Methods: Demographic, biometric, and behavioral measures were obtained from 48 women as part of the Pittsburgh Healthy Women Study, a longitudinal epidemiological investigation initiated between 1983 and 1984. In 2005 and 2006, these women took part in a brain imaging protocol.

Results: Premenopausal BMI and a priori chosen confounding variables, including the number of years post menopause, an aggregate measure of perceived life stress spanning a 20-year period, resting blood pressure, total cerebral volume, and severity of white matter hyperintensities (a suspected indicator of aging-related silent cerebrovascular disease), explained ~22% of variance in total GMV. An additional 15% of the variance was uniquely explained by the change in BMI between pre- and postmenopausal longitudinal assessments, such that an increase in BMI predicted a greater reduction in GMV.

Conclusions: An increase in BMI during the menopausal transition and beyond is associated with reduced GMV among otherwise healthy women.

Methods: We established a historical cohort of 7216 subjects who completed the Minnesota Multiphasic Personality Inventory (MMPI) for research at the Mayo Clinic from 1962 to 1965, and who resided within a 120-mile radius centered in Rochester, MN. A total of 7080 subjects (98.1%) were followed over four decades either actively (via a direct or proxy telephone interview) or passively (via review of medical records or by obtaining their death certificates). We examined the association of pessimistic, anxious, and depressive personality traits (as measured using MMPI scales) with all-cause mortality.

Results: A total of 4634 subjects (65.5%) died during follow-up. Pessimistic, anxious, and depressive personality traits were associated with increased all-cause mortality in both men and women. In addition, we observed a linear trend of increasing risk from the first to the fourth quartile for all three scales. Results were similar in additional analyses considering the personality scores as continuous variables, in analyses combining the three personality traits into a composite neuroticism score, and in several sets of sensitivity analyses. These associations remained significant even when personality was measured early in life (ages 20–39 years).

Conclusions: Our findings suggest that personality traits related to neuroticism are associated with an increased risk of all-cause mortality even when they are measured early in life.

Methods: Cross-sectional survey, enrolling 12,643 individuals aged >18 years. Clustered, stratified sampling procedure was utilized. This sample represented 0.16% of the Hungarian adult population according to age, gender, and geographic regions. The severity of depressive symptoms was measured by the abbreviated Beck Depression Inventory.

Results: The prevalence of diabetes in the sample was 6.2% (95% Confidence Interval (CI) = 5.7–6.6), and 13.4% (95% CI = 12.8–13.9) were classified as depressed. Adults with diabetes were two times more likely to have depression (adjusted odds ratio (OR) = 1.83, 95% CI = 1.53–2.19, p < .001) versus individuals without diabetes. Compared with nondepressed people with diabetes, those with diabetes and comorbid depression were older, less educated, more likely to be female and physically inactive, less likely to be employed, and married and had more comorbidities. In multivariate regression analyses, people with diabetes and depression had significantly greater odds of prolonged bed days due to illness (≥20 days) (OR = 2.6, 95% CI = 1.69–3.88, p < .001), prolonged length of hospital stay (≥18 days) (OR = 2.1, 95% CI = 1.27–3.45, p = .004), and multiple hospital admissions (≥2) (OR = 1.8, 95% CI = 1.13–2.82, p = .01) compared with nondepressed diabetic patients.

Conclusions: These findings further document the association between depression and health resource utilization and lost productivity in people with diabetes. Screening and treating depression are important for everyday clinical care and public health initiatives to improve health outcomes for people with diabetes.

Methods: The standard deviation of the normal-to-normal intervals (SDNN), heart rate (HR), and respiratory sinus arrhythmia (RSA) were measured in 2059 subjects (mean age = 41.7 years, 66.8% female) participating in The Netherlands Study of Depression and Anxiety (NESDA). Based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) and Composite International Diagnostic Interview (CIDI), NESDA participants were classified as healthy controls (n = 616), subjects with an anxiety diagnosis earlier in life (n = 420), and subjects with current anxiety diagnosis (n = 1059).

Results: Current anxious subjects had a significantly lower SDNN and RSA compared with controls. RSA was also significantly lower in remitted anxious subjects compared with controls. These associations were similar across the three different types of anxiety disorders. Adjustment for lifestyle had little impact. However, additional adjustment for antidepressant use reduced all significant associations between anxiety and HRV to nonsignificant. Anxious subjects who used a tricyclic antidepressant, a selective serotonin reuptake inhibitor, or another antidepressant showed significantly lower mean SDNN and RSA compared with controls (effect sizes = 0.20–0.80 for SDNN and 0.42–0.79 for RSA). Nonmedicated anxious subjects did not differ from controls in mean SDNN and RSA.

