati M, Mohajeri SA. Beneficial effects of celery seed extract (Apium graveolens), as a supplement, on anxiety and depression in hypertensive patients: a randomized clinical trial. Inflammopharmacology 2023; 31:395-410. [PMID: 36334223 DOI: 10.1007/s10787-022-01083-y] [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: 08/08/2022] [Accepted: 10/05/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Anxiety and depression are crucial public health issues, affecting the rising in hospitalizations and death. Anxiety and depression can worsen hypertension and vice versa. OBJECTIVE The current study has investigated the effects of celery seed extract, as a drug supplement, with the active ingredient of 3-n-butylphthalide, on mental problems primarily anxiety and secondary depression in hypertensive patients. DESIGN The current study was a randomized, triple-blind, placebo-controlled, cross-over, 4-week clinical trial with a 4-week washout period. Fifty hypertensive patients received 4 placebo or celery seed extract capsules (1.34 g per day) for 4 weeks as a supplement to their usual medication regimen. The blood pressure parameters were assessed using 24-h ambulatory blood pressure monitoring device. Anxiety and depression and their wide range of symptoms were evaluated using Beck anxiety and depression inventories (BAI and BDI). RESULTS In the celery treatment step, the mean reduction in BAI and BDI scores were 6.78 (P < 0.001) and 3.63 (P < 0.01), respectively. Some symptoms of anxiety including unable to relax, nervousness, numbness, dizziness, flushed face, sweating, and breathing difficulty were significantly improved by celery consumption (P < 0.001). Celery could decrease symptoms of depression such as sadness, crying, loss of energy, insomnia, irritability, fatigue, loss of interest in sex, and punishment feeling (P < 0.01). The mean reduction in blood pressure parameters was also significant during celery therapy (P < 0.001). CONCLUSIONS The psychometric properties of anxiety and depression were investigated and the results were promising. The results indicated the anti-anxiety and anti-depressive properties of celery seed extract as a supplement in hypertensive patients. CLINICAL TRIAL REGISTRATION Registry name: Iranian Registry of Clinical Trials (IRCT), Registration number: IRCT20130418013058N8, Registration link: https://www.irct.ir/trial/30021 . The study was carried out between 2018-09-21 and 2020-07-20.
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Affiliation(s)
- Maryam Shayani Rad
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee (SRC), Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Seyed Ahmad Mohajeri
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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11
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Zhang J, Yan H, Wang D. Effects of Acoustic Environment Types on Stress Relief in Urban Parks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1082. [PMID: 36673837 PMCID: PMC9859344 DOI: 10.3390/ijerph20021082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/02/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Urban public space environments are critical to the health of residents. In previous studies on urban park environments and health, landscape environment questionnaires have been the main method to evaluate the environmental quality and comfort of urban parks. The research on sound perception also focuses on the exploration of evaluation methods and evaluation indicators; there is little objective empirical evidence in these studies. To further explore the nature of the health role of urban parks, this study started with the sound types of urban parks, based on a field survey, combined the electrocardiogram (ECG) index with the sound type of the park through a portable intelligent device, and HR and RMSSD were selected as the ECG indicators to evaluate the stress relief status. The regression model between the type of acoustic environments and the ECG data was established through the analysis of relevant data. This paper tries to improve the physiological recovery benefit and influence mechanism of sound types in urban parks from an objective point of view and puts forward reasonable suggestions to improve the sound environment in urban parks. The preliminary results show that, in a short time frame, natural sound has a strong relieving effect on mental pressure, while mechanical sound has an obvious impediment effect on the recovery of mental pressure. The results also reveal that the human voice has no obvious impediment effect, and changes in wind and broadcast sound have little impact on the recovery of mental pressure.
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Affiliation(s)
| | - Hongliang Yan
- School of Landscape Architecture, Northeast Forestry University, Harbin 150040, China
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12
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Academic performance in adolescent offspring of mothers with prenatal and perinatal psychiatric hospitalizations: A register-based, data linkage, cohort study. Psychiatry Res 2023; 319:114946. [PMID: 36463723 DOI: 10.1016/j.psychres.2022.114946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/12/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND This is the first study to investigate the longitudinal association between prenatal and perinatal psychiatric hospitalizations and academic achievements in adolescent offspring. METHODS We conducted an administrative health data-based cohort study of 168, 528 mother-offspring pairs using linked data obtained from health and educational registries in New South Wales, Australia. Prenatal and perinatal maternal psychiatric diagnosis was measured by using ICD-10. The National Assessment Program for Literacy and Numeracy (NAPLAN) was used to assess the educational performance of the offspring. Logistic regression model was used to explore the association. Multivariate models were adjusted for maternal sociodemographic characteristics such as age at birth, marital status, educational status, and occupational status, maternal diabetes and chronic hypertension, maternal smoking during pregnancy, birth weight, and language spoken at home. RESULTS The findings show that after adjusting for important covariates adolescent offspring of mothers with prenatal and perinatal psychiatric hospitalizations were more likely to perform below the national minimum standard in all domains of academic performance at age 14 years, when compared with the offspring of mothers without such hospitalizations, with the highest odds for numeracy (OR = 2.88; 95% CI: 2.50-3.31) followed by reading (OR = 2.08; 95% CI: 1.81-2.38), spelling (OR = 1.74; 95% CI: 1.51-2.01), and writing (OR = 1.56; 95% CI: 1.34-1.80). There was significant gender interaction such that males were more likely to experience lower rates of academic performance than females in all academic domains. Lower academic achievements were observed among offspring of mothers with all major groupings of psychiatric disorders, with a higher risk for severe psychiatric disorders followed by mental disorders due to substance use or medical conditions. CONCLUSION In sum, maternal prenatal and perinatal psychiatric hospitalizations are associated with lower academic achievements in adolescent offspring, with a stronger effect on the academic performance of male offspring. Early intervention strategies that aim to enhance educational performance in the exposed offspring are needed.
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Nasihin N, Pertiwi DA, Khayan K, Puspita WL, Hanif MI. The Effect of Progressive Muscle Relaxation Therapy on Anxiety in Hypertension Patients. JURNAL INFO KESEHATAN 2022. [DOI: 10.31965/infokes.vol20.iss2.858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Anxiety is a condition in which an individual experiences a concern about something that is not certain to happen, even some people experiencing anxiety but do not understand the specific cause of the anxiety source they feel. Anxiety problems, which are common in people, can be treated non-pharmacologically with deep muscle relaxation techniques, which do not require guided imagination or cause side effects in patients undergoing progressive muscle relaxation therapy. The objective of this study is to identify how progressive muscle relaxation techniques affected the anxiety levels of hypertension patients at the Kedaung Wetan Public Health Center. The study was conducted to determine if there was a difference in the level of anxiety experienced by hypertensive patients before and after receiving progressive muscle relaxation therapy. The design in this study employed a quasi-experimental pre-post-test with a control group with a progressive muscle relaxation therapy intervention. Result: there is a significant relationship between the period of occurrence of hypertension with anxiety experienced by respondents. Anxiety in hypertensive patients is more prevalent in those who are unfamiliar with hypertension. Thus, anxiety can arise from a sense of concern and fear of more serious complications which occur from the hypertension they are experiencing. The experimental group who received treatment in the form of progressive muscle relaxation therapy had a lower level of anxiety than the control group at the Kedaung Wetan Public Health Center in Tangerang City, with a p-value of 0.000.
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Abdisa L, Letta S, Nigussie K. Depression and anxiety among people with hypertension on follow-up in Eastern Ethiopia: A multi-center cross-sectional study. Front Psychiatry 2022; 13:853551. [PMID: 36440387 PMCID: PMC9691753 DOI: 10.3389/fpsyt.2022.853551] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 10/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background People with hypertension have a high risk of developing mental disorders, such as depression and/or anxiety. However, there is a paucity of data regarding comorbid depression and anxiety symptoms among people with hypertension in study settings. Objective The study determined the prevalence and associated factors of depression, and anxiety symptoms among people with hypertension on follow-up at public hospitals, in Eastern Ethiopia. Materials and methods A cross-sectional study was carried out among 471 people with hypertension who were randomly chosen from four public hospitals in Harar town and the Dire Dawa Administration. The data were collected by interviewer-administered structured questionnaires. A validated nine-item Patient Health Questionnaire and Generalized Anxiety Disorder scales were used to assess depression and anxiety symptoms, respectively. A logistic regression model was used to identify the association among depression, anxiety, and their predictors. An adjusted odds ratio and a 95% confidence interval were used to report the association. The statistical significance was set at a p-value of < 0.05. Results Depression and anxiety symptoms were present in 27.2 and 32.7% of people with hypertension, respectively. Being women (AOR = 1.74, 1.09-2.78), having no formal education (AOR = 2.19, 1.19-4.81), presence of other medical illnesses (AOR = 2.23, 1.39-3.56), having a family history of depression (AOR = 2.01, 1.25-3.19), and poor social support (AOR = 2.80, 1.60-5.22) were statistically associated with depressive symptoms, whereas being women (AOR = 1.54, 1.01-2.35), widowed and divorced (AOR = 2.22, 1.41-3.52), presence of other medical illnesses (AOR = 1.64, 1.06-2.53), and poor social support (AOR = 3.54, 2.09-6.01) were statistically associated with anxiety symptoms. Conclusion More than a quarter of people with hypertension reported symptoms of depression and anxiety. Findings demonstrated that being a woman, having an additional medical illness and having poor social support were statistically associated with depressive and anxiety symptoms. Regular screening, early detection, and offering the proper intervention should be on top priorities for healthcare professionals.
