Effect of intensity training block on anxiety state and performance in competitive swimmers.

Background: An increase in training intensity could create changes in psychological and physiological variables in competitive athletes. For this reason, it is very relevant to know how an intensive training block could influence psychological variables in competitive swimmers. This study examined the effect of an intensive training block (HIT) for 2 weeks on the anxiety state and swimming performance compared to standard aerobic training. Methods: Twenty-two male competition swimmers were randomly assigned to two groups: HIT group (n = 11; age = 16.5 ± 0.29 years) and control group following the standard training program (n = 11; age = 16.1 ± 0.33 years). Psychological status variables (cognitive anxiety, somatic anxiety and self-confidence) and swimming performance (100-m front crawl) were measured pre-and post-test. Results: A significant effect of time was found for all psychological variables and swimming performance (F ≥ 17.6; p < 0.001; d ≥ 0.97). Furthermore, a significant group × time interaction effect was found in cognitive (F = 14.9; p < 0.001; d = 0.62) and somatic anxiety (F = 5.37; p = 0.031; d = 0.55) were found. Only a significant group effect was found in somatic anxiety (F = 27.1; p < 0.001; d = 1.2). Post hoc comparison revealed that both groups increased their cognitive anxiety and swimming performance, and decreased their self-confidence from pre to post test. However, cognitive anxiety increase significantly more in the HIT group compared to the control group. Furthermore, only the HIT training group significantly increased somatic anxiety over time, while somatic anxiety did not change significantly over time in the control group. Conclusion: Our findings indicated that a sudden increase in training intensity increased state anxiety more than standard training, but both conditions similarly enhanced swimming performance. Although the current level of psychological state is not affecting swimming performance negatively over this period, it should be regularly monitored by psychologists as it over a longer training period perhaps could have a negative influence on swimming performance.

Exploring jump experience, risk perception, anxiety and self-confidence in skydiving: A mixed methods approach.

Skydivers are required to interpret person-context characteristics to overcome inherent internal challenges (i.e., fear and anxiety) and external challenges (i.e., equipment malfunctions) to successfully perform. Research suggests that as skydiving experience increases, skydivers' self-confidence in their actions increases, while their perception of risk and anxiety decreases. However, there is a lack of research investigating the influence of experience and considerations of performance in extreme sports. This study examined the influence of skydiving experience on the interpretation of risk perception, anxiety and self-confidence. Participants comprised 503 experienced Australian skydivers (Mage = 40.10, SDage = 12.40; 79.5 % male). Using a mixed methods approach, skydivers completed measures of risk perceptions, anxiety, and self-confidence related to skydiving, as well as open-ended questions on their skydiving experiences. The findings indicated that increases in jumping experience led to greater self-confidence, and self-confidence mediated the relationship between all elements of jumping experience and cognitive and somatic anxiety associated with skydiving. Thematic analysis reinforced that skydivers understood the inherent risks associated with skydiving, and that skydivers adopted positive strategies that promoted self-confidence and mastery to perform successfully, while also managing their interpretations of risk and associated anxiety that potentially exists. Further research is needed to better understand the interpretation of person-context situations in extreme sports and recognize the important affordances for performance.

Somatic anxiety in patients with laryngopharyngeal reflux.

Objective: This study aimed to evaluate the relationship between laryngopharyngeal reflux (LPR) and anxiety in patients with LPR. Design: Prospective, case-control study. Setting: This study was conducted at a tertiary care center. Participants: Sixty-four patients with LPR and 60 healthy controls. Methods: Patients with LPR and healthy individuals (N = 64 and N = 60) were enrolled in this study. The Beck Anxiety Inventory (BAI) and reflux symptom index (RSI) were used to evaluate anxiety and reflux-related symptoms, respectively. The BAI can be classified into somatic and subjective symptom scales. The prevalence of anxiety was compared between patients with LPR and healthy individuals. This study evaluated the relationship between BAI and RSI scores. Results: No statistical difference was found in the prevalence of anxiety between patients with LPR and healthy individuals (42.2% vs. 33.3%). However, the somatic anxiety symptom score was statistically higher in patients with LPR than in healthy individuals (p = .047). We observed a correlation between RSI and somatic anxiety scores of BAI in patients with LPR (rho = 0.286, p = .021). Conclusion: Patients with LPR had more severe somatic anxiety symptoms, and somatic anxiety was associated with their LPR-related symptoms.

Associations among Distress Rumination, Somatic Anxiety, and Suicidal Ideation in Chinese College Students - Shandong Province, China, 2019-2020.

