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Niu Z, Haley AP, Clark AL, Duarte A. Age exacerbates the negative effect of depression on executive functioning in racial and ethnic minorities. Brain Imaging Behav 2024:10.1007/s11682-024-00898-3. [PMID: 38850388 DOI: 10.1007/s11682-024-00898-3] [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] [Accepted: 05/15/2024] [Indexed: 06/10/2024]
Abstract
Age and depression may interact to produce a "double jeopardy" for cognitive impairment, and executive functioning, in cognitively unimpaired aging. Few studies have considered middle age or the ethnoracial diversity of subjects, despite evidence of more severe cognitive outcomes in historically minoritized people. In this pilot study, we investigated the impact of age on depression-related cognitive impairment and the underlying brain volumes in middle-aged non-Hispanic White adults (116), and Hispanic and Black adults (60), with a total number of 176 adults. The result shows a significant interaction between age and depression for executive functioning, specifically for middle-aged Hispanic and Black adults, but not non-Hispanic White adults. Prefrontal cortex volumes, which were reduced in the Black and Hispanic compared to the non-Hispanic White adults, partially mediated the relationship between depression level and executive functioning, across age and ethnoracial group. Collectively, these results suggest that the negative impact of depression on executive functioning and Prefrontal cortex volumes integrity may be exacerbated by age and that historically minoritized people may be particularly sensitive to this double jeopardy.
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Affiliation(s)
- Zhimei Niu
- Department of Psychology, University of Texas at Austin, 108 Dean Keeton Street, Austin, TX, 78712, USA.
| | - Andreana P Haley
- Department of Psychology, University of Texas at Austin, 108 Dean Keeton Street, Austin, TX, 78712, USA
| | - Alexandra L Clark
- Department of Psychology, University of Texas at Austin, 108 Dean Keeton Street, Austin, TX, 78712, USA
| | - Audrey Duarte
- Department of Psychology, University of Texas at Austin, 108 Dean Keeton Street, Austin, TX, 78712, USA
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2
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Izquierdo Coronel B, López Pais J, Nieto Ibáñez D, Olsen Rodríguez R, Galán Gil D, Perela Álvarez C, Abad Romero R, Álvarez Bello M, Martín Muñoz M, Espinosa Pascual MJ, Mata Caballero R, Fraile Sanz A, Awamleh García P, Fernández-Avilés F, Alonso Martín JJ. Prevalence and prognosis of anxiety, insomnia, and type D personality in patients with myocardial infarction: A Spanish cohort. Cardiol J 2023; 31:261-270. [PMID: 37067334 PMCID: PMC11076035 DOI: 10.5603/cj.a2023.0025] [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: 11/17/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND It has been suggested that patients with myocardial infarction and non-obstructive coronary arteries (MINOCA) have more psycho-emotional disorders than patients with obstructive coronary artery disease (MICAD). The aim of this study is to compare the prevalence of anxiety, insomnia, and type D personality between MINOCA and MICAD and their impact on prognosis. METHODS Patients with myocardial infarction undergoing coronary angiography were prospectively enrolled. Psychological questionnaires were completed by each patient during admission. RESULTS Among a total of 533 patients, 56 had MINOCA and 477 had MICAD. There were no differences in the prevalence of anxiety and insomnia between both groups: trait anxiety median value (M) MINOCA = 18 (11-34) vs. MICAD M = 19 (12-27), p = 0.8; state anxiety MINOCA M = 19 (11-29) vs. MICAD M = 19 (12.2-26), p = 0.6; and insomnia MINOCA M = 7 (3-11) vs. MICAD M = 7 (3-12), p = 0.95. More MINOCA patients had type D personality (45.0% vs. 28.5%, p = 0.03). At 3-year follow-up, there were no differences in mortality between MINOCA and MICAD (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.28-2.17) in major adverse cerebral or cardiovascular events (MACCE) (HR 0.71, 95% CI 0.38-1.31). Scores of trait anxiety and negative affectivity were significantly associated with MACCE (HR 1.65, 95% CI [1.05-2.57]; HR 1.75, 95% CI [1.11-2.77], respectively). High insomnia levels were associated with greater mortality (HR 2.72, 95% CI [1.12-6.61]). CONCLUSIONS Anxiety and insomnia levels were similar between patients with MINOCA and those with MICAD, whilst the prevalence of type D personality was higher in the MINOCA than in the MICAD group. Higher scores in trait anxiety, insomnia, and negative affectivity were related to a worse prognosis at 3-year follow-up.
