Higher Perceived Stress Scale Scores Research Articles

P131 Is stress associated with subclinical inflammation in Ulcerative Colitis? A population-based cross-sectional cohort study in southeastern Sweden

Abstract Background Ulcerative colitis (UC) is an immune-mediated chronic inflammatory bowel disease with a relapsing course. Whether perceived stress affects the disease activity remains debated. This study aimed to investigate if clinical and subclinical disease activity, perceived stress, and hair cortisol concentration (HCC) are associated. Methods We performed a population-based cross-sectional cohort study with 200 randomly selected adult patients with UC living in the catchment area of Linköping University Hospital in southeastern Sweden. Demographic and disease-related data, bowel symptoms registration, the 14-item Perceived Stress Scale (PSS), the Short Health Scale (SHS), the Inflammatory Bowel Disease Questionnaire (IBDQ), fecal calprotectin (FC), CRP, and hair samples for hair cortisol concentration (HCC) were gathered. HCC has proven a reliable marker of long-term stress, with one centimeter of scalp hair accounting for approximately 4–6 weeks of stress level. A PRO2 score was calculated. Clinical remission was defined as a PRO2 score of zero. Results 174 patients participated in the study (45.1% females). The median age was 52.0 years (IQR 40.0–65.0) and the median disease duration was 13.0 years (IQR 6.0–24.0). The median PSS score was 21.0 (IQR 16.0–27.0). 124 patients had a PRO2 score of zero. Patients in clinical remission had a significantly lower PSS score (median 21.0 (IQR 15.0–27.0)) compared to those with PRO2≥1 (median 24.0 (IQR 17.5–27.5)) (p<0.01). Patients experiencing more perceived stress (PSS score>21.0) had an impaired quality of life as measured with the SHS (p<0.01) and the IBDQ (p<0.01) compared with patients with lower PSS scores. The median FC was 43.1 µg/g, CRP 1.5 mg/l and HCC 24.7 pg/mg. HCC was lower in patients with clinically active disease (median 21.9 pg/mg) compared with patients in clinical remission (median 26.0 pg/mg) (p<0.05). No significant differences in FC, CRP or HCC were detected comparing patients with high versus low PSS scores. Neither was a correlation between HCC and FC or CRP observed. Conclusion Bowel symptoms contribute to the feeling of being stressed. Perceived stress is associated with impaired QoL. Among patients in clinical remission, no association between subclinical inflammation (FC), and perceived stress or long-term stress (HCC) was observed. The issue of whether perceived stress may cause or augment intestinal inflammation, or vice versa, requires further investigation.

Altı maddelik Kutcher Ergen Depresyon Ölçeği’nin (KEDÖ-6) Türkçeye uyarlanması: Geçerlik ve güvenirlik araştırması

Background: The scales used to determine the risk of depression in childhood and adolescence are quite long and complex for adolescents. The Kutcher Adolescent Depression Scale (KADS-6) is a short depression screening scale consisting of 6 items developed for individuals between the ages of 12-22. The aim of this study is to adapte KADS-6 to Turkish and examine validity and reliability. Materials and Method: This is a reliability and validity study, conducted with the students of 2 High Schools in Istanbul in March 2019. KADS-6 was translated to Turkish from English with permission of the researchers developed the scale. Then, it was translated back to English by a bilingual person. The test-retest method was used for reliability analysis. For the validity analysis, the scale was applied to 120 students with a mean age of 15±0.98, exploratory factor analysis was done and Cronbach’s alpha coefficient was calculated. In addition, the correlation between the Perceived Stress Scale (PSS) and KADS-6 was investigated. Results: The test-retest correlation coefficient of the scale is 0.983 (p <0.001); Cronbach’s alpha coefficient is 0.83. A single factor emerged that explained 53.8% of the total variance. There is a high and positive correlation between Turkish KADS-6 and PSS scores (r=0.61; p <0.001). Those who are positive in terms of risk of depression have higher PSS scores, than those are negative (31.49 ± 7.49; 24.04 ± 6.77; p <0.001). Conclusion: The findings of the study suggest that Turkish KADS-6 is a valid and reliable scale. Therefore, the use of CADS-6 in the screening of depression in adolescents may be an advantage for family physicians, since it contains few questions and can be completed in a short time.

