Depressive symptoms, perceived stress, and metabolic health: The REGARDS study

Abstract

Objective: To describe the relationship between metabolic health parameters and depressive symptoms and perceived stress, and whether the co-occurrence of these two psychological stressors has an additive influence on metabolic dysregulation in adults at different levels of body mass index (BMI) without diabetes. Methods: Participants without diabetes (N=20,312) from the population-based REasons for Geographic And Racial Differences in Stroke (REGARDS) study (recruited between 2003–2007) who had a body mass index (BMI) ≥18.5 kg/m 2 were included in this cross-sectional analysis. Mean age of sample was 64.4 years, with 36% African American, and 56% women. Depressive symptoms and perceived stress were measured using brief versions of the Center for Epidemiologic Studies Depression (CES-D-4 item) questionnaire and Cohen Perceived Stress Scale (PSS), respectively. Metabolic health parameters included waist circumference, blood pressure (systolic and diastolic), low- and high-density lipoprotein (LDL, HDL) cholesterol, triglycerides, fasting glucose, and high sensitivity C-reactive protein (hs-CRP). Sequentially adjusted General Linear Regression Models (GLM) for each metabolic parameter were used to assess the association between having both elevated depressive symptoms and stress, either of these psychological risk factors, or none with all analyses stratified by BMI category (i.e., normal, overweight, and obesity). Results: The presence of elevated depressive symptoms and/or perceived stress was generally associated with increased waist circumference, higher CRP, and lower HDL. The combination of depressive symptoms and perceived stress, compared to either alone, was typically associated with poorer metabolic health outcomes. However, sociodemographic and lifestyle factors generally attenuated the associations between psychological factors and metabolic parameters. Conclusions: Elevated depressive symptoms in conjunction with high levels of perceived stress were more strongly associated with several parameters of metabolic health than only one of these psychological constructs in a large, diverse cohort of adults. Findings suggest that healthy lifestyle factors may attenuate the association between psychological distress and metabolic health impairment.

Potential metabolic monitoring indicators of suicide attempts in first episode and drug naive young patients with major depressive disorder: a cross-sectional study

“…What's more, referring to perceived stress, Shelef et al reported that perceived stress was identified as one of primary determinants among young suicide attempters [45]. And Gowey MA reported that increased depressive symptoms and perceived stress are usually associated with decreased level of HDL [46]. So, we considered that a certain degree of perceived stress may take part in the influence of lower HDL-C on suicide attempts.…”

Association Between Caregiver Strain and Self-Care Among Caregivers With Diabetes

“…Elevated stress was defined as a score on the 4-item Perceived Stress Scale of 8 or greater. 52 Social support was assessed using self-reported marital status and the presence or absence of a social network, defined as a report of having seen either no friends or relatives or only 1 friend or relative in the past month. 53 Additional caregiver characteristics were also collected; participants who responded affirmatively to being caregivers were asked about their social support system and (1) whether they lived with the care recipient, (2) how this person was related to them (eg, spouse, parent), and (3) how many hours per week they spent providing care to this person (<10, 10-19, 20-29, or >30 hours).…”

Risks associated with the stroke predisposition at young age: facts and hypotheses in light of individualized predictive and preventive approach

“…FS-affected individuals demonstrate obsessive personality and tendency to perfectionism frequently linked to increased psychologic stress [170] that has been extensively discussed in context of several pathologies potentially linked to FS phenotype including both neurodegenerative eye disorders [179] and oncologic diseases [152][153][154], and corresponding molecular mechanisms and targets for response have been clearly identified [180,181]. Similarly, chronic stress and mood disorders have been proposed to play significant role in the pathomechanisms of the multifactorial stroke predisposition [182,183].…”