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Affiliation(s)
| | | | | | | | - David Galán Gil
- Cardiology Department, 12 de Octubre University Hospital, Madrid, Spain
| | | | | | | | | | | | - Rebeca Mata Caballero
- Cardiology Department, Getafe University Hospital, Madrid, Spain
- European University of Madrid, Spain
| | - Alfonso Fraile Sanz
- Cardiology Department, Getafe University Hospital, Madrid, Spain
- European University of Madrid, Spain
| | | | - Francisco Fernández-Avilés
- Cardiology Department, Gregorio Marañón University Hospital, Madrid, Spain
- Complutense University of Madrid, Spain
| | - Joaquín J Alonso Martín
- Cardiology Department, Getafe University Hospital, Madrid, Spain
- European University of Madrid, Spain
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3
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Popp S, Schmitt-Böhrer A, Langer S, Hofmann U, Hommers L, Schuh K, Frantz S, Lesch KP, Frey A. 5-HTT Deficiency in Male Mice Affects Healing and Behavior after Myocardial Infarction. J Clin Med 2021; 10:jcm10143104. [PMID: 34300270 PMCID: PMC8308004 DOI: 10.3390/jcm10143104] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 12/13/2022] Open
Abstract
Anxiety disorders and depression are common comorbidities in cardiac patients. Mice lacking the serotonin transporter (5-HTT) exhibit increased anxiety-like behavior. However, the role of 5-HTT deficiency on cardiac aging, and on healing and remodeling processes after myocardial infarction (MI), remains unclear. Cardiological evaluation of experimentally naïve male mice revealed a mild cardiac dysfunction in ≥4-month-old 5-HTT knockout (−/−) animals. Following induction of chronic cardiac dysfunction (CCD) by MI vs. sham operation 5-HTT−/− mice with infarct sizes >30% experienced 100% mortality, while 50% of 5-HTT+/− and 37% of 5-HTT+/+ animals with large MI survived the 8-week observation period. Surviving (sham and MI < 30%) 5-HTT−/− mutants displayed reduced exploratory activity and increased anxiety-like behavior in different approach-avoidance tasks. However, CCD failed to provoke a depressive-like behavioral response in either 5-Htt genotype. Mechanistic analyses were performed on mice 3 days post-MI. Electrocardiography, histology and FACS of inflammatory cells revealed no abnormalities. However, gene expression of inflammation-related cytokines (TGF-β, TNF-α, IL-6) and MMP-2, a protein involved in the breakdown of extracellular matrix, was significantly increased in 5-HTT−/− mice after MI. This study shows that 5-HTT deficiency leads to age-dependent cardiac dysfunction and disrupted early healing after MI probably due to alterations of inflammatory processes in mice.
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Affiliation(s)
- Sandy Popp
- Comprehensive Heart Failure Center, University Hospital of Würzburg, 97078 Würzburg, Germany; (S.P.); (S.L.); (U.H.); (S.F.); (K.-P.L.)
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, Division of Molecular Psychiatry, University Hospital of Würzburg, 97080 Würzburg, Germany
| | - Angelika Schmitt-Böhrer
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, 97080 Würzburg, Germany; (A.S.-B.); (L.H.)
| | - Simon Langer
- Comprehensive Heart Failure Center, University Hospital of Würzburg, 97078 Würzburg, Germany; (S.P.); (S.L.); (U.H.); (S.F.); (K.-P.L.)
| | - Ulrich Hofmann
- Comprehensive Heart Failure Center, University Hospital of Würzburg, 97078 Würzburg, Germany; (S.P.); (S.L.); (U.H.); (S.F.); (K.-P.L.)
