Psychocardiology concern for the management of thalassemic heart disease: A summarization from an endemic area in Indochina Viroj Wiwanitkit Heart and Mind 2018 2(4):95-97 Thalassemia is an important congenital hemoglobin disorder. This disease can cause anemia and other systematic clinical problems including cardiac problem. The psychological problem due to congenital disorder among patients with thalassemia is also observable. Both cardiac and psychological problems should be well managed. There is an interrelationship between cardiac and psychological problems in thalassemic patients. The interdisciplinary management of thalassemia to manage both mind and heart is necessary. In the present review article, the authors summarize and discuss the psychocardiology concern for the management of thalassemic heart disease.

Ethnic inequalities in cardiovascular disease risk: Strength of ethnic identity predicts obesity prevalence in late adolescence Annalijn I Conklin, Alex C T. Tam, Christopher A Yao, Sherry X R. Guo, Christopher G Richardson Heart and Mind 2018 2(4):98-105 Background: Cardiovascular diseases are a leading cause of death globally, and a major risk factor is obesity in early age groups. Obesity in children and youth is a growing public health concern, and inequalities exist across social groups. Evidence on ethnic disparities in obesity risk is mixed, and little is known about ethnicity and obesity in late adolescence. Moreover, broad ethnic identity categories may be less informative for understanding disparities in obesity risk than the psychosocial process of ethnic identity development during this unique developmental period. Differences in the salience of ethnic identity seem particularly relevant to examining obesity inequalities in multicultural, multigenerational settings. Aims and Objectives: To examine the gender-specific associations of strength of ethnic identity with the obesity prevalence in ethnically diverse urban youth from British Columbia (BC), Canada. Materials and Methods: Cross-sectional study of an adolescent cohort with self-reported data on ethnic identity, sociodemographics, height and weight using regression modeling with interaction terms. Results: Above-average ethnic identity was associated with the higher obesity prevalence in young men only. Multivariable-adjusted models showed that young men reporting the strongest ethnic identity had 57% higher odds of being obese (odds ratio 1.57 [95% confidence interval: 1.05–2.37]). Conclusion: Associations varied by gender and ethnic group: stronger ethnic identity was significantly associated with the higher obesity prevalence in young men from Asian and Indigenous cultural heritage, whereas young women from Indigenous backgrounds with stronger ethnic identity showed a nonsignificant lower obesity prevalence. Future research directions and public health program implications are discussed.

Risk of progression to hypertension from prehypertension and normal blood pressure: Results from a prospective cohort study among industrial workers in Kerala, India GK Mini, PS Sarma, KR Thankappan Heart and Mind 2018 2(4):106-110 Background: In India, studies exploring the incidence rate of hypertension (HTN) are limited particularly among industrial workers. We estimated the incidence rate of HTN among industrial workers with and without pre-HTN during a 2-year follow period and the factors associated with incident HTN among industrial workers in Kerala, India. Materials and Methods: A total of 326 industrial workers (mean age: 51 years, men: 76%), from two major industries in the state, enrolled at baseline were followed up at 2 years. All participants completed a structured interview schedule and had blood pressure (BP) and anthropometry measured using standard protocol. Results: Among the total workers, 36.5% were hypertensive, 39.3% were prehypertensive, and 24.2% had normal BP at baseline. At 2-year follow-up, 49.1% were hypertensive, 30.4% were prehypertensive, and 20.6% had normal BP. During follow-up, 19.8% of the 207 baseline nonhypertensives developed HTN providing an incidence rate of 9.9%/year (men: 10.7% and women: 7.6%). Incidence of HTN among ≥50 years was 11.4% compared to 9.0% among <50 years. Among the 79 workers with normal BP at baseline, 31.6% progressed to pre-HTN and 13.9% developed HTN, and among the 128 prehypertensives, 23.4% developed HTN at year 2. The odds of progressing to HTN from pre-HTN was two times higher compared to those from normal BP. Conclusion: The findings of this study indicated a higher risk for prehypertensive to develop HTN. Efforts should be made to prevent or delay the progression to HTN focusing on prehypertensives with frequent follow-up.

