Stressed, sick, and sad: Neuroendoimmune pathways between subjective lifetime stress and depression.
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ABSTRACT:
SUBMITTER: Gardhouse K
PROVIDER: S-EPMC8474676 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundOne-fifth of the patients with peripheral artery disease (PAD) experience depression and stress. Depression and stress may impact patients' abilities to be physically active, a key recommendation for supporting overall PAD management to improve symptoms and reduce the risk of cardiovascular events. We aimed to study interrelationships between 1-year longitudinal trajectories of depression, stress, and physical activity following a PAD diagnosis.MethodsPatients with new or worsening PAD symptoms enrolled at 10 US PORTRAIT study (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories) vascular specialty clinics (CT, LA, MI, MO, NC, OH, and RI) were assessed at baseline, 3, 6, and 12 months between June 2, 2011 and December 3, 2015. Depressive symptoms were measured with the 8-item Patient Health Questionnaire, perceived stress with the 4-item Perceived Stress Scale and physical activity with items from the INTERHEART study. Path analysis was used to examine the longitudinal relationship between depression and physical activity and perceived stress and physical activity.ResultsA total of 766 patients were included (mean age of 68.2 [±9.4] years; 57.7% male). Overall, 17.8% reported significant depressive symptoms, 36.0% experienced increased perceived stress, and 44.1% were sedentary upon PAD diagnosis. A decrease in physical activity preceded a rise in subsequent depressive symptoms (β ranges -0.45 [95% CI, -0.80 to -0.09]; -0.81 [95% CI, -1.19 to 0.42]) over the course of 1 year. Low physical activity scores at the initial presentation were followed by high perceived stress at 3 months (β=-0.44 [95% CI, -0.80 to -0.07]).ConclusionsIn symptomatic PAD, a decrease in physical activity was followed by an increased risk of depressive symptoms and perceived stress at subsequent intervals over the course of 1 year following PAD diagnosis and treatment. Integrated behavioral health approaches for PAD, addressing physical activity and managing depression or distress, are indicated as collective PAD treatment goals.
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Project description:ObjectivesThe study aims to examine whether the reciprocal effects of physical morbidity and depression are moderated by subjective age-that is, individuals' perception of themselves as young or old.MethodData from the first two waves of the Midlife in the United States study (1995-6, T1; 2004-6, T2; http://midus.wisc.edu/) were analyzed using a cross-lagged design. We assessed 3,591 individuals who participated in both waves and provided full data on all the relevant variables (mean age at T1 = 47.4). Depression and the number of chronic illnesses (the indicator of physical morbidity) were measured at both waves and were tested as predictors and outcomes in a cross-lagged model. The moderating role of subjective age was assessed by examining whether T1 variables interacted with subjective age in predicting T2 outcomes.ResultsSubjective age moderated the T1 depression-T2 morbidity relationship, so that the relationship was stronger for those with older subjective age. Subjective age did not moderate the T1 morbidity-T2 depression relationship.ConclusionOlder subjective age could be a risk factor for experiencing greater physical morbidity following depression. (PsycINFO Database Record
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