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REVIEW ARTICLES
Yoga and brain wave coherence: A systematic review for brain function improvement
Anup De, Samiran Mondal
April-June 2020, 4(2):33-39
DOI:10.4103/hm.hm_78_19  
Background: The recent hype in yoga practice is concomitant with the fact that it helps the practitioner to achieve radiant health and serene mind. The science of yoga has also become a powerful stream of knowledge. It has increased the number of scientific studies on different yogic interventions, but has also been performed to evaluate its effects on brain wave activity, particularly in neural oscillations. Objectives: In this systematic analysis, we reviewed studies investigating the effect of integrated yoga, meditation, and pranayama on brain wave activity that affects overall cognitive functions. Methods: Broad search strategy was practiced using several online databases: PubMed, Google Scholar, Web of Science, Embase, Medline, PsycINFO, Europe PMC, Scopus, and IndMED. Studies were included in integrated yoga, meditation, and pranayama with brain wave activity, and the entire relevant articles were critically analyzed according to the nature of this study. Results: Several studies examined yogic interventions for restoring brain functions, nerve diseases, and cognitive impairment and suggested that integrated yoga, meditation, and pranayama practices improve verbal skills, reaction time, hand–eye coordination, speed accuracy, and neural activity. Yogic intervention increases overall brain wave (delta, theta, alpha, beta, and gamma) activity, which increases overall cognitive functions with greater perceived cognition, working memory, attention, better switching ability, focusing ability, positive mind, and perception. It has also been reported that yogic intervention activates dormant areas of brain while downgrading memories not of interest and upgrading useful ones.Conclusions: There is emerging evidence from randomized controlled trials to support yoga practice, which significantly improves brain wave activity resulting in better cognitive functions.
  36,891 4,372 3
ORIGINAL ARTICLES
Satisfaction with an exercise physiology consultation after treatment for childhood cancer: An opportunity for healthy lifestyle education
David Mizrahi, Claire E Wakefield, Lauren Ha, Richard J Cohn, David Simar, Joanna E Fardell
July-September 2019, 3(3):77-106
DOI:10.4103/hm.hm_47_19  
Purpose: Many childhood cancer survivors are not engaging in sufficient physical activity despite high chronic disease incidence. We assessed satisfaction and acceptability of attending an exercise physiology consultation. Methods: An 8–18-year-old cancer survivor >1-year posttherapy were assessed by an exercise physiologist (T0). We assessed parents' and survivors' satisfaction and acceptability with the consultation and information received 1-month later (T1). Parents and survivors were asked whether they would see an exercise physiologist again and whether other survivors should be assessed. Results: We recruited 102 participants, with 70 unique families retained. Parents were more satisfied with information received about exercise from T0to T1 (43.4 ± 33.2 vs. 81.5 ± 17.6/100,P < 0.001). Parents reported high satisfaction from the consultation (94.7 ± 10.2/100). Most parents (96.6%) and survivors (95.9%) recommended other survivors see an exercise physiologist. Some parents (37.0%) wanted their child to be more active, while 47.8% of survivors wanted to be more active. Conclusions: There was support for an exercise physiology consultation from parents and survivors. Guidance from an exercise physiologist may be important to alter lifestyle behaviors, which can be potentially beneficial to cardiovascular and psychological well-being.
  32,316 3,883 2
REVIEW ARTICLES
Novel comprehensive cardiac rehabilitation to combat the dose-dependent relationship between psychosocial stress and cardiovascular disease
Evan L OKeefe, Carl J Lavie, Sergey M Kachur
October-December 2020, 4(4):109-115
DOI:10.4103/hm.hm_32_20  
The association of cardiovascular disease (CVD) and psychosocial stress (PSS) is a bidirectional function, whereby the two conditions create a self-reinforcing feedback loop. Either can incite and/or magnify the other, prognosis consequently deteriorates and spontaneous remission is unlikely. Several studies show that even subclinical PSS increases mortality. Recent evidence suggests that stress exhibits a strong dose–response toxicity on cardiovascular health with increased levels of PSS directly correlating to additional morbidity and mortality. As such, it will be important that future research considers PSS as a continuous variable capable of causing a spectrum of disease. This article proposes targeted exercise routines as the most efficient therapy for both arms of the feedback loop. A consistent body of data indicates that regular physical activity eases the PSS burden while simultaneously lowering CVD risk. Exercise therapy, mindfulness training, and interventions targeting positive psychological well-being stress management are indispensable therapies, particularly for at-risk and already established cardiovascular patients. Indeed, comprehensive cardiac rehabilitation and exercise training programs inclusive of education, lifestyle, and psychological measures in addition to fitness training are a potent multifaceted therapy for improving quality of life and overall prognosis.
