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OBJECTIVE: No previous study has focused on recognition of myocardial infarction (MI) and the presence of both depressive and anxiety disorders in a large population-based sample. The aim of this study was to investigate the association of recognized MI (RMI) and unrecognized MI (UMI) with depressive and anxiety disorders. METHODS: Analyses included 125,988 individuals enrolled in the Lifelines study. Current mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) were assessed with the Mini-International Neuropsychiatric Interview. UMI was detected using electrocardiogram in participants who did not report a history of MI. The classification of RMI was based on self-reported MI history together with the use of either antithrombotic medications or electrocardiogram signs of MI. Analyses were adjusted for age, sex, smoking, somatic comorbidities, and physical health-related quality of life as measured by the RAND 36-Item Health Survey in different models. RESULTS: Participants with RMI had significantly higher odds of having any depressive and any anxiety disorder as compared with participants without MI (depressive disorder: odds ratio [OR] = 1.86, 95% confidence interval [CI] = 1.38-2.52; anxiety disorder: OR = 1.60, 95% CI = 1.32-1.94) after adjustment for age and sex. Participants with UMI did not differ from participants without MI (depressive disorder: OR = 1.60, 95% CI = 0.96-2.64; anxiety disorder: OR = 0.73, 95% CI = 0.48-1.11). After additional adjustment for somatic comorbidities and low physical health-related quality of life, the association between RMI with any depressive disorder was no longer statistically significant (OR = 1.18; 95% CI =0.84-1.65), but the association with any anxiety disorder remained (OR = 1.27, 95% CI = 1.03-1.57). CONCLUSIONS: Recognition of MI seems to play a major role in the occurrence of anxiety, but not depressive, disorders.
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Infarto del Miocardio , Calidad de Vida , Trastornos de Ansiedad , Estudios de Cohortes , Electrocardiografía , HumanosRESUMEN
Taxonomies and ontologies for the characterization of everyday sounds have been developed in several research fields, including auditory cognition, soundscape research, artificial hearing, sound design, and medicine. Here, we surveyed 36 of such knowledge organization systems, which we identified through a systematic literature search. To evaluate the semantic domains covered by these systems within a homogeneous framework, we introduced a comprehensive set of verbal sound descriptors (sound source properties; attributes of sensation; sound signal descriptors; onomatopoeias; music genres), which we used to manually label the surveyed descriptor classes. We reveal that most taxonomies and ontologies were developed to characterize higher-level semantic relations between sound sources in terms of the sound-generating objects and actions involved (what/how), or in terms of the environmental context (where). This indicates the current lack of a comprehensive ontology of everyday sounds that covers simultaneously all semantic aspects of the relation between sounds. Such an ontology may have a wide range of applications and purposes, ranging from extending our scientific knowledge of auditory processes in the real world, to developing artificial hearing systems.
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Background: The biopsychosocial model of challenge and threat specifies a challenge-threat continuum where favorable demand-resource evaluations, efficient cardiovascular responses, and superior performance characterize challenge; and maladaptive outcomes like clinical depression characterize threat states. The model also specifies task engagement, operationalized as heart rate and ventricular contractility increases, as a prerequisite for challenge and threat states. The blunted cardiovascular reactivity to stress literature describes reductions of these increases and associates them with problems like clinical depression. Objectives: To determine whether blunted cardiovascular reactivity to stress has implications for challenge and threat theory. Methods: We review and synthesize the literatures on blunted cardiovascular reactivity to stress and the biopsychosocial model. Results: Blunted cardiovascular reactivity appears not to reflect a physiological inability to respond to stress. Rather, it reflects a contextually dependent motivational dysregulation and reduced reactivity to stress consistent with deficient task engagement in the biopsychosocial model. Conclusion: We argue that blunted cardiovascular reactivity represents deficient task engagement, and more generally, motivational disengagement due to threat states. Our biopsychosocial model-based approach conceptualizes this motivational disengagement as a tendency to avoid motivated performance situations. This tendency may represent a defense mechanism against subsequent threat and might explain associations with disorders like clinical depression.
