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Psychosocial Stress (psychosocial + stress)
Kinds of Psychosocial Stress Selected AbstractsPsychosocial Stress Augments Tumor Development through ,-Adrenergic Activation in MiceCANCER SCIENCE, Issue 7 2002Hideo Hasegawa Housing conditions affect behavioral and biological responses of animals. We investigated the effect of same-sex-grouped (G), crowded (GC) and isolated (I) conditions on the growth of B16 melanoma or Meth A fibrosarcoma implanted in the footpad of syngeneic male C57BL/6 or BALB/c mice. Differential housing altered host resistance to tumor growth. The host responses to stress were reflected in thymic atrophy, which was lowest in the G mice, highest in the GC mice and intermediate in the I mice. The GC condition was a more stressful social environment than the I condition in both male C57BL/6 and BALB/c mice. Reflecting the extent of psychosocial stress, tumor growth was augmented in the order of GC, I and G condition, and a negative mass correlation between tumor and thymus was observed, thus clearly indicating that the host resistance to tumors was attenuated by psychosocial stress. Furthermore, the stress-enhanced tumor growth and thymus atrophy were completely abrogated by the oral administration of the non-selective ,-adrenergic antagonist, propranolol. On the contrary, the chronic administration of corticosterone significantly induced the atrophy of thymus and spleen without affecting tumor growth. These results suggest an interrelationship among psychosocial stress, tumor growth and ,-adrenergic activation. [source] The Timing of Prenatal Exposure to Maternal Cortisol and Psychosocial Stress Is Associated With Human Infant Cognitive DevelopmentCHILD DEVELOPMENT, Issue 1 2010Elysia P. Davis The consequences of prenatal maternal stress for development were examined in 125 full-term infants at 3, 6, and 12 months of age. Maternal cortisol and psychological state were evaluated 5 times during pregnancy. Exposure to elevated concentrations of cortisol early in gestation was associated with a slower rate of development over the 1st year and lower mental development scores at 12 months. Elevated levels of maternal cortisol late in gestation, however, were associated with accelerated cognitive development and higher scores at 12 months. Elevated levels of maternal pregnancy-specific anxiety early in pregnancy were independently associated with lower 12-month mental development scores. These data suggest that maternal cortisol and pregnancy-specific anxiety have programming influences on the developing fetus. [source] Effects of reproductive condition and dominance rank on cortisol responsiveness to stress in free-ranging female rhesus macaquesAMERICAN JOURNAL OF PRIMATOLOGY, Issue 7 2010Christy L. Hoffman Abstract The hypothalamic,pituitary,adrenal (HPA) axis modulates individuals' physiological responses to social stress, which is an inevitable aspect of the daily lives of group-living animals. Previous nonhuman primate studies have reported that sex, age, rank, and reproductive condition influence cortisol levels under stressful conditions. In this study we investigated cortisol responses to stress among 70 multiparous, free-ranging female rhesus macaques (Macaca mulatta) on the island of Cayo Santiago, PR. Plasma cortisol samples were collected in two consecutive years under similar conditions. Twenty-two females were sampled both years, and most of those females were lactating in only one of the years. Individual differences in cortisol levels were stable across years, even though reproductive condition changed for most individuals. No relationship was found between age or social rank and cortisol levels. Of the females that changed reproductive conditions, cortisol levels were higher when they were lactating than when they were cycling, and the amount of change in cortisol from cycling to lactating was greatest for low-ranking individuals. Heightened reactivity to stress during lactation may be the result of concerns about infant safety, and such concerns may be higher among low-ranking mothers than among higher ranking mothers. Psychosocial stress and hyperactivation of the HPA axis during lactation can suppress immune function and increase vulnerability to infectious diseases, thus explaining why adult females in the free-ranging rhesus macaque population on Cayo Santiago have a higher probability of mortality during the birth season than during the mating season. Am. J. Primatol. 72:559,565, 2010. © 2009 Wiley-Liss, Inc. [source] Social withdrawal behaviors in nonhuman primates and changes in neuroendocrine and monoamine concentrations during a separation paradigm,DEVELOPMENTAL PSYCHOBIOLOGY, Issue 4 2005Kristine Erickson Abstract This study investigated relationships between withdrawal behaviors in rhesus macaques and changes in monoamine metabolite and endocrine concentrations during repeated psychosocial stress. Rhesus monkeys (N,=,71) experienced maternal separation in which four separations took place during four consecutive weeks. Behavioral observations were made, as well as plasma concentrations of cortisol and cerebrospinal fluid concentrations of the serotonin, dopamine, and norepinephrine metabolites were obtained. Animals were assigned to high, moderate, and low