Loss of Continuity of Care in Pediatric Neurology Services during COVID-19 Lockdown: An Additional Stressor for Parents.

Background. This study aimed to investigate the consequence of the COVID 19-related lockdown on the well-being of children with neurological and neurodevelopmental disorders and the repercussion on parental stress during the period 9 March 2020–3 May 2020. Methods. A web-based survey was shared via mail with the parents of children affected by chronic neurologic disorders and neurodevelopmental disorders in the continuity of care in two Italian tertiary centers, independently by the severity of the diseases and the required frequency of controls. For each patient, they were asked to identify a single main caregiver, among the two parents, to fill in the questionnaire. Parental stress was measured via the Perceived Stress Scale (PSS). Statistical analysis was performed with IBM SPSS Statistics version 25. The differences between the clinical groups were performed with one way ANOVA. The dimensional effect of the clinical variables on outcome was evaluated by multiple linear regression analysis. Results. The survey was completed by 250 parents (response rate = 48.9 %). Sars-Cov2 infection was reported in two patients only. A total of 44.2% of the patients had completely interrupted school activities while 70% of parents underwent changes in their job modalities. Health care services were disrupted in 77% of patients. Higher PSS scores were detected in the parents of children with neurodevelopmental disorders (p = 0.035). Conclusions. The loss of continuity of care during the lockdown must be considered as a risk factor for parents caring for children with chronic neurologic diseases and neurodevelopmental disorders in further phases of the current pandemic.

Prevalence of dry eye disease among Chinese high school students during the COVID-19 outbreak

PurposeThe study aimed to investigate the prevalence of dry eye disease (DED) and relevant risk factors among Chinese high school students during the COVID-19 outbreak.MethodsA cross-sectional study was conducted from November to December 2020, and 4825 high school students from nine high schools in Shanghai were recruited. All students completed ocular surface disease index (OSDI) and perceived stress scale (PSS) questionnaires and answered other questions designed to ascertain information on the risk factors related to DED. DED was diagnosed when OSDI scores were greater than or equal to 13. The prevalence of symptomatic DED was determined. A T-test, Kruskal-Wallis test, Chi-square test, and logistic regression analysis were used to examine the possible risk factors.ResultsThe prevalence of symptomatic DED among Chinese high school students was 70.5%. In univariate analysis, higher PSS scores (P<0.001), prolonged video display terminal (VDT) use (P<0.001), wearing contact lenses (P=0.001), poor sleep quality (P<0.001), and being female (P<0.001) were significantly correlated with dry eyes. In multivariate logistic regression analysis, higher PSS scores (P<0.001, OR=1.20), prolonged VDT use (P<0.001, OR=1.07), poor sleep quality (P<0.001, OR=1.84), and being female (P=0.001, OR=1.25) were significant risk factors associated with DED.ConclusionsDue to the epidemic, most Chinese high school students are in a high-risk environment in which they are more likely to suffer from DED, such as long online courses and heavy stress from school. Relevant preventive measures that may have a positive impact on public health and quality of life for high school students should be brought to the forefront.

Evaluation of perceived stress and coronavirus-specific anxiety among hospitalized COVID-19 patients – A cross-sectional study

