Psychosocial characteristics of workers with irritable bowel syndrome and its relationship with abdominal symptoms and work productivity.

OBJECTIVES: This study aimed to validate the psychosocial characteristics and work-related challenges faced by workers exhibiting symptoms of irritable bowel syndrome (IBS) and to clarify the factors that exacerbate abdominal symptoms or hinder work productivity by focusing on IBS-related cognitive-behavioral factors and job-related stressors. METHODS: An online survey was conducted from October 5 to October 20, 2023, among workers in Japan aged 20-49 years with more than 30 hours of work per week, excluding managers and the self-employed. The data were obtained from 1062 participants (551 women; 329 individuals with IBS). RESULTS: The levels of depression in the IBS group were significantly higher than those in the Non-IBS group (p<0.05). Cognitive-behavioral variables associated with abdominal symptoms were positively correlated with work productivity (r=0.367-0.483, p<0.001). Hierarchical multiple regression analysis with IBS symptoms and work productivity as dependent variables revealed a significant effect of the interaction between maladaptive cognition related to abdominal symptoms and job control on IBS symptoms (ß=-0.164, p=0.002). The association between maladaptive cognition and IBS symptoms was more pronounced when job control was lower. Additionally, IBS symptoms (ß=0.130-0.214, p<0.05), maladaptive cognition (ß=0.196-0.233, p<0.01), and job overload (ß=0.106-0.108, p<0.05) significantly influenced work productivity. CONCLUSIONS: Maladaptive cognition regarding abdominal symptoms led to more severe abdominal symptoms in situations with a low sense of work control. Beyond cognitive-behavioral interventions for IBS, enhancing the sense of control over work environments is expected to contribute to alleviating abdominal symptoms and, consequently, enhancing work productivity.

Multifaceted ORganizational InterventiONs (M-ORION) project for prevention of depression and anxiety among workers: study protocol for a five-arm cluster randomized controlled trial.

BACKGROUND: Depression and anxiety are the most common mental health issues experienced by workers. Although organizational intervention has been extensively evaluated as a primary prevention of depression and anxiety, the corresponding scientific evidence remains limited because of the lack of cluster randomized controlled trials (cRCT) and failure to detect organizational-level effects. Therefore, the present study aims to assess the preventive effects of four types of interventions on depression and anxiety among workers in an open, five-arm, parallel-group cRCT. METHODS: Overall, 140 worksites and 18,200 nested employees will be recruited from September 2023. The eligible worksites will be randomly assigned to each of the five arms, and programs will be offered for 6-12 months. The five arms are 1) psychoeducation for workers, 2) psychoeducation for supervisors, 3) work environment improvement, 4) physical activity promotion, and 5) active control. The primary outcomes of interest are depression and anxiety. We will also assess psychosocial factors at work, work engagement, health-related quality of life, well-being, economic outcomes, physiological outcomes of health checkups, cortisol levels extracted from fingernails, and indices representing the process and implementation outcomes, including program completion rates. Follow-up surveys will be conducted at 6, 12, and 18 months from baseline, and the primary endpoint is set at the 6-month follow-up. Repeated-measures multi-level mixed modeling will be used to evaluate the effect of each intervention compared with the control. ETHICS AND DISSEMINATION: The study protocol was approved by the Research Ethics Committee of the Kitasato University Medical Ethics Organization (C22-082). The results and findings of this study will be published in a scientific journal and disseminated to companies that participate in the study. TRIAL REGISTRATION NUMBER: UMIN000050949.

Time-course changes in fingernail cortisol levels during pregnancy and postpartum.

The cortisol level in fingernails can reflect the cumulative hormones produced in the body several months prior. However, previous studies have only demonstrated the cross-sectional associations of fingernail cortisol with salivary or hair cortisol, and not longitudinal changes in fingernail cortisol in situations where cortisol levels in the body could be expected to change. Therefore, this study focused on pregnancy as a model for changes in cortisol levels over a prolonged period of time, and investigating the time courses of fingernail cortisol during pregnancy and the postpartum period. We collected nail samples from 30 healthy women during pregnancy and 12 months postpartum to measure the cortisol levels in the nail. Results showed that cortisol levels in fingernail clippings increased from 1 month before childbirth to 4 months postpartum, with the levels peaking at 2 months postpartum. Additionally, we found higher cortisol levels in fingernail clippings in primiparas than in those of multiparas. The time course of fingernail cortisol levels could replicate the longitudinal changes in cortisol in the body, and differences between multiparas and primiparas seemed to be biologically plausible, which could support the concept of fingernail cortisol as a retrospective index of hormone production.

