摘要:

ObjectiveThe objective of the study was to assess the roles of social stress and social status in susceptibility to upper respiratory infection. Method: Sixty male cynomolgus monkeys were randomly assigned to stable or unstable social conditions for 15 months. Two markers of social status, social rank and percent of behaviors that were submissive, were assessed at independent observation periods. Endocrine, immune, and behavioral responses were each assessed (at 3-month intervals) during the 9th through 14th months of the study. At the beginning of the 15th month, all animals were exposed to a virus (adenovirus) that causes a common-cold-like illness. The primary outcome was whether or not an animal developed an infection (shed virus) after viral exposure. Results: Although the social instability manipulation was associated with increased agonistic behavior as indicated by minor injuries and elevated norepinephrine responses to social reorganizations, the manipulation did not influence the probability of being infected by the virus. However, low social status (as assessed by either marker) was associated with a substantially greater probability of being infected. It was also associated with less body weight, greater elevated cortisol responses to social reorganizations, and less aggressive behavior. However, none of these characteristics could account for the relation between social status and infection. Conclusions: Social stress was not associated with susceptibility to infection. However, animals with lower social status were at higher risk than high social status animals.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectivePrevious research has found differences in respiratory function between panic disorder and other anxiety disorder populations. These differences have been explained as reflecting either a) a specific feature of panic disorder, b) merely a sign of increased general arousal, or c) a result of population sampling error. The current study addressed the question of such differences by using improved methodology over previous research. A preliminary evaluation of respiratory symptoms during panic attacks was undertaken as a means of identifying a respiratory-sensitive subtype of the panic patient. Method: Seventeen panic disorder patients (PD), 18 patients with generalized anxiety disorder (GAD), and 20 normal control (NC) subjects were administered a psychophysiological evaluation composed of baseline, stressor, and recovery phases. Panic patients were measured for the severity of respiratory symptoms during panic attacks. End-tidal CO2(EtCO2) and respiration rate were measured throughout the psychophysiological evaluation. Results: PDs demonstrated significantly lower baseline EtCO2levels than the GADs and NCs, in spite of being equivalent to GADs on baseline anxiety levels. Moreover, panic patients reporting a high level of respiratory symptoms during panic attacks seemed to account for the bulk of observed differences. Conclusions: These findings lend support to a group of studies showing differences in respiratory function between panic disorder and other anxiety disorder populations. In addition, this study provides preliminary support for the presence of a distinct "hyperventilation subtype" of panic disorder. The implications of these findings for future research and treatment are discussed.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveThis study tested the hypothesis that coronary artery disease patients with higher depression scores have lower heart rate variability during daily life. Method: Thirty-three men and nine women, ranging in age from 46 to 79, with coronary artery disease and exercise-induced ischemia were studied. The standard deviation of normal R-R intervals (SDNN) and average heart rate were obtained from 24-hour ambulatory electrocardiographic monitoring. Patients were grouped by a median split of the Minnesota Multiphasic Personality Inventory (MMPI-D) score. Results: SDNN was lower (p =.009) and average heart rate was higher (p =.003) in patients with higher depression scores. These relationships remained substantially unaltered after statistically adjusting for the only demographic/clinical factor that varied between the groups: gender. Conclusions: In comparison to the lower depression score group, those with higher depression scores had lower heart rate variability during daily life. These findings may be related to the reported relationship between depression and survival risk in patients with coronary artery disease.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveTo identify whether there is a lateralized pattern in somatic symptoms related to emotional disturbances. Method: Sixty-one patients with depressive disorders, anxiety disorders, and somatization disorders were examined for the lateralized distribution of somatic symptoms in the body and its relationship to the severity of anxiety and depression. Results: The chief somatic symptoms presented significantly more on the left side than on the right side of the body. Headache and other forms of pain, especially, occurred more on the left side. There was no significant difference between left-sided and right-sided groups in demographic variables such as age, gender, marital status, education level, diagnosis, and duration of illness. The scores on Hamilton's anxiety scale or Hamilton's depression scale were higher in the left-sided group than the right-sided group, although the difference was not statistically significant. Conclusions: These results suggest that the right hemisphere of the brain is more involved than the left with somatization symptom formation related to emotional disturbances.