ijerph-logo

Journal Browser

Journal Browser

Psychophysiological Responses to Stress

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 43289

Special Issue Editor

Special Issue Information

Dear Colleagues,

Stress is a complex multifactorial reaction that produces changes in the organic system of the human being. These changes range from physiological modifications to psychological ones. The acute stress response is an adaptive response that has been modulated during the development of the human species, making it very efficient when dealing with anecdotal events that endanger the physical integrity or life of the subject. When this stress response is maintained over time, which at the acute level is a highly adaptive response, it begins to become the basis of a multitude of pathologies at the physiological and psychological level.

The contextual interpretation that subjects can make will mark, in one way or another, their relationship with it and will be the basis that defines their perception of uncontrollability, threat, or uncertainty regarding the environment to which it relates. A contextual misunderstanding due to a specific psychological profile can cause a stress response, in the same way that exposure to contextual stressors, whether physical, mechanical, environmental, or even social, can trigger this acute response. A multitude of professions, from military, to police, firefighters, health personnel, drivers, miners, teachers, and elite athletes are exposed to highly eliciting environments, which produce in them different stress responses with different manifestations at the psychophysiological level. For a better understanding of all these complex processes, the present Special Issue is proposed, in which it is intended to analyze the psychophysiological responses to the state. This Special Issue intends to provide an overview of the most recent advances in multidisciplinary research connected to psychophysiology of stress. Research articles on topics associated with the modifications at the psychophysiological level due to stress are invited.

Prof. Vicente Javier Clemente Suárez
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Stress
  • Military
  • health
  • psychophysiology