Background: COVID-19 pandemic enmeshed all people across the globe in myriad of problems and adversely affected their physical and mental health. Among all, patients who had been infected with COVID-19 might be at higher risk of psychological distress for obvious reasons. Aims and Objectives: The aim of the study was to find out the prevalence and level of perceived stress and coronavirus-specific anxiety in patients affected by COVID-19. Materials and Methods: This cross-sectional study was conducted on in-patients of a COVID-19 designated hospital who were about to get discharged. After screening the eligible patients with GHQ-12, patients who gave consent were interviewed with perceived stress scale (PSS)-4 and coronavirus anxiety scale. Results: Mean age of the study population was 41 years and majority (54.4%) belonged to 40–60 years of age. Slight preponderance of females (54.1%) noted and17.4% lost their source of income and encountered acute financial crisis. Mean duration of stay in the hospital was 10.2 (±4.4) days. Mean perceived stress and coronavirus-specific anxiety were 9.6 (±2.2) and 10.39 (±3.1), respectively. Loss of a family member due to COVID-19 infection, active COVID-19 infection in any family member, poor social support, and financial crisis were the factors correlated with higher PSS scores. Conclusion: Psychosocial factors contributed significantly for the higher level of perceived stress in COVID-19 patients in our study.

A study to compare the correlation of perceived stress and insomnia between health professionals and other employees in a government medical college of Eastern India

Background: Perception of higher stress may lead to insomnia which can adversely affect the mental and physical well-being of health professionals and patient care. The aim of the study was to compare the correlation of perceived stress and insomnia among health professionals and other employees in a Government Medical College of Eastern India. Materials and Methods: This online survey was conducted using two Google forms in a span of 18 months. In the first section of the document, the relevance was explained, and informed consent was taken. In the second part of the form, participants were asked to fill up demographic details and relevant history. In the third part of the form, participants had to fill up the following four scales: Perceived Stress Scale (PSS) of Sheldon Cohen, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Job Satisfaction Scale (JSS). Results: Participants were divided into two groups: Group A: Health Professionals and Group B: Other Employees. JSS scores were significantly higher among Group A (38.29 ± 6.34) as compared to Group B (35.47 ± 6.98) with a P = 0.0008**. Participants having higher JSS scores also had higher PSS scores (Group A with an r = 0.12; Group B with an r = 0.007). ISI scores were significantly higher in Group A (10.53 ± 3.43) as compared to Group B (6.21 ± 2.77) with a P < 0.001**. Participants having higher PSS scores also had higher scores for ISI (Group A with an r = 0.167 and Group B with an r = 0.333). PSQI scores were significantly higher among Group A (11.52 ± 2.05) as compared to Group B (6.37 ± 2.69) with a P < 0.0001**. PSS scores also positively correlated to PSQI scores (Group A, r = 0.963 and Group B r = 0.959). Participants having higher PSS scores also had higher scores for PSQI (Group A with an r = 0.963 and Group B with an r = 0.959). Conclusions: Perceived stress scores positively correlated to both severities of insomnia and poor quality of sleep among study participants. This suggests that higher perceived stress levels may be a significant contributor to insomnia and poor sleep quality among health professions as they are constantly exposed to higher professional stress in the present health-care system.

Media use, positive and negative emotions, and stress levels of adults during COVID-19 pandemic in Turkey: A cross-sectional study.

This study was conducted to determine media use, positive and negative emotions, and stress levels of adults during the COVID-19 pandemic. Using media tools in the pandemic process has impacted the mental health of individuals. As the COVID-19 outbreak is a new disease fear, anxiety and stress about this situation can cause strong emotions in adults. The research was carried out using a cross-sectional design. The sample consisted of 1541 adults. The Positive and Negative Emotion Scale, and the Perceived Stress Scale were used to collect the data. The Positive Emotion Scale mean scores were lower (p < 0.05) for those people whose daily media use time was more than 4 h and who followed the developments about COVID-19 through the media once a day. It was found that those with daily media use of more than 4 h/day had higher Perceived Stress Scale scores than those with lower use (p > 0.05). This study concluded that the use of media in adults increased during the COVID-19 outbreak and that media use was associated with positive and negative emotions and stress levels. Health professionals should assess the effect of the COVID-19 outbreak on mental health in various community groups and develop interventions to prevent negative consequences of increased media use.