Conclusion: This study shows that anxiety disorders are associated with significantly lower HR variability, but the association seems to be driven by the effects of antidepressants.

Methods: Peak oxygen consumption (VO₂peak), maximum workload (Ppeak), and individual anaerobic threshold (IAT) were assessed in 22 patients suffering from MDD and 22 controls in a stepwise exhaustion protocol, using spirometry and lactate diagnostics. HRR was detected within the first minute after recovery. The Self-Assessment Manikin (SAM) was used to assess mood before and after exercise.

Results: VO₂peak, Ppeak, and IAT were decreased significantly in patients, indicating reduced physical fitness in MDD as compared with control subjects. A single exercise exhaustion significantly improved mood in patients, but not in controls. Mood improvement in patients correlated with maximum lactate levels. Significantly reduced HRR values in patients further point to an elevated cardiovascular risk profile and autonomic dysfunction.

Conclusions: Our results indicate reduced physical fitness in patients with MDD. Thus, special training programs should be developed to improve their cardiovascular risk profile. In addition, the intriguing finding of a correlation between lactate levels and mood changes should be followed up in future studies to unravel putative mechanisms.

Methods: The Interpersonal Support Evaluation List (ISEL, 12-item version), which measures the perceived availability of several types of functional social support, was examined for interactive effects with race on dipping of mean arterial pressure (MAP), systolic blood pressure (SBP), and diastolic blood pressure (DBP) derived from 24-hour ambulatory blood pressure monitoring (ABPM). The sample consisted of 156 young to middle-aged adults (61 blacks, 95 whites; mean age = 35.7 years).

Results: Mean ISEL scores did not differ between racial groups. Controlling for age, body mass index (BMI), resting BP, and socioeconomic status (SES), the interaction of social support by race yielded associations with nighttime dipping in MAP and DBP (p < .001) as well as SBP (p < .01). As ISEL scores increased among white participants, the extent of dipping increased in MAP, SBP, and DBP (p < .01), explaining 10%, 10%, and 8% of the variance, respectively. Conversely, black participants exhibited associations between increasing ISEL scores and decreasing levels of dipping in MAP, SBP, and DBP (p < .05), accounting for 9%, 8%, and 8% of the variance, respectively.

Conclusion: As perceived social support increased, white adults received cardiovascular benefits as suggested by enhanced nocturnal dipping of BP, but black adults accrued risks as evidenced by blunted declines in BP during sleep.

Method: Seventy recently separated or divorced community-dwelling adults (26 men) completed self-report measures of divorce-related psychological adjustment. During a laboratory visit, quasi-continuous BP was assessed across four task periods, including a divorce-specific mental activation task (DMAT). A task-rated emotional difficulty (TRED) index was computed based on participants’ immediate appraisals of the task demands.

Results: After accounting for relevant health-related covariates and depressed mood, participants who reported higher degrees of divorce-related emotional intrusion and physical hyperarousal demonstrated significantly elevated resting BP at entry into the study. When assessing change from a within-person control task to the DMAT, a three-way interaction indicated that men reporting high TRED scores evidenced significant increases in BP, whereas men reporting low TRED scores evidenced significant decreases in BP. Women evidenced no significant changes in BP across study periods.

Conclusions: Results suggest that divorce-related emotional intrusion-hyperarousal and real-time ratings of emotional difficulty (when people think about their separation experience) may play a specific role in BP reactivity, especially for men. These data shed new light on the potential mechanisms that may link marital dissolution and poor health.

Methods: Data from 1278 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study were used to examine the association of SES with oxidation correlates and antioxidant nutrients. Education, occupation, health behaviors, and body mass index (BMI) were assessed during Years 0, 10, and 15 of the study; income and depression were evaluated at Years 10 and 15. F₂-isoprostanes were measured at Year 15, gamma-glutamyltransferase (GGT) at Years 0 and 10, carotenoids at Years 0 and 15, and ascorbic acid at Years 10 and 15.

Results: Cross sectionally, oxidation correlates decreased and antioxidant nutrients increased with increasing SES, estimated in several ways, independent of age, sex, race, and BMI. Prospectively, lower Year 0 education and occupation predicted greater increases in GGT and greater decreases in carotenoids over 10 to 15 years. Prospective associations of Year 0 SES with Year 15 carotenoids were independent of Year 15 SES. Smoking, drinking, and depression symptoms partially mediated these effects.

Conclusions: Circulating oxidation correlates increase and antioxidant nutrients decrease with decreasing SES, both cross sectionally and prospectively.

Methods: Population-based case-control study of 83 persons with CFS, 202 persons with insufficient symptoms or fatigue for CFS (ISF), and 109 well controls living in Georgia. Unconditional logistic regression was used to generate odds ratios (ORs) as measures of the association of AL with CFS.