  29,534 3,678 -
ORIGINAL ARTICLES
Prevalence rates of chronic fatigue complaints in a probability sample of Arab college students
Ahmed M Abdel-Khalek
January-March 2019, 3(1):15-20
DOI:10.4103/hm.hm_49_19  
Objectives: Fatigue is a common complaint in the community. The twofold aims of the present study were (a) to estimate the prevalence rate of reported chronic fatigue syndrome-like (CFS-like) complains, and (b) to explore the sex-related differences in it. Methods: A probability non-clinical sample of 3,465 Kuwaiti volunteer undergraduate men (n = 1,745) and women (n = 1,720) was recruited. Their ages ranged between 16 and 43 years. They responded to the Arabic Scale of Chronic Fatigue (ASCF). It has good internal consistency, temporal stability, criterion-related validity, and factorial validity (its loading on a CFS factor = 0.81). Principal component analysis disclosed 2 factors: Mental fatigue and Physical fatigue. The prevalence rate was computed based on 2 criteria, i.e., the percentage of persons which have total scores greater than (a) the M + 1 SD, and (b) greater than the M + 2 SD. Results: Based on criterion (a), prevalence rates were 13.47% for men and 20.98% for women. As to criterion (b), the rates were 2.35% for men and 5.76 % for women. These rates lie in the rage of the international studies on CFS-like complaints (from 1.2% to 30.5%). Women obtained significantly higher mean score and prevalence rates than did their male counterparts. Conclusion: It is highly probable that the participants obtained the higher scores than did their M + 2 SD are in need of therapeutic intervention. It was concluded that psychological scales may be useful in screening disorders to detect the cases.
  28,624 3,627 -
REVIEW ARTICLES
Cross-country comparison in the evaluation of evolocumab by health technology assessment agencies in England, Canada, and Australia
Swaroop Varghese, Marc-Alexander Ohlow, Narendra Kumar
October-December 2019, 3(4):140-146
DOI:10.4103/hm.hm_17_19  
Evolocumab is a proprotein convertase subtilisin/kexin type 9 inhibitor drug which has shown great treatment effects in the treatment of uncontrolled hypercholesterolemia, particularly elevated low-density lipoprotein cholesterol levels. Due to its significant costs, several health technology assessment agencies (HTA) worldwide have exercised caution in issuing its recommendation across different patient groups. This study attempts to review the processes and compare the approach adopted by the HTA agencies in England (National Institute for Care and Health Excellence [NICE]), Canada (Canadian Agency for Drugs and Technologies in Health [CADTH] Common Drug Review), and Australia (Pharmaceutical Benefits Advisory Committee [PBAC]) in the evaluation of evolocumab. Between July and August 2018, the websites of CADTH, the NICE in England, and the PBAC of the Pharmaceutical Benefits Scheme in Australia were searched for technology appraisal documents pertaining to evolocumab. The search included the initial appraisal, resubmissions, as well as the final recommendation made between 2015 and 2018. Significant variability exists between the recommendations and clinical and economic assessment processes in the evaluation of evolocumab across the three selected HTAs. More collaborative efforts may be required to align the interagency HTAs.
  28,260 3,722 -
Tobacco use topography and etiology: Similarities and differences among teens and emerging adults
Steve Sussman
October-December 2019, 3(4):133-139
DOI:10.4103/hm.hm_53_19  
Tobacco regulatory science seeks in part to reduce harm of new tobacco products. Part of this interest is to help chronic adult smokers switch to potentially less harmful products, while not facilitating use of these modified risk tobacco products by nonusers (particularly teens). Studies to discern a lack of interest in reduced harm products are conducted on emerging adults as a proxy for teens. The present empirical review explores the topography and etiology of tobacco use among emerging adults compared to teens to discern whether they might be a reasonable proxy for such reduced harm studies. Both teens and emerging adults view combustible and e-cigarette smoking as disapproved of by peers and are likely to process tobacco marketing information similarly. I conclude that while some differences do exist (e.g., emerging adults are in a period of escalating use and dependence, whereas teens are relatively likely to be initiating use), emerging adults may indeed be a reasonable proxy, at least for current reduced harm studies.
