[Psychological factors influencing the experience of menstrual pain - the role of pain catastrophizing]. / A menstruációs fájdalom megélését befolyásoló pszichológiai tényezok ­ a fájdalomkatasztrofizálás szerepe.

INTRODUCTION: Research on menstrual pain is lacking in the literature in terms of the number of people affected, the amount of time spent suffering, and the consequences. OBJECTIVE: We examined the role of pain catastrophizing in experiencing the subjective extent and frequency of menstrual pain and its perception as a limitation to daily activities. METHOD: In our study, during personal tests between 2015 and 2018, we collected data from around 1000 healthy women aged 18 to 51 years, predominantly with secondary and higher education, already and still menstruating, mostly living in a large city, mainly in a relationship, perceiving themselves to be in excellent or good health, predominantly not using hormonal contraceptives, mostly having a regular menstrual cycle. We used an open-ended question to measure the extent, frequency, and impact on daily activities of menstrual pain, and used the Pain Catastrophizing Questionnaire. RESULTS: In our own sample, we found that the more the subject "tends" to report pain catastrophizing, the stronger is the menstrual pain she reports, the more often she experiences menstrual pain and says that the pain limits her daily activities. CONCLUSION: The results showed that it is worth examining the personality characteristics among the factors influencing the extent of menstrual pain; the results can be incorporated into diagnostic and therapeutic work. Orv Hetil. 2023; 164(37): 1469-1475.

Anxiety, depression and autonomic nervous system dysfunction in hypertension.

OBJECTIVES: This study examined the relationship between autonomic nervous system dysfunction, anxiety and depression in untreated hypertension. PATIENTS AND METHODS: 86 newly diagnosed hypertensive patients and 98 healthy volunteers were included in the study. The psychological parameters were assessed with Spielberger State-Trait Anxiety Inventory and Beck Depression Inventory by a skilled psychologist. Autonomic parameters were examined during tilt table examination (10min lying position, 10min passive tilt). Heart rate variability (HRV) was calculated by autoregressive methods. Baroreflex sensitivity (BRS) was calculated by non-invasive sequence method from the recorded beat to beat blood pressure values and RR intervals. RESULTS: Significantly higher state (42.6±9.3 vs. 39.6±10.7 p=0.05) and trait (40.1±8.9 vs. 35.1±8.6, p<0.0001) anxiety scores were found in the hypertension group. There was no statistically significant difference in the depression level. LF-RRI (Low Frequency-RR interval) of HRV in passive tilt (377.3±430.6 vs. 494.1±547, p=0.049) and mean BRS slope (11.4±5.5 vs. 13.2±6.4, p=0.07) in lying position were lower in hypertensives. Trait anxiety score correlates significantly with sympatho/vagal balance (LF/HF-RRI) in passive tilt position (Spearman R=-0.286, p=0.01). CONCLUSIONS: Anxiety could play a more important role than depression in the development of hypertension. Altered autonomic control of the heart could be one of the pathophysiological links between hypertension and psychological factors.

Piracetam prevents cognitive decline in coronary artery bypass: a randomized trial versus placebo.

BACKGROUND: Coronary artery bypass grafting (CABG) can be associated with postoperative cognitive impairment and ischemic stroke. No effective treatment is currently available. The aim of this study was to evaluate the effectiveness of piracetam to treat the cognitive impairment after CABG in an investigator-initiated, double-blind, placebo-controlled, randomized clinical trial. METHODS: Patients undergoing CABG (n = 98) were randomized to placebo (n = 48) or piracetam (n = 50). Study drugs were administered intravenously (150 mg/kg daily; 300 mg/kg on the day of surgery) from the day before surgery to 6 days after surgery, then orally (12 g/day) up to 6 weeks after surgery. Cognitive function was assessed before surgery (baseline) and 6 weeks after surgery (outcome) by using a battery of 12 neuropsychologic tests. The Spielberger Anxiety Inventory and the Beck Depression Inventory were also administered. The combined score derived from the standardized neuropsychologic assessments was analyzed by using an analysis of covariance with baseline and education as covariates. RESULTS: Six weeks after surgery, the combined score indicated a statistically significant treatment effect in the per protocol population (1.848, p = 0.041) and a tendency towards statistical significance in the intent-to-treat population (1.624, p = 0.064) in the group treated with piracetam, but no statistically significant treatment effect was seen in the placebo. The state of anxiety measured by the Spielberger Anxiety Inventory was decreased in both groups (-9.27 and -6.37 in the placebo and piracetam groups, respectively). CONCLUSIONS: Six weeks after CABG, cognition was significantly improved in patients treated with piracetam. Additional trials are required to confirm these effects.