What is already known about this topic?: The literature has consistently demonstrated that distress rumination following a traumatic event has significant implications for mental health. However, the potential association between distress rumination and suicidality, as well as the underlying mechanisms driving this relationship, remains to be elucidated. What is added by this report?: The current study demonstrated a significant, positive correlation between distress rumination and suicidal ideation in college students who have encountered traumatic events. The findings indicate that somatic anxiety serves as a mediator between distress rumination and suicidal ideation. What are the implications for public health practice?: Interventions aimed at reducing somatic anxiety may contribute to a decrease in suicidal ideation. Assessing and addressing somatic anxiety symptoms in college students experiencing distressful rumination following traumatic events could potentially lower the risk of suicide.

Dysfunction of default mode network characterizes generalized anxiety disorder relative to social anxiety disorder and post-traumatic stress disorder.

BACKGROUND: The perseverative cognition of generalized anxiety disorder (GAD) is distinctive compared to other anxiety disorders. However, the disease-specific and shared neuropathophysiological mechanisms of GAD remain unclear. METHODS: We recruited medication-free patients of GAD (N = 33), social anxiety disorder (SAD; N = 36), post-traumatic stress disorder (PTSD; N = 59), and healthy controls (HC; N = 50). All subjects underwent clinical assessments and resting-state functional magnetic resonance imaging. We compared both the amplitude low-frequency fluctuation (ALFF) and seed-based functional connectivity across the whole brain, using the significantly different regions from the ALFF analyses as seed regions, followed by post-hoc tests. RESULTS: We found that ALFF of the left angular gyrus (AG), left inferior parietal lobule (IPL), left precentral gyrus, left middle temporal gyrus, and left cerebellum were higher in GAD compared with SAD, PTSD and HC. This trend was further corroborated by the higher functional connectivity between left AG and bilateral IPL, left inferior temporal gyrus, and left medial prefrontal cortex (mPFC) in GAD. In addition, GAD and SAD both showed abnormally higher left AG-right insula connectivity. Significant correlations were found between anxiety symptom severity and the left AG regional activity and left AG-left mPFC connectivity. LIMITATIONS: We did not compare the differences in neuroimaging between GAD and other anxiety disorders, such as panic disorder. CONCLUSIONS: The default mode network dysfunction may underlie the distinctive perseverative thoughts of GAD relative to other anxiety disorders, and left AG-right insula connectivity may reflect somatic anxiety of anxiety disorder spectrum.

Levels of Somatic Anxiety, Cognitive Anxiety, and Self-Efficacy in University Athletes from a Spanish Public University and Their Relationship with Basic Psychological Needs.

Research on self-efficacy, cognitive anxiety and somatic anxiety provides fundamental information to early identify weak areas in the training of athletes and to implement actions that contribute to the improvement and maintenance of sporting activities. The aim of this study was to analyze the relationship between anxiety (somatic anxiety, cognitive anxiety and self-efficacy) and basic psychological needs (competence, autonomy and relationship with others). The sample was composed of 165 university students enrolled in courses related to physical activity and sport sciences, with a mean age of 20.33 years (SD = 3.44), studying in a Spanish public university located in Almeria, in the southeast of Spain (Andalusia). The main findings showed the existence of a continuous and effective relationship between self-efficacy and basic psychological needs. While there was no positive and direct relationship between cognitive anxiety and somatic anxiety and autonomy, there was a direct and positive relationship between cognitive anxiety and somatic anxiety and competence and the relationship with others. Therefore, the results obtained showed that a more positive form of motivation would be autonomous motivation, as it helps to interpret the perception of self-efficacy, favoring performance in competition, whereas controlled motivation has the opposite effect. The importance of this research resides in the fact that it shows that within the sports field, an athlete's self-perception has an indirect negative effect on pre-competitive somatic anxiety, and the link in this relationship is task orientation and the absence of demotivation towards sport. Despite this, the same effect on cognitive anxiety was not produced.

The role of leptin in indirectly mediating "somatic anxiety" symptoms in major depressive disorder.