- Medical Clinic and Policlinic I, University Hospital of Würzburg, 97080 Würzburg, Germany
- Interdisciplinary Center for Clinical Research, University Hospital of Würzburg, 97080 Würzburg, Germany
| | - Leif Hommers
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, 97080 Würzburg, Germany; (A.S.-B.); (L.H.)
- Interdisciplinary Center for Clinical Research, University Hospital of Würzburg, 97080 Würzburg, Germany
| | - Kai Schuh
- Institute of Physiology I, University of Würzburg, 97070 Würzburg, Germany;
| | - Stefan Frantz
- Comprehensive Heart Failure Center, University Hospital of Würzburg, 97078 Würzburg, Germany; (S.P.); (S.L.); (U.H.); (S.F.); (K.-P.L.)
- Medical Clinic and Policlinic I, University Hospital of Würzburg, 97080 Würzburg, Germany
| | - Klaus-Peter Lesch
- Comprehensive Heart Failure Center, University Hospital of Würzburg, 97078 Würzburg, Germany; (S.P.); (S.L.); (U.H.); (S.F.); (K.-P.L.)
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, Division of Molecular Psychiatry, University Hospital of Würzburg, 97080 Würzburg, Germany
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, 97080 Würzburg, Germany; (A.S.-B.); (L.H.)
- Department of Translational Neuroscience, School for Mental Health and Neuroscience, Maastricht University, 6229 Maastricht, The Netherlands
- Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Anna Frey
- Comprehensive Heart Failure Center, University Hospital of Würzburg, 97078 Würzburg, Germany; (S.P.); (S.L.); (U.H.); (S.F.); (K.-P.L.)
- Medical Clinic and Policlinic I, University Hospital of Würzburg, 97080 Würzburg, Germany
- Interdisciplinary Center for Clinical Research, University Hospital of Würzburg, 97080 Würzburg, Germany
- Correspondence: ; Tel.: +49-931-201-39927
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Treating Post-traumatic Stress Disorder with a Prolonged Exposure Protocol Within Primary Care Behavioral Health: A Case Example. J Clin Psychol Med Settings 2020; 28:575-583. [PMID: 33090302 DOI: 10.1007/s10880-020-09747-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2020] [Indexed: 10/23/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a debilitating condition that impacts anywhere from 2 to 39% of primary care patients. Research suggests overall health, instances of hospitalizations, emergency room visits, and utilization of primary care services are impacted by a diagnosis of PTSD. Evidenced based treatments such as cognitive process therapy and prolonged exposure (PE) are available in specialty mental health but pose many barriers to treatment and implementation into primary care. This case study serves as the first known case example with an ethnic minority civilian, examining the treatment of PTSD within the Primary Care Behavioral Health Model using the brief (5 visits), PE protocol for primary care (PE-PC). PTSD was assessed using the PCL-5. Additional variables were assessed and tracked with the following tools: PHQ-9 (depressive symptoms), GAD-7 (anxiety symptoms), QLES-SF (quality of life), and the AAQ-2 (psychological flexibility) pre/post treatment, 6 months post-treatment and 9 months post-treatment. The patient reported clinically significant decreases in symptoms of PTSD, depression, and anxiety symptoms. Additionally, the patient's scores on quality of life and psychological flexibility improved. Brief, exposure-based treatment for PTSD can be delivered within the PCBH model. This treatment may result in improved quality of life and has the potential to reduce health care costs. This case encourages the treatment of PTSD within primary care, increasing access to care for patients. Future research is needed to further investigate this protocol in primary care with underserved, civilian populations and to explore patient attitudes toward brief treatment for PTSD in a primary care setting.
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Mukhtar S. Are individuals with cardiovascular disease at risk of COVID-19-related mental health problems or individuals with cardiovascular disease at risk of cardiovascular disease-related mental health problems during COVID-19? A psychological-psychiatric perspective. Med Hypotheses 2020; 144:109919. [PMID: 32531541 PMCID: PMC7261099 DOI: 10.1016/j.mehy.2020.109919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/28/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Sonia Mukhtar
- University of Management and Technology, Lahore, Pakistan.
