Review: depression, social isolation, and certain life events are associated with the development of coronary heart disease.
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Comment↗
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Results for “SOCIAL ISOLATION”
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[Influence of social isolation at birth on the behavior development of the guinea pig].
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Animals↗
[Physician-patient relations in a service for socially isolated uremic children. Analysis by the Balint type of group technic].
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Altruism↗
Social ties and health: the benefits of social integration.
This article explores the relationship between level of social integration and various aspects of health. A search of the literature published since the mid-1970s (under the MEDLINE key words, "social ties," "social network," "social isolation," "social environment") presented strong evidence that social integration leads to reduced mortality risks, and to a better state of mental health. The evidence on physical health outcomes is less conclusive. There is no consistent evidence that social integration affects the incidence of disease (at least for cardiovascular outcomes). However, social integration does appear to have a highly beneficial effect on post-myocardial infarction prognosis (functioning and longevity). A physiologic basis for these effects on health outcomes is also indicated by research demonstrating that both social isolation and nonsupportive social interactions can result in lower immune function and higher neuroendocrine and cardiovascular activity while socially supportive interactions have the opposite effects. In conclusion, available data suggest that, although social integration is generally associated with better health outcomes, the quality of existing ties also appears to influence the extent of such health benefits. Clearly, individuals' networks of social relationships represent dynamic and complex social systems that affect health outcomes.
Health Status↗
Delusional parasitosis in the elderly: a review and report of six cases from northern Finland.
A patient with delusional parasitosis has a strong conviction of being infested with parasites: for example, lice or worms. Such a patient is not satisfied with assurances or test results that no parasites are present, but is so convinced that he or she will go as far as to bring the parasites in "matchboxes" to a physician. Subjectively worried, the patient may try to pick the parasites out of the skin, causing cutaneous lesions and even ulcerations. The condition is classified as a delusional/paranoid disorder, somatic type according to DSM-III-R. Not much is known epidemiologically of this rare disorder, which usually affects older women who often are isolated socially. Therapy is regarded as difficult, and a wide variety of treatment methods have been attempted. In this article six female cases are presented, showing that a typical patient is an elderly woman who has suffered losses or is socially isolated. These patients lack deeper psychiatric insight into their problem, so they are mostly in the care of nonpsychiatric physicians. Treatment with a low dose of high-potency neuroleptics combined sometimes with antidepressants appears to be effective. Reducing social isolation is also important.
Aged↗
Isolation, flexibility and change in vocational training for general practice: personal and educational problems experienced by general practice registrars in Australia.
BACKGROUND: GP registrars, in common with other doctors, frequently experience high levels of stress; however, little is known about the nature and outcomes of personal and educational problems experienced during vocational training for general practice. OBJECTIVES: The purpose of our study was to elicit the nature, causes and effects of more severe problems experienced during vocational training for general practice from the registrar's viewpoint and put these into the context of their personal circumstances and background. METHODS: This qualitative study used detailed semi-structured telephone interviews with a selected subgroup of 33 of the 1999 entry cohort of general practice registrars in Australia who had reported serious self-defined problems during an earlier longitudinal questionnaire study. Registrars were asked about the nature, antecedents and outcomes of problems experienced during GP training, actions taken to resolve the problem, and their perceptions of what might have helped prevent or minimize the problem. RESULTS: Problems reported by registrars fell into five major themes: isolation (structural isolation, social isolation and professional isolation); flexibility and choice (administrative issues and balancing work with personal life); change and uncertainty (within general practice and training, intergenerational changes); teaching problems; and work conditions. Actions taken and effects of problems are also discussed in the light of workforce imperatives. Results have been used to develop a list of suggestions for the providers of general practice training. CONCLUSIONS: Registrars commonly experience problems during vocational training. These may be related to structural, social and professional isolation, or a lack of flexibility in training arrangements and balancing work and other commitments. Some of these problems may be amenable to relatively simple solutions involving term placements, selection of training practices and administrative adjustments.
Attitude of Health Personnel↗
Social support and the chronically ill individual.