Background: Leptin is a multifunctional hormone secreted from adipose tissue, which plays a core role in regulating energy intake and expenditure. Evidence has demonstrated that leptin receptors are located in brain areas involved in emotional processing, and major depressive disorder (MDD) is characterized by dysfunction of emotional processing. Taken together, these features suggest that leptin may play a potential role in the pathophysiology of MDD. However, the precise roles of leptin in modulating depressive symptoms in MDD remain unclear. Methods: Participants [18 drug-naïve MDD patients, 15 unaffected first-degree relatives of MDD patients (FDR-MDD), and 40 healthy controls] completed clinical assessments and provided blood samples for measurement of leptin levels. We evaluated the effect of leptin on clinical status (MDD or FDR-MDD) and symptomatic dimensionalities of MDD using mediation analysis. Results: We found that leptin was increased in MDD patients and this only predicted "somatic anxiety" symptoms. Furthermore, leptin was a significant and indirect mediator of the association between clinical status (MDD or FDR-MDD) and "somatic anxiety" symptoms. Conclusion: Our finding that leptin was a significant and indirect mediator of clinical status (MDD or FDR-MDD) and "somatic anxiety" symptoms suggests that leptin may indirectly affect somatic depressive symptoms in MDD. Our findings may provide a theoretical basis for novel clinical interventions in MDD.

The Relationship Between Negative Focused Disposition and Suicidal Ideation Among College Students: The Mediating Effects of Somatic Anxiety, General Distress, and Depression.

Objective: Suicide among college students is a major public health problem. Research has confirmed that negative focused disposition had a significant effect on suicidal ideation. This study aims to evaluate somatic anxiety, general distress and depression as mediators of the relationship between negative focused disposition and suicidal ideation. Methods: A total of 1798 college students (942 males) were recruited to complete measures of negative focused disposition, somatic anxiety, general distress, positive affect and suicidal ideation. The mediation models were conducted to assess the mediating effects of somatic anxiety, general distress and depression. Results: There was a significant and positive correlation between negative focused disposition and suicidal ideation in Chinese college students. On mediation analysis, somatic anxiety, general distress and depression mediated the relationship between negative focused disposition and suicidal ideation. Conclusions: Negative focused disposition appears to directedly associate with suicidal ideation and can indirectly relate to suicidal ideation through the relation with somatic anxiety, general distress and depression. College students with few positive expectations of the future may benefit from interventions focusing on somatic anxiety, general distress and depression.

Effect of High-Volume Training on Psychological State and Performance in Competitive Swimmers.

This study aimed to examine the effect of four weeks of aquatic high-volume training (HVT) on the psychological state (somatic, cognitive anxiety, and self-confidence) and sprint swimming performance (50 m front crawl) compared to the standard training program (moderate volume training) in competitive swimmers. Twenty-eight male competitive swimmers participated in this study and were randomly allocated into two groups: HVT group (n = 14; age = 16.4 ± 0.31 years) and control group that underwent the standard training program (n = 14; age = 16.1 ± 0.30 years). All psychological state variables and swimming performance were measured in pre and post-test. Our findings showed a significant increase in anxiety state (34.13% to 45.83%; ES = 3.26 to 3.38) and a significant decrease in self-confidence (18.43%; ES = 2.39) after four weeks of HVT, while all psychological state variables remained unchanged in the control group (p > 0.05). In addition, our results showed no significant enhancement in swimming performance in both groups (p > 0.05). The sudden increase in training mileage negatively affected the anxiety, decreasing the state of self-confidence of the participants. In addition, four weeks of high training volume are insufficient to improve swimming performance. To conclude, gradually increasing the volume of the training load may be an adequate solution to promote adaptation to the effort, thus maintaining the stability of the psychological state of swimmers. In addition, it is recommended to integrate a concurrent mental preparation program with high-volume training to monitor the psychological state of competitive swimmers.

Fear conditioning as a pathogenic mechanism in the postural tachycardia syndrome.

Despite its increasing recognition and extensive research, there is no unifying hypothesis on the pathophysiology of the postural tachycardia syndrome. In this cross-sectional study, we examined the role of fear conditioning and its association with tachycardia and cerebral hypoperfusion on standing in 28 patients with postural tachycardia syndrome (31 ± 12 years old, 25 females) and 21 matched controls. We found that patients had higher somatic vigilance (P = 0.0167) and more anxiety (P < 0.0001). They also had a more pronounced anticipatory tachycardia right before assuming the upright position in a tilt-table test (P = 0.015), a physiological indicator of fear conditioning to orthostasis. While standing, patients had faster heart rate (P < 0.001), higher plasma catecholamine levels (P = 0.020), lower end-tidal CO2 (P = 0.005) and reduced middle cerebral artery blood flow velocity (P = 0.002). Multi-linear logistic regression modelling showed that both epinephrine secretion and excessive somatic vigilance predicted the magnitude of the tachycardia and the hyperventilation. These findings suggest that the postural tachycardia syndrome is a functional disorder in which standing may acquire a frightful quality, so that even when experienced alone it may elicit a fearful conditioned response. Heightened somatic anxiety is associated with and may predispose to a fear-conditioned hyperadrenergic state when standing. Our results have therapeutic implications.

