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van Twillert E, Hulsman MMC, Tak LM. Facilitating and hindering factors in the treatment of persistent somatic symptoms in migrants: A scoping review. J Psychosom Res 2024; 186:111887. [PMID: 39213940 DOI: 10.1016/j.jpsychores.2024.111887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 07/22/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE To identify facilitating and hindering factors in the treatment of persistent somatic symptoms (PSS) in migrants in psychiatry and other health care settings in Western countries. METHODS A scoping literature review was conducted by searching PubMed and Embase, using combinations of search terms related to the treatment of PSS in migrants. Studies outside of the scope of current guidelines or limited to specific underlying diseases such as post-traumatic stress disorder (PTSD) or consequences of torture were excluded. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies, and identified and categorized facilitating and hindering treatment factors. RESULTS Of the 347 unique citations identified in the initial the search, 18 studies met the inclusion criteria. These studies showed a wide variety in study design, interventions used, measurement instruments, and study quality. Common treatment adaptations related to: (a) translation and interpretation, (b) adaptation to lower educational levels, (c) culture-sensitive therapists and materials, (d) gender roles, (e) removal of practical barriers, (f) supportive treatment, and (g) nonverbal therapy forms. The most commonly mentioned influencing factors of treatment success related to: (a) body and experience-oriented treatment elements, (b) translation and communication, (c) cultural sensitivity, (d) group interaction, and (e) caring for one's own health. CONCLUSION This review provides an overview of available research on treatment adaptations for PSS in migratory background patients. Potential facilitating and hindering factors for treatment success that may be useful for healthcare providers treating PSS in patients with a migratory background were identified.
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Affiliation(s)
- Erik van Twillert
- Network Center for Transcultural Psychiatry, Dimence Mental Health Care, Deventer, the Netherlands; Dimence Alkura, Specialist Center Persistent Somatic Symptoms, Dimence Mental Health Care, Deventer, the Netherlands.
| | - Mirjam M C Hulsman
- Royal Visio, Center of Expertise for Blind and Partially Sighted People, Rotterdam, the Netherlands
| | - Lineke M Tak
- Dimence Alkura, Specialist Center Persistent Somatic Symptoms, Dimence Mental Health Care, Deventer, the Netherlands
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2
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Yap AU, Kim S, Jo JH, Lee BM, Park JW. Exploring the Relationship Between Somatisation, Facial Pain and Psychological Distress in East Asian Temporomandibular Disorder Patients. J Oral Rehabil 2024. [PMID: 39287364 DOI: 10.1111/joor.13857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 08/01/2024] [Accepted: 09/02/2024] [Indexed: 09/19/2024]
Abstract
OBJECTIVES The relationship of somatisation with facial pain duration/intensity, pain-related interference/disability and psychological distress was investigated in East Asian temporomandibular disorder (TMD) patients. Correlations between somatisation, facial pain and psychological characteristics were also explored alongside the demographic/physical factors associated with moderate-to-severe depression and anxiety. METHODS Anonymised data were acquired from records of consecutive 'first-time' patients seeking TMD care at a tertiary oral medicine clinic. Axis I physical TMD diagnoses were established utilising the diagnostic criteria for TMDs (DC/TMD) protocol and patients with TMD pain were stratified into those with pain-related (PT) and combined (CT) conditions. Axis II measures administered encompassed the Patient Health Questionnaire-15 (PHQ-15), Graded Chronic Pain Scale (GCPS), Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder Scale-7 (GAD-7). Individuals with PT and CT were further categorised into those without (Pain - Som/Comb - Som) and with somatisation (Pain + Som/Comb + Som). Statistical evaluations were performed with nonparametric and logistic regression analyses (α = 0.05). RESULTS The final sample comprised 473 patients (mean age 36.2 ± 14.8 years; 68.9% women), of which 52.0% had concomitant somatisation. Significant differences in pain duration (Comb + Som > Pain - Som), pain-related interference/disability (Comb + Som > Comb - Som) and depression/anxiety (Pain + Som, Comb + Som > Pain - Som, Comb - Som) were discerned. Depression/anxiety was moderately correlated with somatisation (rs = 0.64/0.52) but not facial pain characteristics. Multivariate modelling revealed that somatisation was significantly associated with the prospects of moderate-to-severe depression (OR 1.35) and anxiety (OR 1.24). CONCLUSION Somatisation exhibited a strong association with psychological distress when contrasted with facial pain in East Asian TMD patients.