Associations of serum cortisol levels, stress perception, and stressful events with suicidal behaviors in patients with depressive disorders

BackgroundStress is a well-known risk factor of suicide. However, there is a lack of research on the best psychobiological markers of stress for monitoring and predicting suicidal behaviors in depressed patients. We aimed to investigate the individual and interactive effects of serum cortisol levels and stress-related parameters, including perceived stress and life stressors, on suicidal behavior in depressed patients. MethodsAt baseline, serum cortisol levels were measured and stress-related data, i.e., Perceived Stress Scale (PSS) scores and the number of stressful life events (SLEs), were collected from 1,094 patients with a depressive disorder, of whom 884 were followed up for 1 year. Suicidal behaviors evaluated at baseline included previous suicide attempts and baseline suicidal severity, while those at the 1-year follow-up were increased suicidal severity and fatal/non-fatal suicide attempts. Individual and interactive associations of exposure variables with suicidal outcomes were analyzed using logistic regression models after adjusting for relevant covariates. ResultsHigher serum cortisol levels were significantly associated with suicidal outcomes at the 1-year follow-up. In addition, higher PSS scores were significantly associated with higher baseline severity, whereas the number of SLEs was not associated with any suicidal outcomes. A significant interactive effect of cortisol level and PSS score on suicidal outcomes at the 1-year follow-up was observed. Higher cortisol levels and PSS scores were associated with increased suicidal severity and more fatal/non-fatal suicide attempts. ConclusionsThe combination of serum cortisol levels and PSS scores may be useful for monitoring and predicting suicidal behaviors in depressed patients.

Association of stress and resilience with cardiometabolic health among American Indian and Alaska Native adults

Evidence suggests that perceived stress and psychological resilience are related to the presence and severity of cardiometabolic disease. Despite increased stress and cardiometabolic disease burden among American Indian and Alaska Native (AI/AN) people, the relationships between these factors are not well established in these populations. The objective of this study was to evaluate the relationships of stress with five cardiometabolic health indicators and to assess whether psychological resilience mediates these relationships in AI/AN adults. Four hundred and ninety-six AI/AN attendees were surveyed at three powwows. The questionnaire included sociodemographic items, questions on self-reported obesity, prediabetes, diabetes, high blood pressure, and high cholesterol, the Perceived Stress Scale, and the Brief Resilience Scale. Multivariable logistic regression models were used to measure associations of health indicators with Perceived Stress Scale and Brief Resilience Scale scores while controlling for sociodemographic characteristics. Among respondents, obesity was the most common cardiometabolic health indicator reported (48%), followed by high blood pressure, prediabetes, diabetes, and high cholesterol. Mean Perceived Stress Scale and Brief Resilience Scale scores were 16.1 (6.4 SD) and 3.5 (0.7 SD), respectively. Higher Perceived Stress Scale scores were associated with greater odds of self-reported prediabetes and diabetes. Brief Resilience Scale scores did not serve as a mediator. These results suggest that perceived stress is associated with some self-reported indicators of cardiometabolic health among AI/AN adults, but findings are limited by the convenience sample, reliance on self-report, and cross-sectional design. Future work should capitalize on nationally representative data, longitudinal designs, and objective measures of cardiometabolic health.

COVID-19 related poor mental health and sleep disorders in rheumatic patients: a citizen science project

BackgroundPatients with chronic rheumatic diseases (RDs) are more vulnerable and the containment measures related to the COVID-19 pandemic might have severe psychological consequences. We investigated the presence of and risk factors associated with poor mental health, sleep disorders among RDs during the pandemic.MethodsThis cross-sectional Italian citizen science project evaluated the psychological impact of the COVID-19 pandemic in patients with RDs. Between May and September 2020, eleven RD patients’ associations sent the survey by using their mailing list and the related webpage and social network. 507 RD patients completed an ad-hoc anonymous online survey including the Perceived Stress Scale (PSS) and Impact Event Scale-Revised (IES-R).ResultsThe mean scores on the PSS-10 and the IES-R were 18.1 and 29.7, respectively. Higher PSS scores were associated with younger age (p < 0.01), female gender (p < 0.01), overweight/obesity (p = 0.01), psychiatric pharmacotherapy (p < 0.01), and anxiety for loss of income (p < 0.01). Higher IES-R scores were associated with female gender (p < 0.01), intestinal diseases (p = 0.03), anxiety (p < 0.01), and health concern (p < 0.01). Among 375 patients with inflammatory arthritis, 246 (65.6%) had trouble staying asleep, 238 (63.5%) falling asleep, and 112 (29.9%) had dreams about the pandemic. Older age (OR = 1.038, CI 1.002–1.076), psychiatric pharmacotherapy (OR = 25.819, CI 11.465–58.143), and COVID infection (OR = 2.783, CI 1.215–6.372) were predictive of insomnia during the pandemic.ConclusionsA considerable COVID-19 related psychosocial burden has been detected in RDs. Different factors were predictive of poor mental health and sleep disorders in these patients. Focused supportive strategies should be implemented to improve the psychological well-being of fragile patients during pandemics.

