Psychosomatic and psychosocial symptoms are associated with low blood pressure in Swedish schoolchildren

Relationship between the number of outpatient visits for hypotension in the springtime in Japan, extracted from clinical electronic records, and global solar radiation levels

Hypotension is commonly reported in springtime when health changes, such as autonomic imbalance, are common and its symptoms may cause difficulties in daily activities. In this study, medical data from 101 outpatient clinic attendees (mean age 43.9 years; 16 males) making their first visit for hypotension symptoms, were compared with meteorological data from the clinic's location. The main symptom of hypotension was giddiness on standing. The most common coexisting conditions were gastrointestinal; e.g. gastro-oesophageal reflux disorder and irritable bowel syndrome. The 7-day moving average of total global solar radiation correlated significantly with the 7-day moving average of the number of patients with hypotension. Discriminant analysis revealed an increase in hypotension consultations in the total global solar radiation moving average range 11-19 MJ/m(2), consistent with the local spring season. Guidance--such as wearing compression stockings during springtime--may help to reduce the occurrence of clinical hypotension in susceptible patients.

Comparison between Japanese and Swedish schoolchildren in regards to physical symptoms and psychiatric complaints

BACKGROUND

Physical symptoms are an increasing problem among Japanese children and adolescents, and the symptoms seem to be related to their school situation. These symptoms are prevalent in Sweden, and a comparison with Japan is of interest due to the differences in the educational system and school climate.

OBJECTIVE AND METHODS

To compare physical symptoms and psychiatric complaints in school pupils from Japan and Sweden, using a questionnaire that also addressed life satisfaction and stressful life events. The study population comprised 742 Japanese children and 1,120 Swedish children attending public compulsory schools, grades 4-9 (10-15 y). Physical symptom and psychiatric complaint scores were calculated for each pupil.

RESULTS

The Japanese children had significantly higher physical symptom and psychiatric complaint scores than did the Swedish children. Both the physical symptom and psychiatric complaint scores were significantly higher in adolescents than in preadolescents in Japan; this trend was less apparent in Swedish children. In addition, Japanese children were found to have considerably lower life satisfaction. Loss of appetite was the only physical symptom more prevalent in the Swedish population compared to the Japanese population.

CONCLUSION

We conclude that Japanese schoolchildren have more physical symptoms and psychiatric complaints and less life satisfaction than Swedish schoolchildren of corresponding ages.

Perceived difficult temperament, hostile maternal child-rearing attitudes and insulin resistance syndrome precursors among children: a 3-year follow-up study

BACKGROUND

We prospectively examined the relationship between latent constructs of perceived difficult temperament and hostile maternal child-rearing attitudes on the one hand, and the cluster of multiple cardiovascular risk factors comprising the insulin resistance syndrome (IRS) on the other.

METHODS

A 3-year follow-up study of 451 randomly selected healthy children was used. The temperament of the children and maternal child-rearing attitudes were self-rated by the mothers. The physiological parameters measured were serum insulin, high-density lipoprotein cholesterol (HDL-C), triglycerides, systolic blood pressure, body-mass index and subscapular skinfold thickness. We analyzed the data using structural equation models that involved specific paths allowing separation, and tests of both unique and common (latent) aspects of measured variables.

RESULTS

Among boys we found a cross-lagged effect between the latent constructs of perceived difficult temperament and IRS, as well as 1 specific effect from hostile maternal child-rearing attitudes to HDL-C. Among girls there were 6 specific effects from specific measures of perceived temperamental difficultness or hostile maternal child-rearing attitudes that influenced the IRS or its components.

CONCLUSIONS

The findings suggest that temperament and maternal child-rearing attitudes may contribute to the early development of the IRS in a gender-specific way among children, thereby potentially increasing the risk of coronary heart disease later in life.

Cardiovascular reactivity in adolescent boys of low socioeconomic status previously characterized as anxious, disruptive, anxious-disruptive or normal during childhood

BACKGROUND

The purpose of the study was to compare cardiovascular reactivity, a potential mechanism underlying the development of cardiovascular disease (CVD), in boys with different behavioral characteristics.

METHOD

Eighty-nine adolescent boys with low socioeconomic status who were classified as anxious, disruptive, anxious-disruptive or boys without these characteristics (i.e. control) during childhood were observed during a laboratory stress experiment.

RESULT

No significant group differences were found for resting levels of diastolic or systolic blood pressure (SBP). Anxious and anxious-disruptive boys exhibited greater SBP reactivity to the social stressor (Social Competence Interview) compared to the disruptive and control boys. The disruptive boys tended to engage in compromising behaviors which are associated with health problems. The anxious boys were significantly more likely to have a positive family history of hypertension.

CONCLUSIONS

Boys with different behavioral problems (anxiety, disruptiveness) may be at risk for CVD via different mechanisms.

Coping with unfair treatment at work--what is the relationship between coping and hypertension in middle-aged men and Women? An epidemiological study of working men and women in Stockholm (the WOLF study)

BACKGROUND

An important hypothesis in psychosomatic medicine is that exposure to psychosocial factors that arouse anger may accelerate the onset of hypertension, particularly if the subject is not allowed to show anger or to deal constructively with the factor that evoked it. For working men and women, being treated in an unfair way at work may be crucial. The present study was designed to answer the question whether the pattern of coping - primarily directed towards the aggressor (open) or directed inwards or towards others (covert) - is associated with hypertension among working men and women.

STUDY GROUP

Five thousand seven hundred and twenty working men and women aged 15-64 participated in the study. The participation rate was 76%.

METHODS

The coping pattern was studied by means of a Swedish version of a self-administered questionnaire that was originally introduced by Harburg et al.

RESULTS

Significant results were confined to the age group 45-54. All analyses were adjusted for age and body mass index. Smoking habits and social class had no effect on the relationships. Low scores (lowest quartile) for open coping tended to be associated with an elevated prevalence ratio (PR) of hypertension both among men (PR 1.3, 95% confidence interval, CI, 0.9-1.7) and women (PR 1.4, 95% CI 1.0-2.0). High scores for covert coping (highest quartile) were associated with an elevated PR of hypertension among men (PR 1.6, 95% CI 1.2-2.2) but not in women. If the analysis was confined to cases without medication, the relationship between a high level of covert coping and high blood pressure was still significant for men. For women, however, no significant findings were made after this operation. Accordingly, the relationship between a low level of open coping and hypertension in women was confined to women with medication. Coping patterns were correlated with psychosocial work environment factors, in particular decision latitude.

CONCLUSION

In men, covert coping was associated with prevalence of hypertension. In women, there tended to be a relationship between low scores for open coping and hypertension.