Heightened risk of anxiety, depression among women after heart attack

A new study by researchers from Lithuania claims women are more likely to experience anxiety and depression following a heart attack than men. Furthermore, patients with depression may be at much higher risk of death in the 6 months after a heart attack than those without depression.

 

Study author Prof. Pranas Serpytis and colleagues presented their findings at the annual meeting of the Acute Cardiovascular Care Association – a part of the European Society of Cardiology – in Geneva, Switzerland.

To reach their findings, the team analyzed 160 patients who were admitted to the Vilnius University Hospital Santariskiu Clinics in Vilnius, Lithuania, with a heart attack.

The researchers interviewed patients around 1 month after their heart attack to gather demographic information, such as age, sex education and marital status, and to determine whether they had a history of mental illness.

The team also collected clinical information from the patients – such as whether they had experienced a heart attack before and whether they had a history of high blood pressure or diabetes – and determined if they had any other risk factors for cardiovascular disease, including smoking and lack of physical activity.

The Hospital Anxiety and Depression Scale (HADS) was used to assess patients. Those who had a score of 0-7 had nodepression or anxiety, a score of 8-10 indicated possible depression and anxiety, while a score of 11 or more suggested mild to moderate levels of depression and anxiety.

The risks of anxiety, depression and death after heart attack

Almost 25% of patients were depressed, the researchers say, and 28.2% of these had used antidepressants.

The team found, however, that women were more likely to be depressed and anxious than men after a heart attack. Men had an average depression score of 6.87, while women’s average score was 8.66. For anxiety, men had an average HADS score of 7.18 and women had an average score of 8.20.

The researchers say that further studies are needed to determine why women appear to be at higher risk of anxiety and depression following a heart attack than men.

Commenting on this finding, Prof. Serpytis says:

“Women are misrepresented in many clinical studies on myocardial infarction (heart attack) even though they often have worse outcomes. Our study shows that women are more likely to develop anxiety and depression after myocardial infarction than men but until now this issue has been largely unnoticed.

Clinicians should assess myocardial infarction patients, particularly women, for anxiety and depression so that timely treatment can be started.”

Earlier this year, Medical News Today reported on a study suggesting the reverse effect – that depressed women are at higher risk of heart attack.

The researchers of this latest study also found that patients with depression following a heart attack were almost six times more likely to die in the 6 months after a heart attack, compared with patients who were not depressed.

“Major depression follows myocardial infarction in approximately 18% of cases and is an important predictor of disability and poor quality of life in the year post-myocardial infarction,” notes Prof. Serpytis.

“The increased risk of death in patients with depression persists up to 18 months after the myocardial infarction. But despite the fact that post-myocardial infarction depression is common and burdensome, the condition remains under-recognised and undertreated.”

Smoking increases anxiety risk, while lack of physical activity linked to depression

Furthermore, the team found an increased risk of anxiety among patients who smoked; the average HADS score for anxiety among smoking patients was 10.16, compared with an average score of 7.3 for patients who had never smoked and 4.55 for patients who stopped smoking more than 2 years before.

No link was found between smoking and depression after a heart attack, the researchers say.

However, a small link was found between lack of physical activity and depression. The 64% of patients who were physically inactive had an average HADS depression score of 8.96.

Commenting on the team’s overall findings, Prof. Serpytis says:

“Our study suggests that encouraging patients to quit smoking and increase their physical activity levels should reduce their risks of anxiety and depression after myocardial infarction. More research is needed on the links between myocardial infarction and mental health problems.”

MNT recently reported on a study by researchers from Duke University Medical Center in Durham, NC, claiming theeffects of mental stress on the heart differ between men and women.

Written by Honor Whiteman

http://www.medicalnewstoday.com/articles/284082.php

 

 

Not everyone loses their depression following bariatric surgery

Most severely obese people experience much better spirits once they shed weight through a diet, lifestyle changes or medical intervention. This is unfortunately not true for everyone, says Valentina Ivezaj and Carlos Grilo of the Yale University School of Medicine in the US. In an article in Springer’s journal Obesity Surgery, the researchers advise that the levels of depression in patients be measured six to 12 months after they have had such bariatric surgery. This will ensure that the necessary help can be provided when needed.

Ivezaj and Grilo set out to investigate how prone bariatric patients are to still experiencing depressive symptoms, and especially if such symptoms increase markedly or not at all, after post-surgery. Their study is the first to examine patients with discernible worsening depressive symptoms six and 12 months following gastric bypass surgery.

Self-reported questionnaires were completed by 107 patients with extreme obesity before they underwent gastric bypass surgery, and then again six and 12 months after the procedure. They were asked to reflect on their levels of depression, possible eating disorders, their self-esteem and general social functioning. Of the 107 participants, 94 were women and 13 were men, 73 were white and 24 had completed college.

