Background: Psychosocial stress and depression have been recognized as major risk factors of coronary artery disease (CAD). Although monocytes are known to be key players in atherosclerosis, monocyte-based associations with psychoneuroendocrino-immuno-inflammatory (PNI) markers have not been widely investigated in stable CAD. Objective: We examined associations between the monocyte-to-lymphocyte ratio (MLR) and key PNI markers in stable CAD. Methods: We studied 23 patients with stable CAD who completed the Beck Depression Inventory (BDI) and Rahe's Brief Stress and Coping Inventory. A white blood cell differential was performed, and levels of cortisol, chromogranin A (CgA), LL-37, interleukin-6 (IL-6) and C-reactive protein (CRP) were assayed in plasma. Results: Monocyte fraction, MLR and plasma CgA levels exceeded reference values, the social support score was low, and 7 patients had elevated BDI scores. In the multivariate-adjusted analysis, a higher MLR was associated with greater depressive symptom severity (r = 0.624, p < 0.01) as well as with higher concentrations of CgA (r = 0.660, p < 0.01), LL-37 (r = 0.643, p < 0.01), IL-6 (r = 0.532, p < 0.05) and CRP (r = 0.470, p < 0.05). BDI scores associated with CgA concentration (r = 0.618, p < 0.01) and CgA level correlated negatively with the social support score (r = -0.511, p < 0.05). Conclusions: Our findings suggest that, in patients with stable CAD, elevated MLR may be associated with depressive symptoms, with increased neuroendocrine-sympathetic activity (marked by CgA) and inflammatory markers that are pertinent to atherosclerosis initiation and progression. The increased neuroendocrine-sympathetic activity correlated with low social support and depressive symptom severity. The MLR might serve as an easy-to-obtain and inexpensive proxy measure of an activated PNI network in stable CAD.

Vital exhaustion and depressive symptomatology showed a different pattern in their relationship with CVD incidence, with vital exhaustion being the more robust predictor. These results suggest that the 2 constructs are not identical and that vital exhaustion deserves consideration when planning and implementing interventions to reduce CVD risk. (PsycINFO Database Record

During cardiac rehabilitation, it is important to detect and treat not only depression but also vital exhaustion and anxiety, because by reducing these psychological conditions, we can improve well-being.

ObjectivesReliable and valid assessment of subjective risk perception is a crucial part of cardiovascular disease (CVD) prevention and rehabilitation. Since the recently developed Attitudes and Beliefs about Cardiovascular Disease (ABCD) Risk Questionnaire complies with these requirements, the aim of the present study was to investigate the psychometric properties of the Hungarian version of the measure.Design and settingCommunity-based cross-sectional observational studyParticipantsIn sum, 410 (M=49.53 years, SD=8.09) Hungarian adults (inclusion criteria: aged 35 and above, not under treatment with a psychiatric disorder) were included in the present study (female: n=277, 67.6%; college or university-level education: n=247, 60.2%).MethodsWe translated the ABCD Risk Questionnaire into Hungarian and checked its psychometric properties and validity indices.Primary outcome measuresInternal consistency, explorative and confirmative factorial validity. Associations with sociodemographic and health-related characteristics, as well as with measures of mental health (depressive symptoms, perceived stress and well-being).ResultsExploratory and confirmatory factor analyses supported a three-factor solution, corresponding to the original subscales of Risk Perception, Perceived Benefits and Healthy Eating Intentions, with a moderate correlation between the latent constructs. The respondents’ level of knowledge on CVD risk factors was largely independent of their subjective risk perception. The results also provided evidence on the weak-to-medium associations between mental health indices and CVD-related perceptions. Based on the results, a shortened scale version was also suggested.ConclusionThis study confirms the factorial structure, internal consistency and validity of the Hungarian version of the ABCD Risk Questionnaire in a non-English-speaking community sample. The ABCD Risk Perception Questionnaire is a parsimonious and psychometrically adequate measure to assess CVD-related attitudes and knowledge in the general population. Further research is needed in socioeconomically more diverse and in clinical samples, as well as in longitudinal intervention studies.

Form C of the Multidimensional Health Locus of Control Scales (MHLC-C) was designed to investigate health-related control beliefs of persons with an existing medical condition. The aim of the present study was to examine the psychometric properties of this instrument in a culture characterized by external control beliefs and learned helplessness—contrary to the societal context of original test development. Altogether, 374 Hungarian patients with cancer, irritable bowel syndrome, diabetes, and cardiovascular and musculoskeletal disorders were enrolled in the study. Besides the MHLC-C, instruments measuring general control beliefs, anxiety, depression, self-efficacy, and health behaviors were also administered to evaluate the validity of the scale. Both exploratory and confirmatory factor analytic techniques were used to investigate the factor structure of the scale. Our results showed that the Hungarian adaptation of the instrument had a slightly different structure than the one originally hypothesized: in the present sample, a three-factor structure emerged where the items of the Doctors and the Others subscales loaded onto a single common component. Internal reliability of all three subscales was adequate (alphas between .71 and .79). Data concerning the instrument's validity were comparable with previous results from Western countries. These findings may suggest that health locus of control can be construed very similarly to Western countries even in a post-communist society—regardless of the potential differences in general control beliefs.

Aims: In the last decades, the number of infertile males increased worldwide which gained more focus. The extent to which a person or a couple is able to cope adaptively with the problem of infertility depends on the combined effect of several variables. Our aim was to apply counselling among males suffering from infertility problems. During the therapybesides providing informationwe aim to elaborate the effects of the treatment and experiences, to process information, to develop adaptive coping strategies against stress and to indirectly or directly change health behaviours influencing reproduction. Methods: Only patients with male factor infertility were involved. They were divided into an observed group (n = 57) and a control (n = 51) group after a thorough physical examination and assessment of their reactions to, and awareness of, the disease. Results: The group that received the interventions had an intense awareness of the diagnosis and aims and nature of the indicated treatment. They employed purposeful problemsolving coping strategies, reported being satisfied with the infertility treatment. Conclusions: The counselling of clients with infertility problems a more favourable mental well-being can be established by the active participation of professional helpers. Patients might receive effective, targeted and problem-specific help.

Bevezetés: Az ischaemiás szívbetegség vezető haláloknak számít hazánkban. Kialakulásában és a betegség prognózisá-ban is kiemelkedő szerepet játszanak a mentális és az életmódbeli tényezők. Célkitűzés: Ischaemiás szívbetegek kö-rében a szorongás, a depresszió és az egészséggel kapcsolatos kontrollérzés, valamint az egészség-magatartások ösz-szefüggéseinek elemzése. Módszer: Keresztmetszeti vizsgálatban 116 kardiológiai rehabilitációs osztályon fekvő beteg vett részt (56,9% férfi , átlagéletkor: 57,65±8,22 év). Eredmények: A betegek 30,9%-a számolt be megemelkedett szorongásról és 21,9%-a depressziós hangulatról. Az egészségkontrollhit tekintetében e betegek körében a más személyek befolyásában való hit volt a legerősebb. A kevésbé szorongó és kevesebb depressziós tünetet mutató betegek gyakrabban fi gyeltek oda az egészséges táplálkozásra és a testmozgásra. Az erősebb belső kontrollhittel rendelkezők nagyobb eséllyel végeztek testmozgást, a társas külső kontroll skálán magas értéket mutatók pedig nagyobb valószí-nűséggel keresték fel orvosukat, ha betegségre gyanakodtak. Következtetések: A kardiológiai rehabilitáció során fontos a szívbetegséggel kapcsolatos mentális tényezők átfogó vizsgálata és szükség esetén adekvát pszichológiai intervenciók alkalmazása. Orv. Hetil., 2015, 156(20), 813-822. Kulcsszavak: szorongás, depresszió, egészségkontrollhit, egészség-magatartás, ischaemiás szívbetegség Anxiety, depression, health-related control beliefs, and their association with health behaviour in patients with ischemic heart diseaseIntroduction: Psychological and lifestyle factors affect the development and outcome of heart disease considerably. Aim: The aims of the authors were to examine health control, level of anxiety and depression and to analyse their relationship with health behaviour in patients with ischemic heart disease. Method: The present cross-sectional study involved 116 patients who took part in residential cardiac rehabilitation (56.9% men, mean age: 57.65±8.22 years). Results: 30.9% of the patients reported elevated anxiety and 21.9% increased depressive symptomatology. Social-external control belief was the strongest among respondents. Further, anxiety and depression were negatively associated with healthy diet and the frequency of exercise. Patients with stronger social-external control beliefs were more likely to seek medical attention if they suspected a disease. Conclusions: It is important to assess psychological risk factors linked to cardiovascular diseases in cardiac rehabilitation departments and to initiate psychological interventions if indicated.

Absztrakt: Bevezetés: A cardiovascularis megbetegedések vezető haláloki tényezőként évente 4 millió halált okoznak Európában. Az életmód mellett 25–40%-ra becsülik a pszichoszociális tényezők szerepét a betegség létrejöttében. A felnőttkori szociális izoláció a krónikus stressz forrása, és másfélszeres rizikót jelent a betegség kialakulására. A társas támogatás alacsony szintje és a társas izoláció növeli a depresszió, a magas vérnyomás és az elhízás valószínűségét, ezáltal növelve a szív- és érrendszeri megbetegedések előfordulását is. Célkitűzés: A jelen kutatásban arra voltunk kíváncsiak, hogy hogyan függ össze a vizsgálati személyek egészségmagatartása társas kapcsolataikkal. Továbbá a már korábban validált Multidimenzionális Társas Támogatás Skálát adaptáltuk az egészség területére. Módszer: Az online kérdőíves adatfelvétel 2018 őszén történt (n = 507). Felvételre került a Társas Támogatás Skála egészségre adaptált változata, a szubjektív egészségi állapot, a szubjektív anyagi helyzet, felvettük a Rövidített Beck Depresszió Kérdőívet, valamint a WHO Rövidített Jóllét Kérdőívet és az Észlelt Stressz Kérdőívet. Eredmények: A megerősítő faktorelemzés összességében igazolta az eredeti háromfaktoros struktúra meglétét (Cronbach-alfák = 0,945, 0,950 és 0,905). A regressziós modellek szerint az egészséggel kapcsolatban a barátoktól kapott társas támogatás tendenciaszerű pozitív összefüggést mutat az intenzív testmozgással (B = 0,205, béta = 0,096, p = 0,093). Logisztikus regressziós modellben vizsgálva, az egészséggel kapcsolatban kapott társas támogatás nem áll összefüggésben a dohányzással. Csupán az iskolai végzettség mutatkozott szignifikáns tényezőnek (B = –1,284, OR = 0,277, p = 0,000). Következtetés: A Társas Támogatás Skála egészséges életmódra adaptált változatának pszichometriai mutatói mintánkon megfelelőnek bizonyultak. A társas támogatás összefüggést mutatott a mentális egészség mutatóival (depresszió, stressz-szint, jóllét), valamint tendenciaszerű összefüggést a testmozgással. Orv Hetil. 2020; 161(4): 129–138.