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6
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Byrne CJ, Khurana S, Kumar A, Tai TC. Inflammatory Signaling in Hypertension: Regulation of Adrenal Catecholamine Biosynthesis. Front Endocrinol (Lausanne) 2018; 9:343. [PMID: 30013513 PMCID: PMC6036303 DOI: 10.3389/fendo.2018.00343] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 06/07/2018] [Indexed: 12/24/2022] Open
Abstract
The immune system is increasingly recognized for its role in the genesis and progression of hypertension. The adrenal gland is a major site that coordinates the stress response via the hypothalamic-pituitary-adrenal axis and the sympathetic-adrenal system. Catecholamines released from the adrenal medulla function in the neuro-hormonal regulation of blood pressure and have a well-established link to hypertension. The immune system has an active role in the progression of hypertension and cytokines are powerful modulators of adrenal cell function. Adrenal medullary cells integrate neural, hormonal, and immune signals. Changes in adrenal cytokines during the progression of hypertension may promote blood pressure elevation by influencing catecholamine biosynthesis. This review highlights the potential interactions of cytokine signaling networks with those of catecholamine biosynthesis within the adrenal, and discusses the role of cytokines in the coordination of blood pressure regulation and the stress response.
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Affiliation(s)
- Collin J. Byrne
- Department of Biology, Laurentian University, Sudbury, ON, Canada
| | - Sandhya Khurana
- Medical Sciences Division, Northern Ontario School of Medicine, Sudbury, ON, Canada
| | - Aseem Kumar
- Department of Chemistry and Biochemistry, Laurentian University, Sudbury, ON, Canada
- Biomolecular Sciences Program, Laurentian University, Sudbury, ON, Canada
| | - T. C. Tai
- Department of Biology, Laurentian University, Sudbury, ON, Canada
- Medical Sciences Division, Northern Ontario School of Medicine, Sudbury, ON, Canada
- Department of Chemistry and Biochemistry, Laurentian University, Sudbury, ON, Canada
- Biomolecular Sciences Program, Laurentian University, Sudbury, ON, Canada
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7
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Sharif Nia H, Pahlevan Sharif S, Lehto RH, Allen KA, Goudarzian AH, Yaghoobzadeh A, Soleimani MA. Psychometric Properties of the Persian Version of Death Depression Scale-Revised in Iranian Patients with Acute Myocardial Infarction. IRANIAN JOURNAL OF PSYCHIATRY 2017; 12:172-181. [PMID: 29062368 PMCID: PMC5640578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/07/2017] [Accepted: 05/14/2017] [Indexed: 11/18/2022]
Abstract
Objective: Limited research has examined the psychometric properties of death depression scales in Persian populations with cardiac disease despite the need for valid assessment tools for evaluating depressive symptoms in patients with life-limiting chronic conditions. The present study aimed at evaluating the reliability and validity of the Persian Version of Death Depression Scale - Revised (DDS-R) in Iranian patients who had recent acute myocardial infarction (AMI). Method: This psychometric study was conducted with a convenience sample of 407 patients with AMI diagnosis who completed the Persian version of the DDS-R. The face, content, and construct validity of the scale were ascertained. Internal consistency, test-retest, and construct reliability (CR) were used to assess reliability of the Persian Version of DDS-R. Results: Based on maximum likelihood exploratory factor analysis and consideration of conceptual meaning, a 4-factor solution was identified, explaining 75.89% of the total variance. Goodness-of-fit indices (GFI), Comparative Fit Index (CFI), Normed Fit Index (NFI), Incremental Fit Index (IFI), and Root Mean Square Error of Approximation (RMSEA) in the final DDS-R structure demonstrated the adequacy of the 4-domain structure. The internal consistency, construct reliability, and Intra-class Correlation Coefficients (ICC) were greater than .70. Conclusion: The DDS-R was found to be a valid and reliable assessment tool for evaluating death depression symptoms in Iranian patients with AMI.
