Psychosomatic medicine
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Psychosomatic medicine · Nov 2008
Multicenter StudyDepressed mood, positive affect, and heart rate variability in patients with suspected coronary artery disease.
To test associations between heart rate variability (HRV), depressed mood, and positive affect in patients with suspected coronary artery disease (CAD). Depression is associated with impaired HRV post acute cardiac events, but evidence in patients with stable coronary artery disease (CAD) is inconsistent. ⋯ Relationships between depression and HRV in patients with CAD may depend on affective experience over the monitoring period. Enhanced parasympathetic cardiac control may be a process through which positive affect protects against cardiovascular disease.
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Psychosomatic medicine · Nov 2008
Relationship of genetic variability and depressive symptoms to adverse events after coronary artery bypass graft surgery.
To assess genetic variability in two serotonin-related gene polymorphisms (MAOA-uVNTR and 5HTTLPR) and their relationships to depression and adverse cardiac events in a sample of patients undergoing coronary artery bypass surgery. ⋯ A serotonin-related gene polymorphism--5HTTLPR--was associated with adverse cardiac events post CABG, in combination with depressive symptoms. Because depressed patients with the L allele of the 5HTTLPR polymorphism were more likely to have an event compared with the S/S carriers, combining genetic and psychiatric profiling may prove useful in identifying patients at the highest risk for adverse outcomes post CABG.
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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.