withdrawal groups, defined using baseline durations of withdrawal behaviors. Highly withdrawn animals showed less reduction than nonwithdrawn animals in serotonin metabolite concentrations over repeated separations. Highly withdrawn macaques also failed to significantly reduce cortisol concentrations across separation weeks. More adaptation in central serotonin functioning and cortisol concentrations was seen in nonwithdrawn primates than in highly withdrawn primates; these findings have implications for increased risk of developing anxiety disorders in highly inhibited children. © 2005 Wiley Periodicals, Inc. Dev Psychobiol 46:331,339, 2005. [source] Impaired glucose regulation and type 2 diabetes in children and adolescentsDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 6 2008Kerstin Kempf Abstract Diabetes mellitus in paediatric patients used to be almost exclusively type 1, but in recent years, case series as well as hospital-based and population-based studies indicated that the number of children and adolescents with type 2 diabetes (T2DM) has been increasing. This development is alarming since T2DM in youth is usually not an isolated condition, but accompanied by other cardiovascular risk factors such as obesity, dyslipidaemia, hypertension and low-grade inflammation. In adults, numerous studies provided detailed data on prevalence, incidence and risk factors for the development of T2DM, but for children and adolescents clinical and experimental data are still rather limited. This review provides an overview about the epidemiology and pathogenesis of T2DM in youth and about impaired glucose regulation as major risk factor for diabetes development with a special focus on the recent literature on clinical and lifestyle-related risk factors. Differences in incidence and prevalence across different populations indicate that ethnic background and genetic pre-disposition may be important risk determinants. In addition, epigenetic factors and foetal programming appear to confer additional risk before birth. Among the environmental and lifestyle-related risk factors there is evidence that obesity, hypercaloric diet, physical inactivity, socio-economic position (SEP), smoking, low-grade inflammation, psychosocial stress and sleeping patterns contribute to the risk for T2DM. However, the assessment of the relevance of risk factors and of incidence or prevalence estimates in youth is complicated by methodological issues that are also discussed. Copyright © 2008 John Wiley & Sons, Ltd. [source] ,2A and ,2C -adrenoceptor regulation in the brain: ,2A changes persist after chronic stressEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 5 2003G. Flügge Abstract Stress-induced activation of the central nervous noradrenergic system has been suspected to induce depressive disorders. As episodes of depression often occur some time after a stress experience we investigated whether stress-induced changes in the ,2 -adrenoceptor (,2 -AR) system persist throughout a post-stress recovery period. Brains of male tree shrews were analysed after 44 days of chronic psychosocial stress and after a subsequent 10-day recovery period. Expression of RNA for ,2A and ,2C -adrenoceptors was quantified by in situ hybridization, and receptor binding was determined by in vitro receptor autoradiography. Activities of the sympathetic nervous system and of the hypothalamo,pituitary,adrenal axis were increased during chronic stress but normalized during recovery. ,2A -AR RNA in the glutamatergic neurons of the lateral reticular nucleus was elevated significantly after stress and after recovery (by 29% and 17%). In the dorsal motor nucleus of the vagus, subtype A expression was enhanced after recovery (by 33%). In the locus coeruleus, subtype A autoreceptor expression was not changed significantly. Subtype C expression in the caudate nucleus and putamen was elevated by stress (by 5 and 4%, respectively) but normalized during recovery. Quantification of 3H-RX821002 binding revealed receptor upregulation during stress and/or recovery. Our data therefore show: (i) that chronic psychosocial stress differentially regulates expression of ,2 -adrenoceptor subtypes A and C; (ii) that subtype A heteroreceptor expression is persistently upregulated whereas (iii), subtype C upregulation is only transient. The present findings coincide with post mortem studies in depressed patients revealing upregulation of ,2A -ARs. [source] Stress and hippocampal plasticity: implications for the pathophysiology of affective disordersHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue S1 2001Bruce S. McEwen Abstract The hippocampal formation, a structure involved in declarative, spatial and contextual memory, is a particularly sensitive and vulnerable brain region to stress and stress hormones. The hippocampus shows a considerable degree of structural plasticity in the adult brain. Stress suppresses neurogenesis of dentate gyrus granule neurons, and repeated stress causes atrophy of dendrites in the CA3 region. In addition, ovarian steroids regulate synapse formation during the estrous cycle of female rats. All three forms of structural remodeling of the hippocampus are mediated by hormones working in concert with excitatory amino acids (EAA) and N -methyl- D -aspartate (NMDA) receptors. EAA and