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Affiliation(s)
- Hamid Sharif Nia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Saeed Pahlevan Sharif
- Senior Lecturer, Taylor’s Business School, Taylor’s University Malaysia, Subang Jaya, Malaysia
| | | | - Kelly A. Allen
- The Melbourne Graduate School of Education, The University of Melbourne, Melbourne, Australia
| | | | - Ameneh Yaghoobzadeh
- Master in Geriatric Nursing, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Soleimani
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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Abstract
Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine.
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Affiliation(s)
- Ashish Chaddha
- Department of Internal Medicine, University of Wisconsin Hospital and Clinics, Madison, WI 53792, USA
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9
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Parruti G, Vadini F, Sozio F, Mazzott E, Ursini T, Polill E, Di Stefano P, Tontodonati M, Verrocchio MC, Fulcheri M, Calella G, Santilli F, Manzoli L. Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study. PLoS One 2013; 8:e54555. [PMID: 23349927 PMCID: PMC3551818 DOI: 10.1371/journal.pone.0054555] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2012] [Accepted: 12/12/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Psychological factors are known predictors of cardiovascular disease in many clinical settings, but data are lacking for HIV infection. We carried out a prospective cohort study to evaluate potential psychological predictors of preclinical and clinical vascular disease in HIV patients. METHODOLOGY/PRINCIPAL FINDINGS HIV patients were consecutively enrolled. Demographics, viral and immune parameters and traditional cardiovascular predictors were considered; Intima-Media Thickness (c-IMT, continuous measure) and Carotid Plaques (CPs, focal thickening ≥1.5 mm) were investigated by B-mode ultrasonography; depressive symptoms by the Beck Depression Inventory (BDI-II), Type D personality (Distressed Personality or Type D) by the DS14, alexithymia by the Toronto Alexithymia Scale (TAS-20). Vascular outcomes included transient ischemic attacks or stroke, acute coronary syndrome, myocardial or other organ infarction. We enrolled 232 HIV subjects, 73.9% males, aged 44.5±9.9 y, 38.2% with AIDS diagnosis, 18.3% untreated. Mean Nadir CD4 T-cell counts were 237.5±186.2/mmc. Of them, 224 (96.5%) attended IMT measurements; 201 (86.6%) attended both IMT assessment and psychological profiling. Mean follow-up was 782±308 days. Fifty-nine patients (29.4%) had CPs at baseline. Nineteen patients (9.5%) had ≥1 vascular event; 12 (6.0%) died due to such events (n = 4) or any cause. At baseline cross-sectional multivariate analysis, increasing age, total cholesterol, current smoking and Alexithymia score≥50 were significantly associated with both increased cIMT (linear regression) and CPs (logistic regression). At follow-up analysis, log-rank tests and Cox's regression revealed that only older age (p = 0.001), current smoking (p = 0.019) and alexithymia score≥50 (p = 0.013) were independently associated with vascular events. CONCLUSIONS/SIGNIFICANCE In HIV-infected subjects, the Alexithymic trait emerges as a strong predictor of increased IMT, presence of CPs and vascular events. Such results are preliminary and require confirmation from studies with larger sample size and longer follow-up.
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Affiliation(s)
- Giustino Parruti
- Unit of Infectious Diseases, Pescara General Hospital, Pescara, Italy.
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Rejai S, Giardino ND, Krishnan S, Ockene IS, Rubenfire M, Jackson EA. Quality of life and baseline characteristics associated with depressive symptoms among patients with heart disease. Clin Epidemiol 2012; 4:181-6. [PMID: 22866019 PMCID: PMC3410688 DOI: 10.2147/clep.s29247] [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] [Indexed: 11/23/2022] Open
Abstract
We sought to examine factors associated with depressive symptoms among patients with heart disease. Data from 197 patients admitted for coronary artery disease were examined using multivariate predictive models. Women and unmarried patients were more likely to report depressive symptoms. In multivariate models, we observed that depressive symptoms were associated with the level of tangible social (but not emotional) support, bodily pain, and vitality, but not the number of comorbidities, gender, or marital status.
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Affiliation(s)
- Sepehr Rejai
- Michigan Cardiovascular Research and Reporting Program, Division of Cardiovascular Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA
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