Association of Suicidal Ideation with Job Demands and Job Resources: a Large Cross-Sectional Study of Japanese Workers

Purpose

This study aimed to identify the association of suicidal ideation with job demands and job resources among Japanese workers.

Methods

Valid data from questionnaires that were pre-collected from 42,499 workers (34,882 males and 7617 females) were used for multilevel logistic regression analyses. Job demands and job resources were selected as potential predictors of suicidal ideation. Lifestyle variables, support from family and friends, and suffering from depressive or eating disorders were used as covariates.

Results

In the employee-level, most job demands and job resources had significant associations with the risk of suicidal ideation in both sexes. High coworker support had a significant negative association with the risk of suicidal ideation in the organization-level, irrespective of their gender. High physical demands and poor physical environment in the organization-level had significant positive associations with increased risk of suicidal ideation only among females.

Conclusions

The risk of suicidal ideation among Japanese workers is associated with job demands and job resources in the employee-level, and coworker support in the organization-level may be important as well.

     

Stress Underestimation and Mental Health Outcomes in Male Japanese Workers: a 1-Year Prospective Study

Purpose

Being appropriately aware of the extent of stress experienced in daily life is essential in motivating stress management behaviours. Excessive stress underestimation obstructs this process, which is expected to exert adverse effects on health. We prospectively examined associations between stress underestimation and mental health outcomes in Japanese workers.

Methods

Web-based surveys were conducted twice with an interval of 1 year on 2359 Japanese male workers. Participants were asked to complete survey items concerning stress underestimation, depressive symptoms, sickness absence, and antidepressant use.

Results

Multiple logistic regression analysis revealed that high baseline levels of ‘overgeneralization of stress’ and ‘insensitivity to stress’ were significantly associated with new-onset depressive symptoms (OR?=?2.66 [95 % CI, 1.54–4.59], p?<?.01) and antidepressant use (OR?=?4.91 [95 % CI, 1.22–19.74], p?<?.05), respectively, during the 1-year follow-up period.

Conclusions

This study clearly demonstrated that stress underestimation, including stress insensitivity and the overgeneralization of stress, could exert adverse effects on mental health.

     

Effect of the Interaction Between Employment Level and Psychosocial Work Environment on Insomnia in Male Japanese Public Service Workers

Background

Little is known about the combined risk of socioeconomic status and psychosocial environment for insomnia.

Purpose

The purpose of this study was to investigate the combined risk of employment level and psychosocial work environment for insomnia in a large Japanese male working population.

Method

We investigated 5,951 male employees aged 34–59 years from two local governments in Japan. Data were obtained from a questionnaire distributed in advance of their annual health check-up. Employment level was categorized as higher-level non-manual workers, lower-level non-manual workers, and manual workers. Psychosocial work environment was assessed using the Demand-Control Model and the Effort-Reward Imbalance Model (ERI). Insomnia was assessed using the Athens Insomnia Scale.

Results

The results showed that 1,382 (23.2 %) participants suffered from insomnia. Lower employment level was significantly associated with a higher risk of insomnia. Job strain (ratio of job demand to job control), E/R (ratio of job effort to job reward), and OC (over commitment) were also significantly associated with insomnia. The relative excess risk due to the interaction between employment level and psychosocial environment (job strain, E/R, and OC) was 0.09 (95 % CI ?0.57 to 0.76), 2.61 (0.74 to 4.48), and 3.14 (0.82 to 5.45), respectively; synergy index?=?1.07 (0.66 to 1.74), 1.99 (1.37 to 2.90), and 2.25 (1.46 to 3.46), respectively.

Conclusion

We found supra-additive interactions between employment level and psychosocial environment, assessed by the ERI (E/R and OC). Our findings suggested that lower level workers are more vulnerable to an adverse psychosocial environment than those at a higher level.     