NMDA receptors are also involved in neuronal death that is caused in pyramidal neurons by seizures and by ischemia and prolonged psychosocial stress. In the human hippocampus, magnetic resonance imaging studies have shown that there is a selective atrophy in recurrent depressive illness, accompanied by deficits in memory performance. Hippocampal atrophy may be a feature of affective disorders that is not treated by all medications. From a therapeutic standpoint, it is essential to distinguish between permanent damage and reversible atrophy in order to develop treatment strategies to either prevent or reverse deficits. In addition, remodeling of brain cells may occur in other brain regions. Possible treatments are discussed. Copyright © 2001 John Wiley & Sons, Ltd. [source] Conceptions of Dementia in a Multiethnic Sample of Family CaregiversJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2005Ladson Hinton MD Understanding variability in conceptions of dementia in multiethnic populations is important to improve care and guide research. The objectives of this study were to describe caregiver conceptions of dementia using a previously developed typology and to examine the correlates of conceptions of dementia in a multiethnic sample. This is a cross-sectional study conducted in Boston and the San Francisco Bay area. Participants were a convenience sample of 92 family dementia caregivers from four ethnic/racial groups: African-American, Anglo European-American, Asian-American, and Latino. In-depth, qualitative interviews explored the caregivers' ideas about the nature and cause of dementia (i.e., explanatory models). Explanatory models of caregivers were categorized as biomedical, folk, or mixed (folk/biomedical). Quantitative analyses examined the association between ethnicity and other caregiver characteristics, and explanatory model type. Overall, 54% of caregivers, including 41% of Anglo European Americans, held explanatory models that combined folk and biomedical elements (i.e., mixed models). For example, many families attributed Alzheimer's disease and related dementias to psychosocial stress or normal aging. Ethnicity, lower education, and sex were associated with explanatory model type in bivariate analyses. In multiple logistic regression analysis, minority caregivers (P<.02) and those with less formal education (P<.02) were more likely to hold mixed or folk models of dementia. Although minority and nonminority caregivers often incorporated folk models into their understanding of dementia, this was more common in minority caregivers and those with less formal education. Further research on cross-ethnic differences in a larger, more-representative sample is needed. [source] Effects of academic stress on oral hygiene , a potential link between stress and plaque-associated disease?JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 5 2001Renate Deinzer Abstract Background: While there seems to be a common belief that psychosocial stress affects oral hygiene behavior, this assumption has rarely been proved. The present study thus aims to analyse stress effects on oral hygiene. Material and Methods: 16 matched pairs of medical students each consisting of 1 student participating in a major academic exam and 1 control without current academic stress, were formed on the basis of baseline plaque levels. At baseline, a professional tooth cleaning was performed. On the last day of exams, students answered questionnaires about oral hygiene during the exams and were afterwards asked to attend for a 2nd dental examination, of which they had no prior knowledge. Results: On the last day of exams, approximately 6 weeks after professional tooth cleaning, 20.9±18.3% of control students' sites but only 10.5±9.3% of exam students' sites were found to be free of any plaque (p=0.022). Differences were most obvious at oral, as compared to vestibular, sites. Exam students reported a reduction in thoroughness (p=0.019) but not of frequency of oral hygiene behavior. Conclusion: The study strongly supports the assumption that psychosocial stress may induce neglect of oral hygiene and increase of plaque accumulation. Zusammenfassung Hintergrund: Obwohl es eine allgemeine Annahme zu sein scheint, daß psycho-sozialer Stress die Mundhygiene beeinflußt, ist diese Annahme bisher selten geprüft worden. Mit der gegenwärtigen Studie sollen deshalb Stresseffekte auf die Mundhygiene analysiert werden. Material und Methoden. 16 gematchte Paare von Medizinstudenten, von denen jedes aus einem Student, der an einem wichtigen akademischen Examen teilnahm, und einer Kontrolle ohne gegenwärtigen akademischen Stress bestand, wurden auf der Basis von Baseline Plaquewerten gebildet. Zur Baseline wurde eine professionelle Zahnreinigung durchgeführt. Zum letzten Tag der Examen beantworteten die Studenten Fragebögen über die Mundhygiene während des Examens und wurde danach zu einer zweiten zahnärztlichen Überprüfung aufgefordert, von der sie zuvor keine Kenntnis hatten. Ergebnisse: Am letzten Tag des Examens ungefähr 6 Wochen nach der professionellen Zahnreinigung waren 20.9%±18.3% der Flächen der Kontrollstudenten, aber nur 10.5%±9.3% der Flächen der Examensstudenten plaquefrei (p=0.022). Die Differenzen waren an den oralen Flächen am deutlichsten, verglichen mit den vestibulären Flächen. Die Examensstudenten berichteten über eine Reduktion in der Gründlichkeit (p=0.019), aber nicht in der Häufigkeit der oralen Hygiene. Schlußfolgerung: Die Studie unterstützt nachhaltig die Annahme, daß psycho-sozialer Stress eine Vernachlässigung der oralen Hygiene und eine Zunahme der Plaqueakkumulation induziert. Résumé Bien que l'idée qu'un psycho-asocial puisse affecter les habitudes d'hygiène buccale, celle-ci n'a que rarement été prouvée. L'étude présente a donc analysé les effets du stress sur l'hygiène buccale. 