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Huang WL, Chang SS, Liao SC. The psychological features of distinct somatic syndromes: A cluster analysis according to population-based somatic symptom profiles in Taiwan. J Formos Med Assoc 2022; 121:1813-1822. [DOI: 10.1016/j.jfma.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/19/2022] [Accepted: 03/13/2022] [Indexed: 11/16/2022] Open
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Heart rate variability in patients with somatic symptom disorders and functional somatic syndromes: A systematic review and meta-analysis. Neurosci Biobehav Rev 2020; 112:336-344. [DOI: 10.1016/j.neubiorev.2020.02.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/19/2020] [Accepted: 02/08/2020] [Indexed: 01/11/2023]
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Jones B. Why we should stop talking about 'medically unexplained symptoms' etc. - the problem of overgeneralisation for research and treatment. J Psychosom Res 2019; 127:109835. [PMID: 31635799 DOI: 10.1016/j.jpsychores.2019.109835] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 09/12/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Brittni Jones
- Millfields Personality Disorder Unit, John Howard Centre, East London NHS Foundation Trust, 12 Kenworthy Road, London E9 5TD, United Kingdom.
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Delvecchio G, Rossetti MG, Caletti E, Arighi A, Galimberti D, Basilico P, Mercurio M, Paoli R, Cinnante C, Triulzi F, Altamura AC, Scarpini E, Brambilla P. The Neuroanatomy of Somatoform Disorders: A Magnetic Resonance Imaging Study. PSYCHOSOMATICS 2019; 60:278-288. [DOI: 10.1016/j.psym.2018.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 11/16/2022]
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Häufigkeit somatoformer Syndrome in der Allgemeinmedizin. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2017; 63:202-212. [DOI: 10.13109/zptm.2017.63.2.202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Huang WL, Chen TT, Chen IM, Ma HM, Lee MT, Liao SC, Gau SF. Depression and anxiety among patients with somatoform disorders, panic disorder, and other depressive/anxiety disorders in Taiwan. Psychiatry Res 2016; 241:165-71. [PMID: 27179181 DOI: 10.1016/j.psychres.2016.05.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 04/30/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
Abstract
The aim of this study is to compare the severity of depression and anxiety in individuals with somatoform disorders, panic disorder, other depressive/anxiety disorders, and healthy controls in a Han Chinese population. According to the DSM-IV-TR-based diagnostic interviews, we recruited 152 subjects with somatoform disorders (SG), 56 with panic disorder (PG), 85 with other depressive/anxiety disorders (OG), and 179 without any psychiatric disorder (NG). The four groups reported on the Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI) for depressive and anxiety symptoms, respectively. Correlation analysis and multivariate regression analysis were used to determine the effects of demographic factors and psychiatric diagnoses on depressive and anxiety symptoms separately. BDI-II scores were not significantly different in SG, PG, and OG but were higher than NG. SG and PG had the highest BAI scores, whereas NG had the lowest. Multiple linear regression analyses revealed that the associated factors for BDI-II were gender, residential location, somatoform disorders, panic disorder, major depressive disorder (MDD), and generalized anxiety disorder, whereas BAI was significantly associated with somatoform disorders, panic disorder, and MDD. Our results strongly suggest the inclusion of clinical assessment of depressive and anxious symptoms in patients with somatoform disorders.
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Affiliation(s)
- Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzu-Ting Chen
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan
| | - I-Ming Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Huei-Mei Ma
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan
| | - Ming-Tzu Lee
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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McBeth J, Tomenson B, Chew-Graham C, Macfarlane G, Jackson J, Littlewood A, Creed F. Common and unique associated factors for medically unexplained chronic widespread pain and chronic fatigue. J Psychosom Res 2015; 79:484-91. [PMID: 26652592 PMCID: PMC4678257 DOI: 10.1016/j.jpsychores.2015.10.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 10/15/2015] [Accepted: 10/16/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Chronic widespread pain and chronic fatigue share common associated factors but these associations may be explained by the presence of concurrent depression and anxiety. METHODS We mailed questionnaires to a randomly selected sample of people in the UK to identify participants with chronic widespread pain (ACR 1990 definition) and those with chronic fatigue. The questionnaire assessed sociodemographic factors, health status, healthcare use, childhood factors, adult attachment, and psychological stress including anxiety and depression. To identify persons with unexplained chronic widespread pain or unexplained chronic fatigue; we examined participant's medical records to exclude medical illness that might cause these symptoms. RESULTS Of 1443 participants (58.0% response rate) medical records of 990 were examined. 9.4% (N=93) had unexplained chronic widespread pain and 12.6% (N=125) had unexplained chronic fatigue. Marital status, childhood psychological abuse, recent threatening experiences and other somatic symptoms were commonly associated with both widespread pain and fatigue. No common effect was found for few years of education and current medical illnesses (more strongly associated with chronic widespread pain) or recent illness in a close relative, neuroticism, depression and anxiety scores (more strongly associated with chronic fatigue). Putative associated factors with a common effect were associated with unexplained chronic widespread pain or unexplained chronic fatigue only when there was concurrent anxiety and/or depression. DISCUSSION This study suggests that the associated factors for chronic widespread pain and chronic fatigue need to be studied in conjunction with concurrent depression/anxiety. Clinicians should be aware of the importance of concurrent anxiety or depression.