Related Special Issue

Published Papers (12 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

9 pages, 345 KiB  
Article
The Impact of Nationality on the Psychophysiological Stress Response and Academic Fulfilment in the Final Degree Dissertation
by Ana Ramírez-Adrados, Beatriz Martínez-Pascual, Cristina Gonzalez-de-Ramos, Silvia Fernández-Martínez, Valentín Emilio Fernández-Elías and Vicente Javier Clemente-Suárez
Int. J. Environ. Res. Public Health 2021, 18(8), 4035; https://doi.org/10.3390/ijerph18084035 - 12 Apr 2021
Cited by 8 | Viewed by 2147
Abstract
The aims of this study were: i. to analyze the effect of nationality on the psychophysiological stress response of physiotherapy last year students in their final degree dissertations; and ii. to analyze the relationship between the stress response and academic results according to [...] Read more.
The aims of this study were: i. to analyze the effect of nationality on the psychophysiological stress response of physiotherapy last year students in their final degree dissertations; and ii. to analyze the relationship between the stress response and academic results according to nationality. We evaluated the autonomic stress response, cortical arousal, distress subjective perception, and objective and subjective academic fulfilment in Spanish, Italian, and French physiotherapy students during their final degree dissertation. Results showed a large anticipatory anxiety response before the dissertation in the three student groups. Only the Spanish group showed an increased tendency in the habituation process, reducing the psychophysiological stress response during the dissertation, while the Italian and French groups maintained a large sympathetic activation until the end of the dissertation. Cortical arousal and subjective perception of distress were similar in the three nationalities. In addition, no correlation between academic fulfilment and autonomic modulation was found. We concluded that there was no nationality effect in the psychophysiological stress response of physiotherapy last year students in their final degree dissertation, all of them showing a large anticipatory anxiety response. Full article
(This article belongs to the Special Issue Psychophysiological Responses to Stress)
8 pages, 306 KiB  
Article
Relationship between Perceived Training Load, Well-Being Indices, Recovery State and Physical Enjoyment during Judo-Specific Training
by Ibrahim Ouergui, Emerson Franchini, Okba Selmi, Danielle Evé Levitt, Hamdi Chtourou, Ezdine Bouhlel and Luca Paolo Ardigò
Int. J. Environ. Res. Public Health 2020, 17(20), 7400; https://doi.org/10.3390/ijerph17207400 - 11 Oct 2020
Cited by 11 | Viewed by 3792
Abstract
This study investigated the relationship between well-being indices and the session rating of perceived exertion (session-RPE), recovery (TQR), and physical enjoyment (PE) during intensified, tapering phases of judo training. Sixty-one judo athletes (37 males, ranges 14–17 years, 159–172 cm, 51–67 kg) were randomly [...] Read more.
This study investigated the relationship between well-being indices and the session rating of perceived exertion (session-RPE), recovery (TQR), and physical enjoyment (PE) during intensified, tapering phases of judo training. Sixty-one judo athletes (37 males, ranges 14–17 years, 159–172 cm, 51–67 kg) were randomly assigned to three experimental (i.e., randori, uchi-komi, running) and control groups (regular training). Experimental groups trained four times per week for 4 weeks of intensified training followed by 12 days of tapering. Session-RPE, well-being indices (i.e., sleep, stress, fatigue, delayed onset of muscle soreness (DOMS), Hooper index (HI)), and TQR were measured every session, whereas PE was recorded after intensified, tapering periods. Recovery (TQR) was negatively correlated with sleep, stress, fatigue, DOMS, HI, session-RPE in intensified period and was negatively correlated with sleep, stress, fatigue, DOMS, HI in tapering. Session-RPE was positively correlated with sleep, fatigue, DOMS, HI in intensified period and positively correlated with fatigue, DOMS in tapering. PE was negatively correlated with stress in intensified training. Enjoyment could be partially predicted by sleep only in intensified periods. Session-RPE could be partially predicted by TQR, fatigue during intensified periods and by sleep, and HI during tapering. Sleep, recovery state, pre-fatigue states, and HI are signals contributing to the enjoyment and internal intensity variability during training. Coaches can use these simple tools to monitor judo training. Full article