  27,498 3,885 -
ORIGINAL ARTICLES
To investigate the role of Withania somnifera in a mouse model of posttraumatic stress disorder
Ravjot Kaur, Amteshwar Singh Jaggi, Anjana Bali
October-December 2019, 3(4):153-160
DOI:10.4103/hm.hm_14_19  
The present study was conducted to explore the role of Withania somnifera in posttraumatic stress disorder (PTSD) in mice. Swiss albino mice were subjected to a 2-day electric foot-shock stress of 5 min, which included 15 alternating inescapable foot shocks of 0.8 mA intensity with 10-s duration and 10-s intershock interval on the electrified grid floor. It was followed by 3 week re-exposures (on day 3, 7, and 14) in the same context (as situational reminders) for 5 min without delivering any foot-shocks. Trauma and situational reminders results a significant development of behavioral deficits and reduced serum corticosterone levels, as assessed on the 21st day. A significant development of freezing behavior was also observed in response to situational reminders on 3rd, 7th and 14th days. Repeated administration (for 21 days) of W. somnifera (50 mg/kg and 100 mg/kg) considerably restored the behavioral changes and normalized the corticosterone levels. W. somnifera led to significant reduction in the freezing behavior in response to situational reminders suggesting the inhibition of formation of aversive fear memory. It may be concluded that W. somnifera may be beneficial in preventing the PTSD symptoms in response to a traumatic event.
  26,113 3,624 -
Inflammatory and vascular correlates of mood change over 8 weeks
Jonathan W Birdsall, Samantha L Schmitz, Oluchi J Abosi, Lyndsey E DuBose, Gary L Pierce, Jess G Fiedorowicz
April-June 2019, 3(2):47-54
DOI:10.4103/hm.hm_24_19  
Background: Mood disorders have been associated with a variety of cardiovascular disease (CVD) risk factors, including inflammation and large arterial stiffness, particularly while depressed, although longitudinal studies have been limited. Materials and Methods: With measurements at baseline and 8 weeks, the researchers prospectively assessed mood, levels of inflammatory markers (high-sensitivity C-reactive protein and tumor necrosis factor-alpha [TNF-α]), serum lipids, and large arterial stiffness in a cohort of 26 participants with a diagnosis of a mood disorder, enriched for current depression. Depressive symptoms were measured using the Montgomery–Šsberg Depression Rating Scale (MADRS) at baseline and 8 weeks. Associations between depressive symptoms and other measures were assessed using linear mixed models, unadjusted and adjusted for age and body mass index. Results: The mean age of the participants (n = 26) was 41.6 (standard deviation [SD] 12.8) years, and 81% were female. During the study, there was a mean (SD) MADRS score improvement of 9.5 (9.4) from baseline to 8 weeks. Reductions in the primary outcome of tumor necrosis factor-α with improvement in depression fell short of statistical significance (P = 0.076). In secondary analyses, there was a statistically significant association between improved cholesterol ratio (P = 0.038) and triglycerides (P = 0.042) with improvement in depression. There was no statistically significant change in large arterial stiffness during the study. Conclusion: Improved depressive symptoms were associated with improved cholesterol ratios even after adjustment, suggesting a possible mechanism by which acute mood states may influence CVD risk. Future longitudinal studies with extended and intensive follow-up investigating CVD risk related to acute changes and persistence of mood symptoms are warranted.
