The development of depressive symptoms during medical internship stress predicts worsening vascular function

J Psychosom Res. 2015 Sep;79(3):243-5. doi: 10.1016/j.jpsychores.2015.06.004. Epub 2015 Jun 18.

Abstract

Objective: We sought to prospectively determine whether the onset of internship stress and any subsequent depression alters physiological markers of early vascular disease

Methods: We explored potential mechanisms linking stress and depression to vascular disease in a prospective cohort of 37 participants exposed to medical internship stress, an established precipitant of depressive symptomatology.

Results: Change in depressive symptom score from baseline over one year of internship stress was inversely correlated with change in the reactive hyperemia index (RHI), a measure of peripheral endothelial function (r=0.41, p=0.01). The change in depressive symptoms in the first six months of internship was similarly related to change in RHI over one year (r=0.38, p=0.02). While the development of depressive symptoms did not significantly impact changes in endothelial progenitor cells (EPCs), EPCs did significantly decrease with the year of internship stress (11.9 to 3.4cells/ml blood; p=0.01).

Conclusion: Endothelial function may be a critical link between stress, depression, and cardiovascular disease and a feasible surrogate outcome for prospective studies.

Keywords: Biological makers; Cardiovascular diseases; Endothelial function; Major depressive disorder.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cardiovascular System / physiopathology*
  • Depression / psychology*
  • Female
  • Humans
  • Hyperemia / psychology*
  • Internship and Residency*
  • Male
  • Prospective Studies
  • Stress, Psychological / complications*
  • Students, Medical / psychology*
  • Vascular Diseases / physiopathology
  • Vascular Diseases / psychology*