Psychological Responses and Adherence to Exercise in Heart Failure.

Psychological Responses and Adherence to Exercise in Heart Failure.

Rehabil Nurs. 2013 May 29;
Duncan K, Pozehl B, Hertzog M, Norman JF

PURPOSE: The purpose of this study was to describe psychological effects and exercise adherence during a multicomponent exercise training intervention. METHODS: A sample of 42 patients with heart failure were randomized into an exercise (INV) group (n = 22) and an attention control (AC) group (n = 20). The exercise protocol included two 12-week phases, a structured phase and a self-managed phase. The psychological responses assessed were mood states and exercise self-efficacy. To meet the second purpose of the study, the exercise group was dichotomized based on the number of sessions completed to create two adherence subgroups. FINDINGS: Results indicate self-efficacy improved for the INV group and was maintained during the self-management phase. The adherence subgroups demonstrated different patterns for weekly exercise. Depression and confusion scores improved for the high-adherence group in contrast to worsening for the low-adherence group. CONCLUSIONS: Results suggest a need for further study of the psychological responses of exercise adherence for patients with heart failure. CLINICAL RELEVANCE: The study indicates the importance of continuous assessment of exercise participation and longer term adherence support for patients with heart failure. HubMed – depression



Depress Anxiety. 2013 May 29;
Kasen S, Wickramaratne P, Gameroff MJ

BACKGROUND: Recent findings suggest that beliefs about religious or spiritual importance or attending religious/spiritual services may protect high-risk offspring against depression. This research has not extended to examining religiosity in relation to psychosocial functioning in high-risk offspring. METHODS: Offspring selected for having a depressed parent and offspring of nondepressed parents were evaluated for lifetime major depressive disorder (MDD) in childhood and adolescence, and at 10-year (T10) and 20-year (T20) follow-ups. Relations between self-reported religiosity at T10 and longitudinal change in psychosocial function from T10 to T20 (assessed by clinical ratings on Global Assessment Scale [GAS]) were examined separately in 109 daughters and 76 sons by risk status. RESULTS: Lifetime MDD was diagnosed in 57.8% of daughters and 40.8% of sons by T20. Among daughters, only those with lifetime MDD showed improved psychosocial functioning in relation to higher level of service attendance at T10, their mean GAS score improving by 3.5 points (P = .018) over the next decade. For daughters with and without lifetime MDD, relations between higher levels of religiosity and improved psychosocial function were of greater magnitude in those with a depressed parent. Among sons, only those with lifetime MDD showed improved psychosocial function in relation to higher level of religious/spiritual importance, their mean GAS score improving by 4.6 points (P < .0001) over the next decade; that relation was of greater magnitude in sons with both lifetime MDD and a depressed parent. CONCLUSIONS: Greater improvement in psychosocial functioning in relation to religious involvement in more vulnerable offspring supports religiosity as a resilience factor. HubMed – depression


Psychiatric co-morbidities in patients with chronic peripheral neuropathic pain: A multicentre cohort study.

Eur J Pain. 2013 May 29;
Radat F, Margot-Duclot A, Attal N

BACKGROUND: Psychiatric co-morbidities are common in patients with chronic pain, but no data are available about their prevalence in patients with neuropathic pain. METHODS: A multicentre study involving neurology practices (n?=?30) and pain departments (n?=?8) was conducted to assess the prevalence of lifetime and current anxiety and mood disorders on the basis of DSM-IV criteria in patients with peripheral neuropathic pain. Factors independently associated with such co-morbidity were also studied. A total of 182 consecutive patients (age 59.5?±?13.8 years, 48% men) were recruited. Assessments included lifetime and current anxiety and mood disorders (Mini International Neuropsychiatric Interview), sleep (Medical Outcome Study sleep scale), pain interference (Brief Pain Inventory) and catastrophizing (Pain Catastrophizing Scale). RESULTS: Lifetime and current prevalence of psychiatric co-morbidity were 39% and 20.3%, respectively, for any anxiety disorder, and 47.2% and 29.7%, respectively, for any mood disorder. The two most common psychiatric disorders were generalized anxiety (current prevalence 12.1%) and major depressive episode (current prevalence: 16.5%). Logistic regression analyses showed that high catastrophizing was the most significant variable independently associated with both current anxiety (OR?=?4.21[1.4-12.7]; p?=?0.04) and mood disorders (OR?=?6.9[2.2-21]; p?HubMed – depression


Lovastatin attenuates effects of cyclosporine A on tight junctions and apoptosis in cultured cortical collecting duct principal cells.

Am J Physiol Renal Physiol. 2013 May 29;
Liu BC, Song X, Lu XY, Fang C, Wei SP, Alli AA, Eaton DC, Shen BZ, Li XQ, Ma HP

We used mouse cortical collecting duct principal cells (mpkCCDc14 line) as a model to determine whether statins reduce the harmful effects of cyclosporine A (CsA) on the distal nephron. The data showed that treatment of the cells with CsA increased transepithelial resistance and that the effect of CsA was abolished by lovastatin. Scanning ion conductance microscopy (SICM) showed that CsA significantly increased the height of cellular protrusions near tight junctions. In contrast, lovastatin eliminated the protrusions and even caused a modest depression between the cells. Western blots and confocal microscopy showed that lovastatin also abolished CsA-induced elevation of both zonula occludens-1 (ZO-1) and cholesterol in tight junctions. In contrast, a high concentration of CsA induced apoptosis which was also attenuated by lovastatin, elevated intracellular reactive oxygen species (ROS) via activation of an NADPH oxidase, and increased the expression of p47phox. Sustained treatment of the cells with lovastatin also induced significant apoptosis which was attenuated by CsA, but did not elevate intracellular ROS. These results indicate that both CsA and lovastatin are harmful to principal cells of the distal tubule, but respectively via ROS-dependent and ROS-independent apoptotic pathways, and that they counteract probably via mobilization of cellular cholesterol levels. HubMed – depression


Social relations and depression in late life-A systematic review.

Int J Geriatr Psychiatry. 2013 May 29;
Schwarzbach M, Luppa M, Forstmeier S, König HH, Riedel-Heller SG

OBJECTIVE: Social relations have become the focus of much research attention when studying depressive symptoms in older adults. Research indicates that social support and being embedded in a network may reduce the risk for depression. The aim of the review was to analyze the association of social relations and depression in older adults. METHODS: Electronic databases were searched systematically for potentially relevant articles published from January 2000 to December 2012. Thirty-seven studies met the inclusion criteria for this review. RESULTS: Factors of social relations were categorized into 12 domains. Factors regarding the qualitative aspects of social relations seem to be more consistent among studies and therefore provide more explicit results. Thus, social support, quality of relations, and presence of confidants were identified as factors of social relations significantly associated with depression. The quantitative aspects of social relations seem to be more inconsistent. Cultural differences become most obvious in terms of the quantitative aspects of social relations. CONCLUSION: Despite the inconsistent results and the methodological limitations of the studies, this review identified a number of factors of social relations that are significantly associated with depression. The review indicates that it is needful to investigate social relations in all their complexity and not reduce them to one dimension. Simultaneously, it is important to conduct longitudinal studies because studies with cross-sectional design do not allow us to draw conclusions on causality. Beyond that, cultural differences need to be considered. Copyright © 2013 John Wiley & Sons, Ltd. HubMed – depression



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