  25,459 3,683 -
CASE REPORT
Concomitant acute aortic thrombosis and pulmonary embolism complicating COVID-19 pneumonia
Hassan H Allam, Abdulhalim Jamal Kinsara, Amt Alkhaliq A Alrajawi, Tareq Tuiama
October-December 2020, 4(4):123-125
DOI:10.4103/hm.hm_34_20  
There is rapidly accumulating literature regarding the hypercoagulable state associated with patients diagnosed with COVID-19 infection. Pulmonary, cardiac, and visceral involvement has been described. We describe a middle-aged male, with a background of diabetes and hypertension, diagnosed with severe COVID-19, who passed away despite maximum support. He had concomitant aortic and pulmonary thrombus. This is a devastating, poorly understood complication of severe COVID-19, adding to the body of medical literature related to severe COVID-19. COVID-19 is a hypercoagulable disease, and multi-organ involvement should be considered. Aortic imaging during a computed tomography pulmonary angiography can add additional information to the risk stratification and clinical implications in a patient diagnosed with COVID-19, with a suspected hypercoagulable state and possible multi-organ involvement.
  24,903 3,576 1
LETTER TO THE EDITOR
Stress-induced cardiomyopathy related to SARS-CoV-2
A Cereda, M Toselli, A Laricchia, A Mangieri, R Ruggiero, F Gallo, A Sticchi, A Khokhar, F Giannini, A Colombo
April-June 2020, 4(2):57-58
DOI:10.4103/hm.hm_10_20  
  24,070 3,540 2
REVIEW ARTICLE
The depressed heart
Seth W Perry, Julio Licinio, Ma-Li Wong
April-June 2019, 3(2):35-46
DOI:10.4103/hm.hm_13_19  
Our appreciation and understanding of the interrelationships between disrupted metabolic function and depression have increased significantly over the last few decades. This review focuses still more specifically on the intersections between cardiovascular disease (CVD) and major depressive disorder (MDD). General pathophysiological mechanisms implicated in both diseases include inflammation, cytokine and hypothalamic–pituitary–adrenal axis dysregulation, oxidative stress, neurotransmitter disruptions, neuroplasticity, and the microbiome. Here, we explore these mechanistic overlaps of depression and CVD, including some discussion of related and frequently comorbid disorders, such as obesity and diabetes, and the closely related “metabolic syndrome.” Finally, we discuss integrated therapeutic strategies for treating MDD comorbid with CVD.
  21,069 2,140 3
ORIGINAL ARTICLES
Escalation: Raising the college students' awareness regarding early signs of abusive relationships
Abir K Bekhet, Courtney A Kailunas, Alina T Atayan
January-March 2020, 4(1):1-6
DOI:10.4103/hm.hm_23_19  
Background: Abusive relationships are highly prevalent in our society, but often go unnoticed. Research showed that dating violence continues to escalate in college student populations. Purpose: The purpose of this study is to determine the effectiveness of the video as a chosen method of education in raising the college students' awareness regarding warning signs of an abusive relationship. Design: This study used a descriptive qualitative design. Sample/Data Collection: Five focus groups of college students' participants (freshmen to seniors) were recruited to participate in the “Escalation” workshop. To facilitate discussion, each focus group originally had 15 college students for a total of 75 college students' participants. Five participants dropped of the study the last minute due to conflicting schedules and personal situations. Each focus group lasted for 90 min and consisted of watching a 38 min “Escalation” video that depicts scenarios of abusive relationships and a pre- and a post-qualitative discussion. Results: The results of the study and the identified themes illustrate the broadened perspectives participants gained through participating in the workshop. Insights from participants became less focused on physical abuse and began to include more mental and emotional effects of abuse in their responses. This study showed that most participants were not previously aware of the progression and scope of violent relationships. Discussion/Conclusion: By recognizing the early signs of an abusive relationship, it is more likely for victims and/or peers to intervene in a safe manner rather than continuing to allow an abusive relationship to escalate to its full potential of violence and physical harm.
