Psycho-emotional Factors Research Articles

Markers of intravascular microinflammation and intima-media complex thickness of carotid arteries in individuals with psychoemotional disorders

Purpose: To examine the markers of intravascular microinflammation and thickness of the intimae-media complex (IMT) of the carotid arteries in healthy individuals with reference to psychoemotional disorders. Methods: A cohort of 173 healthy individuals, age range from 30 to 60, were examined for a psychoemotional state on a hospital anxiety and depression scale. The symptoms of depression, anxiety and asthenia were accumulated to make up an index of psychoemotional disorders (PED). The level of C-reactive protein (CRP) and cytokines: tumor necrosis factor alpha (TNF-α), interleukins (IL) -1, -4, -8, have been studied by enzyme immunoassay test systems (SeroELISA, DSL, USA). The IMT of the carotid arteries was determined with the help of apparatus Aloka 5000 with 07-10 MHz linear transducer in B-mode. Results: All subjects were split into 2 groups with and without psychoemotional disorders. Group 1 consisted of 98 people (45 men and 53 women, average age 43,9±0,9). The anxiety symptoms were found in 59 subjects (60,2%), depression - in 68 (69,4%), asthenia - in 74 (75,5%) of the group. Average index of PED in this group was 3,8±0,1 points. Group 2 included 75 individuals (32 men and 43 women, average age 42,1±0,8, p1-2=0,32) with no psychoemotional disorders. IMT in group 1 was 0,81±0,02 mm, in group 2 - 0,62±0,01 mm (p=0,001). Besides, group 1 was characterized by higher levels of CRP (3,70±0,01 mcg/ml) versus group 2 (1,01±0,04 mcg/ml, p=0,01). Group 1 has also demonstrated an increase of proinflammatory cytokines: IL-1 - 28,0±3,1 pg/ml, IL-8 - 271,8±57,3 pg/ml, TNF-α - 74,7±8,9 pg/ml compared to group 2 (p=0,03-0,001). Correlation analysis of the data indicated a close link between psychoemotional factors and inflammatory markers in group 1. Thus the amount of CRP is directly correlated to the level of anxiety (r=0,51, p<0,05) and asthenia (r=0,46, p<0,05). TNF-α is correlated to severity of depression (r=0,56, p<0,05) and anxiety (r=0,39, p<0,05) level. The research revealed direct correlation between IMT and depressive symptoms (r=0,65, p<0,05) and the degree of anxiety (r=0,74, p<0,05). However, these significant correlations were not found in group 2. Conclusions: The individuals with psychoemotional disorders have shown an increase in blood concentrations of markers of intravascular microinflammation and increased carotid IMT. The symptoms of depression and anxiety identified in these individuals are directly correlated to inflammatory markers and IMT.

Voice disorders in teachers: Occupational risk factors and psycho-emotional factors

Background. Teaching is a high-risk occupation for developing voice disorders. The purpose of this study was to investigate previously described vocal risk factors as well as to identify new risk factors related to both the personal life of the teacher (fluid intake, voice-demanding activities, family history of voice disorders, and children at home) and to environmental factors (temperature changes, chalk use, presence of curtains, carpet, or air-conditioning, acoustics in the classroom, and noise in and outside the classroom).Methods. The study group comprised 994 teachers (response rate 46.6%). All participants completed a questionnaire. Chi-square tests and logistic regression analyses were performed.Results. A total of 51.2% (509/994) of the teachers presented with voice disorders. Women reported more voice disorders compared to men (56.4% versus 40.4%, P < 0.001). Vocal risk factors were a family history of voice disorders (P = 0.005), temperature changes in the classroom (P = 0.017), the number of pupils per classroom (P = 0.001), and noise level inside the classroom (P = 0.001). Teachers with voice disorders presented a higher level of psychological distress (P < 0.001) compared to teachers without voice problems.Conclusion. Voice disorders are frequent among teachers, especially in female teachers. The results of this study emphasize that multiple factors are involved in the development of voice disorders.