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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 Centre Singapore and Duke-NUS Medical School, Singapore Health Services, National Dental Research Institute Singapore, Singapore, Singapore
| | - Sunghae Kim
- Dental Research Institute, Seoul National University, Seoul, Korea
- Center for Future Dentistry, Seoul National University School of Dentistry, Seoul, Korea
| | - Jung Hwan Jo
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea
- Department of Oral Medicine and Oral Diagnosis, Seoul National University School of Dentistry, Seoul, Korea
| | - Byeong-Min Lee
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea
| | - Ji Woon Park
- Dental Research Institute, Seoul National University, Seoul, Korea
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea
- Department of Oral Medicine and Oral Diagnosis, Seoul National University School of Dentistry, Seoul, Korea
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3
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Shu W, Ma X, Zhao X. Changes in Patient Discourse: A Qualitative Study Based on the Treatment Experience of Chinese Patients with Somatization Symptoms. Healthcare (Basel) 2023; 11:2811. [PMID: 37957956 PMCID: PMC10648739 DOI: 10.3390/healthcare11212811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/18/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023] Open
Abstract
This qualitative study examines the characteristics exhibited by Chinese patients with somatization symptoms during their treatment process, focusing on changes in illness interpretation and language use. A semi-structured in-depth interview was conducted with 10 patients receiving treatment in a clinical psychology department of a general hospital who reported somatic symptoms as their main complaint. The interview data were recorded and transcribed, and analyzed using interpretive phenomenological analysis. Two core themes emerged from the analysis: avoidance at the utterance level; and at the semantic level, power and contestation. Patients with somatization symptoms exhibit avoidance behaviors, and their experience of illness and the therapeutic process impact their discourse. Professionals should pay attention to patients' own interpretations, cultural background and acceptance of the illness.
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Affiliation(s)
- Wenting Shu
- School of Humanities, Tongji University, Shanghai 200092, China;
| | - Xiquan Ma
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China;
| | - Xudong Zhao
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China
- Department of Psychosomatic Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
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Kitselaar WM, Büchner FL, van der Vaart R, Sutch SP, Bennis FC, Evers AW, Numans ME. Early identification of persistent somatic symptoms in primary care: data-driven and theory-driven predictive modelling based on electronic medical records of Dutch general practices. BMJ Open 2023; 13:e066183. [PMID: 37130660 PMCID: PMC10163476 DOI: 10.1136/bmjopen-2022-066183] [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] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVE The present study aimed to early identify patients with persistent somatic symptoms (PSS) in primary care by exploring routine care data-based approaches. DESIGN/SETTING A cohort study based on routine primary care data from 76 general practices in the Netherlands was executed for predictive modelling. PARTICIPANTS Inclusion of 94 440 adult patients was based on: at least 7-year general practice enrolment, having more than one symptom/disease registration and >10 consultations. METHODS Cases were selected based on the first PSS registration in 2017-2018. Candidate predictors were selected 2-5 years prior to PSS and categorised into data-driven approaches: symptoms/diseases, medications, referrals, sequential patterns and changing lab results; and theory-driven approaches: constructed factors based on literature and terminology in free text. Of these, 12 candidate predictor categories were formed and used to develop prediction models by cross-validated least absolute shrinkage and selection operator regression on 80% of the dataset. Derived models were internally validated on the remaining 20% of the dataset. RESULTS All models had comparable predictive values (area under the receiver operating characteristic curves=0.70 to 0.72). Predictors are related to genital complaints, specific symptoms (eg, digestive, fatigue and mood), healthcare utilisation, and number of complaints. Most fruitful predictor categories are literature-based and medications. Predictors often had overlapping constructs, such as digestive symptoms (symptom/disease codes) and drugs for anti-constipation (medication codes), indicating that registration is inconsistent between general practitioners (GPs). CONCLUSIONS The findings indicate low to moderate diagnostic accuracy for early identification of PSS based on routine primary care data. Nonetheless, simple clinical decision rules based on structured symptom/disease or medication codes could possibly be an efficient way to support GPs in identifying patients at risk of PSS. A full data-based prediction currently appears to be hampered by inconsistent and missing registrations. Future research on predictive modelling of PSS using routine care data should focus on data enrichment or free-text mining to overcome inconsistent registrations and improve predictive accuracy.