  19,421 1,821 1
Adverse childhood experiences and the structure of personality in patients with takotsubo syndrome versus myocardial infarction
Lutz Goetzmann, Elisabeth Olliges, Barbara Ruettner, Karin Meissner, Karl-Heinz Ladwig, Christian Möller, Daniela Deftu-Kloes, Stefan Pohl, Gert Richardt, Christoph Burgdorf, Alexander Steger, Joram Ronel
January-March 2020, 4(1):12-20
DOI:10.4103/hm.hm_76_19  
Context and Aims: Psychosocial risk factors are known to result in either takotsubo syndrome (TTS) or myocardial infarction (MI). In this article, the results of a cross-sectional study are presented within the framework of “progressive somatization” by comparing the psychosocial traits of TTS and MI patients. Design/Subjects and Methods: 136 patients were administered a battery of questionnaires comprising the Childhood Trauma Questionnaire (CTQ), the Toronto Alexithymia Scale (TAS-20), the Experiences in Close Relationships-Revised Questionnaire, and the Operationalised Psychodynamic Diagnosis Structural Questionnaire (OPD-SQ). Life events prior to the onset of cardiac disease were recorded. Statistical Analysis: Descriptive statistics data were expressed in absolute numbers, percent, and mean and standard deviation. To identify differences between groups, T-tests for independent samples, Chi-square-tests and Mann-Whitney-Tests were used. Pearson correlations were computed to assess the relationship between the patient samples as well as between the patient samples and norms. Results: Few differences were found between TTS and MI patients, with both groups reporting moderate-to-severe “emotional neglect” in their childhood (CTQ). Compared to the norm group, TTS and MI patients showed higher values of “alexithymia” (TAS-20), and MI patients reported higher “attachment avoidance”. There are more “structural limitations of the personality” in TTS and MI patients than in a psychosomatic sample (OPD-SQ). Conclusions: TTS as well as MI patients suffer from “adverse childhood experiences” and “structural limitations of personality.” The results sustain the psychosomatic theory of progressive somatization that leads to severe bodily diseases. Patients might benefit from a specific psychotherapeutical support.
  18,932 1,820 1
CASE SERIES
Cardiac rhythm management devices and ablation procedures in psychiatric patients: A case series and review of the literature
Konstantinos A Gatzoulis, Dimitrios Tsiachris, Georgia Balta, Christos-Konstantinos Antoniou, Petros Arsenos, Polychronis Dilaveris, Dimitrios Tousoulis
January-March 2020, 4(1):21-25
DOI:10.4103/hm.hm_74_19  
Psychiatric patients often present with symptoms similar to those indicating the need for a cardiac rhythm management device or even cardiac arrhythmia ablation. However, due to the unreliability of symptom self-reporting, the ability of the underlying neuropsychiatric condition to elicit similar phenomena, and the perceived reduced compliance and increased complication rates among this population, both of the above approaches remain underutilized with often detrimental effects. In the present case series, it is attempted to describe an alternative, electrophysiology study-guided approach to these patients, aiming to both firmly establish the need for invasive intervention (including implantation of pacemakers – three cases, implantable cardioverter-defibrillators – three cases, and electrophysiological ablations – two cases), as well as dispel preconceptions, bordering on stigma, regarding their outcomes.
  17,742 1,789 1
REVIEW ARTICLES
Cardiovascular complications of COVID-19
Joana Brito, Beatriz Valente Silva, Pedro Alves da Silva, Nuno Cortez-Dias, Doroteia Silva, João R Agostinho, Tatiana Guimar, Dulce Brito, Fausto J Pinto
July-September 2020, 4(3):67-74
DOI:10.4103/hm.hm_28_20  
Coronavirus disease 19 (COVID-19) has rapidly expanded to a global pandemic, resulting in significant morbidity and mortality. Even though predictors of infection remain unclear, age and preexisting cardiovascular conditions have been clearly identified as predictors of adverse outcomes and higher fatality rates. Since the virus infects host cells through angiotensin-converting enzyme 2 receptors, a key player in the renin-angiotensin-aldosterone system, the interaction between the cardiovascular system and the progression of COVID-19 is nowadays a focus of huge interest. In this review, the authors analyze the available and very recent evidence on the risk factors and mechanisms of the most relevant cardiovascular complications associated with COVID-19, including acute cardiac injury, myocarditis, stress-cardiomyopathy, ischemic myocardial injury, cytokine release syndrome, thrombotic disease, cardiac arrhythmias, heart failure, and cardiogenic shock. Finally, we discuss the cardiovascular impact of the therapies under investigation for COVID-19 treatment.
  17,724 1,661 2
Pharmacologic prevention of delirium after cardiac surgery: Current best available evidence
Manish K Soni, Shahzad G Raja
April-June 2020, 4(2):40-44
DOI:10.4103/hm.hm_9_20  
Delirium is a familiar neuropsychological syndrome confronted after cardiac surgery associated with a significant morbidity and mortality. Although several therapeutic options including dexamethasone, rivastigmine, risperidone, ketamine, dexmedetomidine, propofol, and clonidine have been used for delirium prevention, there is still lack of certainty regarding the most effective drug. In the current era of evidence-based medicine, the systematic review (with homogeneity) of randomized controlled trials is regarded as the most precise tool for determining the benefit of a therapeutic intervention. This review article aims to assess the current best available evidence to determine the most effective pharmacologic agent for prevention of delirium post cardiac surgery.
