Is mental stress a risk factor of acute coronary syndrome? – A case–control study

Background: The burden of the cardiovascular disease is on rise throughout the world. Especially in India due to changing food habits, life style changes such as lack of physical activity, sedentary life style, and mental stress all add to the increase in the risk factors for acute coronary syndrome (ACS). Cardiovascular disease has become the leading cause of death. Our country, India has got highest number of deaths due to coronary artery disease in the world. Hence, the health burden is high in India with regard to coronary artery disease. Aims and Objectives: This study aimed to find out is mental stress a risk factor for ACS. Materials and Methods: This is a case–control study. Mental stress was assessed using perceived stress scale by Sheldon Cohen. Sample size of the study was 160 which include 80 cases and 80 controls. Results: Among cases, 73.8% had high stress and among controls, 35% had high stress. Odds ratio for high stress obtained in this study is 5.22 with 95% CI (2.65–10.27). Persons with high stress have 5.22 times more risk of developing ACS than the persons without high stress. Conclusion: In this study, it is proved that persons with high mental stress are a risk factor for ACS (as the persons with high mental stress have 5.5 times more risk of developing ACS). Hence, it is mandatory to focus on stress reduction measures to bring down the occurrence of ACS.

Mental stress induces endothelial dysfunction by AT1R-mediated redox imbalance in overweight/obese men

The main goal of this study was to determine whether oxidative imbalance mediated by AT1 receptor (AT1R) is responsible for deleterious endothelial responses to mental stress (MS) in overweight/obese class I men. Fifteen overweight/obese men (27±7 years old; 29.8±2.6 kg/m2) participated in three randomized experimental sessions with oral administration of the AT1R blocker olmesartan (40 mg; AT1R blockade) or ascorbic acid (AA; 3g) infusion or placebo [both intravenously (0.9% NaCl) and orally]. After two hours, endothelial function was determined by flow-mediated dilation (FMD) before (baseline), 30 min (30MS), and 60 min (60MS) after a five-minute acute MS session (Stroop Color Word Test). Blood was collected before (baseline), during MS, and 60 min after MS for redox homeostasis profiling: lipid peroxidation (TBARS; thiobarbituric acid reactive species), protein carbonylation, and catalase activity by colorimetry and superoxide dismutase (SOD) activity by an ELISA kit. At the placebo session, FMD significantly decreased 30MS (P=0.05). When compared to baseline, TBARS (P<0.02), protein carbonylation (P<0.01), catalase (P<0.01), and SOD (P<0.01) increased during the placebo session. During AT1R blockade, FMD increased 30 min after MS (P=0.01 vs baseline; P<0.01 vs placebo), while AA infusion increased FMD only 60 min after MS. No differences were observed during MS with the AT1R blockade and AA regarding TBARS, protein carbonylation, catalase, and SOD. AT1R-mediated redox imbalances played an important role in endothelial dysfunction to mental stress.

Heart rate variability, task load and perceived exertion associated with a long-distance military ski exercise: A pilot study

OBJECTIVES: Skiing is practiced by the security forces posted at mountain areas for patrolling, securing borders, taking up rescue missions and sometimes as recreational activities. A study was planned to assess physiological and mental stress of a military ski activity through the measurement of heart rate (HR) variability, task load and perceived exertion. MATERIALS AND METHODS: Eleven healthy Indian soldiers, trained with skiing techniques, participated in a 15 km skiing with 22 kg equipment at a predetermined snowy mountainous track. Pre- and post-exercise HR and HR variability (HRV) were recorded (bio-harness, Zephyr, USA) and questionnaires, namely NASA task load index (NASA-TLX) and Borg’s rating of perceived exertion (RPE) scale, were filled after exercise. Time and frequency domain parameters such as HR, variations between successive RR intervals (RMSSD), standard deviation of RR (SDNN) and percentage value of NN50 (pNN50), low- and high-frequency bands (LF and HF %) and LF/HF ratio were derived using Kubios software. Student’s t (paired) test was applied to compare pre- and post-exercise HRV parameters and Pearson’s correlation was applied to observe interdependencies between HRV and subjective scores. RESULTS: The findings depicted increase in post-exercise HR and decrease in overall HRV (both significant). Besides this, there was an increase in LF (significant) and LF/HF ratio (insignificant). Such response shows sympathetic dominance over parasympathetic domain of autonomic nervous system. The physical and mental stress experienced during the exercise was also expressed through high physical demand (79 out of 100) and high overall task load (total score – 77 out of 100) of the NASA-TLX and a moderately heavy RPE score (14 out of 20). CONCLUSION: The pre- and post-exercise differences in physiological variables ensured the presence of physical stress along with dominance of sympathetic nervous system. Overall task load was depicted with high subjective ratings. Carrying out skiing task in an environment infested with cold, wind chill, moderate hypoxia at a snowy and mountainous track possibly has induced the observed physiological and mental stress to the participants. Such findings are important to understand exact requirements of the mountain warfare events carried out by the forces.