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Affiliation(s)
- Lemesa Abdisa
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Shiferaw Letta
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Kabtamu Nigussie
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Małyszczak K, Janocha A. The circadian rhythm of blood pressure in patients with panic disorder and generalized anxiety disorder. J Psychosom Res 2022; 161:110999. [PMID: 36007358 DOI: 10.1016/j.jpsychores.2022.110999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/31/2022] [Accepted: 08/01/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Anxiety disorders affect blood pressure both during the day and at night. Little is known about the effect of individual anxiety disorders on the circadian rhythm of blood pressure. OBJECTIVES The purpose of this study is to compare the nocturnal drop in blood pressure in patients with panic disorder (PD), generalized anxiety disorder (GAD), and healthy individuals. METHODS The study was conducted on fifty consecutive outpatients with anxiety disorders and personality disorders who participated in intensive group psychotherapy. Diagnoses were made according to DSM-IV-TR criteria using the PSE-10 questionnaire. Out of 50 patients under study, 17 were diagnosed with PD and 21 with GAD. The control group consisted of 40 healthy people recruited in the course of other studies. The resulting three groups were compared in terms of circadian blood pressure using the ABPM method. RESULTS Mean nocturnal falls in systolic and diastolic blood pressure were the following: 2% and 3% (PD), 11% and 12% (GAD), 27% and 23% (control). Four people out of PD group had higher systolic and diastolic blood pressure at night than during the day. The ratios between non-dippers/dippers were: 0/15 (PD), 8/21 (38% - GAD) and 40/40 (100% - control). CONCLUSIONS The patients with PD were characterized by an almost flat course of circadian blood pressure. The patients with GAD had a lower mean nocturnal fall in blood pressure than the control group, but significantly higher than the patients with PD. The differences in the circadian course of blood pressure between PD and GAD are so large that the impact of these disorders should be investigated separately.
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Affiliation(s)
- Krzysztof Małyszczak
- Division of Psychotherapy and Psychosomatic Disorders, Department of Psychiatry, Wroclaw Medical University, Poland.
| | - Anna Janocha
- Division of Pathophysiology, Department of Physiology and Pathophysiology, Wroclaw Medical University, Poland
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Ang CW, Tan MM, Bärnighausen T, Reininghaus U, Reidpath D, Su TT. Mental distress along the cascade of care in managing hypertension. Sci Rep 2022; 12:15910. [PMID: 36151113 PMCID: PMC9508187 DOI: 10.1038/s41598-022-20020-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/07/2022] [Indexed: 12/04/2022] Open
Abstract
Hypertension might be a contributing factor of mental illness. The aim of this study was to investigate the association between different levels of hypertension care and mental distress among hypertensive individuals in Malaysia. We constructed a hypertension care cascade using data of 6531 hypertensive individuals aged ≥ 35 years that were collected as part of the community health survey conducted in 2013 in the South East Asia Community Observatory. We examined the association between the status of hypertension care and mental distress using multiple logistic regressions. Respondents who had not been screened for hypertension and those who had uncontrolled blood pressure (BP) had higher odds of depression, anxiety and, stress compared to those who had been screened and those who had controlled BP, respectively. Respondents who were not taking antihypertensive medication had lower odds of depression and anxiety compared to those who were on medication. There was an association between different levels of hypertension care and mental distress. The application of a hypertension care cascade may help improve the provision of mental health support in primary care clinics. Specific mental health interventions could be provided for patients with particular needs along the cascade.
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Affiliation(s)
- Chiew Way Ang
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Min Min Tan
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,ESRC Centre for Society and Mental Health, King's College London, London, UK.,Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Reidpath
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU, UK
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia. .,Heidelberg Institute of Global Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany.
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Effects of the Mindfulness-Based Blood Pressure Reduction (MB-BP) program on depression and neural structural connectivity. J Affect Disord 2022; 311:31-39. [PMID: 35594968 DOI: 10.1016/j.jad.2022.05.059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 05/05/2022] [Accepted: 05/12/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hypertension-related illnesses are a leading cause of disability and death in the United States, where hypertension prevalence in adults is 46%, with only half of those afflicted having it under control. Due to the significant challenges in long-term efficacy and adverse effects associated with pharmacological interventions, there is an eminent need for complimentary approaches for treating hypertension. Although initial studies of the Mindfulness-Based Blood Pressure Reduction program (MB-BP) indicate that this novel 8-week intervention is effective at inducing lasting decreases in blood pressure, the neural correlates are unknown. METHODS The objectives of this study were to identify structural neural correlates of MB-BP using diffusion tensor magnetic resonance imaging (DTI) and assess potential correlations with key clinical outcomes. RESULTS In a subset of participants (14 MB-BP, 22 controls) from a larger stage IIa randomized controlled trial, MB-BP participants exhibited increased interoception and decreased depressive symptoms compared to controls. Analyses of DTI data revealed significant group differences in multiple white matter neural tracts associated with the limbic system and/or blood pressure. Specific changes in neural structural connectivity were significantly associated with measures of interoception and depression. LIMITATIONS Limitations include small sample size (leading to insufficient power in the analysis of blood pressure) and the study duration (3 months). The main MRI limitation is suboptimal resolution in areas of extensive neural tract crossings. CONCLUSIONS It is concluded that MB-BP induces alterations in brain structural connectivity which could mediate beneficial changes in depression and interoceptive awareness in individuals with hypertension.
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Bhatia M, Dixit P, Kumar M, Dwivedi LK. Validity of self-reported hypertension in India: Evidence from nationally representative survey of adult population over 45 years. J Clin Hypertens (Greenwich) 2022; 24:1506-1515. [PMID: 35809220 PMCID: PMC9659862 DOI: 10.1111/jch.14542] [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: 03/30/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 12/03/2022]
Abstract
Self‐reported measures of health, in the context of developed countries, are well‐researched and commonly regarded as reliable predictors of the underlying health of the population. However, the validity of these measures is under‐researched and questionable in the context of low‐ and middle‐income countries. The authors used Longitudinal Ageing Study in India (LASI) survey data from India to compare self‐reported hypertension with biometrically‐measured hypertension. The results are reported in terms of sensitivity, specificity, and kappa as a measure of agreement. Logistic regression was undertaken to examine the characteristics of those who were unaware of their hypertensive status. Our analysis showed a low sensitivity of 56% and a high specificity of 90.5%. Agreement between self‐reported data and biometric measurement of hypertension was observed to be moderate (κ = 0.48). Large variations were observed among states and sub‐groups. The odds of false negative reporting of hypertension were lower in the individuals with higher age, high education, and greater wealth status. The authors conclude that self‐reported hypertension has important limitations and may be a source of systematic bias. It is recommended that planning and policy‐making in India be based more on an objective assessment of hypertension.
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Affiliation(s)
- Mrigesh Bhatia
- Dept. of Health Policy, London School of Economics, London, UK
| | - Priyanka Dixit
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
| | - Manish Kumar
- International Institute for Population Sciences, Mumbai, India
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Zhang Y, Yan L, Long H, Yang L, Wang J, Liu Y, Pu J, Liu L, Zhong X, Xin J. Occupational Differences in Psychological Distress Between Chinese Dentists and Dental Nurses. Front Psychol 2022; 13:923626. [PMID: 35846642 PMCID: PMC9285401 DOI: 10.3389/fpsyg.2022.923626] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background Doctors and allied health professionals are facing serious mental health issues, which have received widespread attention. This study aimed to explore the occupational differences in psychological distress between Chinese dentists and dental nurses. Materials and Methods The data was collected from a cross-sectional study conducted by the Chongqing Stomatological Association. Medical personnel involved in this survey were invited to complete a battery of self-administrated questionnaires, specifically the General Health Questionnaire-12, Maslach Burnout Inventory, and career choice regret scale. Data on demographic characteristics and working conditions were also collected. The results of these questionnaires were analyzed with SPSS (version 23.0). Univariate and multivariable analyzes were conducted to explore the influencing factors. Results A total of 3,020 valid questionnaires, including 1,855 dentists and 1,165 dental nurses, were collected from 11 provinces of China. In general, 23.8% of responders exhibited psychological distress. The rate of dentists was 25.7%, and that of dental nurses was 20.8%. The prevalence was 4.9% higher in dentists than in dental nurses (P < 0.05). The multivariable analysis showed that factors associated with psychological distress for dentists were lower income, burnout, high job stress, career-choice regret, and lack of sufficient personal time, and that for dental nurses were age, lower income, longer working hours per week, burnout, high job stress, low job satisfaction, lack of sufficient personal time, and poor medical environment. Conclusion The prevalence of psychological distress was relatively high among dental medical staff, and dentists showed a higher prevalence than dental nurses. Nurses have more risk factors for psychological distress than dentists. These results indicate that it is necessary to monitor the mental health status of dental medical staff and implement accurate strategies for dentists and dental nurses to promote their physical and mental health.
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Affiliation(s)
- Yingying Zhang
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Li Yan
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Huiqing Long
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Lu Yang
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Jing Wang
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Yiyun Liu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juncai Pu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiaogang Zhong
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Xin Jin,
| | - Jin Xin
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Stomatological Association, Chongqing, China
- Xiaogang Zhong,
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Nemcsik-Bencze Z, Kőrösi B, Gyöngyösi H, Batta D, László A, Torzsa P, Kovács I, Rihmer Z, Gonda X, Nemcsik J. Depression and anxiety in different hypertension phenotypes: a cross-sectional study. Ann Gen Psychiatry 2022; 21:23. [PMID: 35761354 PMCID: PMC9235239 DOI: 10.1186/s12991-022-00400-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/15/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Hypertension is a major risk factor of cardiovascular mortality. Mood disorders represent a growing public health problem worldwide. A complex relationship is present between mood disorders and cardiovascular diseases. However, less data is available about the level of depression and anxiety in different hypertension phenotypes. The aim of our study was to evaluate psychometric parameters in healthy controls (Cont), in patients with white-coat hypertension (WhHT), with chronic, non-resistant hypertension (non-ResHT), and with chronic, treatment-resistant hypertension (ResHT). METHODS In a cross-sectional study setup 363 patients were included with the following distribution: 82 Cont, 44 WhHT, 200 non-ResHT and 37 ResHT. The patients completed the Beck Depression Inventory (BDI) and the Hamilton Anxiety Scale (HAM-A). RESULTS BDI points were higher in WhHT (7 (3-11)) and ResHT (6 (3-11.5)) compared with Cont (3 (1-6), p < 0.05). Similarly, HAM-A points were higher in WhHT (8 (5-15)) and ResHT (10.5 (5.25-18.75)) compared with Cont (4 (1-7), p < 0.05) and also compared with non-ResHT (5 (2-10), p < 0.05). ResHT was independently associated with HAM-A scale equal or above 3 points (Beta = 3.804, 95%CI 1.204-12.015). WhHT was independently associated with HAM-A scale equal or above 2 points (Beta = 7.701, 95%CI 1.165-18.973) and BDI scale equal or above 5 points (Beta = 2.888, 95%CI 1.170-7.126). CONCLUSIONS Our results suggest psychopathological similarities between white-coat hypertension and resistant hypertension. As recently it was demonstrated that white-coat hypertension is not a benign condition, our findings can have relevance for future interventional purposes to improve the outcome of these patients.