Cross-sectional associations of weekly time, social context, and motivation of exercise with mental health among workers.

PURPOSE: Exercise is considered a strategy to promote mental health among workers. However, the optimal exercise conditions that promote mental health benefits for workers are still unclear. This study examined the cross-sectional associations of weekly exercise time duration, social context of exercise, and exercise motivation levels with the mental health among Japanese workers. METHODS: A web-based cross-sectional questionnaire survey was conducted among 18,902 workers, aged 20-59 years. The mental health variables (psychological distress, psychological stress reaction, physical stress reaction, job satisfaction, and work engagement), exercise participation (non-exercisers, exercisers), and demographic factors of all responders were measured. Weekly exercise time, social context of exercise (alone only, with others only, both alone and with others), and exercise motivation (non-regulation, external/introjected regulation, identified regulation, integrated regulation, and internal regulation) were also measured amongst exercisers. After adjusting for demographic factors, multiple regression analyses were conducted. RESULTS: Exercisers had significantly lower psychological distress, lower psychological and physical stress reactions, higher job satisfaction, and higher work engagement than non-exercisers. Among exercisers, while weekly exercise time duration and social context of exercise were not clearly and robustly associated with mental health variables, respondents with intrinsic regulation had significantly lower psychological distress, lower psychological and physical stress reaction, higher job satisfaction, and higher work engagement than those with lower self-determined motivations. CONCLUSIONS: This study found that more self-determined exercise motivation is closely associated with advantageous mental health variables, than the duration or the social context of exercise among Japanese workers.

Effects of work-related electronic communication during non-working hours after work from home and office on fatigue, psychomotor vigilance performance and actigraphic sleep: observational study on information technology workers.

OBJECTIVES: This study examined the effects of work-related electronic communication (WREC) during non-working hours in the work from home or office setting on health. METHODS: The study recruited 98 information technology workers in a 9-day observational study. They recorded work-life events (eg, work style (working mostly from home or the office) and duration of WREC during non-working hours) and subjective ratings (eg, current fatigue, sleepiness and depression) and wore a sleep actigraph to measure objective sleep variables before bedtime every day. They completed the Brief Psychomotor Vigilance Test (PVT-B) before bedtime for 4 days. RESULTS: The frequency of WREC was significantly higher when working mostly from home than in the office (p<0.01). In addition, the duration of WREC was longer when working mostly from home than in the office (p<0.001). Linear or generalised linear mixed model analysis for fatigue, depression and PVT lapse revealed significant interaction effects between work style and WREC (all p<0.05). Post hoc analysis showed that the longer the WREC, the worse the fatigue and depression and the lower the lapse on working mostly from the office (all p<0.05). CONCLUSIONS: Longer WREC is associated with worse fatigue and depression and lower lapse of PVT (higher alertness) before bedtime for working mostly from the office. Workers, especially those working from the office, should minimise WREC during non-working hours to maintain good health. Therefore, companies, managers and other relevant stakeholders should refrain from contacting workers during non-working hours.

Protocol for a web-based study on the work environment and daily lifestyle of Japanese employees.

Mental health problems are prevalent among the working population and must be resolved. We conducted a web-based large-scale study of workers, including a baseline survey and two follow-up surveys, to investigate the associations between self-care behaviors in daily life (e.g., stress coping, sleep, diet, and exercise), work environment improvements, and mental health among Japanese employees from various industries. In this protocol, we demonstrate the study design and demographic data of the participants in the baseline survey. Invitations to participate in this study were sent to 421,825 internet monitor registrants in February 2022. Overall, 20,000 registrants who met the inclusion criteria participated in the survey. There were large variations in occupations and working styles (e.g., physical work, night work, and teleworking) among the participants, and we also found significant differences between male and female participants in the demographic data. An overview of the survey data suggests that the demographic characteristics of the participants in this study are comparable to those reported in previous studies on Japanese employees. We plan to use these survey data in the future to examine the associations of daily lifestyles and work environments with the mental health of Japanese employees.

Blunted diurnal interleukin-6 rhythm is associated with amygdala emotional hyporeactivity and depression: a modulating role of gene-stressor interactions.