16 paires d'étudiants en médicine dont l'un des deux participait à un examen académique majeur ont été formés sur base du niveau de plaque dentaire lors de l'examen initial. Lors de cet examen, un nettoyage professionnel a été effectué. Le dernier jour des examens les étudaints répondaient à des questionnaires à propos de leur hygiène buccale durant les examens et ont ensuite été réexaminés, ce dont ils n'avaint pas été informés précédement. Le dernier jour des examens, environ 6 semaines après le nettoyage professionnel, 21±18% des sites contrôles mais aussi 11±9% des sites des étudiants en examen n'avaient pas de trace de plaque dentaire (p=0.022). Les différenes les plus visibles se situaient au niveau lingual comparé aux sites vestibulaires. Chaque étudiant avait une réduction dans la qualité (p=0.019) mais non dans la fréquence de l'habitude d'hygiène buccale. Cette étude soutient grandement l'idée que le stress psychosocial engendre une négligence de l'hygiène buccale et augmente ainsi l'accumulation de plaque dentaire. [source] The prevalence of temporomandibular disorders in patients with psoriasis with or without psoriatic arthritisJOURNAL OF ORAL REHABILITATION, Issue 11 2005E. DERVIS summary, Psoriasis is a chronic, genetic, non-contagious skin disorder that appears in many different forms and can affect any part of the body, including the nails and scalp. It may affect the quality of life by causing psychosocial stress. Psoriatic arthritis (PA) is considered to be a spondyloarthropathy, and has spinal and peripheral joint involvement associated with psoriasis. The purpose of this study was to evaluate the prevalence of signs and symptoms of temporomandibular disorders (TMD) in patients with psoriasis without PA and in patients with PA and compare with a healthy group. Signs and symptoms of TMD were evaluated by means of Helkimo's Anamnestic (Ai) and Dysfunction indices (Di). In the present study, patients with psoriasis without arthritis did not report TMD signs and symptoms significantly more often than healthy subjects. A statistically significant increase was found in patients with PA when compared with psoriasis patients without arthritis and healthy patients in Di. In patients with PA, muscle tenderness on palpation, temporomandibular joint sounds and stiffness/tiredness in jaws in the morning were the most frequent findings. It is concluded that the signs and symptoms of TMD in PA is caused mainly by related joint involvement that directly affects the masticatory system. [source] Effect of oral melatonin on the procoagulant response to acute psychosocial stress in healthy men: a randomized placebo-controlled studyJOURNAL OF PINEAL RESEARCH, Issue 4 2008Petra H. Wirtz Abstract:, Acute mental stress is a potent trigger of acute coronary syndromes. Catecholamine-induced hypercoagulability with acute stress contributes to thrombus growth after coronary plaque rupture. Melatonin may diminish catecholamine activity. We hypothesized that melatonin mitigates the acute procoagulant stress response and that this effect is accompanied by a decrease in the stress-induced catecholamine surge. Forty-five healthy young men received a single oral dose of either 3 mg melatonin (n = 24) or placebo medication (n = 21). One hour thereafter, they underwent a standardized short-term psychosocial stressor. Plasma levels of clotting factor VII activity (FVII:C), FVIII:C, fibrinogen, D-dimer, and catecholamines were measured at rest, immediately after stress, and 20 min and 60 min post-stress. The integrated change in D-dimer levels from rest to 60 min post-stress differed between medication groups controlling for demographic and metabolic factors (P = 0.047, = 0.195). Compared with the melatonin group, the placebo group showed a greater increase in absolute D-dimer levels from rest to immediately post-stress (P = 0.13; = 0.060) and significant recovery of D-dimer levels from immediately post-stress to 60 min thereafter (P = 0.007; = 0.174). Stress-induced changes in FVII:C, FVIII:C, fibrinogen, and catecholamines did not significantly differ between groups. Oral melatonin attenuated the stress-induced elevation in the sensitive coagulation activation marker D-dimer without affecting catecholamine activity. The finding provides preliminary support for a protective effect of melatonin in reducing the atherothrombotic risk with acute mental stress. [source] Discrimination, psychosocial stress, and health among Latin American immigrants in OregonAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2010Heather H. McClure Chronic psychosocial stress related to discrimination has been shown to be associated with biological measures such as elevated systolic blood pressure (SBP), increased body fat, and higher fasting glucose levels. Few