Just noticed this - and with Johannes W. Dietrich in particular as an author - it looked very much worth posting about.
The title doesn't give much away but it is very much on-topic for thyroid - when you read it. (Mind, I admit I have only managed the abstract for now. )
The idea that this might be a strand of understanding how psychological issues affect physiology makes such a change to it (whatever topic is being discussed) just being pointed out as a psychological issue with no hint as to how that works.
All too often comes across as somehow being the patient's fault and if they could just think differently it would all resolve.
Stress-Mediated Abnormalities in Regional Myocardial Wall Motion in Young Women with a History of Psychological Trauma
Assem Aweimer 1,* , Luisa Engemann 2, Sameh Amar 1, Aydan Ewers 1 , Faegheh Afshari 1, Clara Maiß 2, Katharina Kern 2, Thomas Lücke 3, Andreas Mügge 1 , Ibrahim El-Battrawy 1, Johannes W. Dietrich 4,5,6, and Martin Brüne 2
Abstract
Background: Psychosocial stress has been associated with the development and progression of atherosclerotic cardiovascular disease (CVD). Previously, we reported subtle differences in global longitudinal strain in somatically healthy women with a psychiatric diagnosis of borderline personality disorder (BPD). This study aimed to investigate the impact of BPD on segmental myocardial wall motion using speckle tracking echocardiography (STE) analysis. Methods: A total of 100 women aged between 18 and 38 years were included in this study. Fifty patients meeting the diagnostic criteria for BPD were recruited from the Department of Psychiatry (LWL-University Hospital Bochum) and compared with fifty age-matched healthy control subjects without previous cardiac disease. Laboratory tests and STE were performed with segmental wall motion analysis. Results: The BPD group had a higher prevalence of risk factors for CVD, with smoking and obesity being predominant, when compared with the control group. Other cardiovascular parameters such as blood pressure, glucose, and cholesterol levels were also elevated, even though not to pathological values. Moreover, in the STE analysis, the BPD group consistently exhibited decreased deformation in nine myocardial wall regions compared with the control group, along with a shift toward higher values in the distribution of peak pathological segments. Additionally, significantly higher values of free thyroxine concentration and thyroid’s secretory capacity were observed in the BPD group, despite falling within the (high-) normal range. Conclusions: BPD is associated with chronic stress, classical risk factors, and myocardial wall motion abnormalities. Further exploration is warranted to investigate the relationship between high-normal thyroid metabolism, these risk factors, and myocardial function in BPD patients. Long-term follow-up studies would be valuable in confirming the potential for predicting adverse events.
I am not sure about the BPD diagnosis. These tags are notoriously useless in my view. Mental illness, in all its forms, seems to give carte blanche to many medics, most especially our esteemed endocrinologists and GPs, to write off patients. Basically the patients become non-persons. This is a useful piece of research but to what end when many medics perceive they are ‘relieved’ of their duty of care when a diagnosis of mental illness can be made. They almost seem to relish in the fact that somehow the patient is no longer to be believed, listened to, treated, considered etc because they have a mental illness. I was recently (as I see it) threatened by a GP that I should be taking anti-depressants, and when I refused she humphed and said “We’ll see.” So many people, so let down by our system of medicine.
No expert here, but I rather agree that borderline personality disorder is a problematic and questionable diagnosis.
However, in this study, it might serve simply as "people with symptoms which have resulted in a diagnosis of borderline personality disorder" rather than an agreement with that diagnosis?
Your reply made me look at how I had reacted to the paper and realise that is towards how I had treated it when reading.
My daughter has just recently been diagnosed with PTSD and has had problems with her heart for which she has been prescribed Propanolol. I'm sure that BPD is probably no more than a convenient hook to hang this on and that there are more mental health conditions that could be responsible.
There have been many posts here where members have discussed having been brought up in stressful circumstances - and wondering if they had been a cause of their thyroid issues. (Not necessarily the only cause.)
Me, I am looking at the importance that physical symptoms affect mental symptoms and vice verse. In that way both physical and mental symptoms are therefore ‘valid’ whether they might be cause or effect. Either way, medics should be dealing more effectively with all symptoms. However it seems to me they pick and choose within their limited range of knowledge and experience (both sincerely lacking in thyroid issues) and I think many of us patients have been subjected to this level of stupidity in medics. Americans have a great saying about this, or at least it’s Americans I hear using it. “Going for the low hanging fruit”. It’s seen as laziness and trying to look like you are a winner, when really you have just gone for the easiest job.
Additionally, significantly higher values of free thyroxine concentration and thyroid’s secretory capacity were observed in the BPD group, despite falling within the (high-) normal range.
I don't understand this sentence from the abstract.
It seems to be saying Free T4 was significantly higher in the BPD group despite having levels in the high normal range.
Looks like a poor rewording for the abstract. Later it says:
Additionally, we observed significantly higher values of FT4 concentration and thyroid’s secretory capacity (SPINA-GT) in the BPD group, even though they were still within the (high-) normal range.
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