Influence of academic examination stress on hematological measurements in subjectively healthy volunteers

Some recent reports showed that a brief exposure to a mental stressor during 3-20 min may induce hematological changes in humans. The aim of the present study was to examine the effects of academic examination stress on erythron variables, such as the number of red blood cells (RBC), hemoglobin (Hb), hematocrit (Ht), mean corpuscular volume (MCV), mean cell Hb (MCH), mean cell Hb concentration (MCHC), RBC distribution width (RDW), and serum iron and transferrin (Tf). The above variables were determined in 41 students in three conditions, i.e. the stress condition (the day before a difficult oral exam) and two baseline conditions, i.e. a few weeks earlier and later. At the same occasions, subjects completed the Perceived Stress Scale (PSS), the state version of the State-Trait Anxiety Inventory (STAI) and the Profile of Mood States (POMS). Academic examination stress significantly increased Ht, Hb, MCV, MCH and MCHC and significantly decreased RDW. There were significant relationships between the stress-induced changes in the PSS, STAI and POMS scores and those in Ht, Hb, MCV and MCH (allpositive) and RDW (negative). It is concluded that academic examination stress induces significant hematological changes indicative of an increased number of large RBC and increased hemoglobinisation, which cannot be explained by shifts of fluid out of the intravascular space, concentrating non-diffusible blood constituents.

[1]  G. Lowe.  Blood Viscosity and Cardiovascular Disease , 1992, Thrombosis and Haemostasis.

[2]  K. Matthews,et al.  Behavioral antecedents of coronary heart disease and atherosclerosis. , 1986, Arteriosclerosis.

[3]  P. Kendall,et al.  Anxiety and depression : distinctive and overlapping features , 1989 .

[4]  S. Manuck,et al.  Acute cholesterol responses to mental stress and change in posture. , 1992, Archives of internal medicine.

[5]  T. Kamarck,et al.  A global measure of perceived stress. , 1983, Journal of health and social behavior.

[6]  B. Leonard.  Stress and the Immune System: Immunological Aspects of Depressive Illness , 1990 .

[7]  H. Hoch,et al.  Hemoglobin in Plasma , 1970 .

[8]  D. Berman,et al.  Mental stress and the induction of silent myocardial ischemia in patients with coronary artery disease. , 1988, The New England journal of medicine.

[9]  C. Fraser.  Data on biological variation: essential prerequisites for introducing new procedures? , 1994, Clinical chemistry.

[10]  B. Leonard,et al.  Stress, the immune system, and psychiatry / , 1995 .

[11]  G. J. Mellenbergh,et al.  De verkorte versie van de Nederlandse vertaling van de Profile of Mood States (POMS). , 1990 .

[12]  C. Jern,et al.  Haematological changes during acute mental stress , 1989, British journal of haematology.

[13]  J. Gottdiener,et al.  Effects of acute mental stress on serum lipids: mediating effects of plasma volume. , 1993, Psychosomatic medicine.

[14]  E. Bosmans,et al.  The effects of psychological stress on humans: increased production of pro-inflammatory cytokines and a Th1-like response in stress-induced anxiety. , 1998, Cytokine.

[15]  E. Ernst,et al.  Cardiovascular risk factors and hemorheology. Physical fitness, stress and obesity. , 1986, Atherosclerosis.

[16]  K. Matthews,et al.  Sympathetic Reactivity to Acute Stress and Immune Response in Women , 1995, Psychosomatic medicine.

[17]  H. Neels,et al.  Components of biological variation in prolyl endopeptidase and dipeptidyl-peptidase IV activity in plasma of healthy subjects. , 1994, Clinical chemistry.

[18]  D. Young.  Effects of Preanalytical Variables on Clinical Laboratory Tests , 1993 .

[19]  Shelomo Breznitz,et al.  Handbook of Stress: Theoretical and Clinical Aspects , 1993 .

[20]  S. Wetzler.  Measuring Mental Illness:Psychometric Assessment for Clinicians , 1989 .

[21]  S. Manuck,et al.  Effects of acute psychological stress on serum lipid levels, hemoconcentration, and blood viscosity. , 1995, Archives of internal medicine.

[22]  Ian H. Gotlib,et al.  Self-report assessment of depression and anxiety. , 1989 .

[23]  C. Jern,et al.  'Polycythaemia of stress' in subjects with Type A and Type B behaviour patterns. , 1991, Journal of psychosomatic research.

[24]  P. B. Defares,et al.  Handleiding bij de Zelf-beoordelings Vragenlijst ZBV. Een nederlandstalige bewerking van de Spielberger State-Trait Anxiety Inventory , 1980 .

[25]  M. Pippard,et al.  Iron Metabolism in Health and Disease , 1994 .

[26]  A. Vander,et al.  The effects of psychological stress on plasma interleukin-6 activity in rats , 1990, Physiology & Behavior.

[27]  P. Sorlie,et al.  Hematocrit and risk of coronary heart disease: the Puerto Rico Heart Health Program , 1981 .

[28]  S. Yehuda,et al.  Modification of cytokine secretion following mild emotional stimuli. , 1995, Neuroreport.

[29]  R. Gräsbeck,et al.  Preanalytical factors and standardized specimen collection: influence of psychological stress. , 1992, Scandinavian journal of clinical and laboratory investigation.

[30]  M. Fujishima,et al.  Hematocrit as a risk factor of cerebral infarction: long-term prospective population survey in a Japanese rural community. , 1986, Stroke.

[31]  R. Puri,et al.  Human Cytokines: Their Role in Disease and Therapy , 1995 .

[32]  H. Neels,et al.  Simultaneous determination of lidocaine, bupivacaine, and their two main metabolites using gas chromatography and a nitrogen-phosphorus detector: selection of stationary phase and chromatographic conditions. , 1996, Therapeutic drug monitoring.

[33]  K Rickels,et al.  Short form of depression inventory: cross-validation. , 1974, Psychological reports.

[34]  G. A. Mccain,et al.  Cytokine production and lymphocyte transformation during stress , 1991, Brain, Behavior, and Immunity.

[35]  R. Niaura,et al.  Temporal stability of lipid responses to acute psychological stress in middle-aged men. , 1997, Psychophysiology.

[36]  M. Lorr,et al.  Manual for the Profile of Mood States , 1971 .

[37]  T. Theorell,et al.  Threat of unemployment and cardiovascular risk factors: longitudinal study of quality of sleep and serum cholesterol concentrations in men threatened with redundancy. , 1990, BMJ.