Article Summaries for April 2017 Psychosomatic Medicine, Volume 79, Issue 3

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Vital exhaustion (VE) has been identified as a potential independent psychological risk factor for incident and recurrent coronary heart disease (CHD). A meta-analysis by Friestad and Prescott reviewed and quantified its impact on the development and progression of (CHD). Thirteen prospective and 3 case-control studies reporting the association between VE and CHD outcomes were included. VE was associated with an increased risk of fatal and nonfatal CHD in healthy populations, and with an increased risk of recurrent events in patients with known CHD.
Pages 260–272;
In an accompanying editorial, Alan Rozanski and Randy Cohen discuss the findings in the context of other symptoms of negative affect that may combine with tiredness to produce increased cardiovascular disease risk. They emphasize the importance of improving vitality and the need to clarify biobehavioral mechanisms that play a role in the association between exhaustion and adverse CHD outcomes.
Pages 256–259;
Depression in medical patients has been associated with higher rates of mortality. Martin-Subero et al. evaluated a cohort of 803 medical inpatients and followed them up for 16.5 to 18 years. Depressive disorders as defined by both Patient Health Questionnaire (PHQ-9) and clinical interview were independent predictors of mortality, even after adjusting for several confounders. These results suggest that depression plays a significant role in long-term mortality outcomes of medical inpatients.
Pages 273–282;
Psychosocial resources such as mastery and social support predict health outcomes, and allostatic load is one potential mechanism. In a systematic review, Wiley et al. summarize the evidence for a relationship between psychosocial resources and allostatic load. Critical gaps in the literature include (1) inconsistent reporting of results and effect sizes to allow meaningful comparison or meta-analysis and (2) lack of longitudinal designs with resources predicting change in allostatic load.
Pages 283–292;
Study of the psychobiology of the stress response adds to knowledge of how psychosocial factors contribute to racial and ethnic health disparities. In a sample of healthy African Americans, Lucas et al. measured the coordination of autonomic, adrenocortical, and inflammatory stress systems in response to acute social stress. An interaction of racial identity and perceived discrimination were associated with specific patterns of the stress response.
Pages 293–305;
Woody et al. used a psychosocial stressor to test whether stress-induced decreases in vagally mediated, high-frequency heart rate variability (HF-HRV) predicted increases in circulating markers of inflammation. Greater stress-induced reductions in HF-HRV predicted greater increases in levels of inflammation 1 hour later. Evidence to date for the neural reflex of immunity in humans has relied on resting HF-HRV and inflammation. These findings may have implications for vagally mediated treatment of inflammatory diseases.
Pages 306–310;
Emotional stress, anger, depressed mood, and other psychological states can trigger acute myocardial infarction and sudden cardiac death in susceptible individuals. Mental stress–induced myocardial ischemia (MSIMI) is common in patients with coronary artery disease, but studies of its prognostic significance and underlying pathophysiology are limited. Hammadah et al. describe the prevalence and correlates of MSIMI from the Mental Stress Ischemia Prognosis Study, which is designed to assess vascular, genetic, molecular, and psychosocial variables.
Pages 311–317;
Celano et al. examined relationships between psychological constructs (positive and negative) and markers of inflammation, endothelial function, and myocardial strain in a cohort of postacute coronary syndrome (ACS) patients. Depressive symptoms were associated with more inflammation, myocardial strain, and endothelial dysfunction in the 6 months after ACS, whereas positive psychological constructs were linked to better endothelial function.
Pages 318–326;
African Americans (AAs) have twice the risk of incident stroke compared to white people in the United States. Magnetic resonance imaging of brain volume is prognostic of stroke, dementia, and mortality. Waldstein et al.
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