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Affiliation(s)
| | - Beáta Kőrösi
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Helga Gyöngyösi
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Dóra Batta
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | | | - Péter Torzsa
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Illés Kovács
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary.,Department of Ophthalmology, Weill Cornell Medical College, New York City, NY, USA
| | - Zoltán Rihmer
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Xénia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.,Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary.,Neurochemistry Research Group, MTA-SE, Budapest, Hungary
| | - János Nemcsik
- Department of Family Medicine, Semmelweis University, Budapest, Hungary. .,Health Service of Zugló (ZESZ), Budapest, Hungary.
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21
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Andrew A, Hariharan M, Monteiro SR, Padhy M, Chivukula U. Enhancing Adherence and Management in Patients with Hypertension: Impact of Form and Frequency of Knowledge Intervention. Indian Heart J 2022; 74:302-306. [PMID: 35661781 PMCID: PMC9453054 DOI: 10.1016/j.ihj.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/01/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The alarming rise in prevalence of hypertension warrants psychosocial methods supplementing pharmacotherapy for better management and prevention of cardiac emergencies. The objective of the study was to assess the differential impact of the form and frequency of knowledge intervention on management of primary hypertension. MATERIALS AND METHOD The study was conducted on 256 hypertensive patients recruited through purposive sampling at health centers in Hyderabad, India. Pretest post-test control group quasi-experimental design was adopted for the study. There were two forms of the knowledge intervention, namely 'Direct Interaction' and 'Audio-Visual'. Each form was presented in two frequencies namely 'single exposure' and 'double exposure'. The four groups were labelled as Direct Intervention Single (DIS), Direct Intervention Double (DID), Audio-Visual Single (AVS) and Audio-Visual Double (AVD). Adherence and management of hypertension were assessed at baseline and six weeks post experiment. Analysis of Covariance (ANCOVA) was applied using IBM SPSS Statistics version 20. RESULTS ANCOVA followed by Bonferroni Multiple Group Comparison Test revealed significant differences between the four intervention groups and control group on adherence (p<.001). In case of hypertension management significant differences were observed between Control group and DIS, DID (P<.001), Control and AVS (P<.01). Control group did not differ from AVD. CONCLUSION There was a positive impact of Knowledge Intervention on adherence and management of hypertension. Double exposure in audio visual form was counterproductive in hypertension management.
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Affiliation(s)
- Asher Andrew
- Centre for Health Psychology, School of Medical Sciences, University of Hyderabad, Central University PO, Prof. C R Rao Road, Gachibowli, Hyderabad - 500046, Telangana, India.
| | - Meena Hariharan
- Centre for Health Psychology, School of Medical Sciences, University of Hyderabad, Central University PO, Prof. C R Rao Road, Gachibowli, Hyderabad - 500046, Telangana, India.
| | - Sandra Roshni Monteiro
- Department of Applied Psychology, GITAM School of Humanities and Social Sciences, GITAM (Deemed to Be University), Hyderabad - 502329, Telangana, India.
| | - Meera Padhy
- Centre for Health Psychology, School of Medical Sciences, University of Hyderabad, Central University PO, Prof. C R Rao Road, Gachibowli, Hyderabad - 500046, Telangana, India.
| | - Usha Chivukula
- Centre for Health Psychology, School of Medical Sciences, University of Hyderabad, Central University PO, Prof. C R Rao Road, Gachibowli, Hyderabad - 500046, Telangana, India.
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22
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Asmare Y, Ali A, Belachew A. Magnitude and associated factors of depression among people with hypertension in Addis Ababa, Ethiopia: a hospital based cross-sectional study. BMC Psychiatry 2022; 22:327. [PMID: 35538447 PMCID: PMC9086661 DOI: 10.1186/s12888-022-03972-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The burden of depression is higher among people with chronic illnesses like hypertension and this comorbid condition leads to poor adherence to treatment and failure of compliance to lifestyle modifications, which in turn, increases risk of cardiovascular complications and mortalities. Low income countries, Ethiopia included, suffer from paucity of information describing the burden of hypertension comorbid with depression, which demands studies to narrow this knowledge gap, such as this one. METHODS Institution based cross-sectional study was conducted in three randomly selected public hospitals in Addis Ababa. Through a systematic random sampling method, a total of 416 known hypertensive patients with follow up in hypertension clinics with in the study period enrolled in the study. Data were collected through structured questionnaire administered by trained interviewer, which latter cleaned, edited and entered in to epi-data version 3.1. Descriptive and bi-variable and binary logistic regression analysis were done using the statistical software, SPSS version 25. Depression was assessed through Hospital Anxiety and Depression Scale (HADs). RESULTS The prevalence of depression among hypertensive patients was found to be 37.8% [95% CI (33.4%-42.5%)]. The binary logistic regression model revealed that, female sex [AOR = 5.37, 95% CI (3.089-9.35)], being married [AOR = 0.25, 95% CI (0.08-0.78)], presence of chronic comorbid illnesses [AOR = 3.03, 95% CI (1.78-5.16)], uncontrolled blood pressure [AOR = 2.80, 95% CI (1.65-4.75)], duration of hypertension of 5-10 years [AOR = 3.17, 95% CI (1.61-6.23)] and more than 10 years [AOR = 5.81, 95% CI (2.90-11.65)], family history of depression [AOR = 4.53, 95% CI (2.37-8.66)] and current alcohol consumption [AOR = 1.77, 95% CI (1.02-3.07)] were significantly associated with depression among hypertensive patients. CONCLUSION High proportion of depression was observed among hypertensive patients, and socio-demographic, clinical and behavioral characteristics were found to significantly influence the likelihood of occurrence. Health care providers should consider mental health status of hypertensive patients, and counsel for these factors.
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Affiliation(s)
- Yonatan Asmare
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Ahmed Ali
- grid.7123.70000 0001 1250 5688School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ayele Belachew
- grid.7123.70000 0001 1250 5688School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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23
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Hu Y, Huang Y, Wang L, Liu Z, Wang L, Yan J, Zhang M, Lv P, Guan Y, Ma C, Huang Z, Zhang T, Chen H. Disability and Comorbidity of Mood Disorders and Anxiety Disorders With Diabetes and Hypertension: Evidences From the China Mental Health Survey and Chronic Disease Surveillance in China. Front Psychiatry 2022; 13:889823. [PMID: 35669270 PMCID: PMC9163306 DOI: 10.3389/fpsyt.2022.889823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/26/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The China Mental Health Survey was carried out using the same sampling frame with the China Chronic Diseases and Risk Factors Surveillance. This paper explores the relationship between the disability and the comorbidity of mood disorders and anxiety disorders with diabetes and hypertension. METHODS A large-scale nationally representative sample with both mental disorders and chronic diseases was collected from 157 Disease Surveillance Points in 31 provinces across China. Face-to-face interviews were conducted by trained lay interviewers to make diagnoses of mood disorders and anxiety disorders using the Composite International Diagnostic Interview. Diabetes and hypertension were diagnosed from self-report and blood examination or body measurement. Sampling design weights, non-response adjustment weights, and post-stratification adjustment weights were applied during the analyses of comorbidity and disability. RESULTS Totally 15,000 respondents had information of mental disorders and physical diseases. In the patients with mood disorders or anxiety disorders, the weighted prevalence rates of diabetes or hypertension were not higher than those in persons without the above mental disorders, but the weighed disability rates increased when having the comorbidity of hypertension (P < 0.05). The severity of disability was higher among patients with comorbidity of diabetes and anxiety disorders, or hypertension and mood disorders, compared with that among patients without the physical comorbidity (P < 0.05). After adjusted by age, gender and education, patients with comorbidity of mental disorders and physical disorders had the highest disability, followed by the patients with mental disorders only, and physical diseases only. CONCLUSIONS The disability of mood disorders and anxiety disorders comorbid with diabetes and hypertension are more serious than that of any single disease. The relationship of mental and physical diseases is worth exploring in depth for comprehensive and integrated intervention to decrease the disability.
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Affiliation(s)
- Yuanyuan Hu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yueqin Huang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Limin Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaorui Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Linhong Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Yan
- School of Government, Peking University, Beijing, China
| | - Mei Zhang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ping Lv
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Yunqi Guan
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chao Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Zhengjing Huang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tingting Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Hongguang Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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Alves AM, Rodrigues A, Sa-Couto P, Simões JL. Effect of an Educational Nursing Intervention on the Mental Adjustment of Patients with Chronic Arterial Hypertension: An Interventional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:170. [PMID: 35010430 PMCID: PMC8750213 DOI: 10.3390/ijerph19010170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
The objective of this analytical and interventional prospective quantitative study was to assess the effect of an educational intervention performed by nurses for mental adjustment to chronic disease in patients with hypertension. A convenience sample was studied, composed of 329 participants with chronic hypertension, followed in a primary healthcare unit in the Central Region of Portugal. Data collection was carried out by applying the Mental Adjustment to Disease Scale (MADS) before and 1 month after the educational nursing intervention between September 2017 and February 2018. Prior to the application of the educational intervention, 43.5% of the participants were classified as "unadjusted" in at least one of the subscales of MADS. After the educational intervention, 21.3% of the participants classified as "unadjusted" became "adjusted" in all MADS subscales. The success rate of the intervention varied from 26.9% (in the fatalism subscale) to 44.6% (for the anxious concern subscale). Participants were more likely to be mentally "unadjusted" to hypertension if they lived with other family members, had an active professional situation before the diagnosis of hypertension, still had an active professional situation now, were under 65 years old, had a shorter time to diagnosis (1-2 years), and measured blood pressure less regularly. The educational intervention performed by nurses is relevant for the mental adjustment of hypertensive patients, contributing to increased knowledge, as well as improvement in preventive and self-care practices, facilitating the experience of the health/disease transition process.