Heart rate variability: An overview and a few immediate/short-term assessments Colucci Roberto, Di Ionna Giuseppe, Cavezzi Attilio Heart and Mind 2018 2(4):111-118 Background: Heart Rate Variability (HRV) is a parameter used to investigate the autonomous neural system (sympathetic and parasympathetic system). Reduced HRV is a risk factor which correlates with physical and psychological stress, psychoneuroendocrineimmunology dysregulation as well as with aging. HRV is considered a reliable parameter to investigate psycho-physical resilience, the latter being considered a key-factor for human longevity and the final target of hormesis pathways as well. Different chemical, physical, psychological stressors may interfere with HRV. Aims: The aim of our observational study was to assess the possible changes in HRV changes induced by a few targeted stimulations: breathing, maqui nutraceutical intake, physical activity and thermal stress, and maqui nutraceutical intake. Patients and Methods: An observational study was performed on 4 groups of subjects, for a total of 112 individuals, who underwent HRV analysis after administration of different stressors/stimuli, such as breathing, thermal stimulation, Maqui 500 ® nutraceutical intake and physical activity. The investigated parameters were: SDNN, RMSSD, MHRR, mean heart rate (MHR) and the three frequency-domain based bands (VLF, LF, HF). Results: Our outcomes demonstrate that HRV assessment is a useful and reliable investigation to highlight and monitor the effects of these stressors. Breathing was the stimulus which induced the most significant variation in HV parameters. Conclusions: Notwithstanding the short duration of the follow-up, immediate/short-term HRV assessment showed statistically significant variations of the main parameters (e.g. SDNN, RMSSD and frequency bands) in a few cases after stimuli exposure. Studies including larger cohorts and longer follow-up are needed and justified to corroborate our outcomes furthermore.

Overlooking catatonia: Can't see the forest for the trees Steven A Svoboda, Gurjot K Malhi, Anita S Kablinger Heart and Mind 2018 2(4):119-121 Catatonia is a psychomotor syndrome with poorly understood pathophysiology that frequently occurs concurrently with acute psychiatric and medical illnesses. Its prevalence among psychiatric inpatients has been reported to be as high as 38% and is primarily observed in those with mood disorders. Diagnosis requires the presence of at least three of the following signs: mutism, negativism, immobility, agitation, waxy flexibility, catalepsy, posturing, grimacing, stereotypies, mannerisms, echopraxia, and echolalia. Although the most commonly observed signs are immobility and mutism, the presentation of catatonia is often highly variable and shares significant overlap with other neurological conditions. Consequently, diagnosing this complex clinical syndrome remains a challenge. Here, we present a case of catatonia initially unrecognized in a patient with major depressive disorder with psychotic features. The patient's catatonia was perceived incidentally after administration of a one-time dose of a benzodiazepine while on the inpatient psychiatry ward. Subsequent daily treatment with a benzodiazepine resulted in a drastic improvement in the patient's functioning over the following week. This case underscores the importance of performing a detailed psychiatric examination to avoid missing the diagnosis of catatonia, especially for patients with affective and psychotic disorders as more subtle catatonic signs may be masked. Therefore, being proficient at recognizing all the features and patterns of catatonia is essential for early detection and treatment.

Intersections of counseling, psychiatry, cardiology, and pharmacology to assist in depression and cardiac function Alyson Pompeo-Fargnoli Heart and Mind 2018 2(4):122-124 In the evolving healthcare landscape, providers, patients, and insurers are seeking synergistic ways to improve quality and lower costs. The following presents the attainment of this synergy through a clinical case, illustrating proper patient diagnosis and care, as well as provider knowledge of best treatment practices. This specific case illustrates this through the management of a patient who recently experienced a cardiac event and subsequent depression.