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Affiliation(s)
- Willeke M Kitselaar
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, The Netherlands
- Health, Medical and Neuropsychology unit, Department of Psychology, Leiden University, Leiden, Netherlands
| | - Frederike L Büchner
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, The Netherlands
| | - Rosalie van der Vaart
- Health, Medical and Neuropsychology unit, Department of Psychology, Leiden University, Leiden, Netherlands
| | - Stephen P Sutch
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, The Netherlands
- HSR, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Frank C Bennis
- Computer Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Andrea Wm Evers
- Health, Medical and Neuropsychology unit, Department of Psychology, Leiden University, Leiden, Netherlands
| | - Mattijs E Numans
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, The Netherlands
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5
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Mariman A, Vermeir P, Csabai M, Weiland A, Stegers-Jager K, Vermeir R, Vogelaers D. Education on medically unexplained symptoms: a systematic review with a focus on cultural diversity and migrants. Eur J Med Res 2023; 28:145. [PMID: 37013665 PMCID: PMC10069028 DOI: 10.1186/s40001-023-01105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/20/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Health care providers often struggle with the management of patients with medically unexplained symptoms (MUS), especially in case of a different ethnicity and/or cultural background. These challenges are insufficiently addressed in their training. OBJECTIVES A systematic review on education in the field of MUS in a diverse context to improve MUS healthcare provider-patient interaction focused on intercultural communication. METHODS Screening of PubMed, Web of Science, Cinahl and Cochrane Library on the keywords 'Medical unexplained (physical) symptoms (MUS)', 'Somatoform disorder', 'Functional syndrome', 'Diversity', 'Migrants', 'Ethnicity', 'Care models', 'Medical education', 'Communication skills', 'Health literacy'. RESULTS MUS patients, especially with a different ethnic background, often feel not understood or neglected. Health care providers experience feelings of helplessness, which may provoke medical shopping and resource consumption. Attitudes and perceptions from undergraduate trainees to senior physicians tend to be negative, impacting on the quality of the patient/health care provider relationship and subsequently on health outcomes, patient satisfaction and therapeutic adherence. Current undergraduate, graduate and postgraduate education and training does not prepare health care providers for diagnosing and managing MUS patients in a diverse context. A continuum of training is necessary to achieve a long term and lasting change in attitudes towards these patients and trainers play a key role in this process. Hence, education should pay attention to MUS, requiring a specific competency profile and training, taken into account the variety in patients' cultural backgrounds. CONCLUSIONS This systematic review identified significant gaps and shortcomings in education on MUS in a diverse context. These need to be addressed to improve outcomes.
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Affiliation(s)
- An Mariman
- Faculty of Medicine and Healthcare Sciences, Ghent University, Ghent, Belgium
- Centre for Integrative Medicine, Ghent University Hospital, Ghent, Belgium
| | - Peter Vermeir
- Faculty of Medicine and Healthcare Sciences, Ghent University, Ghent, Belgium.
- Dean's Office of the Faculty of Medicine and Healthcare Sciences, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Marta Csabai
- Institute of Psychology, Károli Gáspár University of the Reformed Church, Budapest, Hungary
| | - Anne Weiland
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Karen Stegers-Jager
- Institute of Medical Education Research, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Ruben Vermeir
- Faculty of Medicine and Healthcare Sciences, Ghent University, Ghent, Belgium
| | - Dirk Vogelaers
- Faculty of Medicine and Healthcare Sciences, Ghent University, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium
- Department of General Internal Medicine, AZ Delta, Roeselare, Belgium
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6
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Bratanov C, Hot P, Vercueil L. The natural history of terms describing functional (neurological) disorders in the medical literature of the last 60 years. J Neurol 2023; 270:2010-2017. [PMID: 36547718 DOI: 10.1007/s00415-022-11526-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Functional neurological disorders (FND), a subtype of functional disorders (FD), are a frequent motive for neurology referrals. The various presentations and the unknown physiopathology of FD have led to the multiplication of terms describing these disorders over the years. METHODS We examined the FD-related articles published from 1960 to 2020 in PubMed and PsycINFO databases. We searched for: psychogenic, somatization, somatoform, medically unexplained symptoms, hysteria, conversion disorder, dissociative, functional neurological disorder, and functional disorder. Use rates in the title, abstract, keyword, or MeSH fields were collected over successive 5-year periods. After correcting for off-topic results, we examined proportional distribution over time, term associations, and disciplinary fields (neurology and psychiatry). Term impact was estimated via H-index and number of citations. RESULTS We found that none of the terms is prevailing in the recent medical literature. We observed three trends in the use rates: stability, increase, and decrease of use over time. While most of the terms were present in a stable proportion of the publications, hysteria and psychogenic lost popularity over time. We found a differential preference for terminology between disciplines. Functional neurological disorder showed the highest citation impact, yielding 10% of highly cited publications. CONCLUSION We found a dynamic and evolving use of the different terms describing FD in the last 60 years. Despite the tendency to use the term functional in the recent highly cited publications, its low prevalence and coexistence with several other terms suggest that a precise, explanatory and non-offensive term remains yet to be found.
