Psychosomatic medicine
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Psychosomatic medicine · Oct 2008
Randomized Controlled TrialBlunted opiate modulation of hypothalamic-pituitary-adrenocortical activity in men and women who smoke.
To examine the extent to which nicotine dependence alters endogenous opioid regulation of the hypothalamic-pituitary-adrenocortical (HPA) axis functions. Endogenous opiates play an important role in regulating mood, pain, and drug reward. They also regulate the HPA functions. Previous work has demonstrated an abnormal HPA response to psychological stress among dependent smokers. ⋯ We conclude that nicotine dependence is associated with attenuated opioid modulation of the HPA. This dysregulation may play a role in the previously observed blunted responses to stress among dependent smokers.
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Psychosomatic medicine · Oct 2008
Randomized Controlled Trial Multicenter StudyAssociation of depression and anxiety alone and in combination with chronic musculoskeletal pain in primary care patients.
To assess the relationship between depression and anxiety comorbidity on pain intensity, pain-related disability, and health-related quality of life (HRQL). ⋯ The added morbidity of depression and anxiety with chronic pain is strongly associated with more severe pain, greater disability, and poorer HRQL.
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Psychosomatic medicine · Oct 2008
Increased acoustic startle responses in IBS patients during abdominal and nonabdominal threat.
Visceral hypersensitivity and symptom severity in Irritable Bowel Syndrome (IBS) are both exacerbated by stress. The eye-blink startle response represents a noninvasive measure of central defensive responding. Evidence for central hyperexcitability was studied in IBS patients by examining potentiation of the startle reflex to a nociceptive threat. ⋯ Female IBS patients show increased startle responses to threat of aversive stimulation at both abdominal and nonabdominal sites compared with controls. The data represent the first demonstration of altered threat potentiated startle in a functional pain condition and provide support for the use of these paradigms in further evaluation of affective mechanisms in these disorders.
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Psychosomatic medicine · Oct 2008
Impairment associated with sleep problems in the community: relationship to physical and mental health comorbidity.
To explore the extent to which associations between sleep problems and functional impairment are attributable to comorbid mental and physical health problems. Sleep problems are being increasingly recognized as a source of morbidity and role impairment. Little is known, however, about the extent to which associations between sleep problems and functional impairment are attributable to comorbid mental and physical health problems. ⋯ More than one third of adults in the community report sleep problems. These often co-occur with other physical and mental health problems, and when they do they are generally associated with an increased burden of role disability and functional impairment.
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Psychosomatic medicine · Oct 2008
Type-D personality and cortisol in survivors of acute coronary syndrome.
To test the hypothesis that Type-D personality is associated with elevated cortisol levels in patients 4 months after an acute coronary syndrome (ACS). ⋯ Type-D personality may be associated with prolonged disruption of the hypothalamic-pituitary-adrenal axis function in survivors of acute cardiac events and may contribute to biological responses influencing future cardiac morbidity.