Association between Self-Perceived Health Status and Health Related Behavior in Routine Health Examinees

Background: Self-perceived health is a good indicator of health status. It is generally accepted that self-perceived health status has important role on one’s health behavior and public health education. Smoking, drinking, and obesity are well known risk factors for one’s health. But its effects on self-perceived health status are not known so well in Korea. This study was planned to evaluate the effect of health behavior such as smoking, drinking, and obesity on self-perceived health status. Methods: We enrolled a total of 6,040 Koreans, visited to one general hospital health promotion center from June, 2004 through June, 2007. Data was collected by questionnaire, including basic demographic variables, family history of cancers or cerobrovascular accidents, psycho-emotional factors such as stress, depression, anxiety, insomnia, and health behaviors including smoking, drinking, and exercise. Risk factors for metabolic syndrome were also obtained including waist circumference, blood pressure, triglyceride, high-density lipoprotein (HDL), fasting blood sugar, and body mass index (BMI). Results: Older age, higher alcohol consumption, higher BMI, and regular exercise were associated with higher selfperceived health status. Higher education status, higher score of stress, symptoms such as depression, anxiety, and insomnia, drug medication, operation history, and abnormal HDL status were associated with lower self-perceived health status. Smoking and metabolic syndrome had no relation with self-perceived health status. Conclusion: Drinking and higher BMI were associated with higher self-perceived health status, indicating discrepancies between self-perceived health status and medical advice. More strict education might be required for those risk factors.

Psychosomatic aspects of chronic low back pain syndrome

Psychosomatic aspects of chronic low back pain syndrome The purpose of the study was to determine the relationships between emotional distress and pain syndrome, its characteristic parameters and impact on the quality of life in patients with chronic low back pain. The study included 110 patients, mean age 44.2 ± 8.0 years, with clinical diagnosis of lumbar spine disk pathology with chronic low back pain syndrome. The results showed that the studied patients differed by their emotional state. Emotional distress was associated with high intensity and specific symptoms of low back pain syndrome. Musculoskeletal dysfunction was associated with both physical and psychoemotional factors. The interaction of chronic low back pain syndrome complexity and biopsyhosocial factors is shown by a correlation between cytokines IL-10 and IL-8 level in blood serum and both pain intensity and duration, characteristics of emotional and physical status, and level of physical activities.

Depresión y diabetes: de la epidemiología a la neurobiología

Worldwide, diabetes mellitus and depression are among the most prevalent diseases in their respective fields, metabolism and psychiatry. However, there is evidence that patients with diabetes are at increased risk of developing depression, although a bidirectional relationship might also exist.To present a comprehensive review of the clinical, epidemiological, psychosocial, emotional, and neurobiological basis of the relation between diabetes and depression.Epidemiological studies indicate that there is not only an augmented risk of developing depression in diabetic patients, but that this association increases the morbidity and mortality of these patients. While there is a considerable number of clinical studies that support this relation, little is known about the neurochemical mechanisms that would constitute its biological basis.Alterations in monoamines (serotonin and noradrenaline), the increases in cortisol by the hypothalamus-pituitary-adrenal axis, and trophic agents such as the brain-derived neurotrophic factor, through glycogen synthase kinase-3, constitute some of the abnormalities documented in diabetic patients and in animal models that could explain the association between depression and diabetes. Additionally, we briefly consider the psychoemotional factors that might underlie the depression-diabetes relation. The effects (most of them deleterious) of the antidepressive therapy in glucometabolic control are also discussed.

ECONOMIC EFFICIENCY OF THE IMPLEMENTATION OF THE PROGRAM OF CARDIOVASCULAR DISEASES MULTIFACTORIAL PREVENTION IN THE ORGANIZED COLLECTIVE OF TECHNICAL RESEARCH INSTITUTE

Aim. To estimate economic efficiency of a complex of resource-saving activities for cardiovascular diseases prevention at a workplace. Material and methods. The complex of activities including preventive examination and preventive intervention with their efficacy monitoring was performed in 523 people of a technical research institute staff. Preventive examination included evaluation procedures for cardiovascular diseases and their risk factors (89,5% of respondents). Preventive intervention based on risk factors modification was performed in intervention group. Control group included staff not participating in preventive consultation. Costs associated with cardiovascular diseases and risk factors (medical care consumption and temporary disability) and cost- efficiency analysis was performed. Results. High prevalence of arterial hypertension, metabolic and psychoemotional risk factors at workplace was found in preventive examination. Significant reduction in blood pressure (BP) and total cholesterol (TC) plasma level as well as a tendency to cardiovascular risk (CVR) decrease was reached due to preventive intervention. Costs associated with cardiovascular diseases and their risk factors in intervention group were lower than these in control group (168 584 and 489 500 rbl per 100 people yearly, respectively). Cost- efficiency analysis shown that costs of BP, TC plasma level and CVR reduction were moderate in intervention group. Costs were not efficient in control group. Conclusion. Implementation of cardiovascular diseases prevention at workplace is economically efficient both for society and for employer.