Comparison of physical fitness and mental stress in exercising and non-exercising medical students

Background: Both physical fitness and mental fitness are essential to achieve success, especially in medical college students, where the academic pressure is high. Studies have shown that exercise helps to reduce mental stress as well as to maintain the fitness. Aims and Objectives: The present study was aimed to compare the level of physical fitness and level of mental stress in exercising and non-exercising medical students. Materials and Methods: A study was done on 60 medical students of age group of 18–20 years with 30 in the exercise group and 30 in the non-exercise group. Modified Harvard step test was used to assess physical fitness index and perceived stress scale questionnaire to assess mental stress. Descriptive analysis and independent t-test were used for statistical analysis. Results: The study demonstrated higher physical fitness (P < 0.01) and lower mental stress levels (P < 0.01) in the exercising group when compared to the non-exercising group. Conclusion: There was better physical fitness and lower mental stress levels among the exercising group when compared with the non-exercising group.

A versão brasileira do Questionário sobre a Experiência de Parto - CEQ-2BR: adaptação, validação e confiabilidade / The Brazilian version of Childbirth Experience Questionnaire - CEQ-2BR: adaptation, validation and reliability / La versión brasileña del Cuestionario sobre la Experiencia en el Parto - CEQ-2BR: adaptación, validación y confiabilidad

INTRODUÇÃO: A avaliação sistemática das experiências das mulheres durante o parto representa uma importante estratégia para viabilizar melhorias na atenção à saúde materna e neonatal. OBJETIVOS: Adaptar o Childbirth Experience Questionnaire (CEQ) para o contexto brasileiro e determinar as propriedades psicométricas da versão em português (do Brasil), denominada CEQ-2BR. MÉTODOS: Estudo transversal com 225 puérperas recrutadas através das redes sociais. Após o consentimento informado, as participantes preencheram um formulário eletrônico, que incluía a versão preliminar da CEQ-2BR. O tratamento dos dados foi realizado através dos pacotes estatísticos SPSS e AMOS 26. A confiabilidade do CEQ-2BR foi avaliada usando o coeficiente alfa de Cronbach. Para medidas paramétricas utilizou-se o Qui-quadrado de Pearson e o T de Student e, nas medidas não-paramétricas, U de Mann Whitney. A magnitude dos coeficientes de correlação foi classificada segundo os critérios de Cohen. RESULTADOS: O CEQ-2BR demonstrou boa consistência interna para "autocapacidade", "suporte profissional", "segurança percebida" e "participação", tendo sido verificado que a avaliação negativa da experiência de parto aumenta em 1,9% e 2,1%, a sintomatologia ansiosa e depressiva pós-parto, respectivamente. CONCLUSÃO: O CEQ-2BR é uma medida válida e confiável sobre experiência de parto na população brasileira, apresenta propriedades psicométricas satisfatórias, sendo recomendado inclusive para multíparas. Houve correlação entre níveis altos de ansiedade pré-natal com experiência negativa de parto. A experiência negativa de parto explica parte das sintomatologias de ansiedade e depressão pós-parto.

INTRODUCTION: The systematic evaluation of women's experiences during childbirth represents an important strategy for implementing improvements in maternal and newborn health care. OBJECTIVE: To adapt the Childbirth Experience Questionnaire (CEQ) for the Brazilian context and to determine the psychometric properties of the Portuguese version (from Brazil), called CEQ-2BR. METHODS: Cross-sectional study with 226 postpartum women recruited from social media. After informed consent, participants completed an electronic form, which included the preliminary Portuguese version of the CEQ-2BR questionnaire. Data processing was performed using statistical packages SPSS and AMOS 26. The CEQ-2BR reliability was evaluated using the Cronbach's alpha coefficient. For parametric measurements Pearson's and Student T's chi-square were used, and Mann Whitney U was used for non-parametric measurements. The magnitude of the correlation coefficients was classified according to Cohen's criteria. RESULTS: The CEQ2BR internal consistence was assured for "Own capacity", "Professional support", "Perceived safety" and "Participation". A negative assessment of the childbirth experience was found to increase postpartum anxious and depressive symptoms by 1.9% and 2.1%, respectively. CONCLUSION: The CEQ-2BR is a valid and reliable measure of childbirth experience in the Brazilian population, has satisfactory psychometric properties and can be recommended even for multiparous women. There was a significant correlation between high levels of prenatal anxiety and negative childbirth experience. The negative experience of childbirth explains part of the symptoms of postpartum anxiety and depression.