studies have examined these relationships in immigrant populations. The present study recruited a sample of 132 Oregon Latino immigrant adults to investigate the relationships between perceived discrimination and several health measures (blood pressure, body mass index [BMI], and fasting glucose). Results indicate that perceived discrimination stress predicted elevated SBP among men but not among women. Perceived discrimination was significantly higher among obese women than among women of normal BMI. The same pattern was not observed for men. Further, a strong trend relationship was detected: the higher women's reported discrimination stress, the higher their fasting glucose levels. Again, this pattern was not observed for men. These results suggest that chronic psychosocial stress plays an important role in disease risk among Latin American immigrants, and that male and female immigrants may have distinctive physiological responses. If confirmed, these findings may have important clinical and public health implications for chronic disease prevention among Latinos. Am. J. Hum. Biol., 2010. © 2009 Wiley-Liss, Inc. [source] Reproductive development and parental investment during pregnancy: Moderating influence of mother's early environmentAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 2 2010David A. Coall The association between a woman's age at menarche and the birth weight of her children is highly variable across human populations. Life history theory proposes that a woman's early environment may moderate this association and thus account for some of the variation between populations. According to one life history theory model, for individuals who develop in a childhood environment of high local mortality rates (experienced subjectively as psychosocial stress), it can be adaptive to mature earlier, have more offspring during their reproductive lifetime, and reduce investment in each offspring. In an environment of low psychosocial stress, however, it may be adaptive to mature later, have fewer offspring, and invest more in each. In this study, birth weight and proportionate birth weight (neonate's birth weight as a percentage of its mother's prepregnancy weight) were used as measures of parental investment during pregnancy. In a sample of 580 first-time mothers, we tested the hypothesis that the psychosocial stress experienced as a child would moderate the association between age at menarche and investment during pregnancy. We found that earlier menarche in those women who experienced stressful life events before 15 years of age was associated with a lower birth weight and proportionate birth weight. Conversely, in those who reported no childhood stressors, earlier menarche was associated with increased birth weight and proportionate birth weight. Our data suggest that the moderating influence of the childhood psychosocial environment on the association between age at menarche and parental investment throughout gestation operates in a dose-dependent manner. Am. J. Hum. Biol., 2010. © 2009 Wiley-Liss, Inc. [source] Reproductive ecology and the endometrium: Physiology, variation, and new directionsAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue S49 2009Kathryn B.H. Clancy Abstract Endometrial function is often overlooked in the study of fertility in reproductive ecology, but it is crucial to implantation and the support of a successful pregnancy. Human female reproductive physiology can handle substantial energy demands that include the production of fecund cycles, ovulation, fertilization, placentation, a 9-month gestation, and often several years of lactation. The particular morphology of the human endometrium as well as our relative copiousness of menstruation and large neonatal size suggests that endometrial function has more resources allocated to it than many other primates. The human endometrium has a particularly invasive kind of hemochorial placentation and trophoblast that maximizes surface area and maternal,fetal contact, yet these processes are actually less efficient than the placentation of some of our primate relatives. The human endometrium and its associated processes appear to prioritize maximizing the transmission of oxygen and glucose to the fetus over efficiency and protection of maternal resources. Ovarian function controls many aspects of endometrial function and thus variation in the endometrium is often a reflection of ecological factors that impact the ovaries. However, preliminary evidence and literature from populations of different reproductive states, ages and pathologies also suggests that ecological stress plays a role in endometrial variation, different from or even independent of ovarian function. Immune stress and psychosocial stress appear to play some role in the endometrium's ability to carry a fetus through the mechanism of inflammation. Thus, within reproductive ecology we should move towards a model of women's fecundity and fertility that includes many components of ecological stress and their effects not only on the ovaries, but on processes related to endometrial function. Greater attention on the endometrium may aid in unraveling several issues in hominoid and specifically human evolutionary biology: a low implantation rate, high rates of early pregnancy loss, prenatal investment in singletons