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Affiliation(s)
- Ana Margarida Alves
- Inpatient Service of Surgical Specialties, Centro Hospitalar do Baixo Vouga E.P.E., 3810-164 Aveiro, Portugal;
| | - Alexandre Rodrigues
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal;
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-531 Coimbra, Portugal
- Center for Health Studies and Research, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Pedro Sa-Couto
- Centre for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics (DMAT), University of Aveiro, 3810-193 Aveiro, Portugal;
| | - João Lindo Simões
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal;
- Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal
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25
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Association between post-traumatic stress disorder and hypertension in Congolese exposed to violence: a case-control study. J Hypertens 2021; 40:685-691. [PMID: 34907991 DOI: 10.1097/hjh.0000000000003061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Numerous risk factors have been involved in the pathogenesis of hypertension. The contribution of psychological factors, including post-traumatic stress disorder, remains largely underexplored, despite their potential role in hypertension. OBJECTIVES We compared the prevalence of trauma, post-traumatic stress and other psychological disorders between hypertensive and normotensive patients from Bukavu (Democratic Republic of Congo), a 25-year war-exposed city. METHODS AND MEASURES In this case-control study, we assessed past traumatic events with the Stressful-Events-Scale, post-traumatic stress disorder through the post-traumatic diagnostic scale, depression and alcohol use disorder through the MINI-International-Neuropsychiatric-Interview, and emotion regulation through the Emotion-Regulation-Questionnaire in 106 hypertensive and 106 normotensive patients, enrolled at the Bukavu General Hospital. RESULTS Compared with normotensive controls (73% women, age: 43 ± 14 years, BP: 121 ± 10/75 ± 8 mmHg), hypertensive patients (57% women, age: 42 ± 13 years, BP: 141 ± 12/82 ± 7 mmHg, on a median of two antihypertensive drugs) were exposed to more man-made traumas (61 vs. 13%, P < 0.001), used more expressive suppression (P = 0.05) and less cognitive reappraisal (P = 0.02) as emotional regulation strategies. They developed more frequent post-traumatic stress disorder (36 vs. 7%, P < 0.001) and major depressive disorder (37 vs. 13%, P = 0.001), often in association with alcohol use disorder (23 vs. 4%, P < 0.001). In multivariate logistic regression, post-traumatic stress disorder [OR = 3.52 (1.23-6.54)], man-made trauma [OR = 2.24 (1.15-4.12)], family history of hypertension [OR = 2.24 (1.06-4.44)], fasting blood glucose [OR = 1.85 (1.07-3.08)], BMI [OR = 1.28 (1.12-2.92)], expressive suppression [OR = 1.23 (1.11-2.23)] and cognitive reappraisal [OR = 0.76 (0.63-0.98)] were independent predictors of hypertension. CONCLUSION In Congolese populations exposed to war, man-made trauma exposure and post-traumatic stress disorder appear to be more tightly related to hypertension than classical hypertension risk factors.
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Ayano G, Betts K, Dachew BA, Alati R. Maternal smoking during pregnancy and poor academic performance in adolescent offspring: A registry data-based cohort study. Addict Behav 2021; 123:107072. [PMID: 34364108 DOI: 10.1016/j.addbeh.2021.107072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/08/2021] [Accepted: 07/28/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Previous studies have suggested associations between maternal smoking during pregnancy (MSDP) and a range of adverse outcomes in offspring. However, evidence reporting adverse effects on poor academic performance in adolescence is scant. METHODS This register-based cohort study used linked data obtained from New South Wales (NSW) educational and health registries in Australia. MSDP was assessed using self-reports of smoking during pregnancy. Offspring's educational performance was assessed using the National Assessment Program for Literacy and numeracy (NAPLAN), when students were in grade 9 and approximately aged 14 years. We used multivariable logistic regression models to explore associations. RESULTS Adolescent offspring exposed to MSDP were at an increased risk of substandard academic performance in all domains, with the highest odds for spelling [OR, 3.12 (95%CI 2.98-3.26)] followed by writing [OR, 2.97 (95%CI 2.84-3.11)], reading [OR, 2.49 (95%CI 2.37-2.62)], and numeracy [OR, 2.43 (95%CI 2.30-2.58)]. In our sex-stratified analysis, MSDP displayed stronger effects on the academic performance of female offspring in all domains. CONCLUSIONS Our findings showed that MSDP was associated with an increased risk of reduced academic performance in adolescent offspring. The different effects of MSDP on the academic performance of male and female offspring is a new finding, which needs further investigation.
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27
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Oliveira J, Paixão V, Cardoso G, Xavier M, Caldas de Almeida JM, Oliveira-Maia AJ. Childhood adversities and the comorbidity between mood and general medical disorders in adults: Results from the WHO World Mental Health Survey Portugal. Brain Behav Immun Health 2021; 17:100329. [PMID: 34589816 PMCID: PMC8474529 DOI: 10.1016/j.bbih.2021.100329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/19/2021] [Accepted: 08/13/2021] [Indexed: 11/24/2022] Open
Abstract
Objective Childhood adversities have been linked to poor health outcomes in adults, including both mood and general medical disorders. Here we tested the hypothesis that childhood adversities specifically increase the risk of comorbidity between mood and general medical disorders, rather than increasing the risk of either one independently. Methods Mood disorders (DSM-IV major depressive, dysthymic and bipolar disorders), childhood adversities and general medical disorders were assessed in 2060 adults in the WHO World Mental Health Survey Portugal. Discrete-time survival analyses were used to investigate the association between mood disorders and subsequent first-onset general medical disorders and between general medical disorders and subsequent first-onset mood disorders, in adults. Discrete-time survival and multinomial regression analyses were used to test the influence of childhood adversities on the comorbidity between mood disorders and general medical disorders. Anxiety disorders were used as a psychiatric control. Results Adult-onset mood disorders were found to precede the onset of diabetes (OR:1.8; 95% CI:1.2-2.9), arthritis (OR:1.6; 95% CI:1.1-2.3) and seasonal allergies (OR:1.6; 95% CI:1.1-2.5) while adult-onset hypertension was found to precede the onset of mood disorders (OR:1.7; 95% CI:1.2-2.6). Maladaptive family functioning (abuse, neglect and parental maladjustment), was associated with mood disorders (OR:1.5; 95% CI:1.2-1.9), hypertension (OR:1.4; 95% CI:1.1-1.7), arthritis (OR:1.3; 95% CI:1.0-1.6) and seasonal allergies (OR:1.5; 95% CI:1.1-2.0) in adulthood. Finally, the effect of maladaptive family functioning in predicting comorbid mood disorders and arthritis significantly differed from its effect in predicting only arthritis (p = 0.01), which was not observed for other comorbidities. Maladaptive family functioning further predicted comorbid anxiety disorders and hypertension. Conclusion Childhood adversities may be a specific risk factor for comorbid mood disorders and arthritis in adults.
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Affiliation(s)
- José Oliveira
- NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisboa, Portugal.,Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisboa, Portugal.,Champalimaud Research, Champalimaud Centre for the Unknown, Lisboa, Portugal.,Centro Hospitalar Psiquiátrico de Lisboa, Lisboa, Portugal
| | - Vítor Paixão
- Champalimaud Research, Champalimaud Centre for the Unknown, Lisboa, Portugal
| | - Graça Cardoso
- CHRC, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal.,Lisbon Institute of Global Mental Health, Lisboa, Portugal
| | - Miguel Xavier
- CHRC, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal.,Department of Mental Health, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - José Miguel Caldas de Almeida
- CHRC, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal.,Lisbon Institute of Global Mental Health, Lisboa, Portugal
| | - Albino J Oliveira-Maia
- NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisboa, Portugal.,Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisboa, Portugal.,Champalimaud Research, Champalimaud Centre for the Unknown, Lisboa, Portugal.,Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
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28
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Lim LF, Solmi M, Cortese S. Association between anxiety and hypertension in adults: A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 131:96-119. [PMID: 34481847 DOI: 10.1016/j.neubiorev.2021.08.031] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
We assessed the association between anxiety and hypertension in adults via a systematic review/meta-analysis. We searched PubMed, Ovid, and PsycINFO through 27 March 2020 with no language or publication type restrictions and systematically contacted study authors for unpublished information/data. We meta-analysed 59 studies including a total of 4,012,775 participants. Study quality was rated with the Newcastle-Ottawa Scale and random-effects analyses were performed. A significant anxiety-hypertension association was found in cross-sectional (OR = 1.37, 95 % CI = 1.21-1.54) and prospective studies (OR = 1.40, 95 % CI = 1.23-1.59). In sensitivity analyses, results were influenced by method of hypertension diagnosis, but not by study quality, method of anxiety diagnosis, study population, and effect size type. In subgroup analyses, study location, in particular country economic status, but not participant age, influenced the results. Longitudinal data and theoretical literature indicate that anxiety may precede hypertension. These findings have important clinical implications for the early detection and treatment of both anxiety and hypertension. Suggestions for future research are discussed.
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Affiliation(s)
- Li-Faye Lim
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK
| | - Marco Solmi
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, UK; Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Samuele Cortese
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK; Centre for Innovation in Mental Health, School of Psychology, University of Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.