Background: The immune system has major roles in the brain and related psychopathology. Disrupted interleukin-6 secretion and aberrant amygdala emotional reactivity are well-documented in stress-related mental disorders. The amygdala regulates psychosocial stress-related interleukin-6 affected by related genes. These led us to comprehensively examine the relationship between interleukin-6, amygdala activity, and stress-related mental symptoms under gene-stressor interactions. Methods: One hundred eight nonclinical participants with various levels of anxiety/depression underwent magnetic resonance imaging scans during an emotional face task for amygdala activity and saliva collection (at 10-time points across 2 days) for the total output and diurnal patterns of interleukin-6. Gene-stressor interactions between rs1800796 (C/G) and rs2228145 (C/A) and stressful life events for the biobehavioral measures were explored. Results: The blunting of interleukin-6 diurnal pattern was associated with hypoactivation of the basolateral amygdala in response to fearful (vs. neutral) faces (t = 3.67, FWE-corrected p = 0.003), and was predominantly observed in individuals with rs1800796 C-allele homozygotes and negative life changes in the past year (F = 19.71, p < 0.001). When considered in a comprehensive model, the diminished diurnal pattern predicted greater depressive symptoms (ß = -0.40), modulated by the amygdala hypoactivity (ß = 0.36) and rs1800796-stressor interactions (ß = -0.41; all p < 0.001). Conclusion: Here we show that the blunted interleukin-6 diurnal rhythm predicts depressive symptoms, modulated by amygdala emotional hyporeactivity and gene-stressor interactions. These findings indicate a potential mechanism underlying vulnerability to depressive disorders, suggesting their early detection, prevention, and treatment through the understanding of immune system dysregulation.

Impaired self-monitoring ability on reaction times of psychomotor vigilance task of nurses after a night shift.

The cognitive ability to self-monitor one's current performance is important for hospital nurses to maintain safety and health. However, studies on the effects of rotating shift work on self-monitoring ability are insufficient. We examined the differences in self-monitoring accuracy across shifts in a rotating three-shift system among 30 female ward nurses (mean age 28.2 years). Their self-monitoring ability was calculated by subtracting the predicted reaction times of the psychomotor vigilance task performed just before exiting the workplace from the actual reaction times. A mixed-effect model was employed to assess the effects of shift, awake hours, and prior sleep duration on self-monitoring ability. We observed impaired self-monitoring ability in nurses, particularly after the night shift. Although actual performance remained high across all shifts, their self-predictions on reaction times became pessimistic in the night shift, resulting in a difference of approximately-100 msec. The effect of the shift on self-monitoring was obvious even after adjusting for sleep duration and hours awake. Our findings indicate that the misalignment between their working hours and circadian rhythms may affect even professional nurses. Occupational management that emphasizes maintaining circadian rhythms will improve the safety and health of nurses.

Shift-Work Schedule Intervention for Extending Restart Breaks after Consecutive Night Shifts: A Non-randomized Controlled Cross-Over Study.

More knowledge is required to determine the optimal shiftwork schedule to reduce the harmful effects of short restart breaks between shifts. This 5-month intervention study aimed to examine the effectiveness of extended restart breaks from 31 h to 55 h after consecutive night shifts by considering the characteristics of the circadian rhythm to mitigate fatigue and sleep among 30 shift-working nurses. Subjective and objective variables, such as vital exhaustion, distress, hair cortisol, salivary C-reactive protein, and sleep mattress sensor sensation, were repeatedly measured to examine the differences between the intervention and control conditions. Two-way (condition × time) multilevel analyses showed significantly lower levels of vital exhaustion and distress in the intervention condition (p = 0.005 and p = 0.004, respectively). However, the expected benefit of the intervention was not observed in objectively measured variables. These findings suggested that an extended restart break after consecutive night shifts can moderately decrease occupational fatigue and stress.

The Joint Association of Daily Rest Periods and Sleep Duration with Worker Health and Productivity: A Cross-Sectional Web Survey of Japanese Daytime Workers.