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Frecuencia Cardíaca/fisiología , Modelos Biopsicosociales , Motivación/fisiología , Estrés Psicológico/fisiopatología , Estrés Psicológico/psicología , Presión Sanguínea , HumanosRESUMEN
As more digital resources are produced by the research community, it is becoming increasingly important to harmonize and organize them for synergistic utilization. The findable, accessible, interoperable, and reusable (FAIR) guiding principles have prompted many stakeholders to consider strategies for tackling this challenge. The FAIRshake toolkit was developed to enable the establishment of community-driven FAIR metrics and rubrics paired with manual and automated FAIR assessments. FAIR assessments are visualized as an insignia that can be embedded within digital-resources-hosting websites. Using FAIRshake, a variety of biomedical digital resources were manually and automatically evaluated for their level of FAIRness.
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Difusión de la Información/métodos , Internet/tendencias , Sistemas en Línea/normas , Recursos en Salud/normas , HumanosRESUMEN
BACKGROUND: Depression predicts poor prognosis in patients with myocardial infarction (MI). However, individual depressive symptoms may have different prognostic value, and age and sex could be important effect modifiers. This study compared the prognostic value of individual depressive symptoms across age and sex subgroups in post-MI patients. METHODS: Individual patient-data were compiled for 6673 post-MI patients from seven studies. Depressive symptoms were measured with 10 items of the Beck Depression Inventory (BDI10). The endpoint was all-cause mortality (mean=3.8 years). Multilevel multivariable Cox regression analysis was used to estimate the mortality risk across age groups (≤55, 56-69 and ≥70 years) and sex for symptoms that potentially interacted with age and sex. RESULTS: At follow-up, 995 (15%) post-MI patients had died. BDI10 depression scores were associated with an increased mortality risk (HR:1.20;95%CI:1.11-1.28,p<.001). Negative self-image (HR:1.53;1.06-2.21;p=.022) and indecisiveness (HR:1.53;1.15-2.04;p=.003) were associated with increased mortality in men <55. Dissatisfaction was associated with increased mortality in men aged 56-69 (HR:1.35;1.07-1.71;p=. 011), and dissatisfaction (HR:1.34;1.10-1.63;p=.003) and fatigue (HR:1.45;1.20-1.74;p<.001) in men >70. Fatigue was associated with mortality in women aged 56-69 (HR:1.54;1.09-2.15;p=.012), and suicidal ideation in women aged >70 (HR:1.58;1.03-2.43;p=.037). Left-ventricular ejection fraction (LVEF) accounted for much of the associations in men ≤55 years and women ≥70 years. LIMITATIONS: Findings are sample-specific and need replication in future research; BDI10 items were derived from the original BDI assessment. CONCLUSIONS: There is large heterogeneity in the prognostic value of individual depressive symptoms in post-MI patients across sex and age subgroups. LVEF partially explained the depression-prognosis association in specific subgroups.
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Trastorno Depresivo/diagnóstico , Trastorno Depresivo/mortalidad , Infarto del Miocardio/mortalidad , Distribución por Edad , Anciano , Causas de Muerte , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Escalas de Valoración Psiquiátrica , Distribución por Sexo , Encuestas y CuestionariosRESUMEN
OBJECTIVES: Evidence suggests that depression is associated with adverse outcomes in patients with myocardial infarction (MI). Some of the symptoms of depression may also be symptoms of somatic illness and these may confound the association between depression and prognosis. We investigated whether depression following MI is associated with medical prognosis independent of these somatic symptoms. METHOD: The database of an individual patient data meta-analysis was used. Endpoints were all-cause mortality and cardiovascular events. Nine studies were included. Bifactor factor analysis included 13,100 participants and 7,595 participants were included in survival models. Dimensions were generated from the Beck Depression Inventory using factor analyses. The prognostic association was assessed using mixed-effects Cox regression analysis. RESULTS: A bifactor model, consisting of a general factor and 2 general depression-free subgroup factors (a somatic/affective and a cognitive/affective), provided the best fit. There was a significant association between the general depression factor and all-cause mortality (hazard ratio [HR] = 1.25; 95% confidence interval [CI] [1.17, 1.34], p < .001) and cardiovascular events (HR = 1.18; 95% CI [1.13, 1.23], p < .001). After adjustment for demographics, measures of cardiac disease severity, and health-related variables, the association between the general depression factor and all-cause mortality (HR = 1.14; 95% CI [1.04, 1.25], p = .003) and cardiovascular events (HR = 1.16; 95% CI [1.10, 1.23], p = .014) attenuated. Additionally, the general depression-free somatic/affective factor was significantly associated with the endpoints, while the general depression-free cognitive/affective was not. CONCLUSIONS: A general depression factor is associated with adverse medical prognosis following MI independent of somatic/affective symptoms that may be partly attributable to somatic illness. (PsycINFO Database Record