INTRODUCCIÓN: La evaluación sistemática de las experiencias de las mujeres durante el parto representa una estrategia importante para implementar mejoras en la atención de la salud materna y neonatal. OBJETIVO: Adaptar el Childbirth Experience Questionnaire (CEQ) para el contexto brasileño y determinar las propiedades psicométricas de la versión portuguesa (de Brasil), denominada CEQ-2BR. MÉTODOS: Estudio transversal con 226 puérperas captadas de redes sociales. Después del consentimiento informado, las participantes completaron un formulario electrónico, que incluía la versión preliminar en portugués del cuestionario CEQ-2BR. El procesamiento de datos se realizó mediante los paquetes estadísticos SPSS y AMOS 26. La confiabilidad del CEQ-2BR se evaluó mediante el coeficiente alfa de Cronbach. Para las mediciones paramétricas se utilizó el chi-cuadrado de Pearson y Student T, y la U de Mann Whitney para las mediciones no paramétricas. La magnitud de los coeficientes de correlación se clasificó según el criterio de Cohen. RESULTADOS: El CEQ-2BR tiene buena consistencia interna para "Auto capacidad", "Apoyo profesional", "Seguridad percibida" y "Participación. Se encontró que una evaluación negativa de la experiencia del parto aumenta los síntomas de ansiedad y depresión posparto en un 1,9 % y un 2,1 %, respectivamente. CONCLUSIÓN: El CEQ-2BR es una medida válida y confiable de la experiencia del parto en la población brasileña, tiene propiedades psicométricas satisfactorias y puede recomendarse incluso para mujeres multíparas. Hubo una correlación significativa entre los altos niveles de ansiedad prenatal y la experiencia de parto negativa. La experiencia negativa del parto explica parte de los síntomas de ansiedad y depresión posparto.

Relación entre hábitos de estudio y estrés académico en los estudiantes universitarios del área de Ciencias Básicas de Lima (Perú) / Relationship between Study Habits and Academic Stress in University Students of the Basic Sciences area of Lima (Peru) / Relação entre hábitos de estudo e estresse acadêmico em estudantes universitários da áreade Ciências Básicas de Lima (Peru)

Introducción: en el artículo se analizan los hábitos de estudio, el estrés académico y la relación entre ellas en estudiantes de una universidad estatal en Lima (Perú). Materiales y métodos: se empleó un estudio transaccional, descriptivo y correlacional a una muestra de tipo probabilístico que estuvo conformada por 316 discentes. Los datos se recolectaron en junio de 2019, utilizando dos instrumentos de investigación: el Inventario de Estrés Académico de Barraza y el Inventario de Hábitos de Estudio de Vicuña. Se usó el coeficiente de correlación de Spearmanpara determinar si existía relación entre hábitos de estudio y estrés académico. Resultados: el 77 % de los estudiantes presenta un nivel de estrés de moderado a profundo; en cuanto a los hábitos de estudio, el 13 % tiene hábitos de estudio de nivel muy negativo a negativo; esto significa que los estudiantes demuestran que sus estrategias y técnicas habituales para la obtención de información y la forma en que realizan sus tareas no les permiten obtener un resultado óptimo, mientras que el 57.6 % tiene hábitos de tendencia negativa. Asimismo, se encontró que los hábitos de estudio y el estrés académico están relacionados de manera directa (p < 0.05). Conclusiones: los hábitos de estudio están relacionados positivamente con los estresores académicos y reacciones o síntomas, sin embargo, no están asociados con estrategias de afrontamiento