A daily rest period (DRP) is a daily inter-work interval that contains sleep opportunity. This study investigates the joint association of DRP and sleep duration with worker health and productivity. A total of 13,306 Japanese daytime workers participated in this web-based cross-sectional survey. Participants reported on their DRPs and sleep duration; moreover, sleep difficulties, mental health, and presenteeism were assessed by the standardized questionnaires. The participants were divided into 10 groups based on their DRPs and sleep duration. Logistic regression analyses showed that the combination of quick return (QR: DRP of <11 h) and short sleep duration (<6 h) was found to be significantly associated with sleep difficulties (odds ratio [OR] = 4.45, 95% confidence interval [CI] = 2.83-7.01), poor mental health (OR = 3.04, 95% CI = 1.79-5.15), and presenteeism (OR = 2.35, 95% CI = 1.47-3.77) compared with the reference group (the combination of adequate DRP [15 h] and a normal sleep duration [≥6 h]). The combination of QR and normal sleep duration or adequate DRP and short sleep duration was significantly associated with high ORs for the outcomes. QR, short sleep duration, or both negatively affect worker health and productivity.

Conversation time and mental health during the COVID-19 pandemic: A web-based cross-sectional survey of Japanese employees.

OBJECTIVE: During the Coronavirus disease 2019 (COVID-19) pandemic, social isolation and impaired social interaction could be the factors that cause mental health problems. This study investigated the association between conversation time in daily life and mental health among Japanese employees. METHODS: In August 2021, a web-based cross-sectional survey was conducted with 1000 Japanese employees. Weekly conversation time was assessed in four domains (family members, friends, someone in the workplace, and others), and mental health was assessed using the Japanese version of the Kessler Psychological Distress Scale (K6 scale). Weekly total conversation time was calculated, and participants were assigned to one of the four conversation time categories based on quantile values to investigate the associations with poor mental health (K6 ≥ 13). RESULTS: The logistic regression analyses revealed that participants with short conversation times (<3.5 h per week) had poorer mental health compared to those with long conversation times (> 21.0 h per week), even after adjusting for confounders (OR = 2.48 [95% CI 1.31-4.71]). For the exploratory analyses of conversation time for each domain, the associations of short conversation time in the workplace with poor mental health was most robust (OR =2.02 [95% CI 1.13-3.63]). CONCLUSIONS: Japanese employees with conversation time of <3.5 h per week (i.e., 30 min per day) had poor mental health. During the COVID-19 pandemic, people have largely limited opportunities to have conversations with others, but a certain level of conversation time might be required to maintain mental health.

Association of childhood maltreatment history with salivary interleukin-6 diurnal patterns and C-reactive protein in healthy adults.

Childhood maltreatment has been associated with increased inflammation, as indicated by elevated levels of proinflammatory markers such as interleukin-6 (IL-6) and C-reactive protein (CRP). Studies in humans show that secretion of IL-6 follows a clear circadian rhythm, implying that its disturbed rhythm represents an important aspect of dysregulated inflammatory system. However, possible alterations in diurnal secretion patterns of IL-6 associated with childhood maltreatment have not been studied. Here we investigated this association in 116 healthy adults. Diurnal levels of IL-6 were examined using saliva samples collected at 5 times a day across 2 consecutive days. Salivary CRP levels were also determined by averaging measurements at 2 times a day for 2 days. Different types of childhood maltreatment were assessed with the Childhood Trauma Questionnaire (CTQ). CTQ total and emotional abuse scores were significantly correlated with smaller IL-6 diurnal variation as indexed by lower standard deviation across the measurement times (p = 0.024 and p = 0.008, respectively). Individuals with emotional abuse, as defined by a cut-off score of CTQ, showed flatter IL-6 rhythm than those without (p = 0.031). These results, both correlation and group comparison, remained significant after controlling for age, sex, and body mass index. Childhood maltreatment was not associated with total output of IL-6 or CRP. Our findings indicate that childhood trauma can have a long-term negative effect on the circadian rhythm of inflammatory system. The findings are consistent with those of previous studies on adulthood trauma, suggesting that the disrupted IL-6 rhythmicity may be associated with a broad range of trauma-related conditions.

Effects of short sleep duration on hemodynamic and psychological responses under long working hours in healthy middle-aged men: an experimental study.

This study examined the effects of short sleep duration (SSD) on hemodynamic and psychological responses under long working hours (LWH) in a laboratory experiment. Sixteen subjects participated in a crossover design experiment consisting of two conditions: normal (7-hours) sleep and short (5-hours) sleep. In each condition, participants engaged in simulated LWH (13 hours a day), comprising 12 task sessions. Hemodynamic and psychological responses were measured in each session. Results showed that there were significant main effects of condition and session but no interaction for hemodynamic and psychological responses. Systolic blood pressure and fatigue were higher in the later sessions than the first one. Stroke volume, sleepiness, fatigue, and stress were higher in the 5-hour than the 7-hour sleep condition (all p<0.05). These results suggest that although the combined effect of LWH and SSD was not significant, both LWH and SSD caused a hemodynamic and psychological burden.

