摘要:

ObjectiveTo evaluate the role of sleep in the relationship of intrusive thoughts/avoidance behaviors to natural killer cell (NKC) number and function.MethodTwenty-nine individuals seeking treatment for bereavement-related depression were studied in the sleep laboratory. Background and clinical variables, including the Impact of Event Scale (IES) and the Hamilton Rating Scale for Depression (HRSD), were administered during the week preceding a 3-night sleep study. Blood samples were collected upon awakening after the second or third night of sleep.ResultsGreater frequency of intrusive thoughts and avoidance behaviors was associated with more time spent awake during the first non-rapid eye movement period (NREM-1) and lower NKC number (p values < .01). Greater time spent awake during NREM-1 was associated with lower NKC numbers (p < .05). Regression analyses revealed that the significant relationship between symptoms of intrusion/avoidance and NKC number was no longer significant when time spent awake during NREM-1 was entered into the regression equation. Time spent awake during NREM-1 accounted for 12% of the variance in NKC number (p < .05), whereas intrusion/avoidance accounted for 7% of the variance in NKC number (NS).ConclusionsThese results suggest that EEG-assessed sleep may be a significant correlate of the stress-immune relationship.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectivePatients with recurrent chest pain but no evidence of coronary artery disease often meet diagnostic criteria for panic disorder (PD). However, it can be argued that the phenomenological diagnosis of PD may not be valid in these normal coronary chest pain (NCCP) patients. The purpose of this study is to additionally validate the diagnosis of PD in chest pain patients by comparing PCO2levels before and during myocardial stress scintigraphy in those with and without PD.MethodEnd-tidal PCO2was measured before and during myocardial stress scintigraphy in 22 patients being evaluated for chest pain. Psychiatric diagnoses were assessed by structured interview.ResultsEleven of the 19 patients (58%) with negative scintigrams met DSM-III-R diagnostic criteria for current panic disorder. Prestress PCO2levels were significantly lower in these patients. Eight of the nine NCCP patients with prestress PCO2< 34 mm Hg had PD.ConclusionsThe finding of stress-related hypocapnia associated with PD in NCCP patients provides additional support for the validity of the diagnosis of PD in this population. The potential value of PCO2measurements in screening for PD in patients with chest pain merits additional study.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveThis study evaluated physiological, neuroendocrine, and psychological status and functioning of patients with coronary artery disease in order to clarify their role in the expression of symptoms during myocardial ischemia (MI), and to establish repeatability of responses to mental stress. Design and methods of the study are presented.MethodsOne hundred ninety-six coronary artery disease patients were examined during physical and mental stress tests in four hospitals. Eligibility criteria included narrowing of at least 50% in the diameter of at least one major coronary artery or verified history of myocardial infarction, and evidence of ischemia on an exercise treadmill test. Psychological, biochemical, and autonomic function data were obtained before, during, and after exposure to mental and exercise stressors during 2 or 3 half-days of testing. Ventricular function was assessed by radionuclide ventriculography, and daily ischemia by ambulatory electrocardiography. Sixty patients returned for a short-term mental stress repeatability study. Twenty-nine individuals presumed to be free of coronary disease were also examined to establish reference values for cardiac responses to mental stress.ResultsStudy participants were 41 to 80 years of age; 83 (42%) had a history of MI, 6 (3%) of congestive heart failure, and 163 (83%) of chest pain; 170 (87%) were men; and 90 (46%) had ischemia accompanied by angina during exercise treadmill testing. Ischemia during ambulatory monitoring was found in 35 of 90 (39%) patients with and 48 of 106 (45%) patients without angina during exercise-provoked ischemia. Intraobserver variability of ejection fraction changes during bicycle exercise and two mental stress tests (Speech and Stroop) was good (kappa = 1.0, .90, and .76, respectively; percent agreement = 100, 97.5, and 93.8%, respectively). Variability of assessed wall motion abnormalities during bicycle exercise was better (kappa, agreement = 85%) than during Speech or Stroop kappa and .57, percent agreement = 70% and 82.5%, respectively).ConclusionsStudy design, quality control data, and baseline characteristics of patients enrolled for a clinical study of symptomatic and asymptomatic myocardial ischemia are described. Lower repeatability of reading wall motion abnormalities during mental stress than during exercise may be due to smaller effects on wall motion and lack of an indicator for peak mental stress.