Introduction: This study analyzes the study habits, academic stress, and the relationship between them in students at a state university in Lima. Materials and methods: For this purpose, we conducted a transac-tional, descriptive, and correlational study. The sample consisted of 316 students. Through two research instruments­the questionnaires used were: Barraza Academic Stress Inventory and the Vicuna Study Habits Inventory­the data were collected in June 2019. For the statistical analysis, the Spearman cor-relation coefficient was used to determine the existence of a relationship between the study habits and academic stress. Results: 77% of the students presented with a moderate to deep level of stress. Regarding the study habits, total of 13% have study habits from a very negative to a negative level, this means that students show that their usual strategies and techniques for obtaining information and the way they carry out their tasks do not allow them to obtain an optimal result, while 57.6% have negative tendency habits. Conclusions: Likewise, it was found that study habits and academic stress are directly related (p< 0.05). Thus, we concluded that study habits are positively related to academic-stress-inducing factors and reactions or symptoms. However, they are not related to the coping strategies

Introdução: no presente trabalho foram analisados os hábitos de estudo, o estresse acadêmico e a rela-ção entre eles em alunos de uma universidade estadual de Lima. Materiais e métodos: utilizou-se um estudo transacional, descritivo e correlacional com amostra probabilística composta por 316 alunos. Os dados foram coletados em junho 2019, por meio de dois instrumentos de pesquisa: o inventário de estresse acadêmico de Barraza e o inventário de hábitos de estudo de Vicuña. Para a análise estatística, o coeficiente de correlação de Spearman foi utilizado para determinar se havia relação entre hábitos de estudo e estresse acadêmico. Resultados: os resultados mostram que 77% dos alunos apresentam um nível de estresse de moderado a profundo; quanto aos hábitos de estudo, 13% têm hábitos de estudo de um nível muito negativo a negativo, isto significa que os alunos demonstram que as suas estratégias e técnicas habituais de obtenção de informação e a forma como realizam as suas tarefas não lhes permitem obter um resultado óptimo, enquanto 57.6% têm hábitos com tendência negativa. Da mesma forma, hábitos de estudo e estresse acadêmico mostraram-se diretamente relacionados (p < 0.05). Conclusões: os hábitos de estudo estão positivamente relacionados a estressores acadêmicos e reações ou sintomas; no entanto, eles não estão relacionados às estratégias de enfrentamento

Respuesta autonómica cardiovascular al estrés mental inducido por la prueba de cálculo aritmético / Autonomic cardiovascular response to mental stress induced by the arithmetic computation test

Introducción: El estrés mental agudo, así como los estados de ansiedad inducidos para influenciar la reactividad psicofisiológica en jóvenes sanos, aportan cambios en los patrones nerviosos que pueden ser medidos mediante la variabilidad de la frecuencia cardiaca. Objetivo: Determinar las diferencias en los parámetros lineales del balance autonómico cardiovascular en individuos jóvenes en estado basal y durante la prueba de cálculo aritmético. Métodos: Se realizó un estudio cuasi-experimental, sin grupo control de tipo antes y después, en el Laboratorio de Ciencias Básicas Biomédicas de la Universidad de Ciencias Médicas de Santiago de Cuba. Población y muestra de 10 sujetos. Se registró el trazado electrocardiográfico (5 min) durante el reposo y luego durante la prueba de cálculo aritmético. Resultados: Existieron diferencias significativas entre ambos estados en las variables frecuencia cardiaca (p = 0,005); mínima (p = 0,007); máxima (p = 0,005); intervalo RR (p = 0,005); stress index (p = 0,028); índice simpático (p = 0,005); bajas frecuencias (p = 0,005); relación LF/HF (p = 0,005); RMSSD (p = 0,007); NN50 (p = 0,008); pNN50 (p = 0,005); índice parasimpático (p = 0,005) y altas frecuencias (p = 0,005). El estrés mental provocó una disminución parasimpática y un predominio simpático uniforme en todos los sujetos participantes en el estudio. Conclusiones: Durante el estrés mental inducido por la prueba de cálculo aritmético la dinámica lineal de la respuesta autonómica cardiovascular experimenta un aumento en la actividad simpática y una disminución del tono parasimpático, traduciendo una respuesta adaptativa en la regulación de la función cardiovascular por el sistema nervioso autónomo(AU)