Consistent with previous research, Ivezaj and Grilo observed that most people who had undergone this procedure were in much better spirits. In fact, most patients reported experiencing a normal and improved mood at six and 12 months after surgery. However, in some cases negative mood changes started to creep in between six and 12 months after the operation, with 3.7 percent of patients reporting that they felt discernibly more depressed 12 months post-surgery. Between six and 12 months after the operation, however, even more patients (13.1 percent) reported increases in depressive symptoms. These changes went hand-in-hand with significantly lower levels of self-esteem and social functioning.

“The majority of patients whose mood had worsened discernibly experienced these mood changes between six and 12 months post-surgery, suggesting this may be a critical period for early detection and intervention, as needed,” explains Ivezaj.

“The increases in symptoms of depression are also notable given that they were associated with other difficulties including lower self-esteem and social functioning,” adds Grilo.

The authors note that the increases in depressive symptoms were indicative of only subthreshold or mild mood disturbances. They also indicated that future research is needed to determine whether these mood changes continue to worsen over time for this group.

http://www.medicalnewstoday.com/releases/283096.php

 

Astronauts’ sleep deficiency in space could affect performance

Imagine hurtling through space at over 17,000 miles per hour in a space shuttle, the Earth shimmering below you. Would you be able to sleep? According to a new study in The Lancet Neurology, astronauts themselves find it difficult, as they suffer significant sleep deficiency in the weeks just prior to and during spaceflight.

 

According to the team – from Brigham and Women’s Hospital, Harvard Medical School in Boston, MA, and the University of Colorado in Boulder – both Neil Armstrong and Buzz Aldrin were either unable to sleep or only got “a couple of hours of mentally fitful drowsing” during their 1969 moon landing expedition.

Unable to escape from the light and noise in the small spacecraft, the astronauts said the cooling system of their spacesuits also made it too cold to sleep.

Though technology has improved by leaps and bounds since then, today’s astronauts are still not getting adequate sleep. This latest research is the most extensive study of spaceflight sleep ever conducted, and it includes objective evaluations of sleep – using an actigraph worn on the astronauts’ wrists to record sleep/wake cycles – and subjective evaluations, which came from daily diaries.

An astronaut’s day is heavily planned, from what they eat, to how much they exercise, to how they spend their free time. The National Aeronautics and Space Administration (NASA) schedule 8.5 hours of sleep per night for crew members in spaceflight, but the study reveals that the average duration of sleep was 5.96 hours on shuttle missions and 6.09 hours on International Space Station (ISS) missions.

Because the sun rises and sets every 90 minutes in a spaceflight environment, getting adequate sleep can be quite difficult, the researchers say.

Use of sleeping pills in space cause for concern

To obtain their data, the research team studied sleep patterns of 64 astronauts on 80 shuttle missions and 21 astronauts on ISS missions before, during and after spaceflight. Overall, they recorded more than 4,000 nights of sleep on Earth and over 4,200 in space.

The results show that the astronauts from shuttle missions attained 7 hours or more of sleep 42% of the time while they were sleeping at home after the missions, and those from ISS missions slept over 7 hours 50% of the time. However, when they were on missions in space, they only attained this level of sleep 12% and 24% of the time, respectively.

Additionally, their sleep deficiency began at least 3 months before they went into space, as the researchers found they averaged less than 6.5 hours of sleep per night during training, which is 30 minutes less per night than the average adult in the US.

Commenting on their findings, study author Dr. Laura K. Barger, from Brigham and Women’s Hospital, says:

“Sleep deficiency is pervasive among crewmembers. It’s clear that more effective measures are needed to promote adequate sleep in crewmembers, both during training and spaceflight, as sleep deficiency has been associated with performance decrements in numerous laboratory and field-based studies.”

Other findings from the study reveal that many astronauts used sleeping medications – such as zolpidem and zaleplon – while in space. At some point during their time on the ISS space station, 75% of crewmembers used the medications, while 78% of shuttle-mission crew members did.

What is more, during their shuttle missions, the astronauts used sleep medication on more than half of the nights in space.

Dr. Barger notes that use of such medications could mean that the “ability for a crewmember to optimally perform if awakened from sleep by an emergency alarm may be jeopardized.” She adds that regular use of such pharmaceuticals in space is a concern, “given that the FDA (Food and Drug Administration) warning that patients using sleeping pills should be cautioned against engaging in hazardous occupations requiring complete mental alertness or motor co-ordination.”

Alarmingly, the researchers found that on four of the shuttle missions – in which all crewmembers participated in the study – all astronauts reported taking sleeping medications on the same night 6% of the time.