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Affiliation(s)
- J. McBeth
- Arthritis Research UK Epidemiology Unit, The University of Manchester, Manchester, UK,Corresponding author.
| | - B. Tomenson
- Biostatistics Unit, Institute of Population Health, The University of Manchester, Manchester, UK
| | - C.A. Chew-Graham
- Research Institute, Primary Care and Health Sciences, Keele University, Newcastle, Staffs, ST5 5BG, UK
| | - G.J. Macfarlane
- Musculoskeletal Research Collaboration (Epidemiology Group), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, UK
| | - J. Jackson
- Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
| | - A. Littlewood
- Arthritis Research UK Epidemiology Unit, The University of Manchester, Manchester, UK
| | - F.H. Creed
- Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
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Tomenson B, Essau C, Jacobi F, Ladwig KH, Leiknes KA, Lieb R, Meinlschmidt G, McBeth J, Rosmalen J, Rief W, Sumathipala A, Creed F. Total somatic symptom score as a predictor of health outcome in somatic symptom disorders. Br J Psychiatry 2013; 203:373-80. [PMID: 24072756 DOI: 10.1192/bjp.bp.112.114405] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The diagnosis of somatisation disorder in DSM-IV was based on 'medically unexplained' symptoms, which is unsatisfactory. AIMS To determine the value of a total somatic symptom score as a predictor of health status and healthcare use after adjustment for anxiety, depression and general medical illness. METHOD Data from nine population-based studies (total n = 28 377) were analysed. RESULTS In all cross-sectional analyses total somatic symptom score was associated with health status and healthcare use after adjustment for confounders. In two prospective studies total somatic symptom score predicted subsequent health status. This association appeared stronger than that for medically unexplained symptoms. CONCLUSIONS Total somatic symptom score provides a predictor of health status and healthcare use over and above the effects of anxiety, depression and general medical illnesses.
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Affiliation(s)
- Barbara Tomenson
- Barbara Tomenson, MSc, Biostatistics Unit, Institute of Population Health, University of Manchester, UK; Cecilia Essau, PhD, Department of Psychology, Whitelands College, University of Roehampton, London, UK; Frank Jacobi, PhD, Technische Universität Dresden, Germany; Karl Heinz Ladwig, PhD, Institute of Epidemiology II, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany; Kari Ann Leiknes, MD, PhD, Norwegian Knowledge Centre for the Health Services, Oslo, Norway; Roselind Lieb, PhD, Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Switzerland; Gunther Meinlschmidt, PhD, Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Switzerland, and Research Department of Psychobiology, Psychosomatics and Psychotherapy, Clinic of Psychosomatic Medicine and Psychotherapy, LWL University Hospital & Faculty of Medicine, Ruhr University Bochum, Germany; John McBeth, PhD, Arthritis Research UK Primary Care Centre, Keele University, UK; Judith Rosmalen, PhD, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, The Netherlands; Winfried Rief, PhD, Department of Clinical Psychology, University of Marburg, Germany; Athula Sumathipala, MD, PhD, King's College London, UK; Francis Creed, FMedSci, Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
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Neural correlates of deficits in pain-related affective meaning construction in patients with chronic pain disorder. Psychosom Med 2013; 75:124-36. [PMID: 23362496 DOI: 10.1097/psy.0b013e31827e60f3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Psychological and neural mechanisms of the affective dimension of pain are known to be disturbed in patients with chronic pain disorder. The aim of this functional magnetic resonance imaging study was to assess the neurofunctional and behavioral measures underlying the ability to construct pain-related affective meaning in a painful situation by comparing 21 clinically and psychometrically well-characterized patients with persistent non-nociceptive somatoform pain with 19 healthy controls. METHODS The functional magnetic resonance imaging task involved viewing pictures depicting human hands and feet in different painful and nonpainful situations. Participants were asked to estimate the perceived pain intensity. These data were correlated with behavioral measures of depression, alexithymia, and general cognitive and emotional empathy. RESULTS In a hypothesis-driven region-of-interest analysis, the healthy control group exhibited greater activation of the left perigenual anterior cingulate cortex than patients with pain (Montreal Neurological Institute coordinates (x y z)=-8 38 0; cluster extent=54 voxels; T=4.28; p=.006 corrected for multiple comparisons at cluster level). No group differences in the activation of the anterior insular cortex were found. Scores on self-assessment instruments (Beck Depression Inventory I, Interpersonal Reactivity Index, and 20-item Toronto Alexithymia Scale) did not influence neuroimaging results. CONCLUSIONS Our results suggest that patients with chronic medically unexplained pain have an altered neural pain perception process owing to decreased activation of empathetic-affective networks, which we interpret as a deficit in pain-related affective meaning construction. These findings may lead to a more specific and detailed neurobiological understanding of the clinical impression of disturbed affect in patients with chronic pain disorder.
