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Zat Çiftçi Z, Delibaş DH, Kaya T, Külcü DG, Sarı A, Nazlıkul H, Coşkun Topsakal İ, Aydın YE, Kavakçı Ö, Savran C, Konuk E. A randomized controlled trial of Eye Movement Desensitization and Reprocessing (EMDR) Therapy in the treatment of fibromyalgia. Front Psychiatry 2024; 15:1286118. [PMID: 38835548 PMCID: PMC11148358 DOI: 10.3389/fpsyt.2024.1286118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 02/27/2024] [Indexed: 06/06/2024] Open
Abstract
Background In addition to pharmacological treatment, psychotherapeutic approaches are recommended for the treatment of fibromyalgia. There is a suggestion that eye movement desensitization and reprocessing (EMDR) therapy may be effective. This study aimed to investigate the impact of EMDR therapy on fibromyalgia symptoms, depression, sleep quality, and traumatic stress in fibromyalgia patients through a randomized controlled study (RCT). Materials and methods The sample for this study comprised 79 individuals diagnosed with fibromyalgia. Participants were randomly assigned to two groups: the "Treatment as Usual" (TAU) group and the TAU + EMDR group. Prior to the study and at six different time points (before starting the study, at the end of the 5th, 10th, and 15th sessions, 1 month later, and 3 months later), participants completed assessments, including the Fibromyalgia Impact Questionnaire (FIQ), Visual Analog Scale (VAS), Fibromyalgia ACR 2010 Diagnostic Criteria [Widespread Pain Index (WPI) and Symptom Severity Scale (SSS)], Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and Trauma Symptom Checklist-40 (TSC-40). Results There were no differences in the sociodemographic variables between the study and experimental groups. Analysis of variance revealed a statistically significant group effect on VAS (p = 0.019), WPI (p = 0.018), BDI (p = 0.019), and TSC-40 (p = 0.21). After applying Bonferroni correction, EMDR was found to be effective for VAS, WPI, SSS, BDI, PSQI, and TSC-40 (p <0.05). Conclusion The results of the current study suggest that EMDR therapy is a viable alternative treatment for fibromyalgia. We believe these findings offer robust evidence supporting the efficacy of EMDR therapy in treating fibromyalgia, particularly in the context of a randomized controlled trial (RCT). The application of EMDR therapy for the treatment of patients with fibromyalgia is likely to be beneficial. Clinical trial registration ClinicalTrials.gov, identifier NCT06265194.
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Affiliation(s)
- Zeynep Zat Çiftçi
- Institute for Behavioral Studies, Adult and Family Department, Istanbul, Türkiye
| | - Dursun Hakan Delibaş
- Department of Psychiatry, Izmir Bozyaka Training and Research Hospital, Izmir, Türkiye
| | - Taciser Kaya
- Department of Physical Medicine and Rehabilitation, Izmir Bozyaka Training and Research Hospital, Izmir, Türkiye
| | - Duygu Geler Külcü
- Physical Medicine and Rehabilitation, Yeditepe University Hospital, Istanbul, Türkiye
| | - Aylin Sarı
- Physical Medicine and Rehabilitation, Erenköy Physical Therapy and Rehabilitation Hospital, Istanbul, Türkiye
| | | | | | - Yunus Emre Aydın
- Institute for Behavioral Studies, Adult and Family Department, Istanbul, Türkiye
| | - Önder Kavakçı
- Department of Psychiatry, Sivas Cumhuriyet University, Sivas, Türkiye
| | - Canan Savran
- Institute for Behavioral Studies, Adult and Family Department, Istanbul, Türkiye
| | - Emre Konuk
- Institute for Behavioral Studies, Adult and Family Department, Istanbul, Türkiye