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Affiliation(s)
- Christo Bratanov
- Neurology Department, CHU Grenoble Alpes, Av. des Maquis du Grésivaudan, La Tronche, 38700, Grenoble, France.
| | - Pascal Hot
- Department of Psychology, Univ. Savoie Mont Blanc, CNRS, LPNC, Chambéry, France
- Institut Universitaire de France, Paris, France
| | - Laurent Vercueil
- Grenoble Institute Neurosciences, Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, 38000, Grenoble, France
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7
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Wainio-Theberge S, Armony JL. Antisocial and impulsive personality traits are linked to individual differences in somatosensory maps of emotion. Sci Rep 2023; 13:675. [PMID: 36635384 PMCID: PMC9837047 DOI: 10.1038/s41598-023-27880-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/09/2023] [Indexed: 01/14/2023] Open
Abstract
Somatosensory experience is an important component of emotion, playing a prominent role in many traditional emotion theories. Nonetheless, and despite the extensive literature on the influence of individual differences in emotional processing, the relation between personality traits and emotion-related somatosensation has received little attention. Here, we addressed this question in a large sample of healthy individuals through the "bodily maps of emotion" behavioural paradigm, in which participants indicated the location and extent of their body sensations for the 6 basic and 4 additional social emotions (contempt, envy, pride, shame). We found that emotional somatosensation in specific body areas, including the heart, the stomach, and the head, was related to specific personality factors, particularly antisocial attitudes and impulsivity. Moreover, the similarity of individual participants' maps to the group-average was likewise negatively correlated with antisocial tendencies. Overall, our results suggest that differences in individuals' sensitivity to somatosensation from different body areas, as well as the typicality of their topographical patterns, may partly underlie variation in higher-order social and affective traits.
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Affiliation(s)
- Soren Wainio-Theberge
- Douglas Mental Health University Institute, 6875 LaSalle boulevard, Verdun, QC, H4H 1R3, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Jorge L Armony
- Douglas Mental Health University Institute, 6875 LaSalle boulevard, Verdun, QC, H4H 1R3, Canada.
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada.
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
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Császár-Nagy N, Bókkon I. Hypnotherapy and IBS: Implicit, long-term stress memory in the ENS? Heliyon 2022; 9:e12751. [PMID: 36685398 PMCID: PMC9849985 DOI: 10.1016/j.heliyon.2022.e12751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/20/2022] [Accepted: 12/27/2022] [Indexed: 01/01/2023] Open
Abstract
The association between irritable bowel syndrome (IBS) and psychiatric and mood disorders may be more fundamental than was previously believed. Prenatal, perinatal, postnatal, and early-age conditions can have a key role in the development of IBS. Subthreshold mental disorders (SMDs) could also be a significant source of countless diverse diseases and may be a cause of IBS development. We hypothesize that stress-induced implicit memories may persist throughout life by epigenetic processes in the enteric nervous system (ENS). These stress-induced implicit memories may play an essential role in the emergence and maintenance of IBS. In recent decades, numerous studies have proven that hypnosis can improve the primary symptoms of IBS and also reduce noncolonic symptoms such as anxiety and depression and improve quality of life and cognitive function. These significant beneficial effects of hypnosis on IBS may be because hypnosis allows access to unconscious brain processes.