Introduction: Acute mental stress and states of anxiety induced to influence psychophysiological reactivity in healthy young people, result in changes in nervous patterns which may be measured in terms of heart rate variability. Objective: Determine the differences in linear parameters for autonomic cardiovascular balance in young individuals at baseline and during the arithmetic computation test. Methods: A non-observational quasi-experimental before-after study without a control group was conducted at the Basic Biomedical Sciences Laboratory of the University of Medical Sciences of Santiago de Cuba. The study population and sample was 10 subjects. The electrocardiographic tracing (5 min) was recorded at rest and then during the arithmetic computation test. Results: Significant differences were found between the two states as to the variables heart rate (p = 0.005), minimum (p = 0.007), maximum (p = 0.005), RR interval (p = 0.005), stress index (p = 0.028), sympathetic index (p = 0.005), low frequencies (p = 0.005), LF/HF ratio (p = 0.005), RMSSD (p = 0.007), NN50 (p = 0.008), pNN50 (p = 0.005), parasympathetic index (p = 0.005) and high frequencies (p = 0.005). Mental stress caused a parasympathetic reduction and uniform sympathetic predominance in all the subjects participating in the study. Conclusions: During the mental stress induced by the arithmetic computation test, the linear dynamic of the autonomic cardiovascular response experiences an increase in sympathetic activity and a reduction in parasympathetic tone, displaying an adaptive response in cardiovascular function regulation by the autonomous nervous system(AU)

Investigation and analysis on the living habits of young and middle-aged patients with recurrent aphthous ulcer in Nanjing / 口腔疾病防治

Objective @#To explore the potential association between particular living habits and recurrent aphthous ulcers (RAU), and provide some references for RAU prevention among the young and middle⁃aged. @*Methods@#The mul⁃ tistage random sampling method was adopted to select 850 young and middle⁃aged people in Nanjing. The disease sta⁃ tus and living habits of young and middle⁃aged people with RAU in Nanjing were investigated by a questionnaire, and the influencing factors were analyzed by univariate and multivariate logistic regression analysis.@*Results@# The preva⁃ lence of RAU was 20.5% among 799 individuals, including 357 men and 442 women. The risk of RAU at medium and low stress levels was 0.533 times and 0.419 times that at high stress levels, respectively (P < 0.05), indicating that high stress was an independent risk factor for RAU. The risk of RAU in patients with low exercise levels was 1.513 times that in patients with high exercise levels (P < 0.05), indicating that high exercise levels were a protective factor for RAU. There were no statistically significant differences in age, sex, smoking, drinking or bedtime (P > 0.05). @*Conclu⁃ sion@#Multivariate logistic regression showed that mental stress and physical activity were independent influencing fac⁃ tors for the development of RAU. The living habits of RAU patients and RAU susceptible populations should be treated with corresponding interventions to prevent RAU.

Advance in Mindfulness-based Intervention for Stress-induced Autonomic Nervous System Activity (review) / 中国康复理论与实践

Mental stress may influence the autonomic nervous system (ANS) activity, and associate with the development of several chronic diseases. Mindfulness-based interventions, such as meditation, Yoga and Taiji Quan, are able to improve mental stress and ANS activity, which is probably related to its effects on the cortex to improve overall mental conditions and parasympathetic tone.

The influence of psychological intervention before percutaneous coronary intervention on mental stress, coping style and related factors of depression in patients with acute coronary syndrome / 中国实用护理杂志

Objective@#To explore the influence of psychological intervention before percutaneous coronary intervention (PCI) on mental stress, coping style and related factors of depression in patients with acute coronary syndrome (ACS).@*Methods@#281 patients with ACS who were treated in our hospital from March 2016 to August 2018 were selected as the study subjects. According to whether psychological intervention was given to ACS patients before PCI, they were divided into intervention group (n = 135) and control group (n = 146). SCL-90 was used to assess mental stress and MCMQ was used to assess coping styles. The changes of mental stress and coping style before and after operation were compared between the two groups. To investigate the incidence of depression in ACS patients after PCI and analyze the related factors affecting their depression.@*Results@#After PCI, the scores of somatization, obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoia, psychosis and bedtime status were decreased in the SCL-90 scores of the intervention group and the control group (P<0.05). The reduction in the intervention group was more obvious, and the difference was statistically significant (P<0.05). After PCI, there was no significant difference in avoidance and yield between the two groups (P>0.05), and there was no significant difference between the two groups before PCI (P>0.05). After PCI, the face score of intervention group was higher than that of control group (P<0.05), and compared with pre-PCI, the difference was also statistically significant (P<0.05). Of the 281 patients with ACS, 84 (29.89%) had depression after PCI. In the intervention group, 26 patients (19.26%) suffered from depression, and 58 patients (39.73%) in the control group suffered from depression. The prevalence of depression in the two groups was statistically significant (P<0.05). Univariate and multivariate logistic analysis showed that the degree of coronary artery disease, education and psychological intervention before PCI were closely related to ACS patients with post-PCI complicated with depression.@*Conclusion@#Psychological intervention can improve the stress of ACS patients and reduce the negative response. At the same time, it can reduce the risk of depression after PCI.