Incidence and predictors of depression after stroke (DAS)

Objective. Depression after stroke (DAS) poses a treble burden to patients, families and health care system. The purpose of this paper is to estimate the incidence of depression among first-ever ischemic stroke patients and identify the predictors of DAS. Methods. A longitudinal study design was undertaken. Of 836 patients admitted to the stroke unit of two regional hospitals in Hong Kong during the period 1 June 2004 to 31 May 2005, 295 patients fulfilled the inclusion and exclusion criteria. A total of 260 patients had given their consents and were interviewed at 1 month after stroke onset. Results. Nearly one-quarter of the first ischemic stroke patients, who were known to be free of personal and family history of psychiatric illnesses, were found to satisfy the criteria of depression using Diagnostic and Statistical Manual IV (24%, 48 out of 200 participants; 95% CI: 18.6%, 30.4%). This result was close to that assessed by the Geriatric Depression Scale (GDS) – 15 items. The psycho-emotional factor and level of dependency were found to be most significant predictors for DAS onset. Conclusion. The high incidence of DAS and low rate of accessibility to treatment indicate timely action to be undertaken.

Effects of leisure time physical activity on psycho-emotional factors in Indian men and women

Burnout, a response to chronic emotional stress, could be influenced by parameters such as healthy lifestyle and physical activity, considered to be important factors in maintaining optimal health and wellness. The objective of this study was to determine the influence of leisure time physical activity participation on the levels of burnout, stress, happiness and quality of life among a sample of Indians in the Potchefstroom Indian community. Indian respondents in Potchefstroom were assessed by a self-report questionnaire for physical activity, burnout, stress, happiness and quality of life. The respondents comprised 101 South African Indian men (n=47) and women (n=54), randomly selected from a semi-urbanized Indian community. The level of burnout, happiness and quality of life were determined by using the Pines et al. Burnout-scale (1981) and the Affectometer 2 questionnaire of Kammann and Flett (1983). Stress symptoms were analyzed by using the 25-item stress symptoms questionnaire (Dickman, 1988). The type, intensity, frequency and duration of participation in physical activity were determined by the Physical Activity Index (PAI) as suggested by Sharkey (1997). One- way analysis of variance was computed for the purpose of this test. The Tukey HSD post-hoc test was used to determine which groups differed statistically from each other (p Keywords : physical activity, stress, happiness, burnout, South African Indians African Journal for Physical, Health Education, Recreation and Dance Vol. 12 (3) 2006: 277-286

Chronic pain: A non-use disease

One of the major problems in modern medicine is to find remedies for the group of people with chronic pain syndromes. Low back pain is one of the most frequent syndromes and perhaps the most invalidating of all of them. Chronic pain seems to develop through several pathways affecting the spinal cord and the brain: (1) neuro-anatomical reorganisation, (2) neuro-physiological changes, and (3) activation of glia cells (immune reaction in the central nervous system). Although all of these pathways seem to provide a (partial) plausible explanation for chronic pain, treatments influencing these pathways often fail to alleviate chronic pain patients. This could be because of the probability that chronic pain develops by all three mechanisms of disease. A treatment influencing just one of these mechanisms can only be partially successful. Other factors that seem to contribute to the development of chronic pain are psychosocial. Fear, attention and anxiety are part of the chronic pain syndrome being cause or consequence. The three pathways and the psycho-emotional factors constitute a psycho-neuro-immunological substrate for chronic pain syndromes; a substrate which resembles the substrate for phantom pain and functional invalidity after stroke. Both phantom pain and functional invalidity are considered non-use syndromes. The similarity of the substrate of both these two neurological disorders and chronic pain makes it reasonable to consider chronic pain a non-use disease (the hypothesis). To test this hypothesis, we developed a "paradoxal pain therapy". A therapy which combines the constraint induced movement therapy and strategies to dissociate pain from conditioning factors like fear, anxiety and attention. The aim of the therapy is to establish a behaviour perpendicular on the pathological pain-behaviour. Clinically, the treatment seems promising, although we just have preliminary results. Further clinical and laboratory studies are needed to measure eventual changes at neuro-anatomical and neuro-psychological level using modern neuro-imaging instruments (PET, SPECT, fMRI). Randomised clinical trials should be carried out to test our hypothesis for all-day use in clinical practice. The hypothesis: chronic pain is a non-use disease produced by psycho-emotional factors like fear, attention and anxiety. Optimal treatment should be based on physiological use, and dissociation of pain and the mentioned psycho-emotional factors. Paradoxal pain therapy could serve these treatment conditions.