‘Effective countermeasures to promote sleep in space are needed’

Although the ISS is now equipped with special quiet, dark “sleep stations,” astronauts are still continuing to experience sleep disturbances, which has led some scientists to believe that microgravity may be the culprit.

“Future exploration spaceflight missions to the moon, Mars, or beyond will require more effective countermeasures to optimize human performance by promoting sleep during spaceflight,” says co-author Dr. Charles Czeisler, of Brigham and Women’s Hospital.

“These may include modifications to schedules, strategically timed exposure to specific wavelengths of light, and behavioral strategies to ensure adequate sleep, which is essential for maintaining health, performance and safety,” he adds.

Though this is the most comprehensive study on the topic to date, it does have a few limitations. For one, it was “limited by the constraints of operational research,” the researchers say. Because actigraphy does not measure sleep stages directly, the team was not able to identify differences in sleep linked to sleeping medications.

They also used sleep duration upon the astronauts’ arrival to Earth as a comparison, but the team says this could be affected by their sleep deficiency during their time in space.

Additionally, because the study was observational, the researchers were not able to record “objective measures of cognitive or operational performance or errors.” As such, they say they can only conclude from research of other operational situations how chronic sleep deficiency and sleeping medications might interfere with the safety and success of a mission.

Still, the team’s findings are revelatory about the sleeping patterns of astronauts while in space, and they conclude by suggesting implementation of countermeasures to promote in-flight sleep.

Written by Marie Ellis

http://www.medicalnewstoday.com/articles/280818.php

 

Making amends gives us moral permission to forgive ourselves

Research published in The Journal of Positive Psychologyclaims that it is easier to forgive ourselves for hurting another person if we first make amends, “or give our inner selves a ‘moral OK.’”

Psychology researchers, from Baylor University in Waco, TX, report the findings of two studies.

One study involved 269 participants recalling previous offenses – such as romantic betrayals, physical injuries, gossip and rejection – they had committed in their lives. In the other study, 208 people were questioned about a hypothetical offense.

Participants in the first study were quizzed on:

• How much they have forgiven themselves for an actual offense
• How much they had tried such efforts as apology, asking forgiveness and restitution
• How much they felt the other person had forgiven them
• How much they saw self-forgiveness as morally appropriate.

The people in the study who made the most amends reported feeling the most that self-forgiveness was morally permissible. This process of being able to self-forgive was also made easier if the participants had received forgiveness from the people they had wronged.

The people who made the most amends reported feeling the most that self-forgiveness was morally permissible.

However, there was a broad variation in the types of offense reported by the participants, so the second study was set up by the researchers to further test their hypotheses.

This second study asked the participants about a hypothetical scenario in which they had to imagine failing to take the blame for an action that caused a friend’s firing.

This study reported similar results to the first experiment, though one difference was that there was little effect from receiving someone else’s forgiveness on whether the participant forgave themselves or not.

Overall, the research showed that the more serious the offense was, and the more guilty the perpetrator felt, the less likely they were to forgive themselves. But making amends could help the wrongdoers reduce their feelings of guilt.

Women less self-forgiving than men

Interestingly, women were also generally found to be less self-forgiving than men. We asked study author Thomas Carpenter, a doctoral student in psychology in Baylor’s College of Arts and Sciences, why he thought this was.

“The gender difference is interesting,” he replied. “First, I should note that in absolute terms, it is not large. However, a variety of studies have found on-and-off gender differences in self-forgiveness over the years. Because the differences aren’t huge, they haven’t been the subject of much investigation. It’s a great question for future research, though.”

Carpenter stresses that the study’s main finding is not so much about receiving forgiveness as how our moral attitudes play a part in self-forgiveness.

He told Medical News Today:

“The idea is that the act of trying to do the right thing, almost a sort of penance, helps the situation feel more balanced and gives us moral permission to let go. We hypothesized that people would actually see it as less moral to forgive themselves unless they had sought to make amends first. In other words, we suspected that people actually are withholding self-forgiveness until they have had a chance to at least try to make things right.

Given that moral attitudes toward self-forgiveness were one of the strongest predictors of self-forgiveness across both studies, our research suggests that the process of morally refusing or allowing ourselves to self-forgive is actually quite important in the self-forgiveness process.”

Last year, Medical News Today reported on a study by Canadian researchers that suggested the “heaviness” ofguilt is more than a metaphor. The researchers published four studies on “embodied cognition” in the journal PLOS ONE, describing how these feelings can be “grounded in subjective bodily sensation,” with the sensation of guilt manifesting as a physical heaviness.

Written by David McNamee

http://www.medicalnewstoday.com/articles/276896.php