男性CHD患者血清性激素、Hcy、hs-CRP和ET水平的关系

目的：为了进行男性冠心病（chronary heart disease,CHD）患者与血清性激素、Hcy、hs-CRP和ET水平关系。方法：发光免疫分析了96例男性CHD患者和68例正常对照组血清性激素和Hcy,放射免疫分析了血清hs-CRP和ET。结果：96例男性CHD患者血清性激素较之68例正常对照组,E2明显增高（P〈0.01）,T明显降低（P〈0.01）,而血清Hcy、hs-CRP和ET均明显增高（P〈0.05～P〈0.01）。结论：男性CHD患者的发生发展与血清性激素、Hcy、hs-CRP和ET水平密切相关。     

Effect of Breastfeeding Duration on Cognitive Development in Infants: 3-Year Follow-up Study

We investigated the association between breastfeeding and cognitive development in infants during their first 3 years. The present study was a part of the Mothers’ and Children’s Environmental Health (MOCEH) study, which was a multi-center birth cohort project in Korea that began in 2006. A total of 697 infants were tested at age 12, 24, and 36 months using the Korean version of the Bayley Scales of Infant Development II (K-BSID-II). The use and duration of breastfeeding and formula feeding were measured. The relationship between breastfeeding and the mental development index (MDI) score was analyzed by multiple linear regression analysis. The results indicated a positive correlation between breastfeeding duration and MDI score. After adjusting for covariates, infants who were breastfed for ≥ 9 months had significantly better cognitive development than those who had not been breastfed. These results suggest that the longer duration of breastfeeding improves cognitive development in infants.     

骨质疏松症患者血清CT、Ca和P的水平观察

目的：为了研究血清降钙素（CT）、钙（Ca）和磷（P）的水平对激素引起男、女性骨质疏松症（OP）的影响。方法：放射免疫分析了血清CT的水平,生化法测定了血钙和血磷,发光免疫分析了性激素水平,并都做了相关性分析。结果：67例男性OP的血清Ca、P和E2均明显高于正常对照组（P均〈0.01）,而血清CT和T较正常对照组明显降低（P〈0.01）。在治疗前,60例女性OP患者血清Ca、P和T均明显高于正常对照组（P均〈0.01）,而血清CT和E2较正常对照组明显降低（P〈0.01）;治疗后女性OP患者血清CT和E2较治疗前明显增高,血清Ca、P和T明显降低,血清CT、E2和T较正常对照组接近（P均〉0.05）,而血清Ca和P较正常对照组仍增高（P〈0.05）。结论：由性激素引起的OP与血清CT、Ca、P和性激素相互之间存在着相关关系。在女性OP治疗时,以CT、E2和T水平为随访的最佳指导。     

男性Graves’病患者血清性激素与Th1/Th2细胞因子相关性研究

目的：观察男性Graves’病（GD）患者治疗前后血清性激素及干扰素γ（IFN-γ）、白介素-4（IL-4）的动态变化,探讨男性GD患者血清性激素与Th1/Th2细胞因子的相关性。方法：选取初发未治的男性Graves’病患者42例为治疗组,经抗甲状腺药物治疗12周后均临床缓解。治疗前后分别应用放免法（RIA）检测血清雌二醇（E2）、睾酮（T）、黄体生成素（LH）、卵泡刺激素（FSH）水平,应用酶联免疫吸附法（ELISA）检测血清干扰素γ（IFN-γ）、白介素-4（IL-4）水平。健康男性体检合格者40例作为正常对照组。结果：男性GD患者治疗前血清E2、T、LH、FSH水平均较正常对照组明显升高（P〈0.05）,治疗后均接近正常对照组。治疗前血清IL-4、IFN-γ水平较正常对照组均升高（P〈0.05）,治疗后IL-4水平下降,接近正常对照组,而IFN-γ水平仍较高。经多元逐步回归分析,血清E2水平是影响IL-4水平的独立因素,呈正相关;血清T水平是影响IFN-γ水平的独立因素,呈正相关;IL-4与IFN-γ水平是相互的独立因素,呈负相关。结论：初发未治的男性GD患者存在性激素水平的变化及Th1/Th2细胞因子失衡,性激素在男性Graves’病患者Th1/Th2平衡方面起着一定的作用。     

The Direction of Longitudinal Associations Between Sleep Problems and Depression Symptoms: A Study of Twins Aged 8 and 10 Years

Study Objectives:

To establish the direction and etiology of longitudinal associations between sleep problems and depression symptoms in children.

Design:

Data on twins aged 8 and 10 years were obtained. At assessments, parents completed the Child Sleep Habits Questionnaire, and twins completed the Children''s Depression Inventory.

Setting:

Participants were mainly interviewed at the Institute of Psychiatry, London.

Patients or Participants:

Three hundred twin pairs initially enrolled in the study.

Interventions:

N/A.

Measurements and Results:

A genetically informative cross-lagged model examined links between sleep and depression. Sleep problems at age 8 predicted depression at age 10 (partial regression coefficient [95% confidence intervals] = 0.10 [0.01-0.18]). The converse was not found. Stability of sleep problems across time was mainly due to genes (46% of the genetic influence on sleep at 10 was due to the same genetic influence on sleep aged 8). Stability of depression was mainly due to nonshared environmental influences (19% of the nonshared environmental influence on depression at 10 was due to the same nonshared environmental influence on depression at age 8). The cross-lagged association between sleep problems at 8 and depression at 10 years was largely due to genes, although this finding was nonsignificant.

Conclusions:

This study adds to our understanding of the temporal precedence of sleep problems and depression and the risks underlying their associations. There are implications regarding the value of specifying genes linked to sleep problems and potential opportunities for informing early intervention strategies in high-risk groups at key points in the progression to developing more serious problems.

Citation:

Gregory AM; Rijsdijk FV; Lau JYF; Dahl RE; Eley TC. The direction of longitudinal associations between sleep problems and depression symptoms: a study of twins aged 8 and 10 years. SLEEP 2009;32(2):189–199.     

Effects of Seasonal Differences in Testosterone and Cortisol Levels on Pain Responses Under Resting and Anxiety Conditions

Purpose

This study investigated whether hormones and pain perception are associated with exam anxiety, and also whether exam anxiety is affected by seasonal differences in testosterone and cortisol levels.

Materials and Methods

Forty-six healthy males were recruited from a medical college. Anxiety was induced by having participants perform the Objective Structured Clinical Examination. Pressure was applied to the participants to induce pain. Pain thresholds, pain ratings, anxiety ratings, blood pressure, heart rate, salivary testosterone and cortisol levels were measured under resting and anxiety conditions in the spring and summer. Data were collected from 46 participants during the spring (n=25) and summer (n=21).

Results

Pain thresholds and testosterone levels were significantly lower under anxiety than at rest for all participants (n=46), while cortisol levels, pain ratings, and anxiety ratings were significantly higher under anxiety than at rest. In the spring (n=25), testosterone levels were significantly higher at rest than under anxiety, while there was no difference in cortisol levels between resting and anxiety conditions. In the summer (n=21), cortisol levels were significantly higher under anxiety than at rest, while there was no difference in testosterone levels between resting and anxiety conditions. There were no significant seasonal differences in pain and anxiety ratings and pain threshold.

Conclusion

These results indicate that seasonal differences in testosterone and cortisol levels under anxiety and at rest may affect pain responses. These results also suggest that acute clinical pain may be relieved by managing anxiety that is related to a decrease of testosterone in spring and a large increase of cortisol in summer.     

Genetic Influences on Change in BMI from Middle to Old Age: A 29-Year Follow-up Study of Twin Sisters

Weight gain through middle age is a common phenomenon that increases the risk for different types of metabolic diseases and functional limitations later in life. This study examined genetic and environmental influences on the evolution of body mass index (BMI) in women from middle to old age. BMI was evaluated in 102 monozygotic and 114 dizygotic pairs of twin sisters from the year 1975, when they were 42.6 ± 3.4 years-old, and thereafter in 1981, 1990, 2001 and 2004, in a total 29-year follow-up period. We examined genetic and environmental influences explaining BMI overall level and its rate of change using a latent growth modeling approach. The results showed that mean (±SD) BMI increased from 24.1 ± 3.1 to 28.2 ± 5.1 kg/m² during the 29-year period. The heritability of BMI showed a consistent increment across occasions, from 54% in 1975, to 72% in 2004. Genetic influences accounted for both overall BMI level (60%) and BMI rate of change (64%). Genetic and environmental correlations between BMI level and rate of change were: r_g = 0.40 and r_e = −0.24, respectively. We conclude that in relatively healthy women, genes affecting level of BMI may differ from those affecting change in BMI with age. These results provide a basis for identifying genetic variants for change in BMI. Edited by Danielle Posthuma.     

2型糖尿病与细胞因子的相关性研究

目的:探讨2型糖尿病患者血浆白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子(TNF-α)在糖尿病发生、发展过程中的浓度变化及相互关系。方法:用放射免疫分析检测45例2型糖尿病患者及33例年龄和性别相匹配的健康志愿者血清IL-6、IL-8、TNF-α的水平。结果:①2型糖尿病患者血中IL-6、IL-8、TNF-α水平明显高于对照组(P<0.01);②有合并症患者血清IL-8、TNF-α水平明显高于单纯糖尿病患者(P<0.02);③三种细胞因子间浓度呈正相关(P<0.01)。结论:细胞因子IL-6、IL-8、TNF-α在糖尿病的发生、发展过程中相互作用,观察其浓度变化对探讨糖尿病的发病机理、预防及指导用药均有重要价值。     

Associations of Insomnia Symptoms With Blood Pressure and Resting Heart Rate: The HUNT Study in Norway

Objective: Although elevated heart rate and blood pressure might represent biologically plausible links for the association of insomnia symptoms with increased risk of cardiovascular disease (CVD), few large studies have investigated the associations of insomnia symptoms with these factors. Our aim was to investigate the associations of self-reported insomnia symptoms with systolic and diastolic blood pressure and resting heart rate in a large population-based study. Participants: Self-reported information on insomnia symptoms, including sleep initiation problems, frequent awakening and early awakenings during night, and measurements of resting heart rate and blood pressure were collected from a total of 50,806 men and women who participated in the third wave of the Nord-Trøndelag Health Study (HUNT-3) in 2006–2008. Methods: In multivariable analyses, we adjusted for sociodemographic factors, lifestyle factors, established CVD risk factors, and snoring or breathing pauses. Results: Compared to participants reporting none of the insomnia symptoms, those having all three insomnia symptoms several times a week had lower diastolic blood pressure (–0.80 [95% CI: –1.47 to –0.14] mmHg, p = 0.02), lower systolic blood (–1.69 [95% CI: –2.76 to –0.63) mmHg, p < 0.001), and higher resting heart rate (0.83 [95% CI: 0.11 to 1.55] beats/minute, p = 0.02). Conclusions: We found a modest positive association of insomnia symptoms with resting heart rate, and a modest inverse association of insomnia with blood pressure. However, the actual differences were small, and likely of less clinical importance. Prospective studies are needed to establish whether the potential link between insomnia and CVD is mediated through changes in heart rate and/or blood pressure.     

初诊DM2患者脂联素、炎性因子与胰岛素抵抗的相关分析

目的：分析初诊2型糖尿病（DM2）患者脂联素、IL-6、TNF-α水平变化及其与胰岛素抵抗（IR）、肥胖的相关性。方法：选择初诊DM292例,分为肥胖组（体重指数BMI≥25kg/m^2）42例、非肥胖组（BMI〈25kg/m^2）50例、正常对照组40例,测定血清脂联素、IL-6、TNF-α、体重、身高、血脂、空腹血糖（fPG）、餐后2h血糖（2hPG）、空腹胰岛素（fINS）、餐后2h胰岛素（2hINS）、计算胰岛素抵抗指数（HOMA-IR）,做相关性分析。结果：肥胖组脂联素低于非肥胖组（P〈0.05）及正常对照组（P〈0.01）,非肥胖组又低于正常对照组（P〈0.05）。而肥胖组IL-6、TNF-α高于非肥胖组（P〈0.05）及正常对照组（P〈0.01）,非肥胖组又高于正常对照组（P〈0.05）。脂联素与BMI、HOMA-IR呈负相关,IL-6、TNF-α与BMI、HOMA-IR呈正相关。结论：脂联素、IL-6、TNF-α与IR密切相关,参与了糖脂代谢紊乱。     

瘦素与2型糖尿病患者微血管病变关系的探讨

目的 :探讨瘦素与 2型糖尿病患者微血管病变的关系。方法 :对照组、糖尿病无微血管病变组及糖尿病微血管病变组各 30例 ,其中糖尿病微血管病变组包括糖尿病肾病 2 5例 ,糖尿病视网膜病变 12例 ,同时合并DN与DR者 7例。检测血清瘦素、胰岛素及血糖浓度 ,分析瘦素水平与其它指标的相关性。结果 :对照组、无微血管病变组及微血管病变组血清瘦素浓度分别为 (7 2 0± 2 11) μl/L、(7 95± 3 78) μg/L及 (10 2 6± 4 37)μg/L ,糖尿病微血管病变组显著高于无微血管病变组 (t=2 .18,P <0 0 5 )及对照组 (t=2 .71,P <0 0 1) ,而后两者间无显著差异 ;瘦素浓度与体重指数、胰岛素呈正相关 (r =0 .2 9,P <0 0 5 ;r =0 .34,P <0 .0 1)。结论 :糖尿病微血管病变组血清瘦素浓度升高 ,瘦素与糖尿病微血管病变的发病密切相关。     

Long-term Effectiveness and Tolerability of Topiramate in Children with Epilepsy under the Age of 2 Years: 4-Year Follow-up

This is a long-term, open label, observational study aimed to broaden our clinical experiences in managing infants and toddlers with epilepsy. The long-term retention rate and side effects of topiramate (TPM) in them were evaluated and compared with carbamazepine (CBZ). A total of 146 children were involved in the study (TPM=41, CBZ=105). The retention rates at 24 , 36, and 48 months were 46.3%, 34.1%, 26.8% for TPM and 36.2%, 23.8%, 13.3% for CBZ, respectively. At 6 months after starting antiepileptic drugs (AED), the seizure freedom or clinical efficacy (seizure reduction rate more than 50 percent) were 73.2% for TPM and 62.9% for CBZ. The major side effects led to discontinuation included psychomotor slowing, poor oral intake from TPM and sleepiness and skin rash from CBZ. TPM was discontinued due to side effects in one case (2.4%) and lack of efficacy in five cases (12.2%), whereas CBZ was discontinued due to lack of efficacy (22.9%) and side effects (6.7%). As compared with CBZ, TPM showed the same long-term retention rate in children under the age of 2 yr, and no serious side effects. It is therefore concluded that TPM can be considered as a major AED for treating children with epilepsy under the age of 2 yr.     

特发性中枢性早熟女孩血清E2、FSH、LH变化与子宫和卵巢形态改变关系的探讨

目的通过血清E2、FSH、LH测定及子宫和卵巢形态改变关系的研究,探讨特发性中枢性性早熟女孩的特点.方法分析了67例特发性中枢性性早熟女孩血清E2、FSH、LH的变化及子宫和卵巢B超形态学改变,并进行直线相关分析.结果(1)不同型卵巢的血清LH和E2值差异有显著性(p＜0.01)且呈递增趋势.FSH在三组间无规律性改变.(2)子宫大小随成熟度增高而显著增大,子宫容积与血清LH、E2之间显著相关(p＜0.002,0.001).(3)卵巢容积随发育分期增大,容积与血清LH、FSH、E2均不相关.结论(1)血清LH和E2的水平与最大卵泡直径相关,而与总容积不相关,但最大卵泡直径与LH、E2及卵巢总容积显著相关,从而证实了LH与卵泡发育的关系及E2的水平主要取决于卵泡发育状态.(2)子宫体容积与LH、E2均相关,子宫的发育呈显著的雌激素依赖性.E2与子宫发育间有密切关系.(3)血清E2、LH、FSH测定及子宫和卵巢形态学检查综合判断有助于对中枢性性早熟作出诊断.     

A Randomized Study of the Effects of Mindfulness Training on Psychological Well-being and Symptoms of Stress in Patients Treated for Cancer at 6-month Follow-up

Background

There is increasing evidence showing beneficial effects of mindfulness and mindfulness training on various indicators of mental and physical health.

Purpose

This paper reports the 6-month follow-up effects of a mindfulness stress reduction training program among patients treated for cancer on perceived stress, depression, anxiety, post-traumatic stress symptoms, positive states of mind, coping self-efficacy, and mindfulness.

Methods

Patients with a previous cancer diagnosis were recruited and randomized into an intervention group or a waiting list control group. The intervention consisted of an 8-week mindfulness training course.

Results

Compared to participants in the control group, the intervention group showed a larger increase in mindfulness at 6-month follow-up. However, there were no differences on any of the other outcomes between the intervention and control groups. Continued meditation practice was associated with a significant reduction in post-traumatic stress symptoms of avoidance.

Conclusions

The study draws attention to the need to better understand the mechanisms behind the effect of mindfulness training and to potential modification of mindfulness interventions to promote sustained benefits over time.     

男性CHD患者血清脱氢表雄酮、游离睾酮浓度的分析

目的：观察血清雄激素水平与男性 （CHD）的相关性。方法：CHD诊断和狭窄程度判断通过冠状动脉造影检查,冠状动脉至少有一处内径狭窄≥50%为诊断标准;冠状动脉狭窄评分标准：主要冠脉即左主干、左前降支、左回旋支、右冠脉,狭窄程度计分如下：无狭窄为0分,狭窄≤25%为1分,狭窄26%～50%为2分,狭窄51%～75%为3分,狭窄76%～100%为4分。若单支血管有多处病变,则以最狭窄病变的分数作为该支血管狭窄分数;若多支血管有狭窄,则将各支血管狭窄分数相加,即为该患者冠脉病变评分;左主干病变计分加倍。血清雄激素检测脱氢表雄酮和游离睾酮两个指标。脱氢表雄酮和游离睾酮采用酶联免疫吸附试验检测;并同时检测空腹血糖、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、尿酸等生化指标。结果：CHD组血清脱氢表雄酮、游离睾酮水平显著低于无CHD组（P〈0.001）。多元logistic回归分析显示,血清脱氢表雄酮（OR=0.526;95%CI：0.361～0.768;P〈0.01）、游离睾酮（OR=0.995;95%CI：0.991～0.999;P〈0.05）为CHD独立危险因素;血清脱氢表雄酮（t=3.424,P〈0.01,r=-0.415）、游离睾酮（t=2.763,P〈0.01,r=-0.359）与CHD冠状动脉狭窄程度呈负相关。结论：血清雄激素水平的降低可能是导致男性CHD发病率升高的重要因素,监测血清雄激素水平有助于判断CHD病变的程度。     

糖尿病对雄性大鼠睾丸及外周血中性激素水平的影响

目的探讨链脲佐菌素在糖尿病造模中对雄性大鼠睾丸及外周血中性激素水平的影响。方法称取性腺重量并进行病理组织学观察,同时用放射免疫法检测正常大鼠和DM大鼠的血清性激素水平。结果 DM组大鼠睾丸质量及附睾质量低于正常对照组,差别明显,具有统计学意义(P0.05);DM组生精细胞数量与T水平明显低于正常对照组,具有显著性差异(P0.05);LH水平对照组显著低于DM组,具有统计学意义(P0.05);FSH在DM组与正常对照组间无显著性差异(P0.05)。结论糖尿病导致雄性大鼠睾丸病理学改变,并严重影响血清中睾酮水平,从而影响生殖能力。     

子宫癌和子宫肌瘤患者血清PRL、T和E2含量的变化

目的：探讨人血清催乳素（PRL）、睾酮（T）和雌二醇（E2）与子宫肌瘤、子宫癌的关系。方法：采用化学发光免疫法（CLIA）分别检测了子宫肌瘤患者（30例）、子宫癌患者（28例）的血清PRL、T和E2三类激素并与健康人组（38人）比较。结果：1．子宫肌瘤和子宫癌的PRL和T含量均明显高于正常组（P〈0．01）。2．子宫肌瘤与子宫癌组的E2水平与正常人无明显差异（P〉0．01）。3．从正常人组经子宫肌瘤患者到子宫癌组其血PRL水平呈持续增高趋势。结论：PRL和T含量的变化与子宫肌瘤及子宫癌疾患有密切关系。