The influence of psychological intervention before percutaneous coronary intervention on mental stress, coping style and related factors of depression in patients with acute coronary syndrome / 中国实用护理杂志

Objective To explore the influence of psychological intervention before percutaneous coronary intervention (PCI) on mental stress, coping style and related factors of depression in patients with acute coronary syndrome (ACS). Methods 281 patients with ACS who were treated in our hospital from March 2016 to August 2018 were selected as the study subjects. According to whether psychological intervention was given to ACS patients before PCI, they were divided into intervention group (n=135) and control group (n=146). SCL-90 was used to assess mental stress and MCMQ was used to assess coping styles. The changes of mental stress and coping style before and after operation were compared between the two groups. To investigate the incidence of depression in ACS patients after PCI and analyze the related factors affecting their depression. Results After PCI, the scores of somatization, obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoia, psychosis and bedtime status were decreased in the SCL-90 scores of the intervention group and the control group (P<0.05). The reduction in the intervention group was more obvious, and the difference was statistically significant (P<0.05). After PCI, there was no significant difference in avoidance and yield between the two groups (P ＞0.05), and there was no significant difference between the two groups before PCI (P＞ 0.05). After PCI, the face score of intervention group was higher than that of control group (P<0.05), and compared with pre-PCI, the difference was also statistically significant (P<0.05). Of the 281 patients with ACS, 84 (29.89%) had depression after PCI. In the intervention group, 26 patients (19.26%) suffered from depression, and 58 patients (39.73%) in the control group suffered from depression. The prevalence of depression in the two groups was statistically significant (P<0.05). Univariate and multivariate logistic analysis showed that the degree of coronary artery disease, education and psychological intervention before PCI were closely related to ACS patients with post-PCI complicated with depression. Conclusion Psychological intervention can improve the stress of ACS patients and reduce the negative response. At the same time, it can reduce the risk of depression after PCI.

A physiology based model of heart rate variability

Heart rate variability (HRV) is governed by the autonomic nervous system (ANS) and is routinely used to estimate the state of body and mind. At the same time, recorded HRV features can vary substantially between people. A model for HRV that (1) correctly simulates observed HRV, (2) reliably functions for multiple scenarios, and (3) can be personalised using a manageable set of parameters, would be a significant step forward toward understanding individual responses to external influences, such as physical and physiological stress. Current HRV models attempt to reproduce HRV characteristics by mimicking the statistical properties of measured HRV signals. The model presented here for the simulation of HRV follows a radically different approach, as it is based on an approximation of the physiology behind the triggering of a heart beat and the biophysics mechanisms of how the triggering process—and thereby the HRV—is governed by the ANS. The model takes into account the metabolisation rates of neurotransmitters and the change in membrane potential depending on transmitter and ion concentrations. It produces an HRV time series that not only exhibits the features observed in real data, but also explains a reduction of low frequency band-power for physically or psychologically high intensity scenarios. Furthermore, the proposed model enables the personalisation of input parameters to the physiology of different people, a unique feature not present in existing methods. All these aspects are crucial for the understanding and application of future wearable health.

A clinical study of mental stress-induced myocardial ischemia in patients with stable coronary artery disease and depression/anxiety / 中华内科杂志

Objectives Exploring the association between depression/anxiety and mental stress-induced myocardial ischemia (MSIMI) in patients with stable coronary artery disease (CAD). Methods A total of 178 subjects was enrolled according to the inclusion and exclusion criterion with 88 men and 90 women at age of (54±12)years. The subjects were divided into four groups including CAD with depression/anxiety, CAD without depression/anxiety, depression/anxiety without CAD, and control group based on the state of coronary artery, the scores of Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item(GAD-7). MSIMI was diagnosed by echocardiography. Data were analyzed by SPSS19.0. Results The incidence of MSIMI in all CAD patients was 17.24%. Within each group, 35.00% patients were MSIMI in CAD with depression/anxiety, 2.13% were in CAD without depression/anxiety, 14.29% were in depression/anxiety without CAD, and 2.38% were in control group. The risks of MSIMI in depression/anxiety without CAD and with CAD groups were 6.83 (P>0.05) and 22.08 times (P<0.05) higher than that in control group, respectively. Logistic regression showed that a 1-point increment in the GAD-7 score, but not PHQ-9 score [ OR=0.95, 95% CI (0.77-1.17), P=0.63], was associated with 1.22-fold increase in the likehood of MSIMI [95% CI (1.07-1.38), P=0.00]. Conclusions The MSIMI rate is much higher in patients with CAD comorbid depression/ anxiety compared with CAD without depression/anxiety. Anxiety, but not depression, is an independent risk factor of MSIMI in CAD patients.