POS1161 A CITIZEN SCIENCE APPROACH TO CAPTURE POOR MENTAL HEALTH RELATED TO COVID-19 IN RHEUMATIC PATIENTS AFTER CONFINEMENT DURING PANDEMIC IN ITALY

Background:A considerable psychosocial burden is one of the relevant consequences of the COVID-19 pandemic. In particular, quarantine measures have been related to negative psychological effects, including symptoms of post-traumatic stress disorder, stress, anxiety, and depression (1). This rise in mental health disorders might be even worse among people more vulnerable to psychological stress such as patients suffering from chronic rheumatic diseases (RDs).Objectives:The present Italian nationwide survey engages patients with rheumatic conditions through eleven associations of RD patients. It is conducted to establish the COVID-19 related self-reported poor mental health symptoms and to identify potential factors associated with these concerns among RDs who experienced the COVID-19 quarantine in Italy.Methods:We collected data from May to September 2020 from RD patients living in Italy during the COVID-19 quarantine by an ad-hoc online survey. By using their mailing list and the related webpage and social network, eleven patients’ associations sent a call to RD patients asking them to complete an anonymous online survey which included the Perceived Stress Scale (PSS), and the Impact Event Scale-Revised (IES-R). χ2 tests were performed to detect statistically significant differences in both rating scale scores between groups defined by qualitative variables. Correlation analyses were realized with quantitative variables and rating scale scores. Variables significant in univariate analyses were then inserted in multivariate regression models.Results:In total, 507 RD patients completed to the survey. 375 (73.9%) patients had inflammatory arthritis (243 rheumatoid arthritis, 76 psoriatic arthritis, 49 ankylosing spondylitis, and 7 Still’s disease), and 96 (18.9%) with connective tissue diseases or systemic vasculitis. 31 (6.1%) patients had primary fibromyalgia and 5 osteoarthritis or crystal arthropathies. Self-reported major sources of anxiety are reported in the Figure 1 below.The mean (SD) scores of the PSS-10 and the IES-R were 18.1 ± 8.1 and 29.7 ± 17.5, respectively. With regard to the IES-R subscale scores, the total sample did not show a prominence of one of the three main domains (intrusion, avoidance and hyperarousal). Higher PSS scores were significantly associated with younger age (p&lt;0.01), female gender (p&lt;0.01), living outside Lombardy (p=0.03), presence of overweight/obesity (p=0.01), ongoing psychopharmacotherapy (p&lt;0.01), and anxiety for loss of incomes (p&lt;0.01). Female gender (p&lt;0.01) and living outside Lombardy (p=0.02) were associated also with higher IES-R scores, together with the presence of intestinal diseases (p=0.03), anxiety disorders (p&lt;0.01), and worries about health (p&lt;0.01).Conclusion:This nationwide study revealed a high impact of self-reported distress, anxiety, and perceived stress among rheumatic patients after confinement during COVID-19 pandemic in Italy. Different factors were found to be predictive of poor mental health such as having female gender, younger age, living outside Lombardy, having overweight/obesity, or intestinal diseases, having a history of psychiatric symptoms (e.g. anxiety). Moreover, the lockdown experience worsened psychiatric symptoms and increased the assumption of psychopharmacotherapy in this vulnerable population. Prevention strategies focused on specific variables should be implemented to ameliorate psychological well-being of fragile patients during pandemics.