(This article belongs to the Special Issue Psychophysiological Responses to Stress)
11 pages, 822 KiB  
Article
Rasch Analysis of the Korean Parenting Stress Index Short Form (K-PSI-SF) in Mothers of Children with Cerebral Palsy
by Eun-Young Park and Soojung Chae
Int. J. Environ. Res. Public Health 2020, 17(19), 7010; https://doi.org/10.3390/ijerph17197010 - 25 Sep 2020
Cited by 9 | Viewed by 2463
Abstract
The purpose of this study was to investigate the psychometric characteristics of the Korean Parenting Stress Index Short Form (K-PSI-SF) for mothers of children with cerebral palsy (CP) by using a Rasch analysis. The participants were 114 mothers of children with CP whose [...] Read more.
The purpose of this study was to investigate the psychometric characteristics of the Korean Parenting Stress Index Short Form (K-PSI-SF) for mothers of children with cerebral palsy (CP) by using a Rasch analysis. The participants were 114 mothers of children with CP whose ages ranged from 2.79 to 11.90 years. The K-PSI-SF consists of 36 items, with a 5-point Likert scale grading along three subscales (Parent Distress, Parent–Child Dysfunctional Interaction, and Difficult Child). The response data were analyzed, and we determined the item fitness and item difficulty, rating scale fit, and separation index. The results show that two items did not have the required fitness. After these two items were deleted, the means of the 34 items in two of the subscales were statistically different from those of the original 36 items. Our analysis of the item difficulty identified the need to add easier question items. The 5-point Likert scale used in the questionnaire was found to be appropriate. This significance of this study is that it suggested the need to modify item fitness and difficulty level, as it identified the psychometric characteristics of the K-PSI-SF through a Rasch analysis based on the item response theory. Full article
(This article belongs to the Special Issue Psychophysiological Responses to Stress)
Show Figures

Figure 1

19 pages, 1529 KiB  
Article
Dissociable Effects of Executive Load on Perceived Exertion and Emotional Valence during Submaximal Cycling
by Vicente Ávila-Gandía, Francisco Alarcón, José C. Perales, F. Javier López-Román, Antonio J. Luque-Rubia and David Cárdenas
Int. J. Environ. Res. Public Health 2020, 17(15), 5576; https://doi.org/10.3390/ijerph17155576 - 2 Aug 2020
Cited by 6 | Viewed by 3278
Abstract
Endurance physical exercise is accompanied by subjective perceptions of exertion (reported perceived exertion, RPE), emotional valence, and arousal. These constructs have been hypothesized to serve as the basis for the exerciser to make decisions regarding when to stop, how to regulate pace, and [...] Read more.
Endurance physical exercise is accompanied by subjective perceptions of exertion (reported perceived exertion, RPE), emotional valence, and arousal. These constructs have been hypothesized to serve as the basis for the exerciser to make decisions regarding when to stop, how to regulate pace, and whether or not to exercise again. In dual physical-cognitive tasks, the mental (executive) workload generated by the cognitive task has been shown to influence these perceptions, in ways that could also influence exercise-related decisions. In the present work, we intend to replicate and extend previous findings that manipulating the amount of executive load imposed by a mental task, performed concomitantly with a submaximal cycling session, influenced emotional states but not perceived exertion. Participants (experienced triathletes) were asked to perform a submaximal cycling task in two conditions with different executive demands (a two-back version of the n-back task vs. oddball) but equated in external physical load. Results showed that the higher executive load condition elicited more arousal and less positive valence than the lower load condition. However, both conditions did not differ in RPE. This experimental dissociation suggests that perceived exertion and its emotional correlates are not interchangeable, which opens the possibility that they could play different roles in exercise-related decision-making. Full article
(This article belongs to the Special Issue Psychophysiological Responses to Stress)
Show Figures