Risk Factors for Voice Problems in Teachers

In order to identify factors that are associated with voice problems and voice-related absenteeism in teachers, 1,878 questionnaires were analysed. The questionnaires inquired about personal data, voice complaints, voice-related absenteeism from work and conditions that may lead to voice complaints and absenteeism. Different factors play a role in the development and consolidation of voice problems. Physical and psycho-emotional factors appear to be the most important risk factors. Remarkably, voice load and environment seem to be less important as risk factors in the development and consolidation of voice complaints. Teachers who experienced voice problems during their training reported more voice problems during their career. The results of this study stress the importance of a multifactorial approach in the diagnosis and treatment of voice problems, whereby physical and psycho-emotional aspects should be considered as sensitive to the risk of developing voice problems. Moreover, this study shows the crucial importance of adequate voice training during the teacher training programme.

Prevalence of Voice Complaints, Risk Factors and Impact of Voice Problems in Female Student Teachers

A cross-sectional questionnaire survey was done among 457 female student teachers and 144 females in the general population. The conclusions are based on the opinions of student teachers and the general population. The results of this study show that 39.6% of the student teachers and 32.6% of the general population reported voice complaints at the moment and/or over the past year (p = 0.198). The association between various risk factors (vocal loading factors, physical factors, environmental factors and psycho-emotional factors) and voice complaints were examined. Vocal load was reported in both the student teachers and the general population (p = 0.322). Among the subjects with voice complaints, the student teachers were significantly more of the opinion than the general population that environmental irritants in the classroom (p = 0.001) and the composition of the group they communicate with (p = 0.033) have a negative influence on their voice. In the groups with voice complaints, the student teachers reported significantly less than the general population that stress (p = 0.004) and the deterioration of their general physical condition (p = 0.003) have a negative influence on their voice. Remarkably, over a third of the student teachers and one fifth of the general population with voice complaints were of the opinion that decrease of hearing has a negative influence on their voices (p = 0.113). There was no significant difference in Voice Handicap Index (VHI) scores (p = 0.284) and impact of voice complaints among student teachers and the general population. Over 15% of the student teachers and the general population with voice complaints reported being or having been disabled due to the voice problem, probably reflecting the severity of the voice problem (p = 0.838). The groups reporting voice complaints and disability in relation to their voice complaints have significantly higher VHI scores than those without voice complaints and disability, which indicates a higher psychosocial impact of voice complaints. Only around a third of the student teachers and the general population with voice complaints sought paramedical care (p = 0.656)/treatment (p = 0.361) for their voice complaint. Only a minority of student teachers (18.6%) and the general population (29.5%) with voice complaints were of the opinion that the number of people they communicate with has a negative influence on their voice (p = 0.120). Only around a third of the student teachers and less than a tenth of the general population with voice complaints were of the view that they would develop a voice complaint due to their profession (p = 0.003). Less than half of the student teachers and less than one fifth of the general population with voice complaints were aware of the potential risks of their profession on their voice (p = 0.002). Voice complaints appear to have a multifactorial genesis. The student teachers are not sufficiently aware of the impact of the various risk factors on their voice. Furthermore, they are not aware of the potential risk that future teaching may have on their voice. This apparent lack of awareness in student teachers may be considered a risk factor for voice complaints.