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Yap AU, Dewi NL, Marpaung C. Psychological characteristics of young adults with temporomandibular disorders, somatization and combined conditions: A multidimensional evaluation. J Oral Rehabil 2023; 50:1382-1392. [PMID: 37605293 DOI: 10.1111/joor.13570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/01/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Temporomandibular disorders and somatization have shown interrelation in many studies. The physical and psychological factors which contributed to the occurrence and relation of both conditions are yet to be determined. OBJECTIVES The personality traits, coping styles and psychological distress of young adults with temporomandibular disorder (TMD) and somatic symptoms were characterized together with the determination of psychological risk factors for TMDs, somatization and combined conditions. METHODS Participants were recruited from university-attending young adults. TMD and somatic symptoms were appraised with the short-form Fonseca Anamnestic Index and Patient Health Questionnaire-15. Psychological variables were assessed with the Big Five Personality Inventory-10, Brief-COPE Inventory and Depression, Anxiety, and Stress Scales-21. Data were evaluated using chi-squared/non-parametric tests and logistic regression analyses (α = .05). RESULTS Among the 507 participants (mean age 22.2 ± 1.5 years), 46.4% reported no TMD/somatic symptoms (NS) while 7.5%, 34.5% and 11.6% had TMDs only (TS), somatization only (SS) and combined TMDs-somatization (CS), respectively. Significant differences in conscientiousness (NS > SS), agreeableness (NS, TS > CS; NS > SS), dysfunctional coping, general distress, depression, anxiety and stress (CS ≥ SS > NS) were discerned. Multivariate analyses indicated that the odds of TS were increased by anxiety (OR = 1.10; 95% CI = 1.01-1.21), while the odds of SS/CS were affected by anxiety (OR = 1.15; 95% CI = 1.06-1.25/OR = 1.34; 95% CI = 0.19-1.52) and problem-focused coping (OR = 0.71; 95% CI = 0.56-0.89/OR = 0.55; 95% CI = 0.39-0.78). CONCLUSION Though individuals with TMDs and somatization have dissimilar psychological profiles, anxiety constantly increased their likelihood. Problem-focused coping strategies may help alleviate psychosocial and physical stressors associated with TMDs and somatization.
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Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore, Singapore
- National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore, Singapore
- Department of Prosthodontics, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Ni Luh Dewi
- Department of Prosthodontics, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Carolina Marpaung
- Department of Prosthodontics, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
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Landa J, Gerner M, Eisenstein E, Barak S. Pediatric Functional Neurological Symptoms Disorder: Walking Ability and Perceived Exertion Post-Pediatric Rehabilitation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1631. [PMID: 36674392 PMCID: PMC9867415 DOI: 10.3390/ijerph20021631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Adolescents with functional neurological symptoms disorder (FNSD) commonly present walking abnormalities. Walking is influenced by 'objective' (e.g., fitness) and 'subjective' (e.g., fear) components. Rate of perceived exertion (RPE) reflects the interaction between these two components. This study compared the walking ability and RPE before and after rehabilitation of adolescents with FNSD to adolescents with moderate-to-severe traumatic brain injury (TBI). Factors predicting walking and RPE were also examined. METHODS Adolescents with FNSD (n = 31) and adolescents with moderate-to-severe TBI (n = 28) aged 6 to 18 years participated in the study. Participants received a multidisciplinary rehabilitation program. Six-minute walk test (6MWT) and RPE were assessed before and after rehabilitation. RESULTS At pre-test, the TBI group presented lower RPE than the FNSD group (3.38 ± 2.49 and 6.25 ± 2.71, respectively). In the FNSD group, pre-test 6MWT was a significant predictor of post-test 6MWT (adjusted R2 = 0.17; p = 0.01). In the TBI group, post-test 6MWT was significantly predicted by both the pre-test 6MWT and age (adjusted R2 = 0.16; p = 0.04). CONCLUSIONS Prior to the intervention, adolescents with FNSD perceived walking as a more difficult activity than adolescents with TBI. Post-intervention, although the intervention was effective in terms of changes in 6MWT and RPE, the 'subjective' component still contributed to the elevated RPE of the FNSD group.