Symptoms of anxiety and depression are related to cardiovascular responses to active, but not passive, coping tasks

Objective: Anxiety and depression have been linked to blunted blood pressure (BP) and heart rate (HR) reactions to mental stress tests; however, most studies have not included indices of underlying hemodynamics nor multiple stress tasks. This study sought to examine the relationships of anxiety and depression with hemodynamic responses to acute active and passive coping tasks. Methods: A total of 104 participants completed the Hospital Anxiety and Depression Scales and mental arithmetic, speech, and cold pressor tasks while BP, HR, total peripheral resistance, and cardiac output (CO) were assessed. Results: After adjustment for traditional risk factors and baseline cardiovascular activity, depression scores were negatively associated with systolic BP, HR, and CO responses to the mental arithmetic task, while anxiety scores were inversely related to the systolic BP response to mental arithmetic. Conclusion: High anxiety or depression scores appear to be associated with blunted cardiac reactions to mental arithmetic (an active coping task), but not to the cold pressor test or speech tasks. Future research should further examine potential mechanisms and longitudinal pathways relating depression and anxiety to cardiovascular reactivity. Clinical trial registration number: TCTR20160208004

Association between Chronic Mental Stress and Academic Performance among Korean Adolescents / Asociación entre estrés mental crónico y desempeño académico en adolescentes koreanos

En este estudio se examinó si el estrés mental crónico se asocia con el rendimiento académico en adolescentes coreanos. La muestra estuvo constituida por los 74.186 adolescentes de entre el 7 y el 12 ° grado (12-18 años) que participaron en la 8va encuesta en internet sobre Comportamiento de Riesgo en Jóvenes en 2012. Se utilizó el análisis de regresión logística multivariante para aclarar cómo el estrés crónico mental se relacionaba con el rendimiento académico después del ajuste por edad, índice de masa corporal, posición económica de la familia, el nivel de educación de los padres, la frecuencia de fumar, la frecuencia de ingesta de alcohol, y la frecuencia de la actividad física vigorosa y moderada y ejercicios de fuerza musculares. Para los varones, las personas con estrés mental crónico muy alto tenían menos probabilidades de lograr un rendimiento académico promedio o superior (odds ratio [OR] = 0.738, 95% intervalo de confianza [IC]: 0.629 a 0.867, p <0,001) que aquellos con muy estrés mental baja. Para las niñas, las que tenían estrés mental muy alto tenían menos probabilidades (OR = 0.668; IC del 95%: 0.521 - 0.857, p = 0.002), mientras que aquellas con estrés mental bajo tenían más probabilidades (OR IC = 1.324, 95%: 1.029 -1.704; p = 0.029) para tener un rendimiento promedio académico o superior, en comparación con las niñas con estrés muy bajo. Los grados (pruebas, exámenes de ingreso) fueron la principal causa de estrés mental crónico tanto en varones (51.7%) y niñas (54.,8%). Los varones y las niñas de la República de Corea de estrés mental crónico muy alto mostraron una disminución del rendimiento académico.

We examined whether chronic mental stress is associated with academic performance in Korean adolescents. Our sample consisted of the 74,186 adolescents between the 7th and 12th grades (aged 12-18 years) who participated in the 8th Korean Youth Risk Behavior Web-based Survey in 2012. We used multivariate logistic regression analysis to clarify how chronic mental stress was related to academic performance after adjustment for age, body mass index, family economic status, parents' education level, smoking frequency, alcohol intake frequency, and frequency of vigorous and moderate physical activity and muscular strength exercises. For boys, those with very high chronic mental stress were less likely to achieve average academic performance or higher (odds ratio [OR] = 0.738, 95% confidence interval [CI]: 0.629-0.867, p < 0.001) than were those with very low mental stress. For girls, those with very high mental stress were less likely (OR = 0.668, 95% CI: 0.521-0.857, p = 0.002), while those with low mental stress were more likely (OR = 1.324, 95% CI: 1.029-1.704; p = 0.029) to have average academic performance or hig-her, compared with girls with very low stress. Grades (tests, entrance examinations) were the primary cause of chronic mental stress in both boys (51.7%) and girls (54.8%). Republic of Korean boys and girls with very high chronic mental stress showed decreased academic performance.