but postnatal support of several dependent offspring at once, and higher rate of reproductive and pregnancy-related pathology compared to other primates, ranging from endometriosis to preeclampsia. The study of the endometrium may also complicate some of these issues, as it raises the question of why humans have a maximally invasive placentation method and yet slow fetal growth rates. In this review, I will describe endometrial physiology, methods of measurement, variation, and some of the ecological variables that likely produce variation and pregnancy losses to demonstrate the necessity of further study. I propose several basic avenues of study that leave room for testable hypotheses in the field of reproductive ecology. And finally, I describe the potential of this work not just in reproductive ecology, but in the resolution of broader women's health issues. Yrbk Phys Anthropol 52:137,154, 2009. © 2009 Wiley-Liss, Inc. [source] Lifestyle incongruity, stress and immune function in indigenous Siberians: The health impacts of rapid social and economic changeAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 1 2009Mark V. Sorensen Abstract The purpose of this study was to investigate the impact of economic and cultural change on immune function and psychosocial stress in an indigenous Siberian population. We examined Epstein-Barr virus antibodies (EBV), an indirect biomarker of cell-mediated immune function, in venous whole blood samples collected from 143 Yakut (Sakha) herders (45 men and 98 women) in six communities using a cross-sectional study design. We modeled economic change through the analysis of lifestyle incongruity (LI), calculated as the disparity between socioeconomic status and material lifestyle, computed with two orthogonal scales: market and subsistence lifestyle. EBV antibody level was significantly negatively associated with both a market and a subsistence lifestyle, indicating higher cell-mediated immune function associated with higher material lifestyle scores. In contrast, LI was significantly positively associated with EBV antibodies indicating lower immune function, and suggesting higher psychosocial stress, among individuals with economic status in excess of material lifestyle. Individuals with lower incongruity scores (i.e., economic status at parity with material resources, or with material resources in excess of economic status) had significantly lower EBV antibodies. The findings suggest significant health impacts of changes in material well-being and shifting status and prestige markers on health during the transition to a market economy in Siberia. The findings also suggest that relative, as opposed to absolute, level of economic status or material wealth is more strongly related to stress in the Siberian context. Am J Phys Anthropol, 2009. © 2008 Wiley-Liss, Inc. [source] The influence of basal metabolic rate on blood pressure among indigenous SiberiansAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 2 2008J. Josh Snodgrass Abstract Hypertension is an important global health issue and is currently increasing at a rapid pace in most industrializing nations. Although a number of risk factors have been linked with the development of hypertension, including obesity, high dietary sodium, and chronic psychosocial stress, these factors cannot fully explain the variation in blood pressure and hypertension rates that occurs within and between populations. The present study uses data collected on adults from three indigenous Siberian populations (Evenki, Buryat, and Yakut [Sakha]) to test the hypothesis of Luke et al. (Hypertension 43 (2004) 555,560) that basal metabolic rate (BMR) and blood pressure are positively associated independent of body size. When adjusted for body size and composition, as well as potentially confounding variables such as age, smoking status, ethnicity, and degree of urbanization, BMR was positively correlated with systolic blood pressure (SBP; P < 0.01) and pulse pressure (PP; P < 0.01); BMR showed a trend with diastolic blood pressure (DBP; P = 0.08). Thus, higher BMR is associated with higher SBP and PP; this is opposite the well-documented inverse relationship between physical activity and blood pressure. If the influence of BMR on blood pressure is confirmed, the systematically elevated BMRs of indigenous Siberians may help explain the relatively high blood pressures and hypertension rates documented among native Siberians in the post-Soviet period. These findings underscore the importance of considering the influence of biological adaptation to regional environmental conditions in structuring health changes associated with economic development and lifestyle change. Am J Phys Anthropol, 2008. © 2008 Wiley-Liss, Inc. [source] Psychological Characteristics and Social Integration of Patients with Ischemic and Non-Ischemic Heart Failure Newly Listed for Heart Transplantation: The Waiting for a New Heart StudyAPPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 2 2009Heike Spaderna It is not known whether psychosocial risk factors for coronary artery disease (CAD) are present in patients listed for heart transplantation (HTx). The aim of this study was to examine whether HTx candidates with ischemic heart failure (due to CAD) have an adverse psychological risk profile and reduced