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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to investigate whether stressors could induce ventricular arrhythmias or myocardial ischemia in the postinfarction period, 130 patients with recent myocardial infarction (1-2 months after the acute episode), after drug washout, were exposed to two stressors in a random sequence. Mental arithmetic and Sacks test (30 incomplete sentences with high emotional content) were used for 3 min, followed by 5 min recovery. Ninety % of the patients underwent an exercise test and 73% a 24 hour ambulatory monitoring in the same conditions. Ventricular arrhythmias occurred respectively in 21%, 26% and 86% of the patients during mental stress, exercise test and ambulatory ECG monitoring. The arrhythmias score (Italian Lown modified classification) was greater than or equal to 40 in 2% of the patients during mental stress and in 39% in the ambulatory ECG. Only 3 patients (2.3%) showed ST-segment depression greater than or equal to 1mm during mental stress vs. 30.7% during exercise. The double product threshold for ST-segment shift was reached or exceeded during mental stress by 22% of the patients. The increments in heart rate and blood pressure were independent from each other, and similar in the two stress tests. Only the heart rate was slightly higher during mental arithmetic (p less than 0.01). In conclusion, the utilized short-lasting stressors were poorly effective in inducing myocardial ischemia and ventricular arrhythmias in patients with recent myocardial infarction. It is suggested to avoid the generalization of these results to patients with different pathophysiological conditions, taking on account the methodological limits of the study.
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PMID:[Limits of mental stress as an instrument for evaluative screening in recent myocardial infarction]. 401 64

Assessed gender differences in the ratings of stressful events, depression, and cognitive distortion. Responses of 70 males and 70 females (N = 140) to the Life Stress Questionnaire, the Beck Depression Inventory, and the Automatic Thought Questionnaire were studied. Statistical analyses revealed significant differences between sexes on all dependent measures. Men reported experiencing more stressful life change. However, women rated the impact of stressors more severely. Women had higher depression ratings, and men exhibited greater distortions in cognitive content. It is proposed that cognitive distortion may insulate men from depressive moods. Research on coping mechanisms used by men and women in dealing with similar stressful life events may be helpful in clarifying the relationship among gender, stress, and depression.
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PMID:Gender differences in rating stressful events, depression, and depressive cognition. 651 44

A psychological investigation of 30 duodenal ulcer patients showed that their profile differed from that of the Western patients in that drinking, smoking, anxiety, depression and psychopathy were not more common than in the general population. Psychological stress as measured by recent life events was low, but 40% had complaints relating to their work. Their scores for Friedman's Type A Behavior as measured by the Bortner's Scale was low. They had a high Lie Score for the Eysenck Personality Inventory indicating a desire to project a socially desirable image.
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PMID:Psychological characteristics of duodenal ulcer patients (a pilot report on 30 patients). 667 35

A mental arithmetic stress test was performed by 122 consecutive patients undergoing diagnostic coronary arteriography. Twenty-two patients showed significant ST segment abnormalities during the test (group 1). Of these patients, 20 performed a bicycle exercise test, which was positive in all of them. Seventy patients had a negative mental stress but a positive exercise test (group 2), whereas in 30 patients both tests were negative (group 3). There were no patients with a positive mental stress test and a negative exercise test. Mental stress induced a significant increase in heart rate and systolic blood pressure in the three groups of patients. Group 1 patients, however, achieved higher values of double product during mental stress and had a shorter exercise duration than group 2 and group 3 patients. The extent of coronary artery disease (CAD) was similar in groups 1 and 2, while group 3 patients had a significantly lower prevalence of two or more vessel disease. To investigate the pathogenetic mechanism of mental stress-induced myocardial ischemia, great cardiac vein flow was measured by means of the thermodilution technique in four patients with isolated left anterior descending artery disease, who showed ST segment depression in anterior leads in response to mental stress. In three patients without vasospastic angina the calculated coronary resistance decreased during mental stress, as a result of a normal vasodilatory response to the increased myocardial oxygen consumption induced by the test. By contrast, in one patient with variant angina, coronary resistance increased suggesting coronary vasoconstriction. Our findings demonstrate that mental arithmetic stress testing may induce significant ST segment abnormalities in patients with CAD.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Mental arithmetic stress testing in patients with coronary artery disease. 673 Dec 83