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Affiliation(s)
- N. Császár-Nagy
- National University of Public Services, Budapest, Hungary,Psychosomatic Outpatient Clinics, Budapest, Hungary
| | - I. Bókkon
- Psychosomatic Outpatient Clinics, Budapest, Hungary,Vision Research Institute, Neuroscience and Consciousness Research Department, Lowell, MA, USA,Corresponding author. H-1238, Budapest, Láng Endre 68, Hungary.
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9
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Woodling C, Wygant DB, Umlauf RL, Marek RJ. Somatoform's placement and validity in the hierarchical taxonomy of psychopathology (HiTOP). Psychiatry Res 2022; 313:114593. [PMID: 35533473 DOI: 10.1016/j.psychres.2022.114593] [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: 10/01/2021] [Revised: 04/04/2022] [Accepted: 04/30/2022] [Indexed: 11/24/2022]
Abstract
Limitations of a polythetic-categorical classification system has sparked ongoing quantitative efforts to establish a valid and reliable method for diagnosing mental illness. Dimensional methods of classification, such as the Hierarchical Taxonomy of Psychopathology (HiTOP), have been found to ameliorate the limitations of a categorical approach - despite the provisional placement of a Somatoform spectrum. The current investigation sought to elucidate the placement of the Somatoform spectrum within the HiTOP model, and to further corroborate discriminant and convergent validity of the Somatoform spectrum. Using a sample of patients seeking chronic low-back pain treatment (n = 200), superior model fit suggested Somatoform fits better as a separate spectrum from Internalizing and placing Somatoform as a subfactor of Internalizing did not improve model fit. Discriminant and convergent validity with an external criteria demonstrated distinctiveness of the Somatoform spectrum from the Internalizing spectrum in the HiTOP model.
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Affiliation(s)
- Chloe Woodling
- Department of Psychological Sciences, Ball State University, Indiana
| | - Dustin B Wygant
- Department of Psychology, Eastern Kentucky University, Kentucky
| | | | - Ryan J Marek
- Department of Primary Care and Clinical Medicine, Sam Houston State University, Texas.
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Sallay V, Martos T, Lucza L, Weiland A, Stegers-Jager KM, Vermeir P, Mariman ANM, Csabai M. Medical educators' experiences on medically unexplained symptoms and intercultural communication-an expert focus group study. BMC MEDICAL EDUCATION 2022; 22:310. [PMID: 35461231 PMCID: PMC9034474 DOI: 10.1186/s12909-022-03275-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Medically unexplained symptoms (MUS) are highly prevalent and remain challenging in healthcare and medical education, along with the increase in the importance of intercultural issues regarding MUS. However, less is known about the challenges of professionally addressing patients with MUS in the interprofessional and intercultural contexts. Thus, the present study aims to provide the first exploration of the experiences of medical specialists regarding treating MUS in intercultural contexts and inputs for training development on the intercultural aspects of MUS. METHODS Three focus groups (total n = 13) consisting of medical specialists from a Hungarian university who were teaching at the medical faculty in intercultural settings and also worked for the university health services were interviewed. The topics covered the participants' personal experiences on addressing MUS and the challenges of intercultural communication and the intercultural educational context. Thematic analysis was used to yield a qualitative account of the interviews as guided by the research questions. RESULTS Representing the different aspects of medical specialists, the study identified three main themes in the experiences of medical specialists, namely, 1) the need to adapt to the personal world of patients and search for common frames to understand MUS, 2) the need to discover methods for adapting to cultural differences and 3) the need to enhance the interprofessional coordination of knowledge and practices. CONCLUSIONS The results are in line with the distinct conclusions of previous studies. Moreover, an integrated educational program on the intercultural aspects of MUS may address the main themes separately and, subsequently, support their integration. Therefore, the study discusses the manner in which an integrated educational program on the intercultural aspects of MUS may address the needs recognized in these aspects.