social integration compared to patients with non-ischemic etiology. In the multi-site study "Waiting for a New Heart", waiting-list-related stressors, depression, anxiety, trait-anger, anger-expression, dispositional coping, social integration, and social support were assessed in 318 newly registered HTx candidates (53.5 ± 11.4 years, 18% female, left ventricular ejection fraction <25%). Medical parameters at time of listing were provided by Eurotransplant. Analyses revealed a high level of stress (on average 70% of 50 HTx-related stressors), and signs of clinical depression in 39 per cent of the sample. Social integration was correlated with reduced depression (p < .05). While ischemic and non-ischemic groups were comparable in terms of disease severity, men with CAD reported significantly more anxiety, anger, anger-in, and less social integration than non-ischemic men after adjusting for age and marital status (ps < .05). To conclude, psychosocial stress is common in HTx candidates, particularly in men with underlying CAD. Thus, targeting psychosocial stress and increasing social integration may enhance well-being in patients waiting for a new heart. [source] Depression during pregnancy: detection, comorbidity and treatmentASIA-PACIFIC PSYCHIATRY, Issue 1 2010Maria Muzik Abstract Depression during pregnancy is common (,15%). Routine prenatal depression screening coupled with the use of physician collaborators to assist in connecting women with care is critical to facilitate treatment engagement with appropriate providers. Providers should be aware of risk factors for depression , including a previous history of depression, life events, and interpersonal conflict , and should appropriately screen for such conditions. Depression during pregnancy has been associated with poor pregnancy outcomes including preeclampsia, insufficient weight gain, decreased compliance with prenatal care, and premature labor. Current research has questioned the overall benefit of treating depression during pregnancy with antidepressants when compared to the risk of untreated depression for mother and child. Published guidelines favor psychotherapy above medication as the first line treatment for prenatal depression. Poor neonatal adaptation or withdrawal symptoms in the neonate may occur with fetal exposure in late pregnancy, but the symptoms are mild to moderate and transient. The majority of mothers who decide to stop taking their antidepressants during pregnancy suffer relapsing symptoms. If depression continues postpartum, there is an increased risk of poor mother,infant attachment, delayed cognitive and linguistic skills in the infant, impaired emotional development, and behavioral problems in later life. Bipolar depression, anxiety and substance use disorders, and/or presence of severe psychosocial stress can lead to treatment-resistance. Modified and more complex treatment algorithms are then warranted. Psychiatric medications, interpersonal or cognitive-behavioral therapy, and adjunctive parent,infant/family treatment, as well as social work support, are modalities often required to comprehensively address all issues surrounding the illness. [source] Clinical characteristics and patterns of referral to a primary mental health team: A retrospective studyASIA-PACIFIC PSYCHIATRY, Issue 2 2009Sean Jespersen MB CHB FC Psych SA MMed Psych FRANZCP Abstract Introduction: The Primary Mental Health Team (PMHT) initiative in Victoria began almost 10 years ago, but there has been little evaluation of this important strategy to improve integration between mental health services and primary care. The present study investigated the demographic and clinical characteristics of patients referred to a PMHT in order to guide development of the service and better meet the needs of primary care providers and their patients. Methods: The referral forms (n=153) and assessment records (n=89) of patients referred consecutively to a PMHT over a 12-month period were investigated in a retrospective file review. Results: Most referrals were from general practitioners requesting consultations. Sixty-five percent of patients were female, 41% were not in a relationship and 47% were unemployed. Fewer children and elderly people were referred. Illnesses tended to be chronic with multiple symptoms, and in half of those referred there had been a poor response to treatment in primary care. Many were victims of abuse and used substances. Medical illnesses were often present and levels of psychosocial stress and functional impairment were high. Referrers appeared to overestimate risk, over diagnose depression, and under diagnose personality disorders and mixed anxiety and depression. Psychotherapy was the most common recommendation made by the PMHT. Discussion: In spite of the limitations of this study the findings are a useful description of the PMHT experience. The review enabled the team to describe and better understand the needs of primary care providers and their patients, and had a significant impact on the subsequent development and expansion of the PMHT. [source] The chronic fatigue syndrome , an updateACTA NEUROLOGICA SCANDINAVICA, Issue 2007Vegard Bruun Wyller Background ,, In this article, current scientific knowledge on the chronic fatigue syndrome (CFS) is reviewed. The US case definition