Figure 1

12 pages, 334 KiB  
Article
Higher Academic Stress Was Associated with Increased Risk of Overweight and Obesity among College Students in China
by Yonghua Chen, Xi Liu, Ni Yan, Wanru Jia, Yahui Fan, Hong Yan, Lu Ma and Le Ma
Int. J. Environ. Res. Public Health 2020, 17(15), 5559; https://doi.org/10.3390/ijerph17155559 - 31 Jul 2020
Cited by 28 | Viewed by 6697
Abstract
This study examined associations between academic stress and overweight and obesity, and moderation effects of gender, grade, and types of college on such associations. Data on academic stress, negative learning events, weight, and height were self-reported by 27,343 college students in China in [...] Read more.
This study examined associations between academic stress and overweight and obesity, and moderation effects of gender, grade, and types of college on such associations. Data on academic stress, negative learning events, weight, and height were self-reported by 27,343 college students in China in 2018. About 23% and 91% of students perceived high academic stress and suffered from at least one negative learning event during the past six months, respectively, especially for females, undergraduates, and students major in humanities and social science subject groups. Perceived academic stress was associated with increased risk of overweight and obesity among all students (OR = 1.05, 95%CI: 1.00–1.10), male (OR = 1.09, 95%CI: 1.03–1.15), undergraduate (OR = 1.06, 95%CI: 1.00–1.11), and students from subordinate universities (OR = 1.13, 95%CI: 1.01–1.26). Negative learning events were associated with increased risk of overweight and obesity among all students (OR = 1.05, 95%CI: 1.01–1.09), undergraduates (OR = 1.05, 95%CI: 1.01–1.09), and students from local universities (OR = 1.07, 95%CI: 1.00–1.14). Interventions are needed to reduce the high academic stress of college students, considering the modifying effects of gender, grade, and college type. Such interventions may further contribute to the prevention of overweight and obesity among college students. Full article
(This article belongs to the Special Issue Psychophysiological Responses to Stress)
12 pages, 379 KiB  
Article
Psychophysiological Stress Markers and Behavioural Differences between Rural and City Primary School Students
by Daniel Mendoza-Castejón and Vicente Javier Clemente-Suárez
Int. J. Environ. Res. Public Health 2020, 17(9), 3157; https://doi.org/10.3390/ijerph17093157 - 1 May 2020
Cited by 11 | Viewed by 3304
Abstract
Academic performance could be affected by multiple factors, including stress and learning environment location. The aim of this study was to analyze differences in psychophysiological stress markers, behavior and academic performance of rural and city students. A sample of 181 children (7.91 ± [...] Read more.
Academic performance could be affected by multiple factors, including stress and learning environment location. The aim of this study was to analyze differences in psychophysiological stress markers, behavior and academic performance of rural and city students. A sample of 181 children (7.91 ± 2.29 years) from elementary schools were evaluated on their grades, subjective academic performance, heart rate variability, state anxiety, nutritional information and physical activity habits. Results presented significant higher values in parasympathetic modulation and physical education grades in rural students than in city students, who showed higher significant values in state anxiety, the ability to complete tasks, physical activity habits and several items relating to their food and drink habits. No significant differences were found in the average grades between the two groups. However, some correlations were found between school performance and stress, physical fitness and nutritional habits. Thus, school location may affect the stress and anxiety status, nutritional habits and physical activities of students, but there were no significant differences in academic performance. In addition, body mass index, quantity of food intake and stress markers may be related to the academic performance attained. Full article
(This article belongs to the Special Issue Psychophysiological Responses to Stress)
15 pages, 333 KiB  
Article
Depressive Symptoms and the Link with Academic Performance among Rural Taiwanese Children
by Yujuan Gao, Derek Hu, Evan Peng, Cody Abbey, Yue Ma, Chyi-In Wu, Chia-Yuan Chang, Wei-Ting Hung and Scott Rozelle
Int. J. Environ. Res. Public Health 2020, 17(8), 2778; https://doi.org/10.3390/ijerph17082778 - 17 Apr 2020
Cited by 25 | Viewed by 3596
Abstract
Previous studies reflect a high prevalence of depressive symptoms among Taiwanese adolescents (ages 13–18), but there is an absence of literature related to the risk of depression of children in Taiwan (ages 6–12), particularly among potentially vulnerable subgroups. To provide insight into the [...] Read more.
Previous studies reflect a high prevalence of depressive symptoms among Taiwanese adolescents (ages 13–18), but there is an absence of literature related to the risk of depression of children in Taiwan (ages 6–12), particularly among potentially vulnerable subgroups. To provide insight into the distribution of depressive symptoms among children in rural Taiwan and measure the correlation between academic performance, we conducted a survey of 1655 randomly selected fourth and fifth-grade students at 92 sample schools in four relatively low-income counties or municipalities. Using the Center for Epidemiological Studies-Depression Scale (CES-D) we assessed the prevalence of depressive symptoms in this sample, in addition to collecting other data, such as performance on a standardized math test as well as information on a number of individual and household characteristics. We demonstrate that the share of children with clinically significant symptoms is high: 38% of the students were at risk of general depression (depression score ≥ 16) and 8% of the students were at risk of major depression (depression score > 28). The results of the multivariate regression and heterogeneous analysis suggest that poor academic performance is closely associated with a high prevalence of depressive symptoms. Among low-performing students, certain groups were disproportionately affected, including girls and students whose parents have migrated away for work. Results also suggest that, overall, students who had a parent who was an immigrant from another country were at greater risk of depression. These findings highlight the need for greater resource allocation toward mental health services for elementary school students in rural Taiwan, particularly for at-risk groups. Full article
(This article belongs to the Special Issue Psychophysiological Responses to Stress)
8 pages, 700 KiB  
Article
Psychophysiological Stress Response in an Underwater Evacuation Training
by Marta Vicente-Rodríguez, Juan Pedro Fuentes-Garcia and Vicente Javier Clemente-Suárez
Int. J. Environ. Res. Public Health 2020, 17(7), 2307; https://doi.org/10.3390/ijerph17072307 - 30 Mar 2020
Cited by 13 | Viewed by 2607
Abstract
Background: This research aimed to analyze the psychophysiological stress response of air crews in an underwater evacuation training. Materials and Methods: We analyzed in 36 participants (39.06 ± 9.01 years) modifications in the rating of perceived exertion (RPE), subjective stress perception (SSP), heart [...] Read more.
Background: This research aimed to analyze the psychophysiological stress response of air crews in an underwater evacuation training. Materials and Methods: We analyzed in 36 participants (39.06 ± 9.01 years) modifications in the rating of perceived exertion (RPE), subjective stress perception (SSP), heart rate (HR), blood oxygen saturation (BOS), cortical arousal (critical flicker fusion threshold, CFFT), heart rate variability (HRV), spirometry, isometric hand strength (IHS), and short-term memory (ST-M) before and after an underwater evacuation training. Results: The maneuver produced a significant (p ≤ 0.05) increase in the SSP, RPE, Mean HR and maximum HR (Max HR), and a decrease in minimum HR (Min HR) and HRV. Conclusion: An underwater evacuation training produced an increase in the sympathetic nervous system modulation, elevating the psychophysiological stress response of the air crews, not negatively affecting their cortical arousal. Full article
(This article belongs to the Special Issue Psychophysiological Responses to Stress)
Show Figures