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Affiliation(s)
- Viola Sallay
- Institute of Psychology, University of Szeged, Egyetem u. 2, 6722, Szeged, Hungary
| | - Tamás Martos
- Institute of Psychology, University of Szeged, Egyetem u. 2, 6722, Szeged, Hungary.
| | - Lilla Lucza
- Doctoral School of Education, University of Szeged, Szeged, Hungary
| | - Anne Weiland
- Department for Internal Medicine & General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Peter Vermeir
- Faculty of Medicine and Healthcare sciences, Ghent University, Ghent, Belgium
- Ghent University Hospital, Ghent, Belgium
| | - An Noelle Margareta Mariman
- Faculty of Medicine and Healthcare sciences, Ghent University, Ghent, Belgium
- Ghent University Hospital, Center for Integrative Medicine, Ghent, Belgium
| | - Márta Csabai
- Institute of Psychology, University of Szeged, Egyetem u. 2, 6722, Szeged, Hungary
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11
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Vermeir P, Mariman A, Lucza L, Sallay V, Weiland A, Stegers‐Jager KM, Vogelaers D. Epidemiology and organisation of care in medically unexplained symptoms: A systematic review with a focus on cultural diversity and migrants. Int J Clin Pract 2021; 75:e14855. [PMID: 34516726 PMCID: PMC9285020 DOI: 10.1111/ijcp.14855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 09/10/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Since the pathophysiology of medically unexplained symptoms (MUS) remains unclear, healthcare providers often struggle with these patients, especially with a different ethnic and/or cultural background. These challenges are insufficiently addressed in their training and in the organisation of care. AIM To improve healthcare provider-patient interaction focused on MUS patients in general and in ethnic minorities and refugees in particular through a systematic review of syndromal definitions and epidemiology and organisation of care of MUS patients. METHODS Screening of PubMed, Web of Science, Cinahl and Cochrane Library on the keywords 'Medical unexplained (physical) symptoms (MUPS)', 'Somatoform disorder', 'Functional syndrome', 'Diversity', 'Migrants', 'Ethnicity', 'Care models', 'Medical education', 'Communication skills', 'Health literacy'. RESULTS Different case definitions result in markedly different epidemiological estimates for MUS patients. Nevertheless, they are prevalent in a wide range of healthcare settings. Literature offers evidence of the effectiveness of structural frameworks in approaching MUS patients. Organisation of MUS care needs to transcend different levels of care: specialist tertiary and secondary care and primary care involving different qualifications of caregivers need to be aligned. CONCLUSION The systematic review identified significant gaps and shortcomings in organisation of care. These need to be addressed in order to improve outcomes.
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Affiliation(s)
- Peter Vermeir
- Ghent University/Ghent University HospitalGentBelgium
| | - An Mariman
- Ghent University/Ghent University HospitalGentBelgium
| | - Lilla Lucza
- Doctoral School of EducationUniversity of SzegedSzegedHungary
| | - Viola Sallay
- Institute of PsychologyUniversity of SzegedSzegedHungary
| | - Anne Weiland
- Erasmus MC University Medical CenterRotterdamThe Netherlands
| | | | - Dirk Vogelaers
- Ghent University/Ghent University HospitalGentBelgium
- AZ Delta RoeselareRoeselareBelgium
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12
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Altered Structural Covariance of Insula, Cerebellum and Prefrontal Cortex Is Associated with Somatic Symptom Levels in Irritable Bowel Syndrome (IBS). Brain Sci 2021; 11:brainsci11121580. [PMID: 34942882 PMCID: PMC8699158 DOI: 10.3390/brainsci11121580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/18/2021] [Accepted: 11/27/2021] [Indexed: 11/29/2022] Open
Abstract
Somatization, defined as the presence of multiple somatic symptoms, frequently occurs in irritable bowel syndrome (IBS) and may constitute the clinical manifestation of a neurobiological sensitization process. Brain imaging data was acquired with T1 weighted 3 tesla MRI, and gray matter morphometry were analyzed using FreeSurfer. We investigated differences in networks of structural covariance, based on graph analysis, between regional gray matter volumes in IBS-related brain regions between IBS patients with high and low somatization levels, and compared them to healthy controls (HCs). When comparing IBS low somatization (N = 31), IBS high somatization (N = 35), and HCs (N = 31), we found: (1) higher centrality and neighbourhood connectivity of prefrontal cortex subregions in IBS high somatization compared to healthy controls; (2) higher centrality of left cerebellum in IBS low somatization compared to both IBS high somatization and healthy controls; (3) higher centrality of the anterior insula in healthy controls compared to both IBS groups, and in IBS low compared to IBS high somatization. The altered structural covariance of prefrontal cortex and anterior insula in IBS high somatization implicates that prefrontal processes may be more important than insular in the neurobiological sensitization process associated with IBS high somatization.