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FİDANCI İ, AKSOY H, AYHAN BAŞER D, CANKURTARAN M. Esansiyel Hipertansiyon Tanılı Hastalarda Anksiyete veya Depresyon Görülme Sıklıklarının Değerlendirilmesi: Retrospektif Çalışma. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.960125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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30
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D'emeh WM, Yacoub MI, Shahwan BS. Work-Related Stress and Anxiety Among Frontline Nurses During the COVID-19 Pandemic: A Cross-Sectional Study. J Psychosoc Nurs Ment Health Serv 2021; 59:31-42. [PMID: 34110949 DOI: 10.3928/02793695-20210322-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has strained the health system worldwide. Nurses caring for patients with COVID-19 reported experiencing significant work-related stress and anxiety. The current online descriptive cross-sectional correlational study aimed to investigate work-related stress and anxiety among nurses caring for patients with COVID-19. Data were collected from 240 nurses using the Stress Overload Scale and Self-Rated Anxiety Scale. Average stress and anxiety scores were 34.96 (SD = 5.85) and 52.8 (SD = 5.48), respectively. Statistically significant differences were found in mean stress overload and anxiety scores based on gender, professional title, average working hours per week, working area, and presence of fear of being infected with COVID-19. These findings suggest the need to promote well-being in nurses and assist nurses and other health care workers experiencing mental and psychological health problems in the context of the COVID-19 pandemic. [Journal of Psychosocial Nursing and Mental Health Services, 59(8), 31-42.].
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Zhou J, Lee S, Wong WT, Leung KSK, Nam RHK, Leung PSH, Chau YLA, Liu T, Chang C, Cheung BMY, Tse G, Zhang Q. Gender- and Age-Specific Associations of Visit-to-Visit Blood Pressure Variability With Anxiety. Front Cardiovasc Med 2021; 8:650852. [PMID: 34026870 PMCID: PMC8137912 DOI: 10.3389/fcvm.2021.650852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/22/2021] [Indexed: 11/27/2022] Open
Abstract
Background: There is a bidirectional relationship between blood pressure variability (BPV) and anxiety, but few studies have examined the gender- and age-specific effects of visit-to-visit BPV on incident anxiety. We examined the predictive value of BPV for the incidence of anxiety in a family clinic cohort. Methods: Consecutive patients with a first attendance to family medicine clinics in Hong Kong between January 1, 2000, and December 31, 2002, with at least three blood pressure measurements available thereafter were included. The primary endpoint was incident anxiety as identified by ICD-9 coding. Results: This study included 48,023 (50% males) patients with a median follow-up of 224 [interquartile range (IQR): 217-229] months. Females were more likely to develop incident anxiety compared to males (incidence rate: 7 vs. 2%), as were patients of older age. Significant univariate predictors were female gender, older age, preexisting cardiovascular diseases, respiratory diseases, diabetes mellitus, hypertension, and gastrointestinal diseases, various laboratory examinations, and the number of blood pressure measurements. Higher baseline, maximum, minimum, standard deviation (SD), coefficient of variation (CV), and variability score of diastolic blood pressure significantly predicted incident anxiety, as did all systolic blood pressure measures [baseline, latest, maximum, minimum, mean, median, variance, SD, root mean square (RMS), CV, and variability score]. Conclusions: The relationships between longer-term visit-to-visit BPV and incident anxiety were identified. Female and older patients with higher blood pressure and higher BPV were at the highest risks of incident anxiety.
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Affiliation(s)
- Jiandong Zhou
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Sharen Lee
- Cardiovascular Analytics Group, Laboratory of Cardiovascular Physiology, Hong Kong, China
| | - Wing Tak Wong
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | | | | | | | - Yau-Lam Alex Chau
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Carlin Chang
- Division of Neurology, Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Bernard Man Yung Cheung
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Gary Tse
- Cardiovascular Analytics Group, Laboratory of Cardiovascular Physiology, Hong Kong, China
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qingpeng Zhang
- School of Data Science, City University of Hong Kong, Hong Kong, China
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Naghipour M, Joukar F, Salari A, Asgharnezhad M, Hassanipour S, Mansour-Ghanaei F. Epidemiologic Profile of Hypertension in Northern Iranian Population: The PERSIAN Guilan Cohort Study (PGCS). Ann Glob Health 2021; 87:14. [PMID: 33614420 PMCID: PMC7879995 DOI: 10.5334/aogh.3027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background Estimates region-related prevalence of hypertension and attempts to identify its related factors at the district levels are required for prevention and management of hypertension. Objective The aim of this study was to investigate the epidemic features and related factors of hypertension and its awareness, treatment, and control rates among the northern Iranian population. Methods It was a community based cross-sectional study based on data from PERSIAN Guilan Cohort Study (PGCS). In total, 10,520 participants (aged 35-70 years) from the Guilan Province in northern Iran included in this study, between October 8, 2014, and January 20, 2017. Hypertension was defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg or a prior diagnosis of hypertension or being on antihypertensive medication. Potential correlates of hypertension and its awareness, treatment and control were analyzed by multivariate logistic regression adjusted for demographic factors, anthropometric characteristics, lifestyle variables, past medical history, and laboratory data. Results The prevalence of hypertension was 43.2% and the hypertension awareness, treatment, and control rate were 53.4%, 49.8%, and 73.7%, respectively. The multivariate logistic regression analyses revealed that older age, urbanization, lower education, overweight and obesity, lower physical activity, prediabetes and diabetes, cardiovascular disease, psychiatric disorder, positive family history of hypertension and raised serum creatinine were independently associated with presence of hypertension. Awareness of hypertension was greater in the female sex, older age, rural residency, higher education and patient with comorbidities. Older age, rural residency and comorbidities were associated with treatment of hypertension. Control of hypertension was better among younger age, higher education, normal weight and higher physical activity. Conclusion Hypertension is highly prevalent in the northern Iranian population. About half of affected persons are unaware of their disease and untreated. Modifying risk factors (such as weight lose and increase physical activity) and increasing hypertension awareness (by screening) is essential for primary and secondary prevention of high blood pressure in this population, especially in urban areas and among males, younger ages, and less educated.
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Affiliation(s)
- Mohammadreza Naghipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Arsalan Salari
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehrnaz Asgharnezhad
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Soheil Hassanipour
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Vallée A, Wiernik E, Kab S, Lemogne C, Goldberg M, Zins M, Blacher J. Association of depressive symptoms and socioeconomic status in determination of blood pressure levels and hypertension: The CONSTANCES population based study. J Affect Disord 2021; 279:282-291. [PMID: 33096326 DOI: 10.1016/j.jad.2020.10.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Inconsistent association between depression and hypertension has been highlighted. The association of depression with blood pressure (BP) might depend upon socioeconomic status (SES), but evidence remains weak. OBJECTIVES This study aimed to examine how the associations between depressive symptoms and BP levels and hypertension and then, according to SES variables (education, income, occupational status). METHODS Among 66,478 volunteers of the French CONSTANCES cohort (31,093 men; mean age (standard deviation): 47.8 (12.9) years), depressive symptoms were assessed with the Center of Epidemiologic Studies Depression scale (CES-D). Overall associations between depressive symptoms and BP and hypertension were estimated using regressions and by stratifying on SES. RESULTS SES were associated with BP in both genders. CES-D score was negatively associated with systolic BP (SBP) in women (b=-0.62 95%CI [-1.03; -0.21] and in men (b=-1.03 95%CI [-1.45; -0.61]) but not with diastolic BP (DBP) in both genders. In women, the decrease in SBP and DBP was more pronounced as educational level increases (p for interaction: 0.012 and 0.013, respectively). In men, few interactions were observed between CES-D score and SES factors for BP levels. The association between CES-D score and hypertension was significant for men, OR=0.86, 95%CI [0.80; 0.93] but not for women, OR=1.03, 95%CI [0.96; 1.10]. No interactions were observed between CES-D score and SES for hypertension. CONCLUSION Gender differences were observed for considering depressive symptoms according to SES factors for BP variation and hypertension. In women, educational level was the SES factor which has the main modifying effect on this association.
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Affiliation(s)
- Alexandre Vallée
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hotel-Dieu Hospital, AP-HP; University of Paris, Paris, France
| | - Emmanuel Wiernik
- Inserm, UMS011, Population-based Epidemiological Cohorts Unit, Villejuif, France
| | - Sofiane Kab
- Inserm, UMS011, Population-based Epidemiological Cohorts Unit, Villejuif, France
| | - Cédric Lemogne
- AP-HP, Hôpitaux Universitaire Paris Ouest, Service de Psychiatrie de l'adulte et du sujet âgé, 75015, Paris, France; Inserm, U894, Centre Psychiatrie et Neurosciences, 75014, Paris, France
| | - Marcel Goldberg
- Inserm, UMS011, Population-based Epidemiological Cohorts Unit, Villejuif, France
| | - Marie Zins
- Inserm, UMS011, Population-based Epidemiological Cohorts Unit, Villejuif, France
| | - Jacques Blacher
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hotel-Dieu Hospital, AP-HP; University of Paris, Paris, France.
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Antidepressants and the Risk of Cardiovascular Events in Elderly Affected by Cardiovascular Disease: A Real-Life Investigation From Italy. J Clin Psychopharmacol 2020; 40:112-121. [PMID: 32134848 DOI: 10.1097/jcp.0000000000001189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of this study was to assess the possible relation between use of antidepressant (AD) drugs, that is, tricyclic ADs, selective serotonin reuptake inhibitors (SSRIs), and atypical ADs (AAs), and the risk of hospitalization for cardiovascular (CV) events among older patients with previous CV diseases. METHODS A nested case-control study was carried out among patients aged 65 years and older from 5 Italian health care territorial units who were discharged for CV disease during 2008 to 2010. The cohort was composed by 344,747 individuals, and of these, 97,739 (28%) experienced hospital admission for CV events (myocardial infarction, arrhythmia, stroke, heart failure) during follow-up (until 2014) and were included as cases. Up to 5 controls were randomly selected and matched to each. A conditional logistic regression was fitted to estimate the risk of CV events associated with ADs past or current use. A within-patient comparison was performed by the case-crossover design to account the effect of depression. FINDINGS Current users of SSRIs and AAs were at increased risk of CV events with odds ratios of 1.25 (95% confidence interval, 1.21-1.29) and 1.31 (1.25-1.37), respectively. An increased risk of arrhythmia and stroke was associated with current use of SSRIs and AAs, whereas an increased risk of heart failure was detected with current use of any ADs. The results were confirmed by the case-crossover approach. IMPLICATIONS Evidence that AD use is associated with an increased risk of CV events in accordance with specific mechanisms of action among older people with CV disease was added by this study.