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Affiliation(s)
- Jana Landa
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Ramat Gan 5265601, Israel
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
| | - Maya Gerner
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Ramat Gan 5265601, Israel
| | - Etzyona Eisenstein
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Ramat Gan 5265601, Israel
| | - Sharon Barak
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Ramat Gan 5265601, Israel
- Department of Nursing, Faculty of Health Science, Ariel University, Ariel 40700, Israel
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Byrne AK, Scantlebury A, Jones K, Doherty L, Torgerson DJ. Communication interventions for medically unexplained symptom conditions in general practice: A systematic review and meta-analysis of randomised controlled trials. PLoS One 2022; 17:e0277538. [PMID: 36374916 PMCID: PMC9662736 DOI: 10.1371/journal.pone.0277538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background Medically unexplained symptoms (MUS) account for 3–50% of all General Practitioner (GP) consultations and are difficult to diagnose due to their unknown aetiology, symptom overlap between conditions, and lack of effective treatment options. MUS patients’ and primary care clinicians frequently face challenges during consultations, with GPs reporting difficulty identifying and classifying MUS, whilst patients report stigma and feeling illegitimised by clinicians. Communication interventions have been proposed as a method to facilitate the doctor-patient relationship and aid the management of MUS. Aim This systematic review aims to evaluate the effectiveness of primary care based communication interventions at improving MUS patients’ and/or clinician outcomes. Method Four electronic databases were searched from inception to November 2021. Two researchers independently undertook screening, data extraction and quality appraisal. Given the heterogeneous nature of the studies identified, narrative syntheses were conducted, along with meta-analyses where possible to pool data. Results 9 papers from 10 Randomised Controlled Trials were included. The included studies displayed considerable risk of bias and poor reporting. Some limited evidence suggests that communication interventions tailored to MUS and not following a pre-specified model (such as reattribution) could improve pain, mental and physical functioning whilst reattribution training may improve clinician confidence treating MUS. However, methodological limitations mean that these findings should be interpreted with caution. Conclusion A range of interventions for improving communication with MUS patients in primary care have been evaluated. However, the heterogeneous nature of existing evidence and poor study quality mean we cannot conclude whether these interventions are effective. Before considering further randomised controlled trials researchers should focus on developing a new or modified communication intervention for MUS patients and their clinicians. Trail registration The systematic review was prospectively registered with PROSPERO (registration record CRD42020206437).
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Affiliation(s)
- Ailish Katherine Byrne
- Department of Health Sciences, York Trials Unit, University of York, Heslington, York, United Kingdom
- * E-mail:
| | - Arabella Scantlebury
- Department of Health Sciences, York Trials Unit, University of York, Heslington, York, United Kingdom
| | - Katherine Jones
- Department of Health Sciences, York Trials Unit, University of York, Heslington, York, United Kingdom
- Warwick Clinical Trials Unit, University of Warwick, Coventry, United Kingdom
| | - Laura Doherty
- Department of Health Sciences, York Trials Unit, University of York, Heslington, York, United Kingdom
| | - David J. Torgerson
- Department of Health Sciences, York Trials Unit, University of York, Heslington, York, United Kingdom
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Cunha IM, Gouveia J, Gomes E. Association between self-reported drug hypersensitivity reactions and psychological disorders. Asia Pac Allergy 2022; 12:e15. [PMID: 35571546 PMCID: PMC9066087 DOI: 10.5415/apallergy.2022.12.e15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/18/2022] [Indexed: 11/04/2022] Open
Abstract
Background Medically unexplained physical symptoms are a well-recognized problem and, in some cases, there is a well-established relationship between behavior and psychopathological disturbances. However, the association between drug hypersensitivity reactions and psychoactive disorders stills under discussion. Objective Our main goal was to establish if there is an association between self-reported drug hypersensitivity reaction and psychopathology with need for psychoactive drug consumption. Methods Retrospective study of adult patients evaluated in a first Immunoallergology appointment because of self-reported drug hypersensitivity over 1 year and register of data concerning psychoactive drugs use. Compare the study group with patients observed for allergic respiratory disease along the same year. Results The study group included 70 patients that referred a total of 92 self-reported drug hypersensitivity reactions. Twenty-nine (41.4%) were under treatment with psychoactive drugs: 20 (70%) were treated with anxiolytics, 13 (18.6%) with antidepressants, 15 (21.4%) with sedatives, and 1 (1.4%) with antipsychotics. The control group included 160 patients and 38 patients (23.8%) were under treatment with psychoactive drugs: 31 (19.4%) where treated with antidepressants, 29 (18.1%) with anxiolytics, and 3 (1.9%) with sedatives. The use of psychoactive drugs in the study group is higher than in the control group (p = 0.007), the difference is especially important for sedative drugs (p < 0.001). Besides a higher use of psychoactive drugs, the study group also has a higher frequency of use of several psychoactive drug (p = 0.002). Conclusion Patients with a self-report drug hypersensitivity have more tendency to be under treatment with psychoactive drugs and could have more tendency to somatization. Personality traces and psychopathology must be taken into account during an allergy workup.