Implicit and explicit emotional memory recall in anxiety and depression: Role of basolateral amygdala and cortisol-norepinephrine interaction.

Anxiety and depression are linked to both explicit and implicit memory biases, which are defined as the tendency to preferentially recall emotionally negative information at conscious and subconscious levels, respectively. Functional connectivity (FC) of the basolateral amygdala (BLA) and related stress hormones (i.e., cortisol and norepinephrine) are purportedly implicated in these biases. However, previous findings on memory biases in anxiety and depression have been inconsistent, likely due to their symptomatic complications. Therefore, the underlying neurobiological mechanism remains unclear. We thus investigated whether anxiety and depression as premorbid predispositions are related to the memory biases, and whether FC of BLA, cortisol, and 3-methoxy-4-hydroxyphenylglycol (MHPG: a major metabolite of norepinephrine) would affect the anxiety/depression-related biased memory recall in 100 participants without psychiatric symptomatology. Psycho-behavioral assessment, resting-state fMRI scans, and saliva collection at 10-points-in-time across two days were conducted. Correlations of memory biases with anxiety/depression and neurobiological markers were explored. As a result, neither anxiety nor depression were correlated with explicit memory bias to negative (vs. positive) information, although depression was associated with better recall of the negative stimuli only when they were perceived as self-relevant. In contrast, both anxiety and depression were correlated with implicit memory bias; however, the effects were solely explained by anxiety. Furthermore, FC of the BLA with subgenual anterior cingulate cortex (sgACC) and the synergetic effect of cortisol and MHPG uniquely affected the implicit memory bias. These findings suggest that anxiety facilitates an initial snapshot of negative information and can be accompanied by depression when the information creates negative semantic associations with the self. The BLA-sgACC neural connectivity and cortisol-norepinephrine interaction that are associated with the implicit memory bias might be one of the important neurobiological targets in the prevention and treatment for comorbid anxiety and depressive disorders.

[Characteristics of compensated mental disorders caused by overwork among drivers and non-drivers in the Japanese trucking industry].

OBJECTIVES: This study examined the characteristics of occupational mental disorders among those involved in the transport and postal activities in the trucking industry. METHOD: We examined 237 out of 3,517 cases of occupational mental disorders, compensated between the fiscal years 2010 and 2017. An assessment was made for sex, "life-or-death" status at compensation, age at the onset and suicide, the diagnosis according to the International Classification of Diseases, Tenth Revision, and other factors regarding occupational compensation. The participants were divided into two groups: truck drivers and non-truck drivers. RESULTS: Men accounted for approximately 90% of the cases. Depressive episode (F32) was the most common diagnosis in drivers and non-drivers, thus constituting 65 out of 149 and 48 out of 88 cases, respectively. The next most common type of mental disorder was adjustment disorders (F43.2), with 34 out of 149 drivers and 24 out of 88 non-drivers reporting them. Furthermore, the majority of drivers that had posttraumatic stress disorder (24 out of 27 cases) reported that they "suffered a serious illness or injury" and "experienced or witnessed a terrible accident or disaster." Occupational disasters due to long working hours were 52.4% for drivers and 73.9% for non-drivers. A total of 30.8% of the drivers reported working long hours since they joined the company. CONCLUSION: Drivers' long working hours entail waiting at the origin and cargo destination site, handling cargo, and incidental tasks other than driving. Thus, the reduction in work hours regarding these tasks needs to be a fundamental goal, and measures that include mental health care for accidents and miserable experiences must be implemented. However, long working hours for non-drivers are likely linked to job expansion/increase and reassignment/relocation. These findings highlight that to prevent overwork-related mental disorders, appropriate actions should be taken considering different sources of exposure for drivers or non-drivers.

[Examining the association between work-life factors and health disorders/excessive fatigue among Japanese truck drivers].