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Piontek K, Wiesmann U, Apfelbacher C, Völzke H, Grabe HJ. The association of childhood maltreatment, somatization and health-related quality of life in adult age: Results from a population-based cohort study. CHILD ABUSE & NEGLECT 2021; 120:105226. [PMID: 34352685 DOI: 10.1016/j.chiabu.2021.105226] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 06/04/2021] [Accepted: 07/22/2021] [Indexed: 05/23/2023]
Abstract
BACKGROUND Population-based data regarding the relationship between childhood maltreatment (CM), somatization and health-related quality of life (HRQoL) in adults are limited. OBJECTIVE To investigate the association of CM history (emotional and physical abuse and neglect, sexual abuse) with somatization and with physical and mental HRQoL in adults. PARTICIPANTS AND SETTING Data from 2305 participants from the population-based Study of Health in Pomerania were analyzed (aged 20 to 80 years). METHODS We applied the Childhood Trauma Questionnaire. Somatoform disorders were diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) in a clinical interview. Using a self-administered questionnaire, we assessed the number of somatic symptoms and physical and mental HRQoL. RESULTS Sexual abuse was related to the diagnosis of a somatoform disorder (odds ratio [OR] 1.87; 95% confidence interval [CI] 1.29, 2.69). Emotional abuse and physical neglect were associated with the number of somatic symptoms (B = 0.93; 95% CI 0.42, 1.45 and B = 0.50; 95% CI 0.17, 1.83, respectively). Sexual abuse and physical neglect were related to lower physical HRQoL (B = -1.87; 95% CI -3.17, -0.57 and B = -1.26; 95% CI -2.02, -0.49, respectively), and emotional abuse was associated with lower mental HRQoL (B = -2.83; 95% CI -4.03, -1.62). CONCLUSIONS A history of CM, in particular sexual abuse, emotional abuse and physical neglect, is a risk factor for somatization and impaired HRQoL in adults. Individuals with somatic symptoms are an important target group for CM screening. Addressing HRQoL might be significant in psychotherapy for individuals with CM experience.
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Affiliation(s)
- Katharina Piontek
- Institute of Social Medicine and Health Systems Research, Medical Faculty Magdeburg, Magdeburg, Germany.
| | - Ulrich Wiesmann
- Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty Magdeburg, Magdeburg, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
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14
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Piontek K, Apfelbacher C, Ketels G, Brünahl C, Löwe B. Depression Partially Mediates the Association of Adverse Childhood Experiences with Pain Intensity in Patients with Chronic Pelvic Pain Syndrome: Results from a Cross-Sectional Patient Survey. PAIN MEDICINE 2021; 22:1174-1184. [PMID: 33155025 DOI: 10.1093/pm/pnaa325] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs), such as emotional and physical maltreatment, are linked to chronic pelvic pain syndrome (CPPS) in adults. Psychological factors are important in understanding CPPS. We aimed to determine the nature and frequency of ACEs in male and female patients with CPPS and to investigate whether somatic symptoms and psychological comorbidities mediate the relationship of ACE severity with pain intensity. DESIGN Cross-sectional study. SETTING Interdisciplinary outpatient clinic for CPPS in Hamburg, Germany. SUBJECTS Individuals with CPPS (n = 234) who were 18 to 84 years of age. METHODS Using a self-administered questionnaire, we assessed the history of ACEs (ACE Scale), pain intensity (McGill Pain Questionnaire), somatic symptoms (Patient Health Questionnaire-15]), depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder Scale). Parallel mediation analysis was conducted to examine whether the association of ACE severity with pain intensity is mediated by somatic symptoms, depression, and anxiety. RESULTS Emotional abuse and neglect were reported more than twice as often as physical abuse and neglect (37.2% vs 17.1%). Depression partially mediated the association of ACE severity with pain intensity in the whole study population. In sex-stratified analyses, different patterns of associations were observed, but somatic symptoms predicted pain intensity in both sexes. CONCLUSIONS Emotional maltreatment was highly prevalent, supporting an increased consideration of psychological factors in CPPS and indicating the need to screen for ACEs in patients with CPPS. Findings further suggest that depression and somatic symptoms may be important targets for therapeutic interventions in patients with CPPS who have a history of childhood adversity.