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveDepression is a prevalent and chronic condition in diabetes and is associated with poor glucose regulation and poor compliance with diabetes treatment. This investigation evaluated the effects of nortriptyline on depression and glycemic control to see whether depression in diabetes is treatable and whether restoring mental health contributes to improved medical outcome. Method: Sixty-eight diabetic patients with poor glycemic control, 28 of whom had active major depression (DSM-IIIR), completed a randomized, placebo-controlled, double-blind trial involving 8 weeks of treatment with nortriptyline targeted to therapeutic plasma levels (50-150 ng/ml). Depression improvement was determined with the Beck Depression Inventory; glucose control was measured by glycated hemoglobin levels. Compliance behavior was assessed using medication dispensing devices and glucometers equipped with electronic memory. Results: The reduction in depression symptoms was significantly greater in depressed patients treated with nortriptyline compared with those receiving placebo (-10.2 vs -5.8, p =.03). Nortriptyline was not statistically superior to placebo in reducing glycated hemoglobin of the depressed subjects (p =.5). However, path analysis indicated that the direct effect of nortriptyline was to worsen glycemic control whereas depression improvement had an independent beneficial effect on glycated hemoglobin. These findings were not explained by the relationships of nortriptyline treatment to weight change (r = -0.21, p =.31) or depression improvement to compliance with the protocol for self-monitoring of blood glucose (r = 0.01, p =.97). Conclusions: Major depression in diabetic patients can be effectively treated with nortriptyline at the expense of a direct hyperglycemic effect. Path analysis demonstrated a treatment-independent effect of depression improvement on glycemic control, suggesting that a more ideal antidepressant agent may both restore mental health and improve medical outcome.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveThe purpose of this study was to determine the effects of chronic stress on beta-adrenergic physiology in elderly spousal caregivers to Alzheimer patients. Methods: Thirty-seven elderly spousal caregivers and matched noncaregiver controls (mean age 73 years, SD = 6) were studied. Life stress categorization (presence of marked threat) covering the previous 6 months was determined using a semistructured interview based on the Psychiatric Epidemiological Research Inventory and the Life Events and Difficulties Schedule. beta2-adrenergic receptor sensitivity (isoproterenol-stimulated cyclic AMP accumulation) and density were determined in lymphocytes. Results: Caregivers with high life stress had higher plasma norepinephrine levels (p <.04) but no change in plasma cortisol. For beta-receptor sensitivity, 30% of the variance was accounted for by high life stress rating, increased age, being male, and lower norepinephrine (p =.018); 17% of the variance in beta-receptor density was accounted for by plasma norepinephrine (p =.03). Conclusions: The findings demonstrate that chronic high stress may be associated with changes in adrenergic physiology and may provide a mechanism through which chronic stress alters cellular immunity.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveTo review studies predicting psychosocial outcome after coronary artery bypass graft surgery (CABG). Methods: Seventeen prospective studies, appearing in the MEDLINE and PsycLIT data bases between 1986 and 1996, were reviewed regarding objectives, methodological issues, results, and clinical relevance. Results: All studies reported that psychological factors had predictive value. In particular, preoperative anxiety and depression predicted postoperative psychological maladjustment; social support, preoperative feelings of control, denial, and optimism contributed to psychological adjustment. Conclusions: Many specific psychological outcomes seem to be best predicted by preoperative assessment of functions in that specific area, especially in the case of anxiety and depression. Furthermore, personality factors including denial, optimism, control, and the need for support appear to be predictors of psychological outcome. Appropriate identification of predictive factors might improve the development of individually tailored interventions for patients at risk of postoperative psychological problems.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveTo describe the development and validation of a scale for assessing openness to discuss cancer in the family. Method: Two studies were conducted. Study 1 was a cross-sectional study designed to test the factor structure of the scale. Four hundred ninety-eight patients with either breast cancer or Hodgkin's disease were interviewed. In Study 2, a longitudinal study, 133 patients with cancer in the head and neck were tested at four points in time: just before treatment, 6 weeks, 13 weeks, and 52 weeks after treatment. Study 2 aimed to confirm the factor structure established in Study 1, to test for construct validity in a new population, to test the psychometric properties of the Openness Scale, and to test the scale's sensitivity to change. Results: In Study 1, a one-factor solution was revealed, resulting in a scale of eight items. In Study 2, the factor structure found in Study 1 was confirmed. In line with theoretical expectations, subjects who perceived their communication about cancer as more open showed more positive rehabilitation outcomes especially at 13 weeks after treatment (less uncertainty, fewer negative feelings, more control, higher self-esteem, fewer psychological and physical complaints). Furthermore, more open communication related with more support by family members and more discussion with the partner. The scale was found to be stable over time. Conclusions: The scale's construction and subsequent analysis show that open discussion of problems (related to cancer) in the family can be measured reliably with an eight-item instrument. Additional validation of the scale is indicated.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID