scholarly journals Cognitive/affective and somatic/affective symptoms of depression in patients with heart disease and their association with cardiovascular prognosis: a meta-analysis

2014 ◽  
Vol 44 (13) ◽  
pp. 2689-2703 ◽  
Author(s):  
R. de Miranda Azevedo ◽  
A. M. Roest ◽  
P. W. Hoen ◽  
P. de Jonge

BackgroundSeveral prospective longitudinal studies have suggested that somatic/affective depressive symptoms, but not cognitive/affective depressive symptoms, are related to prognosis in patients with heart disease, but findings have been inconsistent. The aim of this study was to investigate the association of cognitive/affective and somatic/affective symptoms of depression with cardiovascular prognosis in patients with heart disease using a meta-analytic perspective.MethodA systematic search was performed in PubMed, EMBASE and PsycInfo. Thirteen prospective studies on symptom dimensions of depression and cardiovascular prognosis fulfilled the inclusion criteria, providing data on a total of 11 128 subjects. The risk estimates for each dimension of depressive symptoms, demographic and methodological variables were extracted from the included articles.ResultsIn least-adjusted analyses, both the somatic/affective [hazard ratio (HR) 1.30, 95% confidence interval (CI) 1.19–1.41, p < 0.001] and cognitive/affective (HR 1.07, 95% CI 1.00–1.15, p = 0.05) dimensions of depressive symptoms were associated with cardiovascular prognosis. In fully adjusted analyses, somatic/affective symptoms were significantly associated with adverse prognosis (HR 1.19, 95% CI 1.10–1.29, p < 0.001) but cognitive/affective symptoms were not (HR 1.04, 95% CI 0.97–1.12, p = 0.25). An increase of one standard deviation (±1 s.d.) in the scores of the somatic/affective dimension was associated with a 32% increased risk of adverse outcomes (HR 1.32, 95% CI 1.17–1.48, p < 0.001).ConclusionsSomatic/affective depressive symptoms were more strongly and consistently associated with mortality and cardiovascular events in patients with heart disease compared with cognitive/affective symptoms. Future research should focus on the mechanisms by which somatic/affective depressive symptoms may affect cardiovascular prognosis.

2015 ◽  
Vol 23 (2) ◽  
pp. 208-215 ◽  
Author(s):  
Carina Aparecida Marosti Dessotte ◽  
Fernanda Souza Silva ◽  
Rejane Kiyomi Furuya ◽  
Marcia Aparecida Ciol ◽  
Jeanne Marie Hoffman ◽  
...  

OBJECTIVE: this study investigated the association of somatic and cognitive-affective symptoms with sex and age, among patients hospitalized with heart disease. METHOD: this study was a secondary analysis of two previous observational studies totaling 531 patients with heart disease, hospitalized from 2005 to 2011 in two public hospitals in Ribeirão Preto, state of São Paulo, Brazil. Somatic and cognitive-affective symptoms were assessed using the subscales of the Beck Depression Inventory - I (BDI-I). RESULTS: of 531 participants, 62.7% were male, with a mean age 57.3 years (SD= 13.0) for males and 56.2 years (SD= 12.1) for females. Analyses of variance showed an effect of sex (p<0.001 for somatic and p=0.005 for cognitive-affective symptoms), but no effect of age. Women presented with higher mean values than men in both BDI-I subscales: 7.1 (4.5) vs. 5.4 (4.3) for somatic, and 8.3 (7.9) vs. 6.7 (7.2) for cognitive-affective symptoms. There were no differences by age for somatic (p=0.84) or cognitive-affective symptoms (p=0.84). CONCLUSION: women hospitalized with heart disease had more somatic and cognitive-affective symptoms than men. We found no association of somatic and cognitive-affective symptoms with age. Future research for these patients could reveal whether these differences according to sex continue throughout the rehabilitation process.


2021 ◽  
pp. svn-2020-000693
Author(s):  
Yanan Qiao ◽  
Siyuan Liu ◽  
Guochen Li ◽  
Yanqiang Lu ◽  
Ying Wu ◽  
...  

Background and purposeThe role of depression in the development and outcome of cardiometabolic diseases remains to be clarified. We aimed to examine the extent to which depressive symptoms affect the transitions from healthy to diabetes, stroke, heart disease and subsequent all-cause mortality in a middle-aged and elderly European population.MethodsA total of 78 212 individuals aged ≥50 years from the Survey of Health Ageing and Retirement in Europe were included. Participants with any baseline cardiometabolic diseases including diabetes, stroke and heart disease were excluded. Depressive symptoms were measured by the Euro-Depression scale at baseline. Participants were followed up to determine the occurrence of cardiometabolic diseases and all-cause mortality. We used multistate models to estimate the transition-specific HRs and 95% CIs after adjustment of confounders.ResultsDuring 500 711 person-years of follow-up, 4742 participants developed diabetes, 2173 had stroke, 5487 developed heart disease and 7182 died. Depressive symptoms were significantly associated with transitions from healthy to diabetes (HR: 1.12, 95% CI: 1.05 to 1.20), stroke (HR: 1.31, 95% CI: 1.18 to 1.44), heart disease (HR: 1.26, 95% CI: 1.18 to 1.34) and all-cause mortality (HR: 1.41, 95% CI: 1.34 to 1.49). After cardiometabolic diseases, depressive symptoms were associated with the increased risk of all-cause mortality in patients with diabetes (HR: 1.54, 95% CI: 1.25 to 1.89), patients who had stroke (HR: 1.29, 95% CI: 1.03 to 1.61) and patients with heart disease (HR: 1.21, 95% CI: 1.02 to 1.44).ConclusionsDepressive symptoms increase the risk of diabetes, stroke and heart disease, and affect the risk of mortality after the onset of these cardiometabolic conditions. Screening and treatment of depressive symptoms may have profound implications for the prevention and prognosis of cardiometabolic diseases.


2021 ◽  
Author(s):  
Benjamin W Nelson

Self-injurious thoughts and behaviors (SITB) increase dramatically across adolescence. Despite the prevalence and severity of these outcomes, remarkably little research has elucidated why adolescence represents a particularly high-risk period for the emergence of SITB. Recent theoretical models have posited that SITB may result from failures in biological stress regulation in the context of social stress. However, there is a lack of data examining these associations during the transition to adolescence, a sensitive period of development that is characterized by changes across socio-affective and psychophysiological domains that may interact to heighten risk for SITB. The present study used a prospective longitudinal design among 147 adolescents. We built on advantages offered by the RDoC framework to test the interaction of experiences of social conflict (i.e., parent and peer conflict) with cardiac arousal (i.e., resting heart rate) to predict adolescent non-suicidal self-injury (NSSI) and suicidal ideation (SI) across one year. Longitudinal analyses revealed that while neither greater peer conflict nor higher cardiac arousal at baseline were associated with SITB outcomes at follow-up, adolescents experiencing the combination of greater peer conflict and higher cardiac arousal at baseline showed significant longitudinal increases in NSSI at follow-up. In addition, there were null effects for family conflict and SI outcomes. Findings indicate that youth with greater peer conflict and heightened arousal during the transition to adolescence may be at increased risk for NSSI. Future research should examine these processes at finer timescales in order to elucidate whether these factors are proximal predictors of within-day SITB.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jennifer L Smith ◽  
Misook L Chung ◽  
Jennifer Miller ◽  
Martha J Biddle ◽  
Donna Schuman ◽  
...  

Introduction: Caregivers have an 82% increased risk of cardiovascular disease (CVD) compared to non-caregivers. Depressive symptoms (DS) and anxiety increase CVD risk, and these are worse in rural dwellers. Knowing predictors of DS and anxiety in rural caregivers of patients with chronic illness is important to reduce CVD risk. Purpose: To identify predictors of DS and anxiety in rural caregivers at risk for CVD using a social determinants of health (SDH) model. Method: In this cross-sectional study we measured multiple SDH. These variables included sociodemographic (i.e., age, gender, race, marital status, health insurance, education, financial status), behavioral (i.e., smoking and body mass index [BMI]), and psychosocial (i.e., caregiver burden measured by the Zarit Burden Interview, perceived stress by the Cohen Perceived Stress Scale, and social support by the Medical Outcomes Study Social Support Survey) factors. The outcomes of DS were measured by the Patient Health Questionnaire-9 and anxiety by the Brief Symptom Inventory – Anxiety subscale. Data were analyzed using two separate multiple regression models, one for DS and one for anxiety. As depression and anxiety are often comorbid, they were considered predictors in the appropriate models. Results: In the 262 participants (mean age 53±13, 78% female, 96% Caucasian, 70% were married), mean years of education were 14±2, 56.1% had enough money to make ends meet, and 55% had no insurance or Medicaid only. Significant predictors of worse DS were higher caregiver burden (β=0.05, p=0.004), higher perceived stress (β=2.04, p=0.001), and higher anxiety (β=3.79, p= <0.001). Predictors of worse anxiety, were younger age (β=-0.006, p=0.03), higher caregiver burden (β=0.006, p=0.009), lower social support (β=-0.004, p=0.05), and higher DS (β=0.08, p=<0.001). Conclusion: Predictors of DS and anxiety in these rural caregivers were psychosocial variables. Caregiver CVD Interventions could be optimized by including stress management, education about the psychological effects of caregiving, and social support components. Future research is needed on the role of DS and anxiety in CVD to better support rural caregivers at highest risk.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
B. Van den Bergh ◽  
B. Van Calster ◽  
T. Smits ◽  
S. Van Huffel ◽  
A. Simons ◽  
...  

Early-life exposure to adverse environmental cues during critical windows of time in the prenatal and/or early postnatal life period could predispose the individual for somatic andmental diseases. This especially holds for stress-related disorders such as depression in which HPA-axis dysregulation plays a pathophysiological role. This is in line with the ‘fetal (or developmental) programming-hypothesis’ which has been tested in numerous preclinical experimental. We tested this hypothesis in humans in a prospective longitudinal study in which maternal emotional state was measured during each pregnancy trimester and after pregnancy. When the offspring was 14-15 years old, HPA-axis function was measured through establishing a saliva day-time cortisol profile. Severity of depressive symptoms was measured with the Children's Depression Inventory. Repeated measurements regression analysis and ordinary least-squares regression analyses indicated that maternal anxiety at 12-22 weeks of pregnancy was in female and male offspring associated with a diurnal cortisol profile that was attenuated due to elevated cortisol secretion in the evening. Moreover, in female adolescents this flattened cortisol curve was associated with depressive symptoms. Our results indicate that maternal anxiety during pregnancy enhances neurobiological vulnerability to depressive symptoms, possibly by altering (or ‘programming") foetal physiology. If our results can be replicated in future research they may lead to a re-orientation of the target of primary prevention and treatment of depressive symptoms. Preliminary results of a study on the association between prenatal exposure to maternal anxiety and cortisol stress responsivity during inoculation in the four month old will be presented.


2011 ◽  
Vol 42 (1) ◽  
pp. 51-60 ◽  
Author(s):  
S. Bekke-Hansen ◽  
M. Trockel ◽  
M. M. Burg ◽  
C. Barr Taylor

BackgroundDepression following myocardial infarction (MI) independently increases risk for early cardiac morbidity and mortality. Studies suggest that somatic, but not cognitive, depressive symptoms are responsible for the increased risk. However, the effects of somatic depressive symptoms at follow-up, after sufficient time has elapsed to allow for physical recovery from the initial infarction, are not known. Our aim was to examine the relationship between cognitive and somatic depressive symptom dimensions at baseline and 12 months post-MI and subsequent mortality and cardiovascular morbidity.MethodPatients were 2442 depressed and/or socially isolated men and women with acute MI included in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial. We used principal components analysis (PCA) of the Beck Depression Inventory (BDI) items to derive subscales measuring cognitive and somatic depressive symptom dimensions, and Cox regression with Bonferroni correction for multiple testing to examine the contribution of these dimensions to all-cause mortality, cardiovascular mortality, and first recurrent non-fatal MI.ResultsAfter adjusting for medical co-morbidity and Bonferroni correction, the somatic depressive symptom dimension assessed proximately following MI did not significantly predict any endpoints. At 12 months post-MI, however, this dimension independently predicted subsequent all-cause [hazard ratio (HR) 1.43, 95% confidence interval (CI) 1.13–1.81] and cardiovascular mortality (HR 1.60, 95% CI 1.17–2.18). No significant associations were found between the cognitive depressive symptom dimension and any endpoints after Bonferroni correction.ConclusionsSomatic symptoms of depression at 12 months post-MI in patients at increased psychosocial risk predicted subsequent mortality. Psychosocial interventions aimed at improving cardiac prognosis may be enhanced by targeting somatic depressive symptoms, with particular attention to somatic symptom severity at 12 months post-MI.


2020 ◽  
Vol 11 (2) ◽  
pp. 62-70
Author(s):  
A. O. Lobe ◽  
D. N. Ivanchenko ◽  
N. P. Dorofeeva ◽  
L. P. Sizyakina ◽  
M. V. Kharitonova ◽  
...  

Objective: to investigate the adipokine profile’s changes, depending on the presence or absence the signs of psychoemotional disorders in the form of associated affective symptoms in patients with stable coronary heart disease (CHD) without diagnosed carbohydrate metabolism’s disorders undergoing routine percutaneous coronary intervention (PCI) with stenting, and also to assess their relationship with clinical outcomes within 1 year after hospitalization.Materials and methods: the study included 20 male patients with stable angina pectoris of functional classes II – III, hospitalized for coronary stenting. The severity of affective symptoms were being assessed. The levels markers of adiponectin, leptin, resistin in the blood plasma were determined before PCI and on the 3rd day after the operation.Results: patients with stable coronary artery disease had increase in resistin concentrations and a decrease in adiponectin levels compared with reference. The change of psychoemotional status was accompanied by an initially more expressed increase in the concentrations of plasma resistin. The resistin’s level has been signifi cantly increased on the third day after PCI in patients without depressive symptoms. The dynamics of depressive symptoms hasn’t observed during the year. Clinically unfavorable outcomes, including stent’s restenosis, re-hospitalization, and the increase in angina attacks, were recorded more oft en in patients with subclinical symptoms of depression that persisted throughout the observation period.Conclusions: the factors that negatively aff ected the cardiac prognosis were the disorders of the psychoemotional status and adipokine’s changes, including аn increasе of resistin’s and a decrease of adiponectin’s levels.


2012 ◽  
Vol 200 (4) ◽  
pp. 324-329 ◽  
Author(s):  
Annelieke M. Roest ◽  
Marij Zuidersma ◽  
Peter de Jonge

BackgroundFew studies have addressed the relationship between generalised anxiety disorder and cardiovascular prognosis using a diagnostic interview.AimsTo assess the association between generalised anxiety disorder and adverse outcomes in patients with myocardial infarction.MethodPatients with acute myocardial infarction (n = 438) were recruited between 1997 and 2000 and were followed up until 2007. Current generalised anxiety disorder and post-myocardial infarction depression were assessed with the Composite International Diagnostic Interview. The end-point consisted of all-cause mortality and cardiovascular-related readmissions.ResultsDuring the follow-up period, 198 patients had an adverse event. Generalised anxiety disorder was associated with an increased rate of adverse events after adjustment for age and gender (hazard ratio: 1.94; 95% confidence interval: 1.14–3.30; P = 0.01). Additional adjustment for measures of cardiac disease severity and depression did not change the results.ConclusionsGeneralised anxiety disorder was associated with an almost twofold increased risk of adverse outcomes independent demographic and clinical variables and depression.


2015 ◽  
Vol 39 (5-6) ◽  
pp. 257-271 ◽  
Author(s):  
Trisha Chakrabarty ◽  
Amir A. Sepehry ◽  
Claudia Jacova ◽  
Ging-Yuek Robin Hsiung

Background: Depression is common in Alzheimer's and vascular dementia and is associated with poorer outcomes; however, less is known about the impact of depression on frontotemporal dementia (FTD). Here, we conducted a meta-analysis of diagnostic methods and the prevalence of depressive symptoms in FTD. Methods: PubMed, EMBASE and PsychINFO were queried for ‘depression' and/or ‘depressive mood' in behavioral- and language-variant FTD. The prevalence and diagnosis of depressive symptoms were extracted from relevant studies and the results pooled using a random-effects model. Results: We included 29 studies in this meta-analysis, with sample sizes ranging from 3 to 73 (n = 870). The omnibus estimated event rate of depressed mood was 0.334 (33%; 95% CI: 0.268-0.407). Symptoms were most commonly assessed via standardized neuropsychiatric rating scales, with other methods including subjective caregiver reports and chart reviews. The study results were heterogeneous due to the variability in diagnostic methods. Conclusions: Depressive symptoms similar to those in other dementias are commonly detected in FTD. However, the diagnostic methods are heterogeneous, and symptoms of depression often overlap with manifestations of FTD. Having a standardized diagnostic approach to depression in FTD will greatly facilitate future research in this area.


Author(s):  
Cody Sykes Gilbert ◽  
Mitch Earleywine ◽  
Maha N. Mian ◽  
Brianna R. Altman

AbstractBackgroundAyahuasca's effects on symptoms of depression have generated considerable optimism. Clients frequently report more concern about some symptoms than others, and available treatments alter symptoms differentially. Few studies address the symptom specificity of this psychoactive brew.AimsWe examined self-reported effects of ayahuasca on the individual symptoms of depression assessed by the 10-item short-form of Center for Epidemiological Studies of Depression (CESD-10).MethodsWe asked over 120 participants to complete a retrospective assessment of CESD-10 symptoms one month before and one month after using ayahuasca.ResultsParticipants indicated that ayahuasca had a larger influence on affective symptoms like hope, depressed mood, and happiness, than cognitive, interpersonal, and somatic symptoms like restless sleep, loneliness, and difficulty focusing.ConclusionsPotential clients might appreciate identifying if different treatments provide more relief for some depressive symptoms than others. We examined retrospective reports of ayahuasca's potential for differential impact. Those eager to alter hope, happiness, and other affective symptoms will likely find ayahuasca more helpful than those who want an intervention for restless sleep, loneliness, or trouble focusing. This symptom specificity parallels the effects of serotonergic antidepressant medications, suggesting that psychedelic-assisted psychotherapy using ayahuasca might have considerable appeal for those who seek comparable relief but would rather not use prescription serotonergic medications. Jumpstarting psychotherapy with the rapid onset of ayahuasca-induced relief also appears to have potential.


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