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Article Summaries for April 2019 Psychosomatic Medicine, Volume 81, Issue 3

doi: 10.1097/PSY.0000000000000690

Mindfulness interventions can improve the management of impaired physical and mental health. Creswell et al. review recent developments in the effects of mindfulness interventions on specific stress-related disease burden in conditions such as clinical colds, psoriasis, irritable bowel system, post traumatic stress disorder, diabetes, and responses to human immunodeficiency virus. Biobehavioral and neuroimaging studies suggest a mechanistic stress buffering framework in which mindfulness interventions have beneficial effects on central stress resilience pathways in the brain.

Pages 224–232;

Anxiety and depression are risk factors for obstructive coronary artery disease (CAD), but their effects on coronary artery spasm (CAS) remain unestablished. From over 30,000 patient records, Hung et al. defined a CAD patient group, a CAS patient group, and a control group without CAS or CAD. The prevalence of anxiety and depression diagnoses was substantially higher in patients with new-onset CAS than in either of the other groups.

Pages 237–245;

In an accompanying editorial, Mehta, Thobani, and Vaccarino note that CAS is part of the spectrum of abnormal vasomotion that may underlie the etiology of ischemia that occurs in the absence of obstructive narrowing of the coronary arteries. CAS is underdiagnosed and underreported, and thus its overall role in angina and myocardial ischemia remains uncertain. They discuss the potential reasons for underreporting of CAS and the challenges regarding the use of administrative health records for psychosomatic research. In this editorial, a model is presented to explain the association between emotional stressors and mental health factors with CAS, including the role of sympathetic nervous system activation, inflammation, oxidative stress, endothelial dysfunction, and smooth muscle cell dysregulation.

Pages 233–236;

Depressive disorders are commonly comorbid with other medical illnesses, challenging notions of comorbidity and neat divisions of psychiatric and medical illnesses. The overlap between physical and neurovegetative symptoms adds to the challenge of accurate diagnosis and treatment of depression in the medically ill. In this Clinical Applications article, Thom, Silbersweig, and Boland review literature on these comorbidities, suggesting that major depression may be best conceptualized as a systemic illness whose pathophysiology overlaps with other systemic illnesses. For illustration, they describe a patient with major depression as well as hypersensitivity pneumonitis, multiple sclerosis, chronic pain due to degenerative joint disease, and diabetes mellitus.

Pages 246–255;

High levels of hostility have been shown to increase the risk of coronary heart disease whereas high levels of optimism are potentially protective. Salmoirago-Blotcher et al. used data from the Women’s Health Initiative to examine the role of reduced parasympathetic nervous system activity, as measured by lower levels of heart rate variability (HRV), in explaining these associations. In this study, HRV was inversely associated with levels of hostility. HRV was not associated with optimism. While HRV was associated with higher risk of coronary heart disease, its role in explaining the association between these traits and coronary risk remains to be determined.

Pages 256–264;

Firth et al. combined data from randomized controlled trials (RCTs) of dietary interventions reporting changes in symptoms of depression and/or anxiety in clinical and non-clinical populations. Results showed that dietary interventions have significant, positive effects on symptoms of depression, with lower effects on anxiety. Subgroup analyses showed stronger reductions in depression and anxiety from healthy diets in women versus men, thus suggesting that women may have greater mental health benefits from dietary interventions than men.

Pages 265–280;

In a longitudinal study, Meier et al. tested whether cannabis use was associated with increases in adult cardiometabolic risk factors, including body mass index, cholesterol, fasting glucose, insulin resistance, and blood pressure. Cannabis use was measured periodically in a cohort whose youngest members were 12 at the beginning of the study. Effect sizes were small, but cannabis use was associated with lower body mass index, smaller waist-hip ratio, lower levels of triglycerides and fasting glucose, lower systolic blood pressure, and fewer metabolic syndrome criteria at approximately age 32 years, even after accounting for a variety of covariates, such as tobacco use, childhood socioeconomic status, and childhood health.

Pages 281–288;

Time series analysis (TSA) requires a long sequence of equidistant observations of a single individual and focuses on intra-individual statistics. In the Methods and Statistics series, Stadnitski and Wild describe TSA of patient samples with numerous repeated measurements. They present basic concepts of TSA such as stationarity, auto- and cross-correlation, Granger causality, impulse response function, and variance decomposition. Employing the software program R with accompanying explanation, the authors demonstrate a concrete application of the time series method in two case series of patients with anorexia nervosa.

Pages 289–304;

Resilience models suggest that individual or contextual protective factors help some people thrive despite adversity. Gallo et al. examined associations among socioeconomic adversity, social resources, and allostatic load in 1343 Hispanic/Latino youths. Significant associations were found between higher socioeconomic adversity and higher allostatic load. This association was not accounted for by social resources. Future studies are needed to further clarify the role of social factors in the biobehavioral processes relevant to health and disease in Hispanic/Latino children and young adults.

Pages 305–312;

Somatic symptom disorder (SSD) is potentially associated with alterations of sensory-discriminative processing of pain and other somatic symptoms. Kim et al. document results supporting resting-state functional connectivity between the sensorimotor (SMN) and salience networks, relevant to affective processing. Further analysis of the SMN and connectivity with the dorsal attention network indicated that SSD is associated with deficits in attention, leading to misperception of external stimuli and failure to regulate bodily functions involved in interactions with external stimuli.

Pages 313–318;

Copyright © 2019 by American Psychosomatic Society