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Fava GA, Guidi J, Porcelli P, Rafanelli C, Bellomo A, Grandi S, Grassi L, Mangelli L, Pasquini P, Picardi A, Quartesan R, Rigatelli M, Sonino N. A cluster analysis-derived classification of psychological distress and illness behavior in the medically ill. Psychol Med 2012; 42:401-407. [PMID: 24438853 DOI: 10.1017/s0033291711001231] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The classification of psychological distress and illness behavior in the setting of medical disease is still controversial. Current psychiatric nosology does not seem to cover the spectrum of disturbances. The aim of this investigation was to assess whether the joint use of DSM-IV categories and the Diagnostic Criteria for Psychosomatic Research (DCPR), that provide identification of syndromes related to somatization, abnormal illness behavior, irritable mood, type A behavior, demoralization and alexithymia, could yield subtyping of psychosocial variables in the medically ill. METHOD A cross-sectional assessment using both DSM-IV and the DCPR was conducted in eight medical centers in the Italian Health System. Data were submitted to cluster analysis. Participants were consecutive medical out-patients and in-patients for whom a psychiatric consultation was requested. A total of 1700 subjects met eligibility criteria and 1560 agreed to participate. RESULTS Three clusters were identified: non-specific psychological distress, irritability and affective disturbances with somatization. CONCLUSIONS Two-step cluster analysis revealed clusters that were found to occur across clinical settings. The findings indicate the need of expanding clinical assessment in the medically ill to include the various manifestations of somatization, illness behavior and subclinical distress encompassed by the DCPR.
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Affiliation(s)
- G A Fava
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - J Guidi
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - P Porcelli
- Psychosomatic Unit, IRCCS De Bellis Hospital, Castellana Grotte, Bari, Italy
| | - C Rafanelli
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - A Bellomo
- Section of Psychiatry and Clinical Psychology, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - S Grandi
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - L Grassi
- Section of Psychiatry, Department of Medical Sciences of Communication and Behavior, University of Ferrara, Ferrara, Italy
| | - L Mangelli
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - P Pasquini
- Clinical Epidemiology Unit, Istituto Dermapatico dell'Immacolata (IDI-IRCCS), Roma, Italy
| | - A Picardi
- Mental Health Unit, Italian National Institute of Health Center of Epidemiology, Surveillance and Health Promotion, Roma, Italy
| | - R Quartesan
- Section of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy
| | - M Rigatelli
- Department of Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - N Sonino
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA
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[Medically unexplained and somatoform complaints and disorders in the elderly: a systematic review of the literature]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2011; 57:115-40. [PMID: 21626477 DOI: 10.13109/zptm.2011.57.2.115] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To provide a systematic overview of the research concerning the frequency of medically unexplained, somatoform complaints and disorders in the elderly, their risk factors, comorbidity, course, management in primary and secondary care, and psychotherapy. METHOD We evaluated 248 clinical and randomized trials, reviews, meta-analyses and practice guidelines for adult samples identified from "PubMed" and "PsycInfo" using the search terms "somatoform" OR "medically unexplained" OR "somatization" OR "somatisation" in combination with other terms for their relevance for the elderly. Other relevant trials were identified from the references from these publications. RESULTS Medically unexplained, somatoform complaints and disorders occur in older persons and are more frequent in elderly women than in elderly men. Although many studies found no increased frequency of somatoform complaints in the elderly, based on present research we cannot draw final conclusions concerning the frequency of somatoform disorders and complaints in the elderly, and we cannot give evidence based recommendations for their treatment in primary and secondary care and psychotherapy. DISCUSSION This situation results from the special problems encountered in the diagnosis of somatoform complaints and disorders in the elderly, from problems in conceptualisation also found in younger adults, and from the lack of research concerning treatment focussed solely on the old and very old.
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Current world literature. Curr Opin Psychiatry 2011; 24:78-87. [PMID: 21116133 DOI: 10.1097/yco.0b013e3283423055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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The genetic, physiological and psychological mechanisms underlying disabling medically unexplained symptoms and somatisation. J Psychosom Res 2010; 68:395-7. [PMID: 20403497 DOI: 10.1016/j.jpsychores.2010.01.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Revised: 01/28/2010] [Accepted: 01/28/2010] [Indexed: 11/21/2022]
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