Psychosomatic medicine
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Psychosomatic medicine · Jun 2015
Injustice at work and leukocyte glucocorticoid sensitivity: findings from a cross-sectional study.
Organizational justice refers to perceived fairness at the workplace. Low organizational justice has been identified as a major source of distress and a predictor of poor health. Impaired regulation of immunological and inflammatory pathways may, in part, underlie these health effects. The present study investigated the association of organizational justice with leukocyte glucocorticoid sensitivity in vivo. ⋯ Low justice at work is associated with an impaired ability of endogenous cortisol to regulate leukocyte distribution in vivo. These findings identify a novel biological pathway by which organizational justice may affect health.
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Psychosomatic medicine · May 2015
Posttraumatic stress disorder and the risk of respiratory problems in World Trade Center responders: longitudinal test of a pathway.
Posttraumatic stress disorder (PTSD) is associated with high medical morbidity, but the nature of this association remains unclear. Among responders to the World Trade Center (WTC) disaster, PTSD is highly comorbid with lower respiratory symptoms (LRS), which cannot be explained by exposure alone. We sought to examine this association longitudinally to establish the direction of the effects and evaluate potential pathways to comorbidity. ⋯ These analyses provide further evidence that PTSD is a risk factor for respiratory symptoms and are consistent with evidence implicating physiological dysregulation associated with PTSD in the development of medical conditions. If these effects are verified experimentally, treatment of PTSD may prove helpful in managing physical and mental health of disaster responders.
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Psychosomatic medicine · Feb 2015
The association of depression, cognitive impairment without dementia, and dementia with risk of ischemic stroke: a cohort study.
To determine if depression, cognitive impairment without dementia (CIND), and/or dementia are each independently associated with risk of ischemic stroke and to identify characteristics that could modify these associations. ⋯ CIND and co-occurring depression and CIND are independently associated with increased risk of ischemic stroke. Individuals with co-occurring depression and CIND represent a high-risk group that may benefit from targeted interventions to prevent stroke.
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Psychosomatic medicine · Feb 2015
Depression as an independent risk factor for mortality in critically ill patients.
Mortality on medical intensive care units (ICU) is approximately 25%. It is associated with age, severity of illness, and comorbidities. Preexisting depression is a risk factor for worse outcome in many diseases. The impact of depression on outcome of ICU patients has not been investigated. We assessed a possible association between mortality and preexisting depressive mood at the time of ICU admission. The primary end point was 28-day mortality. ⋯ Preexisting depressive mood might be an independent risk factor for 28-day mortality in medical ICU patients. This could have diagnostic and therapeutic implications for critically ill patients.
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Psychosomatic medicine · Jan 2015
Review Meta AnalysisEthnic differences in resting heart rate variability: a systematic review and meta-analysis.
Ethnic disparities in cardiovascular morbidity and mortality are widely documented in the literature. Recently, research has shown that decreased parasympathetic cardiac modulation is associated with the established and emerging risk factors for cardiovascular disease (CVD) and stroke. In consideration of the disproportionate CVD risk and disease profile of African Americans (AAs), it is plausible that decreased cardiac parasympathetic functioning may partially explain these disparities. In the present systematic review and meta-analysis, we assess the available evidence for a reliable ethnic difference in tonic vagally mediated heart rate variability (HRV), an indicator of parasympathetic cardiac modulation. ⋯ These findings suggest that decreased vagally mediated HRV is not likely to account for the persistent health disparities experienced by AAs with respect to CVD risk and burden. These disparities underscore the need for continued research addressing socioethnic cardiovascular differences and the biobehavioral mechanisms involved.