A comparative study of voice complaints and risk factors for voice complaints in female student teachers and practicing teachers early in their career

A cross-sectional questionnaire survey was performed to compare female student teachers (454 subjects; 1st to 4th year of training) and practicing teachers (82 female teachers; 1st to 4th year of teaching career) of primary education early in their career, with regard to risk factors perceived to be a negative influence on the voice, and the relative risk of the given risk factors for voice complaints. This enables the observation of whether there is a sudden increase or difference in the perceived risk factors after starting a professional teaching career. Additionally, the existence of a history of voice problems during training was questioned among the teachers. Teachers with voice complaints compared to teachers without voice complaints reported a history of voice complaints during their training (P =0.013). Teachers compared to student teachers reported more voice complaints at the moment and/or during the past year (P =0.002). The following data were obtained from student teachers and teachers reporting voice complaints. Only around a third of the subjects of both groups sought voice care (P =0.286-0.893). Risk factors were estimated in relation to voice complaints. Student teachers reported less frequently than teachers that stress (P =0.014), work pressure (P =0.003) and the composition of the class (P =0.013) have a negative influence on their voice. Student teachers reported less frequently than teachers that the number of people they communicate with (P <0.001) and the deterioration of their general physical condition (P =0.010) have a negative influence on their voice. Student teachers reported more frequently than teachers that environmental irritants (P <0.001) and humidity (P =0.020) of the classroom have a negative influence on their voice. Student teachers more than teachers were of the opinion that the attention paid to the voice during their training was sufficient (P <0.001). To test whether professional status (student teacher versus teacher) is an effect modifier for the risk factors, odds ratios (OR) were compared between the group of teachers and of student teachers (total group with and without voice complaints) to search for interactions between the risk factors and professional status. There is a significant difference in the pattern of risk factors for student teachers and teachers (P =0.010). There is an indication that vocal loading factors and environmental factors are more influential in student teachers and that there is a tendency for psycho-emotional factors to be more influential for teachers early in their career.

Chiropractic management: Beyond manual care

Background: Chiropractic, which is recognized for its success in the management of back pain, relies on manual intervention for clinical care. However, psychoemotional factors are known to influence the presentation and clinical outcome of patients with back pain. Objective: This study describes the psychologic profile of chiropractic patients and argues for broadening chiropractic's case management. Method: Eight chiropractors were requested to recruit patients, taking care to include workers' compensation cases. Patients were requested to complete as many as 3 questionnaires. Patients completed the first questionnaire on admission and the second 3 weeks later or on discharge, whichever occurred first. Patients still receiving care at 3 months completed a third questionnaire. Validated questionnaires were used to assess psychologic status. Practitioners were asked to document the patient's level of disability. Results: A total of 116 patients entered the study; 57% had acute symptoms on admission, and 53% of all recruited patients were injured at work. Analysis with the Dallas Pain Questionnaire suggested that only 2 acute patients with non-work care injurieswould respond well to medical intervention alone; all other patients also required behavioral intervention. Of the 105 patients who completed the Distress and Risk Assessment Method questionnaire, 36% were found to be normal, 34% were found to be at risk, and 30% were found to be distressed. Of the 108 patients in this study who completed the Bedford Foulds Personal Disturbance scale analysis, 31% were personally disturbed, and 40% were psychologically ill. Conclusion: The extent of psychologic disease among chiropractic patients with acute and chronic work care and non-work care injuries suggests it may be prudent for chiropractors to consider expanding their clinical focus to include psychoemotional status. (J Manipulative Physiol Ther 2002;25:e4)

Female reproductive function in areas affected by radiation after the Chernobyl power station accident

This paper reports the results of a comprehensive survey of the effects of the accidental release of radiation caused by the accident at the Chernobyl nuclear power station in April 1986. The accident and the resulting release of radiation and radioactive products into the atmosphere produced the most serious environmental contamination so far recorded. We have concentrated on evaluating the outcomes and health risks to women, their reproductive situation, and consequences for their progeny. We have concentrated on two well-defined areas: the Chechersky district of the Gomel region in Belorussia and the Polessky district of the Kiev region in the Ukraine. A number of investigations were carried out on 688 pregnant women and their babies, and data were obtained from 7000 labor histories of the development of newborns for a period of 8 years (3 years before the accident and 5 years after it). Parameters examined included birth rate, thyroid pathology, extragenital pathology such as anemias, renal disorders, hypertension, and abnormalities in the metabolism of fats, complications of gestation, spontaneous abortions, premature deliveries, perinatal morbidity and mortality, stillbirths and early neonatal mortality, infections and inflammatory diseases, neurological symptoms and hemic disturbances in both mothers and infants, trophic anomalies, and biochemical and structural changes in the placenta. Several exogenous, complicating influences were also considered such as psycho-emotional factors, stress, lifestyle changes, and others caused directly by the hazardous situation and by its consequences such as treatment, removal from affected areas, etc.(ABSTRACT TRUNCATED AT 250 WORDS)