  17,332 1,663 -
EDITORIAL
Guidelines for prevention and treatment of internet addiction in adolescents during home quarantine for the COVID-19 pandemic
Shiqiu Meng, Ping Dong, Yaqi Sun, Yangyang Li, Xiangwen Chang, Guangqiang Sun, Xijuan Zheng, Yankun Sun, Yan Sun, Kai Yuan, Hongqiang Sun, Yumei Wang, Min Zhao, Ran Tao, Coreen Domingo, Yanping Bao, Thomas R Kosten, Lin Lu, Jie Shi
October-December 2020, 4(4):95-99
DOI:10.4103/hm.hm_36_20  
The COVID-19 pandemic threatens physical and mental health of adolescents worldwide and has caused increased risks of dependence and addiction on Internet use during home quarantine. Internet addiction has become an important issue in mental healthcare and its prevention and treatment is of great significance for the development of adolescents. We have gathered leading experts in China and developed this guideline to provide references and suggestions to prevent and treat Internet addiction in adolescents during home quarantine and help them get through the pandemic.
  16,214 2,051 5
REVIEW ARTICLES
Prevalence of psychological distress in type ii diabetes in China: A systematic review and meta-analysis
Jin-Qiao Li, Yun-He Wang, Qing-Dong Lu, Ying-Ying Xu, Jie Shi, Lin Lu, Yan-Ping Bao
October-December 2019, 3(4):147-152
DOI:10.4103/hm.hm_67_19  
Type 2 diabetes mellitus (T2DM) patients are commonly comorbid with psychological distress, such as depressive symptoms, anxiety symptoms, and diabetes distress, which cause great health and economic burden. However, the estimated prevalence of this psychological comorbidity is quite different between studies. Our aim is to estimate the pooled prevalence of depressive symptoms, anxiety symptoms, and diabetes distress in T2DM patients in China. Two Chinese academic databases (China National Knowledge Infrastructure and Wanfang) and two English academic databases (PubMed and Embase) were systematically searched for studies with information on the prevalence of depressive symptoms, anxiety symptoms, and diabetes distress among Chinese T2DM patients published from inception to April 20, 2018. Random-effects meta-analysis was performed to estimate the pooled prevalence. Data were extracted from 80 cross-sectional studies involving 31874 Chinese T2DM patients. The pooled prevalence of depressive symptoms, anxiety symptoms, and diabetes distress were 37.8% (95% confidence interval [CI] 34.6–41.0), 28.9% (95% CI 21.0–36.9), and 50.5% (95% CI 42.4–58.7), respectively. Patients aged 60 years or older have higher prevalence than patients aged <60 years for depressive symptoms, anxiety symptoms, or diabetes distress. Much attention should be paid to the psychological conditions of Chinese T2DM patients, especially for those patients aged 60 years or older in T2DM management.
  14,517 1,741 3
ORIGINAL ARTICLES
Treatment patterns of patients with schizophrenia based on the data from 44,836 outpatients in Russia
Karel Kostev, Galina Osina, Marcel Konrad
October-December 2019, 3(4):161-164
DOI:10.4103/hm.hm_73_19  
Aim: The goal of the present study was to estimate the treatment patterns in outpatients with schizophrenia in Russia. Methods: A total of 44,836 outpatients with schizophrenia treated by 812 psychiatrists in 2018 were selected in the LRx database in Russia. We descriptively analyzed the proportions of patients treated with different therapy classes and drugs. Results: Typical antipsychotics (58.2%) were the therapies with the highest patient proportion, followed by anti-Parkinson drugs (38.3%) and antidepressants (30.6%). The most frequent anti-Parkinson drug was trihexyphenidyl; the most frequent antidepressant was amitriptyline. Conclusions: The findings of this study imply that the proportion of older drugs is higher in schizophrenia therapy in Russia than reported based on samples in Europe and the U.S.
  13,911 1,726 3
Psychosocial and medical predictors of 1-year functional outcome in male and female coronary bypass recipients
Sandra Young, Wolfgang Linden, Andrew Ignaszewski, Andrea Con, Sonia Terhaag, Tavis Campbell
July-September 2019, 3(3):113-121
DOI:10.4103/hm.hm_64_19  
Background and Purpose: This study examines coronary artery bypass graft (CABG) patients, their baseline medical and psychosocial characteristics, and level of functioning after 1 year. Functioning was defined as ability to play their role in social, family, recreational, and occupational areas. Sex differences and the buffering effect of social support were also investigated. Methods: This prospective, observational study recruited 296 (42% female) post-CABG patients, of whom 234 (79%; 44% female) had complete data at 1-year follow-up. Clinical and demographic variables were collected following surgery via chart review and provincial database. Depressive symptoms, perceived social support, household responsibilities, marital status, pain, and role interference were assessed at baseline and 1 year later. Hierarchical linear regression examined relationships between baseline psychosocial variables and 1-year role interference controlling for potential medical confounding variables. Results: One-year role interference was partially predicted by baseline depression, social support, household responsibilities, and marital status (R2 = 0.20,P < 0.001), but not disease severity. Baseline depression predicted 1-year role interference only at mean (b = 0.15, 95% confidence interval [CI] [0.01, 0.31]) and high (b = 0.30, 95% CI [0.12, 0.48]) perceived social support. Baseline perceived social support predicted greater reduction in 1-year role interference in women compared to men (interaction b = 0.29; 95% CI [0.06, 0.52]) and reduced the association between high depression symptoms and role interference in women only (b = −0.25, 95% CI [−0.42, −0.09]). Conclusions: Long-term role interference in bypass graft recipients was not associated with disease severity, but was predicted by social variables and depressive symptoms. In women perceived social support moderated the association between depression and role interference.
  13,670 1,735 3
REVIEW ARTICLES
Mental health challenges raised by rapid socioeconomic transformations in China: Lessons learned and prevention strategies
Yankun Sun, Yanping Bao, Arun Ravindran, Yan Sun, Jie Shi, Lin Lu
July-September 2020, 4(3):59-66
DOI:10.4103/hm.hm_22_20  
China's rapid economic development has contributed to health improvement, such as increasing life expectancy, reducing communicable diseases, and mortality rate. However, the sustainable social and economic transformations, including industrialization, urbanization, globalization, and informatization, have triggered huge challenges to population health in China, particularly to mental health. This review discussed the mental health problems due to socioeconomic changes such as population, life-style, and environment changes, as well both the economic and disease burden of mental disorders. With awareness of these challenges, the following three possible responses are proposed: identify social and economic impact on mental health based on high-quality qualitative and quantitative analysis; improve mental health awareness and literacy; and enhance mental health-care system and promote implementation research. Lessons from China can be a great reference for other low- and middle-income countries. With efforts overcoming the current and potential challenges on mental health, the Sustainable Development Goals on mental health can be possibly achieved by 2030.
  13,497 1,627 4
ORIGINAL ARTICLES
Program planning in education and light exercise training for atrial fibrillation patients: A feasibility study
Connor Tripp, Zachary Force, Nichelle L Huber, J Paul Mounsey, Aditi Naniwadekar, Rajasekhar Nekkanti, Samuel F Sears
July-September 2020, 4(3):80-84
DOI:10.4103/hm.hm_25_20  
Background: Contemporary management of patients with atrial fibrillation (AF) indicates the need for educational and self-care programs to address lifestyle factors. Aims: This study examined the clinical need and interest in programming for risk factor modification in AF patients residing in a mostly rural area. Methods: Participants with AF (n = 86) were recruited during university-based cardiac electrophysiology appointments and asked to complete a 10-min survey battery assessing a range of risk factors spanning physical activity, knowledge, ability, interest, and engagement, as well as psychologic function. Results: AF risk factor reports indicated broad potential need for AF programming with an average CHADS-VASC of 3.8, with approximately 67% reporting low physical activity, and 38% significant anxiety. Related to self-care topics, education on physical activity was the highest-rated program, but weight-loss programming was rated as the most likely to attend. Distance to the clinic was the most often cited barrier, 50% of sample. Conclusions: AF patients demonstrated a need and view educational programming in the realm of physical activity and weight-loss as desirable. Increased research is needed to determine format and duration of treatment deemed efficacious and able to overcome specific barriers such as distance to care.