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Endomba FT, Mazou TN, Bigna JJ. Epidemiology of depressive disorders in people living with hypertension in Africa: a systematic review and meta-analysis. BMJ Open 2020; 10:e037975. [PMID: 33303433 PMCID: PMC7733170 DOI: 10.1136/bmjopen-2020-037975] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Better knowledge of epidemiology of depressive disorders in people living with hypertension can help to implement pertinent strategies to address its burden. The objective was to estimate the prevalence of depressive disorders and symptoms in people living with hypertension in Africa. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, EMBASE, African Index Medicus, African Journals OnLine were searched up to 31 January 2020, regardless of the language of publication. ELIGIBILITY CRITERIA We included studies conducted among adult patients with hypertension (≥18 years) living in Africa and reporting the prevalence of depressive disorders and symptoms. DATA EXTRACTION AND SYNTHESIS Two independent investigators selected studies, extracted data and assessed the methodological quality of included studies by using the tools developed by Joanna Briggs Institute. Multivariate random-effects meta-analysis served to pool data by considering the variability between diagnostic tools used to identify patients with depressive disorders or symptoms. RESULTS We included 11 studies with 5299 adults with hypertension. Data were collected between 2002 and 2017, from South Africa, Nigeria, Ghana, Ethiopia and Burkina Faso. The mean age varied between 50.3 years and 59.6 years. The proportion of men ranged from 28% to 54%. The adjusted prevalence of depressive disorders taking into account the variance between diagnostic tools was 17.9% (95% CI 13.0% to 23.4%). The prevalence of depressive symptoms and major depressive symptoms was 33.3% (95% CI 9.9% to 61.6%) and 7.8% (95% CI 3.0% to 14.5%), respectively. There was heterogeneity attributable to the diagnostic tools for depressive disorders and symptoms. There was no publication bias. CONCLUSION Notwithstanding the representativeness lack of some (sub) regions of Africa, weakening the generalisability of findings to the entire region; depressive disorders and symptoms are prevalent in people living with hypertension in Africa, indicating that strategies from clinicians, researchers and public health makers are needed to reduce its burden in the region.
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Affiliation(s)
- Francky Teddy Endomba
- Health Economics and Policy Research and Evaluation for Development Results Group, Yaounde, Cameroon
- Psychiatry Internship Program, Université de Bourgogne, Dijon, Bourgogne, France
| | - Temgoua Ngou Mazou
- Health Economics and Policy Research and Evaluation for Development Results Group, Yaounde, Cameroon
| | - Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur du Cameroun, Yaounde, Cameroon
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Alam MM, Ahmed S, Dipti RK, Siddiquee REJ, Hawlader MDH. The prevalence and associated factors of depression during pre-, peri-, and post-menopausal period among the middle-aged women of Dhaka city. Asian J Psychiatr 2020; 54:102312. [PMID: 32795954 DOI: 10.1016/j.ajp.2020.102312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/21/2020] [Accepted: 07/10/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Depression is a serious mental health issue and a major concern among middle-aged women, especially during the menopause transition time. This study aimed to determine the prevalence and associated factors of depression among the middle-aged women of the menopause transition in Dhaka. METHODOLOGY A cross-sectional study was conducted among 41 to 60 years older women in Dhaka city using a multistage cluster sampling technique and face to face interview. RESULT In total 326 middle-aged women participated in the study, and among them, 30.4% had major depression. No statistically significant association was observed between menopause status and major depression. However, peri-(34.2%) and post-menopausal (33.3%) groups were more depressed compared to pre-menopausal (26.8%) groups. Our adjusted analysis indicates, marital status (p = 0.004), having salaried job (p < 0.001), number of offspring (p = 0.003), sedentary hours (p = 0.002), smoking habit (p = 0.012), hypertension (p = 0.012), chronic disease other than diabetes/hypertension (p = 0.006), vasomotor symptoms (p = 0.004) and sleep problem (p = 0.007) were significantly associated with depression status. CONCLUSION The study result indicates a high prevalence of major depression among middle-aged Bangladeshi women during the menopause transition. Therefore, depression should be routinely evaluated among middle-aged women for the monitoring and prevention of depression.
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Affiliation(s)
- Mohammad Morshad Alam
- Health, Nutrition and Population Global Practice, The World Bank, Agargaon, Dhaka, 1207, Bangladesh; Graduex Research Group, Dhaka, 1209, Bangladesh.
| | - Shakil Ahmed
- Department of Public Health, North South University, Dhaka-1229, Bangladesh.
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Huang Y, Su Y, Jiang Y, Zhu M. Sex differences in the associations between blood pressure and anxiety and depression scores in a middle-aged and elderly population: The Irish Longitudinal Study on Ageing (TILDA). J Affect Disord 2020; 274:118-125. [PMID: 32469794 DOI: 10.1016/j.jad.2020.05.133] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Anxiety and depression are considered risk factors for cardiovascular diseases (CVDs), but their relationship to blood pressure (BP) is still uncertain. Lifestyle factors and age-related comorbidities may confound these relationships. Our study aimed to evaluate the associations between BP and anxiety and depression scores in a population aged ≥49 years. METHODS Data on 8504 participants from The Irish Longitudinal Study on Ageing (TILDA) were analyzed for associations between BP and anxiety and depression questionnaire scores, accounting for relevant confounding factors. RESULTS Multivariable analyses showed negative associations between systolic BP and anxiety and depression scores, independent of age, body mass index (BMI), marital status, education level, smoking status, alcohol consumption, level of physical activity, self-reported CVDs (≥2) and antihypertensive medication use in men (coefficient=-0.112, P=0.013; coefficient=-0.051, P=0.026) but not in women (coefficient=-0.001, P=0.855; coefficient=-0.005, P=0.556). Diastolic BP was not associated with anxiety or depression scores in either men (coefficient=-0.018, P=0.223; coefficient=-0.001, P=0.924) or women (coefficient=-0.007, P=0.338; coefficient=-0.015, P=0.293) after adjusting for these same confounding factors. After a follow-up of 4 years, lower BP in subjects not using antihypertensive medications was significantly associated with more anxiety and depression events. LIMITATION Time-varying confounding factors may have interfered with our results. CONCLUSION Our results show that systolic BP in a middle-aged and elderly population is negatively associated with anxiety and depression scores in men but not women after adjustment for a range of lifestyle factors. These results contrast with the predisposition of anxious or depressed participants to CVDs in later life when decades of unhealthy lifestyles have persisted.
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Affiliation(s)
- Ying Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Yuhao Su
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Ying Jiang
- Department of Rehabilitation, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Meilan Zhu
- Department of Rehabilitation, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
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Ranjan R, Nath S, Sarkar S. Association between depression, anxiety and quality of life among patients with diabetes mellitus and/or hypertension in a tertiary care railway hospital in India: A cross-sectional study. Indian J Psychiatry 2020; 62:555-558. [PMID: 33678837 PMCID: PMC7909011 DOI: 10.4103/psychiatry.indianjpsychiatry_794_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/11/2020] [Accepted: 08/10/2020] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Comorbid depression and anxiety have been found to be highly present in patients suffering from chronic physical illnesses such as diabetes mellitus (DM) and hypertension (HTN). These comorbid psychiatric conditions further reduce the quality of life (QOL) in the sufferers. The present study aimed to assess the association between depression, anxiety, and QOL among patients with DM and/or HTN. MATERIALS AND METHODS This cross-sectional study was carried out in the outpatient setting of the medicine department of the tertiary care referral hospital of East Central Indian Railways. One hundred and twenty-three individuals of DM and/or HTN of more than 1-month duration were assessed for depression, anxiety, and QOL using the Hospital Anxiety and Depression Scale (HADS) and the World Health Organization QOL Brief (WHOQOL-BREF) version scale. RESULTS The mean age of the sample (53.7% had HTN, 12.2% had diabetes, and 34.1% had both HTN and diabetes) which comprised 87% males was 50.20 (±6.0) years. The mean HADS (anxiety and depression) scores were 3.6 for both (range 0-14). Nearly 10.6% and 17.1% of the samples had scores above the cutoff for HADS anxiety and depression subscales. The WHOQOL-BREF scores were highest for the environmental domain and were lower for psychological, physical, and social domains. The HADS anxiety and depressive scores correlated significantly negatively with the WHOQOL-BREF physical and psychological domains. Female gender and the presence of an additional medical illness were significantly associated with higher HADS depression scores. CONCLUSION Fair proportion of patients with HTN and/or diabetes has been affected with higher anxiety and depressive scores, which predicted a poor QOL. This calls for early identification of these mental health issues in sufferers of depression and HTN, which will facilitate an early holistic management.
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Affiliation(s)
- Rajeev Ranjan
- Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Santanu Nath
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Siddharth Sarkar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
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Ghazizadeh H, Yaghooti-Khorasani M, Asadi Z, Zare-Feyzabadi R, Saeidi F, Shabani N, Safari-Ghalezou M, Yadegari M, Nosrati-Tirkani A, Shivappa N, Hébert JR, Moohebati M, Ferns GA, Esmaily H, Ghayour-Mobarhan M. Association between Dietary Inflammatory Index (DII®) and depression and anxiety in the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) Study population. BMC Psychiatry 2020; 20:282. [PMID: 32503468 PMCID: PMC7275599 DOI: 10.1186/s12888-020-02663-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/11/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Systemic inflammation is emerging as an important factor in the etiology of psychiatric disorders such as depression and anxiety. Therefore, the inflammatory potential of the diet may also be an etiological factor for these conditions, and this may be estimated by calculating the dietary inflammatory index (DII®) score. We aimed to investigate the association between DII score and incidence of depression and anxiety among a representative sample in northeastern Iran. METHODS This cross-sectional study undertook in a sub-sample of 7083 adults aged 35 to 65 years recruited as part of Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study population, and after excluding subjects with incomplete data. All participants completed the Beck Anxiety Inventory (BAI), the Beck Depression Inventory II (BDI-II), and a validated 65-item food frequency questionnaire (FFQ). Logistic regression was used to evaluate the association between DII score and depression/anxiety score. RESULTS Of the study participants, 37.1% (n = 2631) were found to have mild to severe depression, and 50.5% (n = 3580) were affected by mild to severe anxiety. After adjusting for confounding factors, in women, the third (OR: 1.41, 95% CI: 1.06-1.88, p-values< 0.05) and fourth quartiles (OR: 1.37, 95% CI: 1.03-1.83, p-values< 0.05) of DII score were associated with increased risk of a high depression score compared to the first quartile of DII score. CONCLUSION There was a significant association between DII score and severe depression among women but not men in this Iranian population. In order to confirm the association between DII food score, depression, and anxiety, further research is required in different populations, and perhaps an intervention study.