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveMany patients with coronary artery disease (CAD) develop myocardial ischemia in response to mental stress. This has been documented both in the natural environment and in the laboratory. However, the reproducibility of laboratory mental stress-induced ischemia has not been investigated.MethodSixty patients with documented CAD and a positive exercise stress test discontinued cardiac medications and underwent two standardized mental stress tests (a timed Stroop Color-Word test and a public speaking task) in a nuclear cardiology laboratory (Visit 1), and repeated this procedure between 2 and 8 weeks later (Visit 2). Measurements of cardiovascular function and neurohormonal responses were obtained throughout testing, and mood state was assessed before and after testing.ResultsSixty-eight percent of the 56 patients with detailed radionuclide data from both visits had consistent responses (ie, ischemia either present during both sessions or absent during both) to the Stroop task (kappa = .29, p = .03), 61% had consistent responses to the speech task (kappa = .20, p = .12), and 60% had consistent responses when ischemia was considered present if it occurred during either the Stroop test, the speech task, or both, and absent if it did not occur during either task (kappa = .22, p = .07). Hemodynamic and neuroendocrine responses to the tests were moderately reproducible.ConclusionsWe conclude that two popular laboratory tests for mental stress-induced myocardial ischemia are modestly reproducible. The relatively low reproducibility is probably influenced by uncertainties in detecting relatively small changes in wall motion, habituation of the patient to repeated exposure to psychological stressors, and physiological differences in threshold for ischemia on different days of testing.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectivePrevious studies have reported poorer health behaviors in high vs. low hostile subjects. The role of stress in these observed differences has not been explored although interpersonal stress does increase cardiovascular response in high hostiles. Given evidence that stress may induce increased salt-intake, this study examined the role of hostility and interpersonal stress in increasing sodium consumption in addition to cardiovascular reactivity.MethodSixty-nine male undergraduates were categorized into high (HiHo) and low hostile (LoHo) groups based on Buss-Durkee Hostility Inventory scores. Subjects engaged in either a math task with harassment, math task without harassment, or a control/rest condition. Sodium intake was assessed posttask by having subjects ingest a sodium-free soup that was presented with a saltshaker without any comments. Cardiovascular measures were also recorded.ResultsHiHo subjects consumed more salt than LoHo subjects irrespective of experimental condition. HiHo subjects who were harassed also exhibited greater cardiac output, systolic blood pressure, and forearm blood flow than did HiHo nonharassed, HiHo control, or LoHo subjects.ConclusionHiHo subjects exhibited increased salt-intake, although evidence for stress-induced salt-intake was not obtained. Nonetheless, the combination of salt and stress may contribute to the cardiovascular hyperreactivity and risk for cardiovascular disease in hostile individuals.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveWe examined the effects of hostility and harassment on neuroendocrine, cardiovascular, and emotional responses in 52 healthy white men.MethodsSubjects were preselected on the basis of scores in the top and bottom quartiles (above 23 and below 15, respectively) on the Cook and Medley Hostility (Ho) scale. Subjects participated in a solvable anagram task. Thirty subjects were harassed by the technician during the task.ResultsHarassed subjects with high Ho scores exhibited enhanced and prolonged blood pressures, heart rate, forearm blood flow, forearm vascular resistance, norepinephrine, testosterone, and cortisol responses relative to low-Ho subjects in the harassed condition and high and low-Ho subjects in the nonharassed condition. Heightened physiological reactivity in high-Ho subjects was correlated with arousal of negative affects.ConclusionsThe findings are consistent with the general hypothesis that high hostile men show excessive behaviorally-induced cardiovascular and neuroendocrine responsivity to interpersonal challenging situations. Moreover, in high-Ho men, the stress-induced cardiovascular and neuroendocrine hyperreactivity is associated with the arousal of negative affects such as anger.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo emphasize the importance of treating a major depressive episode in an elderly patient with small cell lung cancer (SCLC).MethodA case report is described to illustrate the importance of treating depression in an elderly patient with SCLC undergoing chemotherapy.ResultsDuring the course of antidepressant therapy with nefazodone, the patient also experienced a remission of cancer chemotherapy-induced emesis.ConclusionsThis case report suggests that the remission of emesis could be related to the 5-hydroxytryptamine (5-HT) antagonistic property of nefazodone.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID