Preliminary Efficacy of an Emotion Regulation Intervention on Physical Activity and Depressive and Anxious Symptoms in Individuals in Cardiac Rehabilitation

Depressive and Anxiety Symptoms, Defense Mechanisms, and Mentalized Affectivity in Individuals with Myocardial Infarction: An Empirical Investigation

Myocardial infarction (MI) is associated with emotional distress, depression, and anxiety. Defense mechanisms and mentalized affectivity play key roles in affective regulation; however, their roles in individuals with MI remain underexplored. This study examined the relationship between depressive and anxiety symptoms, defensive functioning, and mentalized affectivity in MI patients. Sixty-seven patients with MI and 80 healthy controls completed the DSM-5 Self-Rated Level 2 Cross-Cutting Symptom Measures-Depression and Anxiety-Adult, the Defense Mechanisms Rating Scales-Self-Report-30, and the Brief-Mentalized Affectivity Scale. Multivariate analyses were used to compare the MI and healthy groups, while correlations and mediation models were used to evaluate associations between variables within the MI group. Compared to controls, patients with MI exhibited more severe depressive and anxiety symptoms, maladaptive defenses, and lower levels of mentalized affectivity. Within the MI group, the severity of depressive and anxiety symptoms was associated with immature defensive functioning and poorer abilities to regulate affects. Notably, the relationship between worse defensive functioning and severe depressive and anxiety symptoms was mediated by the capacity to process emotions. The mediating role of this specific dimension of mentalized affectivity emphasizes the potential of affect regulation as a target for tailored psychosocial interventions aimed at improving clinical outcomes.

2023 TAMIS/TSOC/TACVPR Consensus Statement for Patients with Acute Myocardial Infarction Rehabilitation

Cardiac rehabilitation is a comprehensive intervention recommended in international and Taiwanese guidelines for patients with acute myocardial infarction. Evidence supports that cardiac rehabilitation improves the health-related quality of life, enhances exercise capacity, reduces readmission rates, and promotes survival in patients with cardiovascular disease. The cardiac rehabilitation team is comprehensive and multidisciplinary. The inpatient, outpatient, and maintenance phases are included in cardiac rehabilitation. All patients admitted with acute myocardial infarction should be referred to the rehabilitation department as soon as clinically feasible. Pre-exercise evaluation, including exercise testing, helps physicians identify the risks of cardiac rehabilitation and organize appropriate exercise prescriptions. Therefore, the Taiwan Myocardial Infarction Society (TAMIS), Taiwan Society of Cardiology (TSOC), and Taiwan Academy of Cardiovascular and Pulmonary Rehabilitation (TACVPR) address this consensus statement to assist healthcare practitioners in performing cardiac rehabilitation in patients with acute myocardial infarction.

Neuromarkers associated with two levels of physical activity in persons with chronic conditions

Although research has largely focused on the effects of physical activity (PA) on the brain, less is known about the influence of the brain on engagement in healthy-living behaviors, such as regular PA. In this secondary analysis of a study of brain activity and participation in healthy-living behaviors, we examined relationships between the activation of selected brain networks and PA in persons self-managing chronic conditions. Fifty-eight individuals with chronic conditions underwent functional magnetic resonance imaging while exposed to a protocol consisting of listening to emotion-focused and analytic-focused information and measures of activation of three neuromarkers were obtained: default mode network (DMN), task-positive network (TPN), and ventromedial prefrontal cortex (vmPFC). In an exploratory analysis, we assessed differences in neuromarker activation between two PA levels (representing higher and lower accelerometry-measured PA levels) of 1) moderate-to-vigorous physical activity (MVPA) minutes, 2) metabolic equivalents expended (METs), and 3) daily steps. Results showed positive associations between MVPA and DMN (r = 0.31, P = 0.018), steps and DMN (r = 0.28, P = 0.035), and MVPA and vmPFC (r = 0.29, P = 0.026). No associations were found between the TPN and any of the PA measures. Individuals with high MVPA and METs had higher DMN values compared with those with low MVPA (t = -2.17, P = 0.035) and METs (t = -2.02, P = 0.048). No differences in TPN and vmPFC were found among PA levels. These results suggest that providing health information that activates the emotion-focused brain network may be more useful than analytic-focused information (centered on logic and reasoning) to assist people with chronic conditions to engage in more PA.NEW & NOTEWORTHY The influence of the brain on engagement in regular physical activity (PA) has not been well studied. We examined relationships between the activation of three neuromarkers and two PA levels in 58 persons self-managing chronic conditions. Findings suggest that individuals who optimally process health-information when the emotional tone is high (Empathic Network; DMN) may engage in more PA compared with individuals who respond to health information when the emotional tone is low (Analytic Network; TPN).

Anxiety/Depression Predominance in Liaison-Psychiatry Users of a South-East Mexico Tertiary Hospital

Patients at tertiary hospitals may find themselves in need of mental health support due to the distress associated with the illness that may or not lead to a psychiatric condition. Here is an overview of the clinical cases treated by the liaison psychiatry service of a public tertiary hospital from Southeast Mexico during its first years of operation (2008–2018), with the purpose of gathering information about the status and needs of this population. A sample of 304 clinical records of patients treated for the first time by the psychiatry service was reviewed, and the distribution by demographic characteristics, diagnosis of mental illness and medical area of reference was analyzed. Anxiety and depression symptoms were the most frequent. Most patients were women, lived in Merida and returned after the first appointment. The neurology service referred most patients, yet most attended directly. General tertiary hospitals should prioritize integrating ad hoc mental and physical health care. Adult women with a profile of anxiety and/or depression would be the first target group. Some areas of opportunity for further research and improvement of mental health services are: preventive services for anxiety and depression, follow-up of patients, attention to relatives of patients at intensive care units, implementation of telehealth alternatives, training on mental health screening and inter- and intra-institutional collaboration.

Application of pulmonary rehabilitation in patients with pulmonary embolism (Review)

As a common clinical emergency, pulmonary embolism (PE) is the third most fatal cardiovascular disease worldwide. Although current sophisticated medical technology has considerably improved the prognosis of patients with PE, they remain at risk of developing long-term complications such as post-PE syndrome. Pulmonary rehabilitation is of great value for patients with chronic lung diseases since it can improve their quality of life while also relieving clinical symptoms. Rehabilitation therapy has been demonstrated to improve recovery and prognosis of patients with PE. Due to short implementation time and the small number of studies, its effectiveness and safety in PE warrant further investigation. The present review focused on elucidating PE pathogenesis, post-PE syndrome and the clinical application of pulmonary rehabilitation in patients with PE.