Nurses caring for the chronically ill need to be alert for the problems of social isolation and social impairment. Families often respond initially to serious illness by becoming over-protective and fostering dependence and a sense of impaired competence in the ill person. As the illness continues, families often experience exhaustion because of the demands of new roles, depleted finances, and other aspects of a changed lifestyle. Feelings of anger, guilt, and helplessness occur in the network, often leading to withdrawal of support--especially as the ill person's ability to reciprocate support is impaired. Nursing interventions in situations of social isolation focus on reducing isolation by promoting social interaction as appropriate, and by directly or indirectly mobilizing or expanding the social network. The problem of impaired social interaction may occur secondary to the personality changes that often accompany chronic illnesses, or as a function of the chronic illness or disability itself, as in the case of mental illnesses. Social impairment is an appropriate nursing diagnosis in abusive families. Nursing interventions range from educational programs for social skill development to reduction of the amount of contact within the network to involvement of protective and psychotherapy services. Chronic illness has profound effects on social support and the social network of both the ill person and his or her family. As both long-term illnesses and family involvement in care giving increase, nursing care in situations of chronic illness must include attention to issues of social support. Nursing diagnosis provides a framework for nurses to include social support in their care of the chronically ill patient. Social isolation and social impairment can be reduced by nursing interventions.
Chronic Disease↗
After-school child care and self-esteem in school-age children.
Although more than 2 million US children are in self-care after school, little is known of the extent to which self-care may adversely affect developmental processes, such as the development of self-esteem. To test the hypothesis that lower self-esteem is associated with being in self-care, 297 subjects in fourth and sixth grades from three ethnically diverse schools in northern California were enrolled in a cross-sectional study during November 1987. Sixty percent of subjects were in adult in-home care, 13% in adult out-of-home care, 19% in self-care, and 8.0% in older sibling care. No significant differences in self-competence scores, as measured by the Harter Self-perception Profile for Children, were observed for children in self-care compared with the three other care groups. However, children who were cared for by older siblings unexpectedly exhibited lower self-competence scores for five of the six self-competence domains, with three domains showing significance at P less than .05. Children in self-care were significantly more isolated socially than children in adult care, reporting fewer opportunities to play outside or have friends visit at their homes. The results indicate that children in sibling care may be at potentially greater risk for negative effects on self-esteem and social development. Children in self-care may also experience more social isolation after school than children in other forms of afterschool care.
Age Factors↗
Assessment of sensitivity to interpersonal stress in stutterers and nonstutterers.
The Revised Willoughby Personality Schedule (WPS-R) was used to determine its applicability for assessing social sensitivity in stutterers. Forty-one adult stutterers and 41 nonstutterers completed the WPS-R. Confirmatory factor analysis revealed three dimensions differentiating stutterers from nonstutterers. The dimensions--labeled social isolation, social confidence, and social sensitivity--were similar to dimensions of the WPS-R labeled as sensitivity to interpersonal stress by other investigators. The results suggest that the WPS-R may be useful for evaluating general anxiety and for monitoring changes in emotional reactivity as clinical intervention progresses.
Adolescent↗
Changes in brain opiate receptors in rats with isolation syndrome.
Prolonged social isolation of Wistar rats produces various neurochemical, neuroendocrine and behavioral changes. Some of isolated rats exhibit interspecies aggressive behavior (mouse-killing). It is suggested that social isolation leads to a stress-like state of rats. On the other hand, the participation of endogenous opioid mechanisms in stress is well known. We found that social isolation induced a decrease in the number of opiate receptors in rat frontal cortex, striatum, hippocampus and periaqueductal grey matter. The decrease was most pronounced in isolated aggressive rats. The affinity of opiate receptors in striatum and hippocampus was increased and in frontal cortex was decreased, these changes being more distinct in isolated aggressive than in isolated non-aggressive rats. These data suggest that social isolation of rats induces great changes in brain opiate receptor functions.
Aggression↗
Factor analysis of Forced Swimming test, Sucrose Preference test and Open Field test on enriched, social and isolated reared rats.
Developmental and social factors are known to play a crucial role in the pathogenesis of affective disorders. Although it has been demonstrated that early life aversive experiences can be a risk factor in the development of human depression, most of the investigation in animals that try to model depression do not include postnatal manipulations. Since housing represents a fundamental ethological factor which modifies behavior and brain development, this study aimed to investigate the impact of different social and structural housing conditions on the development of a depressive-like syndrome in the behavioral despair paradigm and an anxiety-like syndrome in the unconditioned anxiety paradigm. The present study uses several multivariate analyses to study the impact of housing conditions in animal models of depression and anxiety. In this study, social isolation was able to reproduce the effects found in other animals models based on stress, suggesting that only 2 months of social isolation are enough to produce effects that can be useful as behavioral model of depression. Moreover, environmental enrichment showed an antidepressive and anxiolytic like effect in animal models of depression and anxiety. This effect, which has not been reported in earlier studies, suggests that stimulation during the first stages of growth might play a "protective" role on behavior and brain development.
Animals↗
Feeling at home in one's school: a first look at a new measure.