Relationship among mental stress, coping style and self-efficacy beliefs of highland recruits / 中华行为医学与脑科学杂志

Objective To explored the mental stress situations and the relationship between mental stress, coping style and self-efficacy beliefs of the highland training recruits, and suggestions about mental health education of the recruits to be proposed.Methods The solider mental stress self-reported questionnaire, simplied coping style questionnaire, and generalized self-efficacy beliefs scale were administrated to 256 recruits from 3 companies have been randomly selected in a military training base of Qinghai province.Results The mental stress of the recruits included tension, sleepless, physical and mental exhaustion.The mental stress was significant positive correlation with negative coping style( r=0.349, P＜0.01 ), and significant negative correlation with active coping style( r= -0.179, P＜0.01 ), and with self-efficacy beliefs( r= -0.210, P＜0.01 ).Meantime selfefficacy beliefs was significant positive correlation with active coping style( r = 0.532, P ＜ 0.01 ).Negative coping style and self-efficacy beliefs could significantly predict mental stress.Conclusion Through these ways which improving the self-efficacy beliefs and instructing them to use suitable coping style may help the recruits reduce the mental stress.

Conceito(s) de burnout: questões atuais da pesquisa e a contribuição da clínica / Concept(s) on burnout current themes in research and the contribution of clinical practice

Considerando o crescente interesse científico no fenômeno burnout, apresentamos uma amostra da diversidade teórica que forma o campo de pesquisa neste tema a partir de algumas questões atuais de discussão sobre o seu conceito. Discutimos aparentes limitações da abordagem empírica à compreensão da natureza conceitual do burnout, apontando uma possível contribuição da clínica (dentro do campo da Psiquiatria) a este debate.

Considering the growing scientific interest in burnout phenomenon, we present a sample of the theoretic diversity that constitutes the research in this area presenting some of the debates currently being held on its concept. We discuss apparent limitations of the empirical approach on the comprehension of burnout conceptual nature, indicating a possible contribution from the clinical practice (within the of psychiatry) to this debate.

Mental stress,coping style and their correlating with emotion of adolescent / 中华行为医学与脑科学杂志

Objective To understand adolescent's mental stress, coping style and their correlating with emotion. Methods This research, in order to be tried with 5870 middle school students, adopt Mental Stress Questionnaire, Coping Style Scale and Profile of Mood States. Results Compared with male students, female students had higher scores on stress from school work achievement and appearance(P＜0.05) and lower scores on stress from family[(2.04±1.19)vs(2.11±1.25)](P＜0.05),also they had higher sores on extra-coping style[(3.11±0.77)vs(2.77±0.81)](P＜0.01). Compared with lower grade students, higher grade students had higher scores on all mental stress except stress from family, while they had lower scores on extra-coping style (P＜0.01). Stepwise logistic regression analysis indicated that high scores on mental stress and intro-coping style could predict negative emotion (P＜0.01), and extra-coping style could predict positive emotion (P＜0.01).Conclusion The middle school students suffered more stress from school work achievement than from other aspects. Students who differed in sex, grade had significant different scores on mental stress and coping style. Mental stress and coping style could predict adolescents' emotion.

The comparative study of effects of mental stress and physiological stress on the anxiety behavior in Sprague-Dawley rats / 中华行为医学与脑科学杂志

Objective To compare the effects of mental stress and physical stress on the anxiety behavior in SD rats.Methods 24 male SD rats were allocated into mental stress group,physiological stress group and control group randomly,and the Communication Box was applied to establish animal model of mental stress,then assessed their anxiety behavior through the Open field test and elevated plus nlaze test.Results In the Open field test.the numbers of squares crossed peripherally and centrally,and the grooming frequency significantly lowered in physiological stress group and in mental stress group compared with that in control group,and were significantly higher in mental stress group than in physiological stress group.The elevated plus maze test demonstrated similar results in the numbers of open arm entries and the time spent in open arms among these three groups.Conclusion In Communication Box model,the anxiety behavior level of physiological stress mats were higher than that in mental stress rats.