A history of early adverse life events is a potential vulnerability factor for the development of several disorders, including irritable bowel syndrome (IBS). Gupta et al.http://www.psychosomaticmedicine.org/content/76/6/404.full (pages 404–412) tested the hypothesis that a history of early adverse life events is related to brain activity in networks that are involved in determining the salience of somatic, visceral, or environmental stimuli in IBS. These networks play a role in pain perception, which is important in the research on the association between early adverse life events and IBS. Results also highlight the need to consider sex differences in these associations between early adverse life events, central nervous system networks involved in pain, and IBS.
In another brain imaging study related to the experience of pain, Lloyd et al.http://www.psychosomaticmedicine.org/content/76/6/413.full (pages 413–421) explored brain activity in patients with chronic low back pain but limited spinal abnormality. They found that patients who display major pain behaviors have increased activity in the emotional circuitry of the brain. This study demonstrates an association between major pain behavior in chronic low back pain (Waddell signs) and neurobiology of the brain areas involved in emotion regulation, which may mediate and maintain psychological distress in some patients with low back pain.
In an editorial, Stuart Derbyshirehttp://www.psychosomaticmedicine.org/content/76/6/402.full (pages 402–403) addresses the challenges of interpreting findings derived from brain imaging studies on pain-related disorders such as IBS and low back pain. Critical aspects concerning study design are discussed that can improve the research on mechanisms of pain regulation and point toward possible treatments.
Depression has been associated with vascular dysfunction, which may be of particular relevance in pregnancy. Rash and Campbellhttp://www.psychosomaticmedicine.org/content/76/6/422.full (pages 422–429) assessed the effect of oxytocin on acute pain. Participants underwent two laboratory sessions, 1 week apart, during which they received intranasal administration of oxytocin or a placebo delivered in a similar manner. Pain was induced by submersing the participant’s nondominant hand in cold water. Relative to placebo, oxytocin administration resulted in reductions in perceived pain intensity and unpleasantness.
Raw et alhttp://www.psychosomaticmedicine.org/content/76/6/430.full. (pages 430–436) investigated differences in markers of vascular function that are part of the nitric oxide pathway [asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-arginine] in pregnant women with depression. Maternal plasma L-arginine and ADMA levels were significantly lower during pregnancy in women with depression compared to pregnant women without depression. These findings did not result from differences in excretion or inflammation.
Doering et al.http://www.psychosomaticmedicine.org/content/76/6/437.full (pages 437–444) examined the relationship between depressive symptoms and pain in 251 cardiac surgery patients before and 6 weeks after hospital discharge. Patients with persistent depressive symptoms experienced higher levels of pain severity. In multivariate analysis, only changes in depressive symptoms were related to pain, not clinical and demographic variables. Successful interventions for postsurgical pain may need to include screening for and treatment of depressive symptoms.
Identifying people at risk of attempting suicide remains a primary clinical challenge. Cáceda et al.http://www.psychosomaticmedicine.org/content/76/6/445.full (pages 445–451) explored the role of impulsivity and psychological pain in patients who survived a suicide attempt. Four groups of adults were compared: depressed patients within 72 hours after a suicide attempt; depressed patients with active suicidal ideation; nonsuicidal depressed patients; and healthy controls. Transient impulsive choice abnormalities were found in a subset of those who attempted suicide. Overall, suicidal ideation and behavior were associated with choice impulsivity and intense psychological pain.
In a prospective population-based cohort study in Japan, Yamauchi et al.http://www.psychosomaticmedicine.org/content/76/6/452.full (pages 452–459) examined whether stroke increases the risks of suicide and deaths related to other externally caused injuries. The results indicated that the risks of suicide and ECI deaths were substantially elevated within the first 5 years after a stroke. The authors suggest that patients should be closely monitored for symptoms of depression and suicidal thoughts during the first few years after stroke.
Schreier et al.http://www.psychosomaticmedicine.org/content/76/6/460.full (pages 460–467) investigated whether family chaos influences adolescents’ inflammatory profiles and whether this association is moderated by socioeconomic status (SES). Greater family chaos was associated with greater systemic inflammation and greater stimulated proinflammatory cytokine production as family SES declined. These findings suggest that youth who are already vulnerable from lower SES backgrounds may potentially be at a higher risk for inflammation-related diseases if simultaneously exposed to chaotic home environments.
Gallo et al.http://www.psychosomaticmedicine.org/content/76/6/468.full (pages 468–475) examined several dimensions of stress as related to coronary heart disease and stroke in 5313 adults from the Hispanic Community Health Study/Study of Latinos. They found that greater chronic stress was associated with higher prevalence of cardiovascular disease, diabetes, and hypertension. More lifetime traumatic stress were unexpectedly associated with lower diabetes and hypertension prevalence. Both greater current perceived stress and lifetime traumatic stress were related to a higher smoking prevalence. The findings show that the direction and consistency of associations of stress with cardiovascular risk and disease may vary depending on how stress is operationalized.