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Affiliation(s)
- Hamideh Ghazizadeh
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdiyeh Yaghooti-Khorasani
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Asadi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Zare-Feyzabadi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Saeidi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Niloofar Shabani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahshid Safari-Ghalezou
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehran Yadegari
- Department of Nutrition, faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abolfazl Nosrati-Tirkani
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Connecting Health Innovations LLC, Columbia, SC, 29250, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Connecting Health Innovations LLC, Columbia, SC, 29250, USA
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, UK
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
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Villarreal-Zegarra D, Bernabe-Ortiz A. Association between arterial hypertension and depressive symptoms: Results from population-based surveys in Peru. Asia Pac Psychiatry 2020; 12:e12385. [PMID: 32119760 DOI: 10.1111/appy.12385] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/19/2019] [Accepted: 02/10/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Approximately 350 million people have depression. The presence of arterial hypertension is a major risk factor for mental health. However, several studies on the association between arterial hypertension and depressive symptoms present controversial evidence. We aimed at identifying whether there is an association between arterial hypertension and depressive symptoms, taking into account the time since hypertension diagnosis. METHODS A secondary analysis of the Demographic and Health Survey in Peru (2014-2016) was conducted. The outcome was depressive symptoms, while hypertension and time since hypertension diagnosis were the exposure of interest. Poisson regression models were created, reporting prevalence ratios (PR) and 95% confidence intervals (95% CI). RESULTS Data from 87 253 participants were analyzed. A total of 2633 (3.0%; 95% CI: 2.8%-3.2%) individuals had depressive symptoms, whereas hypertension was present in 15 681 (19.6%; 95% CI: 19.1%-20.1%) subjects. In the multivariable model, people with less than a year since diagnosis were more than twice as likely to have depressive symptoms (PR = 2.08, 95% CI 1.65-2.63) compared to the group of people without hypertension. This probability decreased for individuals with 1 to 4 years since diagnosis (PR = 1.42, 95% CI 1.13-1.80), and for people with ≥5 years since diagnosis (PR = 1.29, 95% CI 1.01-1.64). CONCLUSIONS There is an association between hypertension and depressive symptoms, but this varies depending on time since diagnosis. Thus, individuals with <1 year since diagnosis had the highest probability of having depressive symptoms; after that, that probability decreased as the time since diagnosis increased.
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Affiliation(s)
- David Villarreal-Zegarra
- Instituto Peruano de Orientación Psicológica, Lima, Peru.,CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Universidad Científica del Sur, Lima, Peru
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Regulator of G-protein signaling 5 protein protects against anxiety- and depression-like behavior. Behav Pharmacol 2020; 30:712-721. [PMID: 31625976 DOI: 10.1097/fbp.0000000000000506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Anxiety and depression are a major health burden. Angiotensin II, via activation of angiotensin II type 1 receptor (AT1R)-mediated brain oxidative stress and inflammation may contribute to these emotional abnormalities. In this study, we investigated the role of a regulator of G-protein signaling 5 (RGS5) protein, which regulates AT1R activity, in angiotensin II-induced brain oxidative stress, inflammation and anxiety-, and depression-like behavior. We hypothesized that deletion of the RGS5 protein would worsen angiotensin II-induced anxiety- and depression-like behavior, cerebral vascular oxidative stress, and brain inflammation. Adult male wild-type and RGS5-deficient mice were implanted with osmotic minipumps delivering either vehicle (saline) or angiotensin II (1 mg/kg/d) for three weeks. Subsequently, mice were tested for locomotor activity, anxiety-like behavior (using the elevated plus maze), and depression-like behavior (using the tail suspension test). After behavioral testing, brain tissue was collected to assess oxidative stress and inflammatory proteins. RGS5 deletion resulted in anxiety-like but not depression-like behavior when compared to wild-type mice. Combined deletion of RGS5 and angiotensin II treatment did not further worsen anxiety-like behavior observed in RGS5-deficient mice. In contrast, depression-like behavior was worsened in RGS5-deficient mice treated with angiotensin II. Interestingly, RGS5 deficiency and angiotensin II treatment had no effect on cerebral vascular oxidative stress, or on expression of the inflammatory marker vascular cell adhesion molecule-1 in the brain. RGS5 deficiency was also associated with decreased blood pressure and an enhanced pressor response to angiotensin II. These data suggest that RGS5 protects against anxiety-like behavior and against angiotensin II-induced depression-like behavior.
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Jones HJ, Minarik PA, Gilliss CL, Lee KA. Depressive symptoms associated with physical health problems in midlife women: A longitudinal study. J Affect Disord 2020; 263:301-309. [PMID: 31818793 PMCID: PMC6989369 DOI: 10.1016/j.jad.2019.11.166] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/11/2019] [Accepted: 11/30/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND It is unclear if the relationship between depression and physical health problems in women is related to age, reproductive stage, obesity or socio-demographic risk factors. METHODS Longitudinal data were obtained every 6 months for 36 months in 264 midlife African American, Caucasian and Latina women who began the study as healthy regularly menstruating 40 to 50-year-olds; 75 transitioned to peri- or post-menopause by 36 months. Scores of 16 or higher on the Center for Epidemiologic Studies-Depression (CES-D) scale were used to estimate depression risk. RESULTS Depression risk was 28% at study initiation and 25% at 36 months. Significantly more women at risk for depression were unemployed, obese, or hypertensive. Women at risk were more likely to become peri- or post-menopausal during the study period. A higher percentage (38%) of overweight and obese women had CES-D scores ≥ 16 compared to normal weight women (23%; p < .001). Over half (58%) of the 73 women at higher depression risk at the initial visit reported a health problem or chronic illness at 36 months, compared to only 36% of the 191 women with CES-D scores <16 (p = .001). LIMITATIONS This was a secondary analysis of data from a relatively healthy sample of women in the decade before menopause. Chronic illness was self-reported and the CES-D is a screening tool for depressive symptoms rather than a clinical diagnostic tool. CONCLUSIONS Health care providers may be underestimating the impact of unemployment on depressive symptoms, obesity and chronic health problems in midlife women.
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Affiliation(s)
| | | | | | - Kathryn A. Lee
- School of Nursing, University of California, San Francisco
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Dich N, Rod NH, Doan SN. Both High and Low Levels of Negative Emotions Are Associated with Higher Blood Pressure: Evidence from Whitehall II Cohort Study. Int J Behav Med 2020; 27:170-178. [DOI: 10.1007/s12529-019-09844-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Dehesh T, Dehesh P, Shojaei S. Prevalence and Associated Factors of Anxiety and Depression Among Patients with Type 2 Diabetes in Kerman, Southern Iran. Diabetes Metab Syndr Obes 2020; 13:1509-1517. [PMID: 32440180 PMCID: PMC7211308 DOI: 10.2147/dmso.s249385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/16/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Depression and anxiety are common disorders in patients suffering from type 2 diabetes. These disorders can lead to premature morbidity, exacerbate disease complications, make patients suffer more, and increase health-care costs. As diabetes has increased worldwide recently, it is necessary to reduce the prevalence of factors that are associated with depression and anxiety in diabetes patients. This study aimed to assess the prevalence of anxiety and depression and to identify their associated factors, including metabolic components among people with type 2 diabetes. PATIENTS AND METHODS We performed a cross-sectional study in 1500 patients with type 2 diabetes in Kerman, in the southern part of Iran. The prevalence of depression and anxiety was estimated using the Beck Depression Inventory and the Hamilton Anxiety questionnaires, respectively. After calculating the proportions of depression and anxiety, univariate logistic regression was performed. Factors whose P-values were smaller than 0.2 in univariate logistic regression were included in multiple logistic regression for confounder adjustments. The analysis was performed using SPSS version 20. RESULTS The rates of depression and anxiety were 59% (95% CI: 54.48-63.12) and 62% (95% CI: 59.51-66.27), respectively. Factors found to be independently associated with anxiety were high FBS, high LDL-C, high TG, hypertension, complications, low physical activity. Factors found to be independently associated with depression were female gender, older age, high BMI, high FBS, high LDL-C, low HDL-C, high TG, high HbA1c, hypertension, and low physical activity. Complications were independently associated with anxiety but not with depression. Female gender, older age, high BMI, low HDL-C, and high HbA1c were independently associated with depression but not with anxiety. CONCLUSION Current findings demonstrated that a large proportion of patients with type 2 diabetes suffer from depression and anxiety. This study also identified factors associated with these disorders. Controlling some metabolic variables will decrease the prevalence of these disorders and improves clinical remedy and quality of life in patients with type 2 diabetes.