Psychological impact of the COVID-19 pandemic on training of postgraduate year 1 doctors in Singapore.

Psychological impact of the COVID-19 pandemic on training of postgraduate year 1 doctors in Singapore.

Greater Stress Level Fluctuation in Lower Income Earners since onset of Coronavirus Pandemic

Natural disasters, mental illnesses, injuries, and crime are all known factors that lead to stress (Casarella 2020). People were in various levels of confinement due to Coronavirus all over the world, leading to job loss and inability to finance basic living expenses. This study evaluated the relationship between stress and income by surveying different socioeconomic groups. All the participants took anonymous PSS (Perceived Stress Scale) and SRRS (Social Readjustment Rating Scale) test that included questions about race, age range, income range, and the number of times they think about Coronavirus each day. Dr.Cohen's 2009 PSS score samples of the American population were used as a baseline measurement for the pre-Coronavirus stress score levels. The stress level fluctuation was calculated by subtracting participants' survey scores from Cohen's scores to determine the overall stress level change. A p-value of 0.00000001196 for the lower-income group (&lt;$30k/yr) and a p-value of 0.01214 for the higher income group (&gt;$91k/yr) was obtained using the independent-t-test. These p-values supported the alternative hypothesis proposed in this study that there is a more significant change in the stress levels spanning the onset and duration of the Coronavirus pandemic in members of a lower socioeconomic bracket (&lt;$30,000/yr) than of people in a higher income bracket (&gt;$91,000/yr). The results revealed that the PSS score of the 65 years and older group had increased the most and no significant difference in stress scores between racial groups. Additionally, people who think about Coronavirus more frequently have higher PSS scores.

Depression, Stress, and Perceived Medical Errors in Singapore Psychiatry Residents.

Doctors in training, especially psychiatrists, are at high risk of depression and burnout, which have been linked to increased medical errors. This study looks at prevalence and risk factors of depression and perceived stress among psychiatry residents in Singapore. An anonymous online questionnaire was completed by 65.3% (47/72) of residents, which included the Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale (PSS), and 2 burnout screening questions. They were asked if they were concerned about making a medical error. Majority of residents (70.2%) slept 6-8h/night, while 55.3% worked <60h/week. Based on PHQ-9 score ≥10, 38.3% had depression. Depression was associated with sleeping <6h/night (OR 13.62, 2.96-62.6; p=0.0008) and working ≥60h/week (OR 3.8, 1.096-13.18; p=0.035). Six residents (12.8%) endorsed suicidal ideation. The mean score on the PSS scale was 23.89±1.95. Higher PSS scores were associated with sleeping <6h/night (OR 4.92, 1.51-8.33; p=0.007). One third of residents (34%) reported feeling burnt out fairly or very often. Residents who slept <6h/night were more likely to report feeling burnt out (OR 6.69, 1.69-26.45; p=0.0068). PHQ scores correlated highly with PSS scores and burnout measures. Self-perceived medical errors were associated with depressive symptoms, suicidal thoughts, and <6h/night of sleep. Less sleep and longer working hours were associated with higher risk of depression, suicidality, stress, and perceived medical errors in Singapore psychiatry residents. It is important to address depression and stress as it can affect physician well-being and patient care.

Serum osteocalcin is associated with subjective stress in people with depression and type 2 diabetes