OBJECTIVES: Karoshi problems (overwork-related deaths and disorders caused by cerebrovascular and cardiovascular diseases) still occur in Japan. Truck drivers, who are in one of the riskiest occupations, are reported to show an increased prevalence of hypertension, obesity, hyperlipidemia, and diabetes, which are characteristic of Karoshi. Their health problems also include excessive fatigue. This cross-sectional study aimed to examine the association between work-life factors and health disorders/excessive fatigue among Japanese truck drivers. METHODS: We distributed a questionnaire regarding work hours, health status, lifestyle, burden of driving, and excessive fatigue to 5,410 truck drivers and collected a total of 1,947 responses, all from males. The association between work-life factors and health outcomes was evaluated by multivariable logistic regression analysis adjusted for age, drinking, and smoking status. RESULTS: The prevalence rates of obesity, hypertension, hyperlipidemia, diabetes, cardiovascular disease, cerebrovascular disease, and excessive fatigue were 22.2%, 19.3%, 8.5%, 5.6%, 2.5%, 0.7%, and 6.0%, respectively. Significant associations were observed for long-haul trips (two days or more) with obesity (adjusted odds ratio 1.5 [95% Confidence Interval 1.1-2.1]), local and night trips with hypertension (1.5 [1.0-2.2]), early morning awakening on workdays with obesity (1.5 [1.1-2.1]), being indoor-oriented on weekends with hypertension (1.5 [1.1-2.0]); and heavy burden of driving at night with hyperlipidemia (2.0 [1.3-3.0]). The adjusted odds ratios were significant for waking after sleep onset (2.6 [1.2-5.3]) and lack of sleep satisfaction (2.7 [1.4-5.1]) on workdays, less than six hours of sleep (2.8 [1.0-7.8]) and lack of sleep satisfaction (2.8 [1.5-5.2]) on weekends, 0-3 days off per month (3.6 [1.3-10.2]), and heavy burden of driving at night (2.2 [1.0-4.8]) with excessive fatigue. CONCLUSIONS: The present findings highlight that night and early morning work, heavy burden of night driving, and the resultant decreases in the quality and quantity of sleep may represent shared risk factors for health disorders and excessive fatigue among truck drivers. Adequate measures should be taken to limit the amount of night and early morning work, reduce the burden of night driving, and ensure days off for sleep opportunities and leisure activities, with the goal of preventing Karoshi.

Work e-mail after hours and off-job duration and their association with psychological detachment, actigraphic sleep, and saliva cortisol: A 1-month observational study for information technology employees.

OBJECTIVE: A sufficient duration of time off after work is necessary to ensure workers' health. Better quality of off-job time can also facilitate recovery from fatigue, but its quantitative influence is largely unknown. We aimed to examine how off-job time quality (as measured by the frequency of emailing after work), and off-job duration is associated with psychological detachment, actigraphic sleep, and saliva cortisol using a 1-month observational study. METHODS: The participants were 58 daytime employees working at an information technology company. Sleep actigraphy and saliva cortisol as well as self-reported outcomes were repeatedly measured for 1 month. Two-way (work e-mail frequency × off-job time) multilevel mixed-effects linear regression analyses were performed in both continuous and categorical variables. RESULTS: The frequency of work e-mailing after hours was significantly associated with self-reported outcomes and actigraphic sleep quality, while a significant association was not found in cortisol awakening responses and actigraphic sleep duration. A significantly larger cortisol response after awakening was found in shorter, rather than longer, durations of off-job time. Self-reported detachment, rumination and carry-over fatigue showed significant interactions between work e-mail and off-job time, suggesting that worse outcomes were found in a higher frequency of work e-mail even when employees had longer amounts of off-job time. CONCLUSION: Our findings suggest that ensuring the quality and duration of off-job time is beneficial for recovery from work with sufficient sleep. Specifically, the frequency of e-mailing after work should be minimized to make recovery complete.

A validation study on fingernail cortisol: correlations with one-month cortisol levels estimated by hair and saliva samples.

Several studies have focused on the cortisol levels in fingernail samples as a possible index of cumulative hormone production; however, the biological validity of fingernail cortisol has not been fully established. We investigated the association between cortisol levels in fingernail samples and other biological specimens, including hair and saliva samples, in healthy young adults to determine whether fingernail cortisol was associated with past cumulative hormone production. Participants were 23 adults (14 men and 9 women; mean age = 22.7 ± 2.8 years). Saliva samples were collected three times per day for 30 days, and hair samples (1 cm) from participants' scalps were obtained. Fingernail samples were repeatedly collected for 8 months, considering growth rate of fingernail and time lag for fingernails to fully extend from the nail matrix. Cortisol levels in hair samples were significantly associated with the levels in fingernail samples that were obtained 3 months after hair collection (r = .48, p < .05). The 30-day integrated area under the curve, based on salivary cortisol levels at awakening and bedtime, were significantly associated with cortisol levels in fingernail samples that were collected 2-5 months after saliva collection. This finding was especially significant after adjusting for the awakening time when the saliva was collected. This study provided evidence that fingernail cortisol was associated with cumulative hormone levels measured several months before but not those in the present. The samples may be useful for endocrinological evaluation in the investigation of chronic stress, cortisol levels, and health; moreover, the use of fingernail samples would permit larger-scale studies.

Childhood trauma affects autobiographical memory deficits through basal cortisol and prefrontal-extrastriate functional connectivity.

BACKGROUND: Psychological trauma can damage the brain, especially in areas where glucocorticoid receptors are expressed, via perturbed secretion of cortisol. Childhood trauma is associated with blunted basal cortisol secretion, brain alterations, and autobiographical memory deficits referred to as overgeneral autobiographical memory (OGM). However, it remains unknown whether childhood trauma affects OGM through altered cortisol and brain alterations. METHODS: Using resting-state fMRI in 100 healthy humans, we examined whether childhood trauma affects OGM through its related basal cortisol and brain functional connectivity (FC). Trauma and OGM were assessed using the Childhood Trauma Questionnaire (CTQ) and Autobiographical Memory Test (AMT), respectively. Basal cortisol levels were measured by 10 points-in-time across two days. Multiple mediation analysis was employed. RESULTS: CTQ was associated with greater semantic-associate memory of OGM, a retrieval tendency toward semantic content with no specific contextual details of an experienced event, as well as blunted basal cortisol levels. While CTQ was correlated with decreased FC between the hippocampus and medial prefrontal cortex (PFC), it showed a more predominant correlation with increased FC between the lateral and anteromedial PFC and extrastriate cortex. Importantly, the increased prefrontal-extrastriate FC completely mediated the relationship between CTQ and semantic-associate memory, affected by hyposecretion of cortisol. CONCLUSION: Childhood trauma may lead to the lack of visuoperceptual contextual details in autobiographical memory by altering basal cortisol secretion and connectivity of the prefrontal-hippocampal-extrastriate regions. The intensified prefrontal-extrastriate connectivity may contribute to OGM formation by strengthening the semantic content in memory retrieval. Understanding the mechanisms underlying the trauma-cortisol-brain-memory link will provide important clinical implications for trauma-related mental disorders.

Shorter sleep duration is associated with potential risks for overwork-related death among Japanese truck drivers: use of the Karoshi prodromes from worker's compensation cases.

PURPOSE: We aimed to cross-sectionally investigate how work and sleep conditions could be associated with excessive fatigue symptoms as an early sign of Karoshi (overwork-related cerebrovascular and cardiovascular diseases; CCVDs). METHODS: We distributed a questionnaire regarding work, sleep, and excessive fatigue symptoms to 5410 truck drivers, as the riskiest occupation for overwork-related CCVDs, and collected 1992 total samples (response rate: 36.8%). The research team collected 1564 investigation reports required for compensation for Karoshi. Of them, 190 reports listed the prodromes of Karoshi, which were used to develop the new excessive fatigue symptoms inventory. RESULTS: One-way analyses of variance showed that the excessive fatigue symptoms differed significantly by monthly overtime hours (p < 0.001), daily working time (p < 0.001), work schedule (p = 0.025), waiting time on-site (p = 0.049), number of night shifts (p = 0.011), and sleep duration on workdays (p < 0.001). Multivariate mixed-model regression analyses revealed shorter sleep duration as the most effective parameter for predicting excessive fatigue symptoms. Multiple logistic regression analysis confirmed that the occurrences of CCVDs were significantly higher in the middle [adjusted ORs = 3.56 (1.28-9.94)] and high-score groups [3.55 (1.24-10.21)] than in the low-score group. CONCLUSION: The findings suggested that shorter sleep duration was associated more closely with a marked increase in fatigue, as compared with the other work and sleep factors. Hence, ensuring sleep opportunities could be targeted for reducing the potential risks of Karoshi among truck drivers.