of CFS (the CDC-definition) is most widespread in research and clinical practice. Estimates of prevalence vary from 0.2% to above 2%. The female,male ratio is approximately 3:1. Clinical Features ,, Severe fatigue is the dominating complaint; it is worsened from exertions and not substantially relieved by rest. In addition, the patients might have a varying combination of accompanying symptoms. Clinical evaluation should be based upon standardized guidelines, including an assessment of functional impairments. Pathophysiology ,, The pathophysiology should be interpreted within a biopsychosocial framework. Present knowledge suggests that certain genetic polymorphisms and personality traits might be regarded as predisposing factors, some infections and severe psychosocial stress constitute precipitating factors, whereas disturbances of immunity, skeletal muscle, cognitive abilities, endocrine control and cardiovascular homeostasis are possible perpetuating factors. Treatment ,, Cognitive behavioural therapy and graded exercise therapy are of proven value in randomized controlled trials. Several pharmaceutical measures have been explored and found to have no beneficial effect. Most patients might expect long-term improvement, but full recovery is rare; however, the prognosis is better among adolescents. [source] A community study on the relationship between stress, coping, affective dispositions and periodontal attachment lossCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 4 2006Sam K. S. Ng Abstract,,, Background:, Psychological factors may increase the risk for periodontal diseases. Contemporary conceptualization of the stress process supports the evaluation of stress at three levels: stressors, moderating and mediating factors, and stress reactions. Objective:, This study was undertaken to investigate the relationship of periodontal disease in terms of clinical attachment level (CAL) to psychosocial stress, making reference to the major components of stress process. Methods:, A cross-sectional study of 1000 subjects aged 25,64 years in Hong Kong was conducted. Subjects were asked to complete a set of questionnaires measuring stressors including changes, significant life event and daily strains, stress reactions including physiological and affective responses, and coping and affective dispositions. CAL was assessed. Results:, Individuals with high mean CAL values had higher scores on the job and financial strain scales than periodontally healthy individuals (P < 0.05), after adjusting for age, gender, cigarette smoking and systemic disease. Depression, anxiety trait, depression trait, problem-focused coping, and emotion-focused coping were also related to CAL. Logistic regression analysis indicated that all these factors were significant risk indicators for periodontal attachment loss, except problem-focused coping, which reduced the odds of CAL. Individuals who were high emotion-focused copers, low problem-focused copers, trait anxious, or trait depressive had a higher odds of more severe CAL. Conclusion:, Chronic job and financial strains, depression, inadequate coping, and maladaptive trait dispositions are significant risk indicators for periodontal attachment loss. Adequate coping and adaptive trait dispositions, evidenced as high problem-focused coping and low anxiety/depression trait, may reduce the stress-associated odds. [source] Quality of life for Korean patients with vitiligo: Skindex-29 and its correlation with clinical profilesTHE JOURNAL OF DERMATOLOGY, Issue 6 2009Do Young KIM ABSTRACT Vitiligo considerably influences the psychological well-being of patients. Disease-induced disfigurement can cause patients to experience a high level of stigmatization, which can lead to psychosocial stresses and negative impacts on quality of life (QOL). This study aims to ascertain the QOL of vitiligo patients compared to patients with other mild skin disorders. We also attempt to study which clinical features of vitiligo are closely related to the patient's QOL. One hundred and thirty-three vitiligo patients and 112 patients with mild skin disorders were analyzed. All participants were asked to fill out questionnaires covering comprehensive clinical profiles and the Korean version of Skindex-29. Statistical correlation between Skindex-29 and each clinical profile were analyzed. The symptom scale of Skindex-29 was significantly lower in vitiligo patients than in controls, but the function scale and the emotion scale were significantly higher in the vitiligo group than in controls. However, the difference in function scales between groups was significant in female patients, but not in male patients. Several clinical profiles, such as duration of disease, severity scores and previous history of treatments, showed close correlations with the function scale. Family history of vitiligo, Köebner phenomenon, patients' perspectives on disease prognosis, and discordance of the severity scores between physicians and patients also influenced the Skindex-29 subscales differently. In conclusion, the present study suggests that patients with vitiligo were highly affected in the functional and emotional aspects of QOL, with some sex differences. Various clinical features may play an important role in the QOL of vitiligo patients. [source] | ||||||||||||||||