We report on the development of the Hospitality Scale, which measures two aspects of adolescents' perception of social capital in school-the extent to which they perceive that they have social capital and the extent to which they provide social capital to others. The scale was developed in reference to the literature exploring adolescent social isolation and social tolerance, as well as constructs developed in research on adults, especially related to psychological sense of community and collective efficacy. We examine the reliability of the scale and the association between scale scores and behavioral factors that may reflect social isolation.
Adolescent↗
Are antagonists of dopamine D1 receptors drugs that attenuate both positive and negative symptoms of schizophrenia? A pilot study in Java monkeys.
Amphetamine is known to elicit stereotyped behavior in various species. For a long time, this effect was considered to be an animal model for the positive symptoms of schizophrenia. In addition, amphetamine is known to induce a strong social isolation in socially living monkeys. Both on symptomatologic and pharmacologic grounds, this amphetamine-induced social isolation has been suggested to represent an animal model for the negative symptoms of schizophrenia. To date no effective treatment has been found for these negative symptoms. We now report that the selective D1 dopamine antagonist SCH 23390 is very effective in antagonizing both the stereotyped behavior and the social isolation in Java monkeys induced by amphetamine. Moreover, SCH 23390 is able to reinstate normal behavior in these animals. These results may have important consequences for our understanding of the functional significance of the D1 receptor as well as for the clinical treatment of the positive and negative symptoms of schizophrenia.
Animals↗
Social isolation-induced enhancement of the psychomotor effects of morphine depends on corticosterone secretion.
Short-term social isolation has been shown to increase individual reactivity to addictive drugs, although the biological factors involved in this effect are largely unknown. In this study, we investigated the influence of corticosterone secretion on the effects of social isolation on the response to opioids. The effects of social isolation on morphine-induced locomotor activity were compared in: (i) animals with an intact hypothalamo-pituitary-adrenal (HPA) axis; (ii) animals in which stress-induced corticosterone secretion was blocked by adrenalectomy. The animals in the latter group were implanted with subcutaneous corticosterone pellets (50 mg), which slowly release corticosterone, producing stable plasma levels within the physiological range. Social isolation increased the locomotor response to morphine (2 mg/kg s.c.) in animals with an intact HPA axis, but not in animals in which corticosterone secretion was blocked. These results suggest that corticosterone secretion is required for the expression of the enhanced locomotor response to opioids induced by isolation. Since an enhanced locomotor reactivity to addictive drugs has been found to be frequently associated with an enhanced vulnerability to drug self-administration, these findings suggest a role for glucocorticoids in the vulnerability to the reinforcing effects of opioids.
Adrenalectomy↗
Social isolation-induced decreases in both the abundance of neuroactive steroids and GABA(A) receptor function in rat brain.
The effects of social isolation on behavior, neuroactive steroid concentrations, and GABA(A) receptor function were investigated in rats. Animals isolated for 30 days immediately after weaning exhibited an anxiety-like behavioral profile in the elevated plus-maze and Vogel conflict tests. This behavior was associated with marked decreases in the cerebrocortical, hippocampal, and plasma concentrations of pregnenolone, progesterone, allopregnanolone, and allotetrahydrodeoxycorticosterone compared with those apparent for group-housed rats; in contrast, the plasma concentration of corticosterone was increased in the isolated animals. Acute footshock stress induced greater percentage increases in the cortical concentrations of neuroactive steroids in isolated rats than in group-housed rats. Social isolation also reduced brain GABA(A) receptor function, as evaluated by measuring both GABA-evoked Cl(-) currents in Xenopus oocytes expressing the rat receptors and tert-[(35)S]butylbicyclophosphorothionate ([(35)S]TBPS) binding to rat brain membranes. Whereas the amplitude of GABA-induced Cl(-) currents did not differ significantly between group-housed and isolated animals, the potentiation of these currents by diazepam was reduced at cortical or hippocampal GABA(A) receptors from isolated rats compared with that apparent at receptors from group-housed animals. Moreover, the inhibitory effect of ethyl-beta-carboline-3-carboxylate, a negative allosteric modulator of GABA(A) receptors, on these currents was greater at cortical GABA(A) receptors from socially isolated animals than at those from group-housed rats. Finally, social isolation increased the extent of [(35)S]TBPS binding to both cortical and hippocampal membranes. The results further suggest a psychological role for neurosteroids and GABA(A) receptors in the modulation of emotional behavior and mood.
Animals↗
Social isolation-induced changes in the hypothalamic-pituitary-adrenal axis in the rat.