BackgroundLow serum osteocalcin is a risk factor for type 2 diabetes mellitus (T2DM), and osteocalcin release from bone is associated with an acute stress response in mice. Both diabetes and stress are associated with depression. Here, we assess relationships between serum osteocalcin, depression and subjective stress in people with T2DM. MethodsParticipants with T2DM (HbA1c above 6.4 %, impaired fasting glucose or impaired glucose tolerance) were assessed for a major depressive episode using the research version of the Structured Clinical Interview for DSM-5 depression criteria (SCID-5RV). Subjective stress over the past month was assessed using the Perceived Stress Scale (PSS). Serum carboxylated (cOCN) and fully decarboxylated (dcOCN) osteocalcin were assayed from fasting morning blood by commercial enzyme-linked immunosorbent assay. ResultsAmong 95 participants (mean age 62.4 ± 9.9, 51 % women), 22 % were experiencing a depressive episode (9 men, 12 women). The presence of a depressive episode was not associated with dcOCN or cOCN concentrations; however, higher concentrations of cOCN were associated with higher PSS scores in participants with depression (r = 0.585, p = 0.005). In an analysis of covariance model controlling for age, sex, body mass index, glycemic control (glycosylated hemoglobin), insulin resistance (homeostatic model), depression, and antidepressant use, cOCN was associated with PSS scores (F=10.302, p = 0.002), and this relationship was stronger in those with depression (depression × cOCN interaction F=4.978, p = 0.028). Although associations between dcOCN concentrations and PSS scores did not reach significance, the same trend seen with cOCN concentrations was observed in participants with depression for dcOCN (r=0.365, p=0.10), and for a depression × dcOCN interaction associated with PSS scores in the whole group (F=2.165, p = 0.15). ConclusionsOsteocalcin is a neuroendocrine marker associated with perceived chronic stress among people with T2DM experiencing a depressive episode.

Perceived Stress is Associated with Alzheimer's Disease Cerebrospinal Fluid Biomarkers in African Americans with Mild Cognitive Impairment.

African Americans (AA) have a higher Alzheimer's disease (AD) prevalence and report more perceived stress than White Americans. The biological basis of the stress-AD link is unclear. This study investigates the connection between stress and AD biomarkers in a biracial cohort. Establish biomarker evidence for the observed association between stress and AD, especially in AA. A cross-sectional study (n = 364, 41.8% AA) administering cognitive tests and the perceived stress scale (PSS) questionnaire. A subset (n = 309) provided cerebrospinal fluid for measurement of Aβ42, Tau, Ptau, Tau/Aβ42 (TAR), and Ptau/Aβ42 (PTAR). Multivariate linear regression, including factors that confound racial differences in AD, was performed. Higher PSS scores were associated with higher Ptau (β= 0.43, p = 0.01) and PTAR (β= 0.005, p = 0.03) in AA with impaired cognition (mild cognitive impairment). Higher PSS scores were associated with Tau-related AD biomarker indices in AA/MCI, suggesting a potential biological connection for stress with AD and its racial disparity.

SUN-313 Depression, Subjective Stress and Serum Osteocalcin Concentrations in People with Type 2 Diabetes Mellitus

Serum osteocalcin is emerging as a potential marker of glucose homeostasis and risk of type 2 diabetes mellitus (T2DM). In mice, osteocalcin knockouts exhibit depressive-like behaviours but knockouts of a putative osteocalcin receptor, GPR158, are resistant to chronic unpredictable mild stress. Recently, osteocalcin release from bone has been suggested to mediate some aspects of the acute stress response. Here, we assess relationships between serum osteocalcin, depression and perceived stress in people with T2DM. Participants with T2DM were assessed for whether they met the DSM-5 criteria for Major Depressive Disorder using the research version of the Structured Clinical Interview for DSM-5 depression criteria (SCID-5RV). Subjective stress was assessed using the Perceived Stress Scale (PSS) with higher scores indicating greater subjective stress. Serum carboxylated (cOCN) and uncarboxylated (unOCN) osteocalcin were assayed from fasting morning blood by commercial ELISA. Among 87 participants (mean age 62.9±9.5, 52% women), 18 (26%) were experiencing a depressive episode (7 men, 11 women). Both serum unOCN and cOCN were associated with higher PSS scores in participants with depression (unOCN, r=0.566, p=0.014; cOCN, r=0.564, p=0.015) but not in those without depression (unOCN, r=0.002, p=0.985; cOCN, r=0.090, p=0.463). A significant interaction was found between depression and PSS scores predicting serum unOCN in a linear model adjusted for age, sex, body mass index, antidepressant use and HbA1c (F=6.225, p=0.015). The results are consistent with reports that osteocalcin release from bone may be a mediator of stress perception; however, among people with T2DM, this relationship was observed only among those currently experiencing a depressive episode.