Understanding the context of perceived health ratings: The case of spousal bereavement in later life

Using a sample of 339 older adults at 2 to 3 months of bereavement the following research questions are addressed: What objective physical and psycho-emotional factors influence the perceived health ratings of older adults following the death of their spouses and how much of the variance in their ratings can be explained by the specific set of characteristics? This investigation helps to identify the major factors that older adults take into account in rating their perceived health. Perceived health status was most strongly related to the number of symptoms reported. The objective physical health indicators as well as grief and depression were significantly correlated with perceived health ratings. Nearly 41% of the variance in perceived health was explained by six factors of which 25.9% was due to the number of reported symptoms. Depression and medical conditions made a moderate contribution while the role of unresolved grief was minimal. Physician visits and days sick also made minor contributions. The general conclusion is that the bereavement context influences the factors that older adults take into account in their perceived health ratings and that it is important to recognize that perceived health ratings occur within and are influenced by personal and situational factors of the context.

The importance of a home care program for patients with advanced cancer pain.

At the Pain Clinic of the National Cancer Institute of Milan, a special Home Care Program has been set up to assist advanced cancer patients with pain and their families during their remaining survival. The Home Care Unit comprises a team of physician, nurse clinicians, psychologists and many volunteers who are active both in the hospital and at the patient's home. This entire operation provides a continuous relationship between the family, the patient and the Home Care Unit. This Home Care Program, which is one of a kind with other forms of treatment for advanced cancer patients (i.e. hospices), has produced interesting results. Out of a sample group of 50 patients, 33 were monitored at home by the Home Care Unit while 17 had their families to do the monitoring. Over a six-week period the following results were reported: a) Improvement of psycho-emotional factors such as anxiety, weakness and mood for both patients and their families who entered the Home Care Program. b) The Quality of Life Index remained unchanged for the sample group that entered the Home Care Program whereas it deteriorated for patients monitored by their families. c) A decrease in the Integrated Pain Score for both groups; however, results showed a statistically significant difference in favor of patients on the Home Care Program. d) The Performance Status decreased by very little over the study period, and there was little difference between the two groups. These results confirm the need for a Home Care Program which must go hand in hand with the Pain Clinic as an effective way to control Total Pain.

Possible relationship between psycho-emotional factors and haemodynamic patterns in the pathogenesis of mild blood pressure elevation.

1. Psycho-emotional profiles were compared with invasive haemodynamic findings in a population sample of 37 young men (mean age 27 years) with mild blood pressure elevation and in 21 matched normotensive controls. 2. In comparison with normotensive controls, subjects with hyperkinetic blood pressure elevation had higher irritability levels, more guilt feelings and more psychic distressful symptoms. 3. In subjects with blood pressure elevation and normokinetic circulation structural vascular changes were found, and their psycho-emotional profiles showed high irritability levels but not significantly increased guilt or anxiety. 4. These results indicate a relationship between psychological factors and haemodynamic patterns in mild blood pressure elevation. A psychosomatic aetiology in hyperkinetic blood pressure elevation is suggested, and the psychological findings are compatible with a gradual development from hyperkinetic to normokinetic blood pressure elevation.

Techniques for Determining the State of Public Health

The broad sociological conception of health does not admit of limitation to any single indicator of health, but requires definition from many aspects on the basis not only of mortality statistics but of other techniques as well. It must be borne in mind that man's health depends upon a complicated set of natural and social factors: heredity, factors of climate and geography, social conditions of health (the economic system, the system of government, working conditions, daily life, upbringing). A major role is played by the psycho-emotional factor, which depends to a considerable degree upon the place and role of the individual in society. The state of medical science, as well as the forms of organization of medical aid, and the degree to which the achievements of medicine are available to the working population, are also of considerable significance to the morbidity rate and its structure. …