Relationships between somatic anxiety, cognitive anxiety, self-efficacy, and emotional intelligence levels in university physical education students.

One of the most studied topics nowadays, from psychology in general, and from sport psychology, is anxiety. In fact, research on anxiety has been approached from various theoretical perspectives ranging from psychoanalysis, behaviorism, or more recently, those theories that take into consideration the importance of affective, rational, and emotional processes. The aim of this study is to analyze the levels of anxiety and emotional intelligence, and their relationship. The sample is composed of 165 university physical education students with a mean age of 20.33 years (SD = 3.44), (70.9% male and 27.9% female). We used the CSAI-2 questionnaire (to measure cognitive anxiety, somatic anxiety, and self-confidence), and the TMMS-24 (to measure emotional intelligence). The main findings of this research highlighted the presence of significant correlations between emotional clarity and emotional regulation, self-confidence, cognitive anxiety, and somatic anxiety. Therefore, we conclude that sporting performance is influenced by various variables of different kinds, including emotions, and highlight the importance of the incorporation of the emotional component in the field of sport.

Dimensionality of the State-Trait Inventory of Cognitive and Somatic Anxiety.

The State-Trait Inventory of Cognitive and Somatic Anxiety (STICSA) is a commonly administered self-report instrument of state-trait cognitive and somatic anxiety. Extant research has consistently supported the intended oblique two-factor scoring structure for the STICSA. However, this model assumes that population-level data have (or approximate) a simple structure and that item-level variance is unidimensional. These assumptions may not be tenable and have unintended consequences for STICSA subscore interpretation. Consequently, we tested these assumptions by fitting confirmatory and exploratory structural equation models to STICSA scores for a diverse sample of college students enrolled at a large Southwestern university in the United States (n = 635). Results indicated that cognitive and somatic factors are not equally robust and that STICSA items appear to measure a nonnegligible mixture of both latent cognitive and somatic anxiety. It is recommended that future research use exploratory structural equation model in tandem with CFA to directly model data complexity.

Effects of Mental Training Through Imagery on the Competitive Anxiety of Adolescent Tennis Players Fasting During Ramadan: A Randomized, Controlled Experimental Study.

This study aimed to analyze the effects of mental training through imagery on the competitive anxiety of adolescent tennis players fasting during Ramadan. This is an experimental study conducted with 38 male tennis players, randomly allocated to two groups: an experimental group (EG, n = 18), aged 16.9 ± 0.6 years, and a control group (CG, n = 20), aged 16.7 ± 0.8 years. The study was designed as a randomized, controlled experimental trial (registration code PACTR 202006847771700). CG watched historical videos of the Olympics, while EG performed mental training. The competitive anxiety state assessment was recorded four times. The first measurement was carried out 1 week before Ramadan, the second measurement during the first week of the month, the third measurement at the end of the second week, and, finally, the fourth measurement during the fourth week of Ramadan. Our results revealed a significant interaction (time × groups) for all competitive anxiety subscales. Higher intensity and direction scores for the cognitive and somatic anxiety subscales during Ramadan compared with before Ramadan for both groups could be reported at P < 0.001. Higher intensity and direction scores for the cognitive and somatic anxiety subscales during Ramadan compared with pre-Ramadan for both groups could be found at P < 0.01. This increase in scores was greater for the CG than for the EG in the middle and at the end of Ramadan at P < 0.001. Finally, for the self-confidence subscale score, results revealed that intensity and direction scores were lower during Ramadan compared with pre-Ramadan for the two groups at P < 0.01. The score for the intensity of self-confidence was higher for the EG compared with the CG at the end of Ramadan at P < 0.001. It was concluded that mental imagery training was effective in reducing anxiety (cognitive and somatic) and increasing self-confidence in the intensity dimension of adolescent tennis players who fast during Ramadan.

Dimensionality and Measurement Invariance of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and Validity Comparison With Measures of Negative Emotionality.