Social isolation of rats both reduces the cerebrocortical and plasma concentrations of 3a-hydroxy-5a-pregnan-20-one (3a,5a-TH PROG) and 3a,5a-tetrahydrodeoxycorticosterone and potentiates the positive effects of acute stress and ethanol on the concentrations of these neuroactive steroids. We now show that social isolation decreased the plasma level of adrenocorticotropin (ACTH), moreover, intracerebroventricular administration of corticotropin releasing factor (CRF) induced a marked increase in the plasma corticosterone level in both isolated and group-housed rats, but this effect was significantly greater in the isolated rats (+121%) than in the group-housed rats (+86%). In addition, in isolated rats, a low dose of dexamethasone had no effect on the plasma corticosterone concentration, whereas, a high dose significantly reduced it; both doses of dexamethasone reduced plasma corticosterone in group-housed rats. Furthermore, the corticosterone level after injection of dexamethasone at the high dose was significantly greater in the isolated animals than in the group-housed rats. These results suggest that social isolation increased sensitivity of the pituitary to CRF and impaired negative feedback regulation of the hypothalamic-pituitary-adrenal (HPA) axis.
Animals↗
Social isolation-induced increase in the sensitivity of rats to the steroidogenic effect of ethanol.
Social isolation of rats for 30 days immediately after weaning results in marked decreases in the cerebrocortical and plasma concentrations of pregnenolone, progesterone, 3alpha-hydroxy-5alpha-pregnan-20-one (3alpha,5alpha-TH PROG), and 3alpha,5alpha-tetrahydrodeoxycorticosterone (3alpha,5alpha-TH DOC), as well as a moderate increase in the plasma concentration of corticosterone. This mildly stressful condition has now been shown to increase the sensitivity of rats to the effect of acute ethanol administration on the cerebrocortical and plasma concentrations of neuroactive steroids. The percentage increases in the brain and plasma concentrations of pregnenolone, progesterone, 3alpha,5alpha-TH PROG, and 3alpha,5alpha-TH DOC, apparent 20 min after a single intraperitoneal injection of ethanol (1 g/kg), were thus markedly greater in isolated rats than in group-housed animals. A subcutaneous injection of isoniazid (300 mg/kg) also induced greater percentage increases in the concentrations of these steroids in isolated rats than in group-housed animals. These results suggest that mild chronic stress, such as that induced by social isolation, enhances the steroidogenic effect of ethanol, a drug abused by humans under stress or affected by neuropsychiatric disorders. Social isolation also induced hyper-responsiveness of the hypothalamic-pituitary-adrenal (HPA) axis, as was apparent after reduction of GABA-mediated inhibitory tone by isoniazid administration.
Animals↗
Neurosteroidal modulation of social isolation-induced decrease in pentobarbital sleep in mice.
Stressful manipulations are known to change the level of neurosteroids capable of interacting with GABAA receptor in the brain. To clarify the involvement of these neurosteroids in social isolation stress-induced decrease in pentobarbital sleep in mice, we examined the effects of 3 beta-hydroxy-5-pregnen-20-one-3-sulfate (pregnenolone sulfate, PS), a steroidal GABAA antagonist, and 3 alpha,21-dihydroxy-5 alpha-pregnan-20-one (allo-THDOC) and 3 alpha,21-dihydroxy-5 beta-pregnan-20-one (THDOC), positive allosteric modulators of the GABAA receptor, on the hypnotic activity of pentobarbital in socially isolated mice. Pentobarbital (50 mg/kg, i.p.)-induced sleep was significantly shorter in isolated mice than in group-housed mice and adrenalectomy had no effect on the decrease of pentobarbital sleep following social isolation. PS (5-10 mg/kg, i.p. or 12-24 nmol, i.c.v.) decreased pentobarbital sleep in group-housed mice in a dose-dependent manner without affecting the sleep in socially isolated mice. In contrast, allo-THDOC (14.9-37.4 nmol, i.c.v.) and THDOC (5-12.5 mg/kg, i.p. or 14.9-37.4 nmol, i.c.v.) reversed the pentobarbital sleep decreased by social isolation to the level in group-housed mice. These steroids had no effect on the pentobarbital sleep in group-housed mice. Such a reversing effect of THDOC in isolated mice was significantly blocked by PS (24 nmol, i.c.v.). Moreover, i.c.v. injection of yohimbine (30 nmol), methoxamine (200 nmol) and CRF (2.1 nmol) significantly decreased pentobarbital sleep in group-housed mice but not that in isolated mice. The effects of these drugs on pentobarbital sleep in group-housed mice were significantly attenuated by THDOC (12.5 mg/kg, i.p.). These results suggest that changes in the level of neurosteroids with ability to modulate GABAA receptor function are involved in social isolation-induced decrease in the hypnotic activity of pentobarbital in mice.
Adrenalectomy↗