Figure 1

11 pages, 1113 KiB  
Article
Challenging the Top Player: A Preliminary Study on Testosterone Response to An Official Chess Tournament
by Guillermo Mendoza, Manuel Jiménez, Jerónimo García-Romero, Jorge García-Bastida, Iván Rivilla, Margarita Carrillo de Albornoz-Gil, Francisco Javier Baron-Lopez, Javier Benítez-Porres and José Ramón Alvero-Cruz
Int. J. Environ. Res. Public Health 2020, 17(4), 1204; https://doi.org/10.3390/ijerph17041204 - 13 Feb 2020
Cited by 3 | Viewed by 3188
Abstract
According to the Challenge Hypothesis, high levels of testosterone (T) are associated with status-seeking behaviors, especially in competitive situations. However, there have not been many studies about rivals’ social status and pre-competition neuroendocrine responses. The aim of this study was to analyze whether [...] Read more.
According to the Challenge Hypothesis, high levels of testosterone (T) are associated with status-seeking behaviors, especially in competitive situations. However, there have not been many studies about rivals’ social status and pre-competition neuroendocrine responses. The aim of this study was to analyze whether the participants in a chess tournament showed different pre-match testosterone and cortisol levels depending on differences in ELO (i.e., the International Chess Federation rating to rank the competitive potential and social status between players). The sample was six male participants (mean ± SD) aged 25.5 ± 8.4 years with experience in official tournaments of 16.33 ± 5.72 years and an average ELO rating of 2217.67 ± 112.67. Saliva samples were collected before each round for hormonal determination when participants competed against a rival with a different ELO rating. After five competition rounds per participant, higher rival pre-competition T concentrations were shown when playing against the best-rated participant, but there were no differences in cortisol (C). The multilevel model confirmed rises in rivals’ precompetitive T levels modulated by the difference in the opponent’s ELO rating. No significant changes were observed in C. The results suggest that the rival’s status can determine the opponent’s anticipatory neuroendocrine responses to an official chess tournament. Full article
(This article belongs to the Special Issue Psychophysiological Responses to Stress)
Show Figures

Figure 1

9 pages, 482 KiB  
Article
Competition Seriousness and Competition Level Modulate Testosterone and Cortisol Responses in Soccer Players
by Manuel Jiménez, José Ramón Alvero-Cruz, Juan Solla, Jorge García-Bastida, Virginia García-Coll, Iván Rivilla, Enrique Ruiz, Jerónimo García-Romero, Elvis A. Carnero and Vicente Javier Clemente-Suárez
Int. J. Environ. Res. Public Health 2020, 17(1), 350; https://doi.org/10.3390/ijerph17010350 - 4 Jan 2020
Cited by 17 | Viewed by 4301
Abstract
This study aimed to analyze the modulating effect of competition seriousness and competition level in the testosterone and cortisol responses in professional soccer player. Ninety five (95) soccer players were included in this study (professional, n = 39; semiprofessional, n = 27; amateur, [...] Read more.
This study aimed to analyze the modulating effect of competition seriousness and competition level in the testosterone and cortisol responses in professional soccer player. Ninety five (95) soccer players were included in this study (professional, n = 39; semiprofessional, n = 27; amateur, n = 29) before and after training, friendly game and official games. Repeated measures ANOVA showed higher testosterone levels (F(1,89) = 134, p < 0.0001, η2p = 0.75) in professional soccer players, when compared with semiprofessional (p < 0.0001) or amateur athletes (p < 0.0001). After winning a competition game an increase in testosterone levels was observed in professionals (t = −3.456, p < 0.001), semiprofessionals (t = −4.400, p < 0.0001), and amateurs (t = −2.835, p < 0.009). In contrast, this momentary hormonal fluctuation was not observed after winning a friendly game or during a regular training day. Additionally, statistical analysis indicated that cortisol levels were lower in professional (t = −3.456, p < 0.001) and semiprofessional athletes (t = −4.400, p < 0.0001) than in amateurs (t = −2.835, p < 0.009). In soccer players a rise in testosterone was only observable when the team was faced with an actual challenge but did not support a different response between categories. Thus, the desire to achieve a goal (and keep the social status) may be one of the key reasons why testosterone levels rise promptly. Conversely, testosterone did not change after friendly games, which suggests these situations are not real goals and the players do not perceive an actual threat (in terms of dominance) more than the preparation for their next competitive game. Full article
(This article belongs to the Special Issue Psychophysiological Responses to Stress)
Show Figures