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Affiliation(s)
- Inês Machado Cunha
- Immunoallergology Department, Centro Hospitalar Universitario do Porto, Porto, Portugal
| | - Joana Gouveia
- Immunoallergology Department, Centro Hospitalar Universitario do Porto, Porto, Portugal
| | - Eva Gomes
- Immunoallergology Department, Centro Hospitalar Universitario do Porto, Porto, Portugal
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Rausch K. "This Might Be Your New Normal…" Storytelling Amidst Uncertainty and Medically Unexplained Symptoms. HEALTH COMMUNICATION 2021; 36:2031-2034. [PMID: 32838545 DOI: 10.1080/10410236.2020.1810513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The medical diagnostic journey can be filled with uncertainty, anxiety, tension, and complications. This essay moves between first-person storytelling and analytic memos to illustrate defining moments of a diagnostic journey. It brings to life the complexity of navigating the healthcare system through the eyes of someone with medically unexplained symptoms (MUS). Additionally, it presses into the complex nature of the medical world and how one communicates through those tensions with healthcare professionals, loved ones, and colleagues when their illness is questioned and doubted.
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Affiliation(s)
- Kayla Rausch
- School of Communication Studies, Ohio University
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Ekerholt K, Bergland A. Embodied Knowledge - the Phenomenon of Subjective Health Complaints reflected upon by Norwegian Psychomotor Physiotherapy specialists. Physiother Theory Pract 2021; 38:2122-2133. [PMID: 33957856 DOI: 10.1080/09593985.2021.1920073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Many patients report subjective health complaints (SHCs) during primary health care consultations. Objective: To elucidate Norwegian Psychomotor Physiotherapy (NPMP) specialists' clinical experiences in treatment of patients suffering from SHCs. Methods: Twelve NPMP specialists were interviewed. The transcripts were qualitatively analyzed using systematic text condensation. Results: "Embodied knowledge" seemed to be an unfamiliar concept to those suffering from SHCs. The NPMP specialists regarded increased body awareness to be a vital element in the process of recovery from SHCs. Differences between NPMP specialists' professional view and that of some medical doctors were reported. Three categories emerged from the material: 1) "The process of establishing a joint understanding of subjective health complaints"; 2) "The process of increasing the patients' embodied awareness"; and 3) "The challenge of sharing embodied knowledge in inter-professional communication." Conclusion: The NPMP specialists emphasized the importance of increasing patients' consciousness of their embodied knowledge. They searched to adjust their therapeutic approaches, depending on the individual patient's specific problems and degree of emotional and/or bodily strain. The NPMP specialists experienced the importance of creating a shared understanding of the meaning embedded in SHCs between patients, NPMP specialists, and medical doctors.
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Affiliation(s)
- Kirsten Ekerholt
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Astrid Bergland
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
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Wang X, Zhong Z, Balmer L, Wang W. Glycosylation Profiling as a Biomarker of Suboptimal Health Status for Chronic Disease Stratification. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1325:321-339. [PMID: 34495543 DOI: 10.1007/978-3-030-70115-4_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
WHO defines health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." We coined and defined suboptimal health status (SHS) as a subclinical, reversible stage of the pre-chronic disease. SHS is a physical state between health and disease, characterized by health complaints, general weakness, chronic fatigue, and low energy levels. We have developed an instrument to measure SHS, Suboptimal Health Status Questionnaire-25 (SHSQ-25), a self-reported survey assessing five health components that has been validated in various ethnical populations. Our studies suggest that SHS is associated with the major components of cardiovascular health and the early onset of metabolic diseases. Besides subjective measure of health (SHS), glycans are conceived as objective biomarkers of SHS. Glycans are complex and branching carbohydrate moieties attached to proteins, participating in inflammatory regulation and chronic disease pathogenesis. We have been investigating the role of glycans and SHS in multiple cardiometabolic diseases in different ethnical populations (African, Chinese, and Caucasian). Here we present case studies to prove that a combination of subjective health measure (SHS) with objective health measure (glycans) represents a window of opportunity to halt or reverse the progression of chronic diseases.
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Affiliation(s)
- Xueqing Wang
- School of Health and Medical Sciences, Edith Cowan University, Perth, Australia
- College of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Zhaohua Zhong
- College of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Lois Balmer
- School of Health and Medical Sciences, Edith Cowan University, Perth, Australia
| | - Wei Wang
- School of Health and Medical Sciences, Edith Cowan University, Perth, Australia.
- Centre for Precision Health, ECU Strategic Research Centre, Edith Cowan University, Perth, Australia.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China.
- First Affiliated Hospital, Shantou University Medical College, Shantou, China.
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Thompson CM, Parsloe S. "I Don't Claim to Be the World's Foremost Expert, But . . . ": How Individuals "Know" Family Members Are Not Experiencing Health Issues as Severely as They Claim. QUALITATIVE HEALTH RESEARCH 2019; 29:1433-1446. [PMID: 30762486 DOI: 10.1177/1049732319827518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
To understand how individuals come to "know" that their family members are not experiencing their health issues as severely as they claim, we interviewed 32 individuals (nine men and 23 women, M age = 35.28 years, SD = 9.91 years) about a family member who they believe falsifies or exaggerates his or her health condition(s). Our analyses illuminate two interlinked processes of knowledge construction: (a) developing evidentiary standards and (b) gathering evidence. In engaging these processes, participants sought two types of consistency: correspondence with external "facts" (e.g., medical information, cultural [mis]conceptions), and internal coherence (i.e., complaints were highly self-contradictory and unpredictable or were overly predictable). When initial inconsistencies made participants doubt their family member, participants gathered additional evidence, including experiential, behavioral, and interactional evidence, to test and revise their initial suspicions. We discuss the implications of this research for theory and for families coping with illness.
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Mostafaei S, Kabir K, Kazemnejad A, Feizi A, Mansourian M, Hassanzadeh Keshteli A, Afshar H, Arzaghi SM, Rasekhi Dehkordi S, Adibi P, Ghadirian F. Explanation of somatic symptoms by mental health and personality traits: application of Bayesian regularized quantile regression in a large population study. BMC Psychiatry 2019; 19:207. [PMID: 31269925 PMCID: PMC6610832 DOI: 10.1186/s12888-019-2189-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 06/19/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Somatic syndrome is one of the remarkably prevalent issues in primary health care and subspecialty settings. We aimed to elucidate multidimensional associations between somatic symptoms with major mental problems and personality traits in the framework of the quantile regression model with a Bayesian approach. METHODS A total of 4763 employees at Isfahan University of Medical Sciences and Health Services in Isfahan province, Iran, filled out four validated questionnaires including Hospital Anxiety and Depression Scale (HADS), NEO Questionnaire, General Health Questionnaire (GHQ) and PHQ-15 for somatic symptom severity. In addition, Functional Gastrointestinal Disorders (FGIDs) were determined using Rome IV criteria. Exploratory Factor Analysis (EFA) and Bayesian regularized quantile regression with adaptive LASSO penalization were applied for reduced dimension of somatic symptoms and variable selection and parameter estimation, respectively. RESULTS The 25 major somatic symptoms were grouped into four factors including general, upper gastrointestinal, lower gastrointestinal and respiratory by EFA. Stress, depression, and anxiety had significant effects on all of the four extracted factors. The effect of anxiety in each four extracted factors was more than stress and depression. Neuroticism and agreeableness had significant effects on all of the four extracted factors, generally (p < 0.05). CONCLUSIONS Given the high prevalence of somatic symptoms and psychosomatic complaints in correlation with the diverse range of mental co-morbidities, developing more detailed diagnostic tools and methods is crucial; nonetheless, it seems that providing better interdisciplinary approaches in general medical practice is groundwork.