This study explored the factor structure of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and measurement invariance between genders. We also measured concurrent and divergent validity of the STICSA as compared to the State-Trait Anxiety Inventory (STAI). A sample of 1064 (N Females = 855) participants completed questionnaires, including measures of anxiety, depression, stress, positive and negative affect. Confirmatory factor analyses supported the original factor structure of the STICSA, which was invariant between genders. Overall, the STICSA had superior concurrent and divergent validity as compared to the STAI. The somatic subscales were also significantly less correlated with depression, and positive and negative affect. Further, the somatic, as compared to cognitive anxiety STICSA subscales were less correlated with depression. This suggests that the STICSA, especially the somatic anxiety subscales, might hold the key to distinguishing between different types of anxiety, as well as between anxiety and depression.

Mastery Imagery Ability Is Associated With Positive Anxiety and Performance During Psychological Stress.

Mastery imagery (i.e., images of being in control and coping in difficult situations) is used to regulate anxiety. The ability to image this content is associated with trait confidence and anxiety, but research examining mastery imagery ability's association with confidence and anxiety in response to a stressful event is scant. The present study examined whether trait mastery imagery ability mediated the relationship between confidence and anxiety, and the subsequent associations on performance in response to an acute psychological stress. Participants (N = 130; 55% male; M age = 19.94 years; SD = 1.07 years) completed assessments of mastery imagery ability and engaged in a standardized acute psychological stress task. Immediately prior to the task, confidence, cognitive and somatic anxiety intensity, and interpretation of anxiety symptoms regarding the task were assessed. Path analyses supported a model whereby mastery imagery ability mediated the relationship between confidence and cognitive and somatic anxiety interpretation. Greater mastery imagery ability and confidence were both directly associated with better performance on the stress task. Mastery imagery ability may help individuals experience more facilitative anxiety and perform better during stressful tasks. Improving mastery imagery ability by enhancing self-confidence may help individuals successfully cope with anxiety elicited during stressful situations.

Competitive Anxiety, and Guilt and Shame Proneness From Perspective Type D and Non-type D Football Players.

The precompetitive, competitive, and postcompetitive mental states of athletes are currently not sufficiently researched. Long-term exposure to stressors contributes to the formation of mental blocks and leads to various health problems. One of the factors that can explain the variability of athletes' reactions to stress is their personality. This study is the first to examine competitive anxiety, and guilt and shame proneness in the context of the reaction of football players to distress in sports. The study consists of 112 male football players aged 16-24 (21.00 ± 1.90) who were divided into type D and non-type D football players according to scoring on the Denollet Scale (DS14). Football players also filled out the Sport Anxiety Scale (SAS-2) and the Guilt and Shame Proneness Scale (GASP). The taxonomic approach was conducted to test and to examine differences in stressor intensity as a function of type D personality. A correlation, multivariate analysis of variance, and regression analysis were performed in the study. We found that type D football players were more afraid of failures in sports (worry), felt more often autonomous excitement concentrated in the stomach and muscles (somatic anxiety), and showed more frequent concentration disruption than did non-type D football players. We also found that although type D football players were more likely to rate their behavior as negative and inappropriate, they showed a much greater effort to correct it than did non-type D football players. Negative affectivity and social inhibition of type D football players were positively correlated with competitive anxiety. In addition, we noted lower levels of somatic anxiety and lower concentration disruption for football players who used escape strategies to manage stress. The shame proneness subscale monitoring negative self-evaluation was also closely related to the concentration disruption of football players. We found that the examination of athletes by type D personality is necessary due to the fact that negative affectivity and social inhibition are significant predictors of competitive anxiety of football players, which explains their worries at 24.0%, somatic anxiety at 8.2%, and concentration disruption at 10.6%.

Comparative efficacy of add-on rTMS in treating the somatic and psychic anxiety symptoms of depression comorbid with anxiety in adolescents, adults, and elderly patients-A real-world clinical application.

BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is an effective adjuvant treatment for depression. Many patients with depression have comorbid anxiety symptoms. However, previous rTMS studies have focused on patients with depression, and often excluded comorbid anxiety. This real-world study aimed to investigate the comparative efficacy of add-on rTMS in treating the somatic and psychic anxiety symptoms of depression comorbid with anxiety in adolescents, adults and elderly patients. METHODS: This study included 147 depression patients with anxiety symptoms who were treated with at least 10 sessions of rTMS. The symptoms of anxiety and depression were assessed with the Hamilton Rating Scale for Anxiety (HAMA) and the Hamilton Rating Scale for Depression (HAMD) at baseline and after 2 and 4 weeks of treatment. This was done to compare the improvement degree of add-on rTMS on somatic and psychic anxiety symptoms in adolescents, adults and elderly patients respectively. RESULTS: Both somatic and psychic anxiety symptoms were significantly improved after the add-on rTMS in adolescents, adults and elderly patients. The improvement of somatic anxiety was better than that of psychic anxiety after rTMS treatment in elderly patients (t2w=3.895, P<0.001; t4w=2.823, P = 0.008). LIMITATION: The overall sample was mostly composed of elderly patients, while adolescents and adult patients were fewer. CONCLUSIONS: The add-on rTMS treatment can improve somatic anxiety better than psychic anxiety in depression with anxiety symptoms, especially in elderly patients.

