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Article Summaries for May 2019 Psychosomatic Medicine, Volume 81, Issue 4

doi: 10.1097/PSY.0000000000000700

Exposure to maternal depression before birth has been linked with adverse infant and child health outcomes, but the mechanisms are not well understood. Hahn et al. examined the association of maternal depression with immune responses in cells from newborns’ cord blood. Lymphocyte proliferation and levels of pro-inflammatory cytokines did not differ with respect to maternal depression. Stimulated levels of the important anti-inflammatory cytokine interleukin-10, however, were lower in cord blood from infants of depressed women. Further longitudinal studies may shed light on whether immune differences observed at birth persist into childhood and beyond.

Pages 320–327;

Self-rated health has been shown to predict morbidity and mortality, even after taking functional status and comorbid disease into account. To explore the biological mechanisms underlying this association, Uchino et al. tested whether self-rated health was associated with markers of inflammation in healthy volunteers aged 42 to 78. Poorer self-rated health was related to higher C-reactive protein levels, a connection mediated in part by sleep quality but not depression.

Pages 328–332;

Thun et al. examined the development and interrelationships of insomnia with mixed anxiety and depression during an 8-week course of cognitive behavioral therapy (CBT). The results indicate that changes in insomnia predicted changes in mixed anxiety and depression at follow-up measurements; in contrast, changes in mixed anxiety and depression did not predict changes in insomnia. Targeting insomnia in the context of brief CBT may not only reduce symptoms of insomnia, but also symptoms of anxiety and depression.

Pages 333–340;

Conscientiousness is typically associated with better psychological resources and lower cardiovascular risk, but associations may be amplified, reduced, or reversed depending on race/ethnicity or socioeconomic status (SES). In urban black and white men, Duggan et al. found that adolescent conscientiousness benefited adult psychological resources regardless of race/ethnicity or SES. In black men of low SES, however, adolescent conscientiousness was related to higher adult metabolic syndrome scores, consistent with John Henryism and “skin deep” resilience perspectives that suggest that there can be a physiologic cost to persistent efforts to cope with severe chronic stressors.

Pages 341–351;

Platelet activation and response to serotonin may be mechanisms by which depression is associated with adverse cardiovascular outcomes. Williams et al. explored platelet serotonin signaling in cardiovascular patients with and without depression. Depressed cardiovascular patients had higher serotonin receptor density and significantly higher incidence of major and minor cardiac adverse events.

Pages 352–362;

Mental stress–induced myocardial ischemia (MSIMI) is a common phenomenon in patients with coronary artery disease (CAD) and is associated with an increased risk of adverse cardiac events. Previous studies have reported that psychosocial factors are associated with MSIMI vulnerability but evaluated each psychosocial factor as a separate exposure variable. Pimple et al. developed a composite measure of psychosocial distress using latent class analysis, integrating scales of depression, posttraumatic stress, anxiety, anger, hostility, and perceived stress, in people with stable CAD. A higher level of this composite psychosocial distress factor was associated with a greater number of resting (fixed) perfusion abnormalities in women. However, this composite factor was not associated with MSIMI. Men and women with a higher composite psychosocial distress factor showed a blunted hemodynamic response to mental stress. The findings suggest that chronic psychosocial distress, considered as a global measure, may affect the severity of CAD more than ischemia provoked by acute stress exposure, especially among women.

Pages 363–371;

The mechanisms by which depression affects cardiovascular disease (CVD) risk remain incompletely understood, particularly with co-occurring risk factors such as smoking. Carroll et al. evaluated associations between 15-year patterns of depressive symptoms and smoking with CVD biomarkers in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Depressive symptom patterns were associated with greater levels of inflammation, whereas smoking patterns were associated with greater oxidative stress and endothelial dysfunction. This study gives direction to further studies interpreting the complex interactions between depression, co-occurring health behaviors, and CVD risk.

Pages 372–379;

The generalized chronic pain condition fibromyalgia (FM) has been associated with multiple cognitive impairments, including altered inhibitory processes. Inhibition is a key component of human executive function and shares neural substrate with pain processing, which may explain inhibitory deficits in FM. González-Villar et al. analyzed the integrity of brain mechanisms via task-induced modulations in electrophysiological inhibitory markers. Results indicated that mechanisms of motor inhibition were preserved in patients with FM. Lower modulation of posterior alpha power suggested greater difficulty in mobilizing and maintaining visual attentional resources, a result that may explain cognitive dysfunction observed in FM.

Pages 380–388;

Heightened sensory sensitivity is an important biological factor in a spectrum of psychiatric conditions. Enhanced odor sensitivity, for example, may be a key to poorly understood disorders such as multiple chemical sensitivity (MCS) that lack satisfactory treatments. Houghton et al. randomized healthy volunteers to see whether treatments that have been shown to improve pain tolerance could be effective in modulating odor sensitivity. Participants who received brief cognitive behavioral intervention showed significantly increased odor thresholds (reduced sensitivity) over the course of the intervention.

Pages 389–395;

Copyright © 2019 by American Psychosomatic Society