Dysmenorrhea and Heavy Menstrual Bleeding in Elite Female Athletes: Quality of Life and Perceived Stress.

In female athletes, the incidence of menstrual disorders is variable, and their impact on perceived stress and quality of life (QoL) is poorly known.The aim of the present study was to investigate the menstrual cycle characteristics and disorders in athletes performing different sports, also evaluating perceived stress and QoL according to their menstrual cycle features.A cross-sectional survey was conducted in nulliparous elite athletes of reproductive age, and the study population included 112 cases. Three questionnaires were administered on (1) gynecological health, (2) perceived stress scale (PSS), and (3) short form QoL (SF-12). A group of women not practising regular sport activities (n = 103) was used as control. Data obtained in elite athletes were also analyzed according to the static and dynamic component percentage of practised sports in 3 sub-groups.Athletes had a significantly higher incidence of irregular periods and heavy menstrual bleeding (HMB) (p < 0.01) and a lower incidence of dysmenorrhea (p < 0.01) than controls. Furthermore, athletes had a better physical QoL (53.9 ± 5.9 vs 51.2 ± 6.0) (p < 0.05) but higher PPS level (17.3 ± 4.8 vs 13.8 ± 4.8) and a worse mental QoL (44.9 ± 9.9 vs 47.6 ± 9.0) (p < 0.05) than controls. HMB was associated with lower mental scores (39.7 ± .8.9 vs 45.6 ± 9.9) and higher PSS scores (19.8 ± .3.2 vs 17.0 ± .4.9) than those observed in athletes with normal bleeding. No difference was found in different sports regarding gynecological health, PSS level, and QoL. An increased incidence of HMB should be considered in elite athletes with increased PSS and impaired QoL.

Fecal microbiota and metabolites are distinct in a pilot study of pediatric Crohn’s disease patients with higher levels of perceived stress

Stress is associated with increased Crohn’s Disease (CD) activity. This pilot study tested whether pediatric patients with CD reporting higher levels of perceived stress exhibited differences in the fecal microbiome and metabolome. The perceived stress scale (PSS) questionnaire was administered within 2 days of collecting a stool sample for microbiome (using 16S rRNA gene sequencing) and metabolome (using NMR metabolomics) analyses. Higher levels of perceived stress were correlated with increased disease activity on the short Pediatric Crohn’s Disease Activity Index (sPCDAI). Patients with High PSS scores vs. Low PSS scores based on a median split had significantly lower relative abundances of Firmicutes and Anaerostipes, as well as higher relative abundances of Parabacteroides. Fecal alanine and nicotinate were also significantly different in patients with High vs. Low PSS Scores. This pilot study suggests that the fecal microbiome and metabolome differs in pediatric patients with CD and high perceived stress.

Perceived stress, life events, fatigue and temperament in patients with psoriasis

ObjectiveTo evaluate the perceived stress, life events, fatigue and temperament profile in patients with psoriasis and to investigate the relationship between these factors.MethodsThis cross-sectional study included patients with psoriasis and healthy control subjects. The two groups were compared regarding the number of life events, Perceived Stress Scale (PSS) and Multidimensional Assessment of Fatigue scores. The Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire was used to evaluate the personality traits among the two groups.ResultsA total of 75 patients with psoriasis (mean ± SD age, 44.94 ± 13.62 years) and 75 healthy controls (mean ± SD age, 41.10 ± 8.89 years) were included in the study. A statistically significant difference was found between the two groups in terms of the presence of life events, PSS score, fatigue and temperament profiles. Patients with psoriasis with depressive, cyclothymic and anxious temperament profiles were found to have higher PSS scores. In the psoriasis group, the PSS scores were positively correlated with the number of life events.ConclusionsStress and life events were found to be correlated with psoriasis. In the patients with psoriasis, depressive, cyclothymic and anxious temperament profiles seemed to be associated with higher perceived stress.