Effects of Psychological and Physical Stress on Oxidative Stress, Serotonin, and Fatigue in Young Females Induced by Objective Structured Clinical Examination: Pilot Study of u-8-OHdG, u-5HT, and s-HHV-6

Tadayuki Iida; Yasuhiro Ito; Miho Kanazashi; Susumu Murayama; Takashi Miyake; Yuki Yoshimaru; Asami Tatsumi; Satoko Ezoe

doi:10.1177/11786469211048443

Effects of Psychological and Physical Stress on Oxidative Stress, Serotonin, and Fatigue in Young Females Induced by Objective Structured Clinical Examination: Pilot Study of u-8-OHdG, u-5HT, and s-HHV-6

Int J Tryptophan Res. 2021 Oct 10:14:11786469211048443. doi: 10.1177/11786469211048443. eCollection 2021.

Authors

Tadayuki Iida¹, Yasuhiro Ito², Miho Kanazashi¹, Susumu Murayama³, Takashi Miyake⁴, Yuki Yoshimaru⁵, Asami Tatsumi⁶, Satoko Ezoe⁷

Affiliations

¹ Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara, Japan.
² School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan.
³ Department of Physical Therapy, Hospital of Shiromachi, Mihara, Hiroshima, Japan.
⁴ Department of Clinical Gene Therapy, Graduate School of Medicine, Osaka University, Suita, Japan.
⁵ Hiroshima City Rehabilitation Hospital, Asaminami, Japan.
⁶ Department of Nursing, University of Human Environments, Obu, Aichi, Japan.
⁷ Health Service Center Izumo, Shimane University, Izumo, Japan.

Abstract

Background: To establish a method to prevent and manage fatigue caused by psychological and physical stress in young females, early detection factors, such as understanding of fatigue and causes of psychological and physical stress, as well as a review of early management of psychiatric disease, are important. With increasing knowledge regarding the diverse causes of stress, it is important to select biomarkers with consideration of the types of stress burden and mechanisms underlying the development of physical symptoms. The methods used to search for stress characteristics is an issue that needs to be addressed. However, consensus regarding objective assessment methods for impaired mental health is lacking.

Methods: We examined the effects of an objective structured clinical examination (OSCE), considered to be a uniform source of psychological and physical stress, on biomarkers of oxidative stress and fatigue in 16 third-year female medical university students (21.3 ± 2.1 years old) in Japan with a normal menstrual cycle. A self-administered questionnaire consisting of Zung's Self-rating Depression Scale (SDS) and State-Trait Anxiety Inventory (STAI) was used to assess subjective stress. Furthermore, stress-related biomarkers (urinary 8-hydroxy-2'-deoxyguanosine [u-8-OHdG], urinary 5-hydroxytryptamine [u-5-HT], and salivary human herpesvirus-6 [s-HHV-6]) were examined at 1 month, 1 week, and 1 day before, and 1 week after the OSCE.

Results: The results indicated that the OSCE did not have effects on u-8-OHdG, a biomarker of oxidative stress. However, u-5-HT and s-HHV-6 were found to be elevated in examinations performed prior to the OSCE.

Conclusions: The present findings suggest that u-5-HT and s-HHV-6 levels can be used for objective assessment of mental and physical fatigue in young females, including that produced not only by knowledge regarding an upcoming OSCE, but also by skill and attitude aspects related to that examination.

Keywords: SDS; STAI; objective structured clinical examination; s-HHV-6; u-5-HT; u-8-OHdG.