Distinct effects of cognitive versus somatic anxiety on cognitive performance in old age: the role of working memory capacity.

Objective: The adverse effects of anxiety on cognition are widely recognized. According to Attentional Control Theory, worry (i.e. facet of cognitive anxiety) is the component that is responsible for these effects, and working memory capacity (WMC) plays an important role in regulating them. Despite the increasing importance of this problem with aging, little is known about how these mechanisms interact in old age. In this study, we explored the distinct contributions of the somatic and cognitive components of anxiety to neuropsychological performance, and the potential moderating role of WMC.Method: We administered cognitive tasks testing processing speed, cognitive flexibility and working memory to 605 older adults, who also underwent depression and test anxiety assessments (data from VLV study).Results: Multiple regression analyses showed that cognitive (but not somatic) aspects of anxiety affected cognitive flexibility. The effect of cognitive anxiety on processing speed was moderated by WMC: the anxiety-performance association was lower for participants with greater WMC.Conclusion: Results confirmed the specific role of worry in the anxiety-performance relationship in old age and supported the hypothesis that working memory resources regulates its deleterious effect on cognition. The absence of a moderation effect in the more costly switching task may reflect a limitation of resources with aging.

Associations between heart rate, perceived heart rate, and anxiety during acute psychological stress.

Background: Acute psychological stress elicits increases in heart rate (HR) and anxiety. Theories propose associations between HR, perceived HR, and anxiety during stress. However, anxiety is often measured as a unidimensional construct which limits a comprehensive understanding of these relationships. Objectives: This research explored whether HR reactivity or perceived HR change was more closely associated with cognitive and somatic anxiety during acute psychological stress. Design: Two laboratory-based studies were conducted. Methods: In a single laboratory session, healthy male (N = 71; study 1) and female (N = 70; study 2) university students completed three laboratory psychological stress tasks (counterbalanced), each with a preceding baseline. Heart rate, perceived HR change, and cognitive and somatic anxiety intensity and interpretation of anxiety symptoms were assessed immediately following each task. Data were aggregated across tasks. Results: Actual HR change was unrelated to anxiety intensity, but was associated with more debilitative interpretations of anxiety (study 2). Perceptions of HR change were consistently associated with greater intensity of cognitive (study 1) and somatic (study 1 and 2) anxiety. Conclusions: Perceived HR rather than actual HR is more closely associated with anxiety intensity during psychological stress. The findings have implications for stress management and the clinical treatment of anxiety symptoms.

Clinical characteristics of elderly depressive patients with low metaiodobenzylguanidine uptake.

BACKGROUND: Recently, depression with Lewy body pathology before the appearance of parkinsonism and cognitive dysfunction has been drawing attention. Low cardiac metaiodobenzylguanidine (MIBG) uptake is helpful for early differentiation of Lewy body disease (LBD) from late-onset psychiatric disorders even before parkinsonism or dementia appears. In this study, we used MIBG uptake as a tool in suspected LBD, and evaluated the relationship of MIBG results to clinical characteristics and depressive symptoms. METHODS: Fifty-two elderly inpatients with depression were included in this study. The Hamilton Depression Rating Scale (HDRS) was administered at admission, and 123 I-MIBG cardiac scintigraphy was performed. Of 52 patients, 38 had normal and 14 had reduced MIBG uptake. RESULTS: Correlation analyses of the late phase heart-to-mediastinum (H/M) ratio on the MIBG test and each item of the HDRS revealed that the H/M ratio was significantly correlated with scores of 'agitation', 'anxiety-somatic', and 'retardation' on the HDRS. Mean HDRS composite scores of 'somatic and psychic anxiety (Marcos)' and 'somatic anxiety/somatization factor (Pancheri)' were higher in the low uptake group than in the normal uptake group. CONCLUSION: Elderly patients with depression who manifested an obvious somatic anxiety tend to show low MIBG uptake, and are more likely to have Lewy body pathology.