Results: Relative to well controls, each 1-point increase in allostatic load index (ALI) was associated with a 26% increase in likelihood of having CFS (OR_adjusted = 1.26, 95% Confidence Interval (CI) = 1.00, 1.59). This association remained in the presence and absence of depression (OR_adjusted = 1.35, CI = 1.07, 1.72; OR_adjusted = 1.35, CI = 1.10, 1.65). Compared with the ISF group, each 1-point increase in ALI was associated with a 10% increase in likelihood of having CFS (OR_adjusted = 1.10, CI = 0.93, 1.31). Among persons with CFS, the duration of fatigue was inversely correlated with ALI (r = –.26, p = .047).

Conclusions: Compared with well controls, persons with CFS were significantly more likely to have a high AL. AL increased in a gradient across well, ISF, and CFS groups.

Methods: We used random digit dialing to identify unwell individuals. A detailed telephone interview identified those with CFS-like illness. These individuals participated in a 1-day clinical evaluation to confirm CFS or ISF status. We identified 113 cases of CFS and 264 persons with ISF. To identify current and lifetime psychiatric disorders, participants completed the Structured Clinical Interview for DSM-IV.

Results: Sixty-four persons (57%) with CFS had at least one current psychiatric diagnosis, in contrast to 118 persons (45%) with ISF. One hundred one persons (89%) with CFS had at least one lifetime psychiatric diagnosis compared with 208 persons (79%) with ISF. Of note, only 11 persons (9.8%) with CFS and 25 persons (9.5%) with ISF reported having seen a mental healthcare specialist during the past 6 months.

Conclusions: Our findings indicate that current and lifetime psychiatric disorders commonly accompany CFS in the general population. Most CFS cases with comorbid psychiatric conditions had not sought appropriate help during the past 6 months. These results demonstrate an urgent need to address psychiatric disorders in the clinical care of CFS cases.

Methods: We performed 3 Tesla magnetic resonance imaging of the brain in 14 patients with fibromyalgia and 14 healthy controls. Regional differences of the segmented and normalized gray matter volumes in brain areas of the pain system between both groups were determined. In those areas in which patients structurally differed from healthy controls, the correlation of disease-related factors with gray matter volumes was analyzed.

Results: Patients presented a decrease in gray matter volume in the prefrontal cortex, the amygdala, and the anterior cingulate cortex (ACC). The duration of pain or functional pain disability did not correlate with gray matter volumes. A trend of inverse correlation of gray matter volume reduction in the ACC with the duration of pain medication intake has been detected.

Conclusions: Our results suggest that structural changes in the pain system are associated with fibromyalgia. As disease factors do not correlate with reduced gray matter volume in areas of the cingulo-frontal cortex and the amygdala in patients, one possible interpretation is that volume reductions might be a precondition for central sensitization in fibromyalgia.

Methods: We used data from 1238 older persons without dementia from two longitudinal cohort studies (Rush Memory and Aging Project and Minority Aging Research Study) with baseline evaluations of purpose in life and up to 5 years of follow-up to test the hypothesis that greater purpose in life is associated with a reduced risk of mortality among community-dwelling older persons.

Results: The mean ± standard deviation score on the purpose in life measure at baseline was 3.7 ± 0.5 (range = 2–5), with higher scores indicating greater purpose in life. During the 5-year follow-up (mean = 2.7 years), 151 of 1238 persons (12.2%) died. In a proportional hazards model adjusted for age, sex, education, and race, a higher level of purpose in life was associated with a substantially reduced risk of mortality (hazard ratio = 0.60, 95% Confidence Interval = 0.42, 0.87). Thus, the hazard rate for a person with a high score on the purpose in life measure (score = 4.2, 90th percentile) was about 57% of the hazard rate of a person with a low score (score = 3.1, 10th percentile). The association of purpose in life with mortality did not differ among men and women or whites and blacks. Further, the finding persisted after the addition of terms for several potential confounders, including depressive symptoms, disability, neuroticism, the number of chronic medical conditions, and income.

Conclusion: Greater purpose in life is associated with a reduced risk of all-cause mortality among community-dwelling older persons.

Methods: In Study 1, the gait patterns of 14 inpatients suffering from major depression were compared with those of matched never-depressed participants. In Study 2, we employed musical mood induction to induce sad and positive mood in a sample of 23 undergraduates. A Fourier-based description of walking data served as the basis for the computation of linear classifiers and for the analysis of gait parameters.

Results: Gait patterns associated with sadness and depression are characterized by reduced walking speed, arm swing, and vertical head movements. Moreover, depressed and sad walkers displayed larger lateral swaying movements of the upper body and a more slumped posture.

Conclusion: The results of the present study indicate that a specific gait pattern characterizes individuals in dysphoric mood.