Figure 1

10 pages, 623 KiB  
Article
Heart and Brain Responses to Real Versus Simulated Chess Games in Trained Chess Players: A Quantitative EEG and HRV Study
by Juan Pedro Fuentes-García, Telmo Pereira, Maria António Castro, António Carvalho Santos and Santos Villafaina
Int. J. Environ. Res. Public Health 2019, 16(24), 5021; https://doi.org/10.3390/ijerph16245021 - 10 Dec 2019
Cited by 12 | Viewed by 4309
Abstract
The aim of the present study was to investigate how the heart and the brain react to playing chess with a computer versus in a real context in chess players. We also aim to investigate if familiarization with simulated practice leads to changes [...] Read more.
The aim of the present study was to investigate how the heart and the brain react to playing chess with a computer versus in a real context in chess players. We also aim to investigate if familiarization with simulated practice leads to changes in heart rate variability (HRV) and the electroencephalographic (EEG) power spectrum. We designed a cross-sectional study, enrolling 27 chess players. They were randomly assigned to 3 minutes plus 2-second chess games: one with a computer (simulated scenario), and another in a real context. Additionally, participants were divided into two groups according to their level of familiarization of playing chess in a computer context. While they were playing, HRV and EEG were continuously recorded. Differences in HRV and EEG theta power spectrum between playing chess in a real or a simulated scenario were not found in chess players (p-value > 0.05). When participants were divided into groups (familiarized and unfamiliarized with simulated chess practice), significant differences were observed in HRV and EEG (p-value < 0.05). The EEG theta power spectrum was significantly lower, and HRV was higher in unfamiliarized players during the simulated scenario, which could indicate that they were less focused in a simulated environment than in a real context. Therefore, familiarization with simulated environments should be taken into account during the training process to achieve the best performance. Full article
(This article belongs to the Special Issue Psychophysiological Responses to Stress)
Show Figures

Figure 1

12 pages, 651 KiB  
Article
Increased Risks of Suicide Attempt and Suicidal Drug Overdose Following Admission for Head Injury in Patients with Depression
by Dorji Harnod, Tomor Harnod, Cheng-Li Lin, Wei-Chih Shen and Chia-Hung Kao
Int. J. Environ. Res. Public Health 2019, 16(19), 3524; https://doi.org/10.3390/ijerph16193524 - 20 Sep 2019
Cited by 7 | Viewed by 2568
Abstract
Aims: To determine the risks of suicide attempt (SA) and suicidal drug overdose (SDO) following the admission for head injury of patients with depression. Design: We analyzed the NHIRD data of patients aged ≥20 years who had received depression diagnoses between 2000 and [...] Read more.
Aims: To determine the risks of suicide attempt (SA) and suicidal drug overdose (SDO) following the admission for head injury of patients with depression. Design: We analyzed the NHIRD data of patients aged ≥20 years who had received depression diagnoses between 2000 and 2010. They were divided into cohorts of those with admission for head injury (DHI) and those without it (DWI) during the follow-up period and compared against a sex-, age-, comorbidity-, and index-date-matched cohort from the general population. Setting: The Taiwan National Health Insurance Research Database (NHIRD). Participants/Cases: We analyzed the NHIRD data of patients (≥20 years) who had received depression diagnoses between 2000 and 2010. Intervention(s): Regular interventions. Measurements: We calculated the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of SA and SDO in these cohorts after adjustment for age, sex, and comorbidities. Findings: Up to the end of 2011, our results revealed extremely high incidences of SA and SDO with 63.3 and 88.6 per 10,000 person-years, respectively, in the DHI cohort. The DHI cohort had a 37.4-times higher risk for SA and a 17.1-times higher risk for SDO compared with the comparison group and had aHRs of 14.4 and 16.3, respectively, for poisoning by medicinal substances and poisoning by tranquilizers compared with patients in the DWI cohort. Patients with DHI aged <50 years, of female sex, with high incomes, living in more urbanized areas, and without other comorbidities had extraordinarily higher risks for SA. Conclusions: The risks of SA and SDO were proportionally increased by head injury in patients with depression in Taiwan. Our findings provide crucial information to implement efficient suicide prevention strategies in the future. Full article
(This article belongs to the Special Issue Psychophysiological Responses to Stress)
Show Figures

Figure 1

Back to TopTop