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Affiliation(s)
- Tania Dehesh
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Paria Dehesh
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Correspondence: Paria Dehesh Email
| | - Shahla Shojaei
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Venkataraman R, Saha I, Karmakar N, Sarkar T, Sinha R, Chakraborty T. A community-based study on modifiable risk factors of hypertension among Adults of rural Bengal, India. CHRISMED JOURNAL OF HEALTH AND RESEARCH 2020. [DOI: 10.4103/cjhr.cjhr_101_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ge D, Zhang X, Guo X, Chu J, Sun L, Zhou C. Suicidal ideation among the hypertensive individuals in Shandong, China: a path analysis. BMC Psychiatry 2019; 19:266. [PMID: 31477070 PMCID: PMC6719379 DOI: 10.1186/s12888-019-2256-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 08/22/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Although massive studies have explored the risk factors of suicidal ideation (SI), the prevalence of SI and its associated factors in the hypertensive individuals are largely unknown. This study aims to investigate the factors associated with SI in the hypertensive individuals. METHODS Three thousand nine hundred eleven hypertensive individuals in Shandong, China were included in the analysis. SI was assessed by using a question from the NCS (National Comorbidity Survey). We used binary logistic regression analysis to explore the factors associated with SI, and path analysis to test the direct and indirect relationships between associated factors and SI among hypertensive patients. RESULTS The prevalence of SI in the hypertensive individual was19.6%. Psychological distress had the greatest direct (β = 0.640, p-value <0.01) and total effect (β = 0.640, p-value <0.01) on SI. Other factors including comorbidity (β = 0.090, p-value <0.01), gender (β = 0.088, p-value <0.01), marital status (β = - 0.037, p-value <0.01), economic status (β = - 0.106, p-value <0.01), residence (β = - 0.050, p-value <0.01), alcohol use (β = 0.011, p-value <0.01), exercise (β = - 0.114, p-value <0.01), hospitalization (β = 0.041, p-value <0.01) only had indirect effects on SI. Psychological distress was a mediator between SI and those variables. CONCLUSION A significant mediation effect of psychological distress on the associations between SI and some associated factors (i.e., economic status, comorbidity) was demonstrated.
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Affiliation(s)
- Dandan Ge
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China
| | - Xinyi Zhang
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China
| | - Xiaolei Guo
- 0000 0000 8803 2373grid.198530.6Shandong Center for Disease Control and Prevention, Jinan, China
| | - Jie Chu
- Shandong Centre for Disease Control and Prevention, Jinan, 250014 China
| | - Long Sun
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China
| | - Chengchao Zhou
- School of Public Health, Shandong University, Jinan, 250012, China. .,School of Public Health, NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
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Risk correlates for physical-mental multimorbidities in South Africa: a cross-sectional study. Epidemiol Psychiatr Sci 2019; 28:418-426. [PMID: 29198237 PMCID: PMC6998962 DOI: 10.1017/s2045796017000737] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIMS The aim of this study was to identify the risk correlates for coexisting common mental disorders (CMDs) in the chronic care population in South Africa, with the view to identifying particularly vulnerable patient populations. METHODS The sample comprised 2549 chronic care patients enrolled in the baseline and endline rounds of a facility detection survey conducted by the Programme for Improving Mental Health Care in three large facilities in the Dr Kenneth Kaunda district in the North West province of South Africa. Participants were screened for depression using the Patient Health Questionnaire (PHQ9) and for alcohol misuse using the Alcohol Use Disorders Identification Test (AUDIT). Data were analysed according to the number of morbidities, disorder type (physical or mental) and demographic variables. Multimorbidity was defined as the presence of two or more disorders (physical and/or mental). RESULTS Just over one-third of the sample reported two or more physical conditions. Women were more at risk of being depressed than were men, with men more at risk of alcohol misuse. Those who were employed were at lower risk of having coexisting CMDs, while being younger, HIV positive, and food deprived were all found to be associated with higher risk for having coexisting CMDs. CONCLUSION In the face of the large treatment gap for CMDs in South Africa, and the role that coexisting CMDs can play in exacerbating the burden of chronic physical diseases, mental health screening and treatment interventions should target HIV-positive, younger patients living in circumstances where there is household food insecurity.
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Gong X, Liu C, Wang H, Fan J, Jiang C, Zou Y. Effect of heme oxygenase 1 and renin/prorenin receptor on oxidized low-density lipoprotein-induced human umbilical vein endothelial cells. Exp Ther Med 2019; 18:1752-1760. [PMID: 31410134 PMCID: PMC6676210 DOI: 10.3892/etm.2019.7769] [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: 08/03/2018] [Accepted: 04/12/2019] [Indexed: 12/12/2022] Open
Abstract
The incidence of depression has previously been correlated to hypertension. The aim of the present study was to explore the mechanisms of depression and hypertension by examining the expression and interaction of renin/prorenin receptor (PRR) and heme oxygenase 1 (HO-1) in vascular endothelial cells. A case-control study was conducted, and general data and serum factors were compared between hypertension patients complicated with depression and patients with hypertension alone. Logistic regression analysis was used to detect risk factors associated with hypertension complicated with depression. In addition, human umbilical vein endothelial cells (HUVECs) were treated with oxidized low-density lipoprotein (ox-LDL) and/or PRR gene silencing, and a Cell Counting Kit-8 (CCK-8) assay was performed to test their proliferation. The concentrations of inflammatory factors and oxidative stress factor were also detected using enzyme-linked immunosorbent assay and chemical colorimetry. Western blot analysis and reverse transcription-quantitative polymerase chain reaction were applied to detect protein and mRNA expression levels, respectively. The results revealed that HO-1 and renin precursor (Rep) were independent factors that affected hypertension complicated with depression. Serum HO-1 levels in patients with hypertension complicated with depression were significantly lower than that in hypertensive patients without depression, while Rep levels in patients with hypertension complicated with depression were significantly higher than that in hypertensive patients without depression. In HUVECs, ox-LDL reduced the cell proliferation in a dose-dependent manner, upregulated the expression of PRR gene and downregulated the expression of HO-1 gene. It was also observed that silencing of the PRR gene promoted the expression of the HO-1 gene. Furthermore, ox-LDL upregulated the inflammatory response and oxidative stress levels, while PRR gene silencing inhibited the ox-LDL-induced inflammatory factor and oxidative stress levels in HUVECs. Thus, regulating the expression levels of HO-1 and PRR to inhibit the oxidative stress and pro-inflammatory effect of ox-LDL may provide new insight for the treatment of hypertension patients with depression.
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Affiliation(s)
- Xin Gong
- Department of Integrated Chinese and Western Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Congyang Liu
- Department of Integrated Chinese and Western Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Hongling Wang
- Central Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Jinying Fan
- Department of Cardiology, Yantaishan Hospital, Yantai, Shandong 264000, P.R. China
| | - Cuihong Jiang
- Department of Integrated Chinese and Western Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Yong Zou
- Department of Integrated Chinese and Western Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, P.R. China
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Prevalence and Associated Factors of Depression among Patients with Diabetes at Jazan Province, Saudi Arabia: A Cross-Sectional Study. PSYCHIATRY JOURNAL 2019; 2019:6160927. [PMID: 30792987 PMCID: PMC6354152 DOI: 10.1155/2019/6160927] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 01/06/2019] [Indexed: 12/22/2022]
Abstract
Context Patients with diabetes mellitus (DM) have a poorer quality of life when compared with patients without DM. In fact, one in every five diabetic patients suffers from comorbid depression, which can lead to poor management, poor compliance with treatment, and low quality of life. Therefore, we assessed the prevalence of depression and identified its associated factors among diabetic patients at Jazan Province, KSA. Methods and Materials A cross-sectional study was conducted among 500 diabetic patients attending a diabetic center in addition to four primary healthcare centers. We used a simple Arabic translation of the Beck Depression Inventory (BDI II) tool to evaluate the depression level among the subjects. We also evaluated the frequencies of certain sociodemographic characteristics and clinical information. Moreover, we performed univariate and multivariate analyses to identify the potential risk factors using adjusted odds ratios (AORs). Results The prevalence of depression among DM patients was 20.6%. The majority of patients showed no depression (N = 285, 59.4%), one-fifth had mild depression (N = 96, 20.0%), some (N = 55, 11.4%) had moderate depression, and some had severe depression (N = 44, 9.2%). Depression was significantly more prevalent among uneducated patients (N = 27, 31.8%) (X2 = 17.627, P = 0.001) and patients with low monthly income (< 2500 SR/month) (N = 33, 22.8%) (X2 = 9.920, P = 0.019). Hypertension (AOR = 2.531, 95% CI [1.454, 4.406]) and ischemic heart diseases (AOR = 3.892, 95% CI [1.995, 7.593]) were considered as risk factors for depression among diabetic patients. Conclusions Almost one in every five patients with DM is affected by depression coexisting with cardiovascular diseases. Therefore, screening for psychological problems, proper treatment, and educating patients with diabetes about DM self-management should be routine components of DM care.
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Zainal NH, Newman MG. Executive function and other cognitive deficits are distal risk factors of generalized anxiety disorder 9 years later. Psychol Med 2018; 48:2045-2053. [PMID: 29224581 PMCID: PMC6707521 DOI: 10.1017/s0033291717003579] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The cognitive model (Hirsch & Mathews, 2012) and attentional control theory (Eysenck & Derakshan, 2011) postulate that compromised executive function (EF) and other cognitive constructs are negatively linked to increased excessive and uncontrollable worry, the core symptom of generalized anxiety disorder (GAD). However, the prospective link between neuropsychological constructs and GAD are not well understood. METHODS A nationally representative sample of 2605 community-dwelling adults whose average age was 55.20 (s.d. = 11.41, range 33-84; 56.31% females) participated at baseline and 9-year follow-up. Baseline neuropsychological function and symptoms were measured using the Brief Test of Adult Cognition by Telephone and Composite International Diagnostic Interview - Short Form. Multivariate Poisson and negative binomial regression analyses were conducted with 11 baseline covariates entered simultaneously: age, gender, years of formal education, perceived control, hypertension/diabetes, body mass index, exercise status, as well as GAD severity, panic disorder severity, and depression severity. Those with baseline GAD were also removed. RESULTS Lower Time 1 composite global cognition z-score independently predicted higher Time 2 GAD severity and diagnosis [odds ratio (OR) 0.60, 95% confidence interval (CI) 0.40-0.89, p = 0.01]. Poor inhibition, set-shifting, working memory (WM) updating, inductive reasoning, and global cognition sequentially forecasted heightened GAD. However, processing speed, verbal WM, verbal fluency, and episodic memory did not predict future GAD. CONCLUSION Global cognition, inductive reasoning, inhibition, set-shifting, and WM updating EF impairments may be distal risk factors for elevated GAD nearly a decade later.
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Affiliation(s)
- Nur Hani Zainal
- Department of Psychology,The Pennsylvania State University,University Park,PA 16802,USA
| | - Michelle G Newman
- Department of Psychology,The Pennsylvania State University,University Park,PA 16802,USA
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