The electrocardiographic effects of mental arithmetic stress were studied in 19 young, healthy male subjects. Blood pressure was measured by the cuff method before and during mental stress and electrocardiogram (V5) was monitored and recorded continuously throughout the study using a computerized ECG monitoring system. Heart rate increased from 65.8 +/- 7.0 (mean +/- standard deviation) to 76.7 +/- 9.9 beats/min (p less than 0.001). Systolic blood pressure rose from 122.7 +/- 9.6 to 129.1 +/- 11.7 mmHg (p less than 0.05), diastolic blood pressure from 76.2 +/- 8.8 to 83.0 +/0 11.0 mmHg (p less than 0.001), and mean blood pressure from 91.7 +/- 7.9 to 98.5 +/- 10.1 mmHg (p less than 0.001). These changes were all statistically significant. R wave amplitude decreased significantly from 18.6 +/- 6.9 to 17.0 +/- 6.5 mm for the group (p less than 0.001). No changes in the ST segment were observed; ST depression decreased from 0.56 +/- 0.47 to 0.54 +/- 0.43 mm (N.S.) and ST slope from 0.87 +/- 0.59 to 0.77 +/- 0.63 mm/sec (N.S.). Thus it is apparent that mental stress reduced R wave amplitude without causing ST segment changes in young, healthy subjects. The mechanism and clinical implications are discussed.
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PMID:Effect of mental stress on R wave amplitude of the electrocardiogram in young healthy male subjects. 685 59

To determine whether a standardized psychological stressor combined with physical stress might disclose ischemic abnormalities not evident with physical stress alone, 30 men, mean age 54, were evaluated seven weeks after clinically uncomplicated myocardial infarction. In the first 20 patients, two symptom-limited treadmill tests (TM) were performed on the same day, with and without superimposed psychological quiz (Q). In the next 10 consecutive patients, the Q was administered at a submaximal level (4 METs). When TM and TM + Q responses were compared, no significant differences were noted in the maximal levels of heart rate (HR), systolic blood pressure (SBP), rate pressure product, or in the prevalence of ischemic ST segment depression or angina pectoris. The HR and double product at which ischemic ST segment depression and angina pectoris appeared were similar for the two types of testing. The psychological stress of a psychological quiz may not, of course, approximate the effect of the more severe stressors individuals may encounter in their daily routines.
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PMID:The effect of a standardized psychological stressor on the cardiovascular response to physical effort soon after uncomplicated myocardial infarction. 707 57

Patients diagnosed as reactively or endogenously depressed were given electroconvulsive therapy (ECT). The endogenously depressed patients tended to respond to the treatment more quickly and favourably. Measures of age and severity of depression were as predictive as the classification into endogenous or reactive depression using the Newcastle rating scale. The degree of psychological stress ascertained and presumed to be operating did not contribute to the prediction of outcome.
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PMID:The response of endogenously and reactivity depressed patients to electroconvulsive therapy. 713 5

To determine whether basal blood pressure or pressor responses to stress are related to sympathetic nerve tone or to psychological factors in hypertensives, 15 hypertensives and 13 normotensives were studied by mean of a self-administered questionnaire, isometric handgrip exercise (IHE), and the mental stress of serial subtraction. Plasma norepinephrine (NE), epinephrine (E), blood pressure (BP) and heart rate (HR) were measured before and at the end of IHE and mental stress. A greater number of hypertensives had suppressed anger (p less than 0.01) and scored higher on anxiety trait (p less than 0.01) and depression (p less than 0.05). Prestress (IHE and mental) BP and NE values were significantly greater in hypertensives (all p less than 0.01). During IHE, both groups had a significant increase of BP, HR, and NE (all p less than 0.01) but E rose in hypertensives only (p less than 0.05). The percentage change of BP, HR, NE, and E during IHE was similar in both groups. The changes of BP and HR were not related to NE or E. During mental stress, HR (p less than 0.01) and E (p less than 0.05) increased in both groups. However, BP (systolic and diastolic) increased in normotensives only (p less than 0.01). Plasma NE contents were unchanged in both groups. There were significant positive correlations of anxiety trait with systolic BP (p less than 0.05), diastolic BP (p less than 0.05), and NE (p less than 0.05) and E (p less than 0.05). Although hypertensives had increased neurogenic tone related perhaps to inward anger and anxiety, the percentage responses of neurogenic tone and BP to IHE were equivalent to those of normotensives. The challenge of serial subtraction did not elicit further noradrenergic or pressor responses in hypertensives. Suppressed anger and anxiety, via increased basal neurogenic tone, may be pathogenic factors in some patients with primary hypertension.
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PMID:Anxiety, anger, and neurogenic tone at rest and in stress in patients with primary hypertension. 729 29

Psychological stress, as measured by the parameters of trait anxiety, hostility, and depression, was compared in the group of males age 30-55 with serum levels of testosterone. Those males who were classified as high psychological stress had significantly lower testosterone levels than did their low stress counterparts. However, comparison of their serum cortisol values revealed similar concentrations in both groups.
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PMID:The relationship between high and low trait psychological stress, serum testosterone, and serum cortisol. 732 32

One hundred and fifty consecutive patients with unipolar psychotic ("endogenous") depression were investigated to illuminate any relationships existing between premorbid personality traits and the development of depressive illness. In some cases personality and psychological stress appeared to combine to produce depression, while in others physical stresses appeared to be the principal etiological agents, and to operate in the absence of personality and psychological factors. The contribution of these different factors to causation are discussed and explored.
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PMID:Relationships between premorbid personalities and unipolar depressions. 737 77


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