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Affiliation(s)
- Shayan Mostafaei
- Department of Community Medicine, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran. .,Epidemiology and Biostatistics Unit, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kourosh Kabir
- 0000 0001 0166 0922grid.411705.6Department of Community Medicine, Faculty of Medicine, Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Anoshirvan Kazemnejad
- 0000 0001 1781 3962grid.412266.5Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Awat Feizi
- 0000 0001 1498 685Xgrid.411036.1Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- 0000 0001 1498 685Xgrid.411036.1Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ammar Hassanzadeh Keshteli
- 0000 0001 1498 685Xgrid.411036.1Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ,grid.17089.37Department of Medicine, University of Alberta, Edmonton, AB Canada
| | - Hamid Afshar
- 0000 0001 1498 685Xgrid.411036.1Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeed Masoud Arzaghi
- 0000 0001 0166 0922grid.411705.6Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Rasekhi Dehkordi
- 0000 0001 1781 3962grid.412266.5Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Peyman Adibi
- grid.17089.37Department of Medicine, University of Alberta, Edmonton, AB Canada
| | - Fataneh Ghadirian
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. .,International Network of Integrated Nursing (INICN), Universal Scientific Education and Research (USERN), Tehran, Iran.
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Prise en charge des symptômes médicalement inexpliqués en médecine interne : un paradigme de la relation médecin-malade en situation d’incertitude. Rev Med Interne 2017; 38:458-466. [DOI: 10.1016/j.revmed.2016.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/17/2016] [Indexed: 11/18/2022]
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12
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Albrecht PJ, Rice FL. Fibromyalgia syndrome pathology and environmental influences on afflictions with medically unexplained symptoms. REVIEWS ON ENVIRONMENTAL HEALTH 2016; 31:281-294. [PMID: 27105483 DOI: 10.1515/reveh-2015-0040] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 03/10/2016] [Indexed: 06/05/2023]
Abstract
Fibromyalgia syndrome (FMS) is a clinical disorder predominant in females with unknown etiology and medically unexplained symptoms (MUS), similar to other afflictions, including irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS), post-traumatic stress disorder (PTSD), Gulf War illness (GFI), and others. External environmental stimuli drive behavior and impact physiologic homeostasis (internal environment) via autonomic functioning. These environments directly impact the individual affective state (mind), which feeds back to regulate physiology (body). FMS has emerged as a complex disorder with pathologies identified among neurotransmitter and enzyme levels, immune/cytokine functionality, cortical volumes, cutaneous innervation, as well as an increased frequency among people with a history of traumatic and/or emotionally negative events, and specific personality trait profiles. Yet, quantitative physical evidence of pathology or disease etiology among FMS has been limited (as with other afflictions with MUS). Previously, our group published findings of increased peptidergic sensory innervation associated with the arterio-venous shunts (AVS) in the glabrous hand skin of FMS patients, which provides a plausible mechanism for the wide-spread FMS symptomology. This review focuses on FMS as a model affliction with MUS to discuss the implications of the recently discovered peripheral innervation alterations, explore the role of peripheral innervation to central sensitization syndromes (CSS), and examine possible estrogen-related mechanisms through which external and internal environmental factors may contribute to FMS etiology and possibly other afflictions with MUS.
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