  13,007 1,621 -
Heart rate variability: New perspectives on assessment of stress and health risk at the workplace
Adrian Low, Rollin McCraty
January-March 2018, 2(1):16-27
DOI:10.4103/hm.hm_11_18  
Introduction: Cardiovascular diseases are the highest cause of death in the world. Many of these deaths may be workplace related. Long hours at work seem to be influencing the increased risks of heart diseases. Workplace stress can be defined as the “discrepancies between the physiological demands within a workplace and the inability of employees to either manage or cope with such work demands.” The varied nature and perception of stress are exemplified from literature that shows stress being either a stimulus, or a response, or a stimulus–response combination, also known as a transactional relationship between one or more individuals and the environment, leading to an initiative toward a physiological standpoint. Methods: This research opted for a correlational study which involves 85 full-time employees who were working at least 40 h per week in a large corporation participated in this study. The Personal and Organizational Quality Assessment and Perceived Stress Scale were used to correlate with heart rate variability (HRV). Objectives: The primary objective of this study is to introduce a new quantitative assessment tool emWave Pro Plus (Institute of HeartMath) and compare heart rate variability (HRV) results with the Personal and Organizational Quality Assessment (POQA) and the Perceived Stress Scale (PSS). Results: Astonishing findings emerged. Significant positive correlations were found between emotional stress and HRV and between intention to quit and HRV. In other words, the researcher has to make sense the following surprising findings: (1) The higher the emotional stress an employee faces, the healthier they are. (2) Healthier employees may have higher intentions of quitting their jobs. Conclusion: The surprising results may be attributed to personality, culture, emotional regulation, and age among others.
  9,122 952 -
REVIEW ARTICLES
The Safety, efficacy, and tolerability of pharmacological treatment of depression in patients with cardiovascular disease: A look at antidepressants and integrative approaches
Laura Chang, Nina Liu
January-March 2017, 1(1):8-16
DOI:10.4103/hm.hm_6_16  
Patients with cardiovascular disease (CVD) are at an increased risk of developing psychiatric illnesses, particularly depression. Depression is an independent risk factor leading to a cardiac event, which has been shown in patients with or without known coronary artery disease (CAD). Treatment of depression has been shown to improve quality of life and result in a better cardiovascular prognosis in patients with comorbid CVD. However, pharmacological treatment of depression in this particular patient population is not without risk and is not always effective. An emerging approach to improve nonresponse to antidepressants is the use of adjunctive nutraceuticals. This article is to review the pharmacological options for treating depression in patients with CAD. The use of integrative approaches and supplements in patients with CVD is also discussed.
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Autism spectrum disorders: Autonomic alterations with a special focus on the heart
Bart A Ellenbroek, Hatice K Sengul
April-June 2017, 1(2):78-83
DOI:10.4103/hm.hm_5_17  
Autism spectrum disorders (ASD) is a heterogeneous group of developmental disorders characterized by stereotyped behaviors and thoughts, and deficits in social behavior, interactions, and communication. The epidemiological evidence shows an increase in the prevalence of ASD although the etiology and pathology of ASD are still largely unknown. In addition to the core symptoms, patients with ASD show emotional and cognitive deficits, and are thought to suffer from abnormal levels of arousal and therefore increasingly studies have been performed to investigate alterations in the autonomic nervous system. The aim of the review is to focus on the changes in the cardiovascular system. Overall, the literature provides some evidence for an increase in baseline heart rate (HR) and a decrease in HR variability (HRV), specifically for high-frequency respiratory sinus arrhythmia. However, the review also illustrates the large variability in results. This is in part due to differences in methodology, but also to the heterogeneity of ASD per se. Moreover, as ASD already occurs at a very young age, differences in the age of the patients are also likely to play a role. Therefore, we propose a more systematic analysis of autonomic dysfunction in well-defined patient populations. In addition, given the plethora of genetic and environmental animal models for ASD that have been developed in recent years, we argue that investigation of HR and HRV could substantially improve the translational validity of these models.
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