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Affiliation(s)
- Katharina Piontek
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Gesche Ketels
- Department of Physiotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Brünahl
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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15
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Piersiala K, Akst LM, Hillel AT, Best SR. Chronic Pain Syndromes and Their Laryngeal Manifestations. JAMA Otolaryngol Head Neck Surg 2021; 146:543-549. [PMID: 32352483 DOI: 10.1001/jamaoto.2020.0530] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), and chronic fatigue syndrome (CFS) are traditionally considered as distinct entities grouped under chronic pain syndrome (CPS) of an unknown origin. However, these 3 disorders may exist on a spectrum with a shared pathophysiology. Objective To investigate whether the clinical presentation of FMS, IBS, and CFS is similar in a population presenting with voice and laryngeal disorders. Design, Setting, and Participants This case series was a retrospective review of the medical records and clinical notes of patients treated between January 1, 2016, and December 31, 2017, at the Johns Hopkins Voice Center in Baltimore, Maryland. Patients with at least 1 CPS of interest (FMS, IBS, or CFS) were included (n = 215), along with patients without such diagnoses (n = 4034). Diagnoses, demographic, and comorbidity data were reviewed. Diagnoses related to voice and laryngeal disorders were subdivided into 5 main categories (laryngeal pathology, functional voice disorders, airway problems, swallowing problems, and other diagnoses). Main Outcomes and Measures Prevalence and odds ratios of 45 voice and laryngeal disorders were reviewed. Odds ratios (ORs) were calculated by comparing patients with CPS with control patients. Results In total, 4249 individuals were identified; 215 (5.1%) had at least 1 CPS and 4034 (94.9%) were control participants. Patients with CPS were 3 times more likely to be women compared with the control group (173 of 215 [80.5%] vs 2318 of 4034 [57.5%]; OR, 3.156; 95% CI, 2.392-4.296), and the CPS group had a mean (SD) age of 57.80 (15.30) years compared with the mean (SD) age of 55.77 (16.97) years for the control group. Patients with CPS were more likely to present with functional voice disorders (OR, 1.812; 95% CI, 1.396-2.353) and less likely to present with laryngeal pathology (OR, 0.774; 95% CI, 0.610-0.982) or airway problems (OR, 0.474; 95% CI, 0.285-0.789). Conclusions and Relevance The voice and airway presentation of patients with FMS, IBS, and/or CFS appears to be indistinguishable from each other. This finding suggests that these 3 diseases share upper airway symptoms.
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Affiliation(s)
- Krzysztof Piersiala
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland.,Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Lee M Akst
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Alexander T Hillel
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Simon R Best
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
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16
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Quality of Working Life, Psychosocial Factors, Burnout Syndrome and Emotional Intelligence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249550. [PMID: 33419344 PMCID: PMC7767310 DOI: 10.3390/ijerph17249550] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 01/08/2023]
Abstract
The objective of this work is to study the quality of working life associated to psychosocial factors and risks, burnout syndrome and emotional intelligence, as well as being able to detect predictors of the said syndrome. The sample consisted of 311 professionals working in direct contact with an intellectual disability from 15 associations of Extremadura (Spain). The Spanish version of the CESQT questionnaire was administered to evaluate burnout syndrome, the Wong & Law Emotional Intelligence Scale (WLEIS) was used to evaluate emotional intelligence, while the UNIPSICO Battery was used to evaluate the psychosocial factors of demands (work–family conflict and psychosomatic problems) and resources, such as social support and work satisfaction. The results indicate average values of burnout, revealing that work satisfaction, emotional intelligence, and social support are related to burnout syndrome. In addition, there are also positive correlations between psychosomatic symptoms and work–family conflict. Satisfaction at work, social support, and emotional intelligence (intrapersonal and interpersonal perception, use and regulation of emotions) predict burnout syndrome. What is more, the psychosomatic symptoms and work–family conflict explain, respectively, 17% and 17.9% of their variance. Thus, there is a need to develop intervention programs that encourage social support and the conciliation of family life, as well as training skills related to emotional intelligence, such as communication and conflict resolution.
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17
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Haghighatdoost F, Feizi A, Esmaillzadeh A, Keshteli AH, Roohafza H, Afshar H, Adibi P. The MIND (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay) and Mediterranean Diets are differently associated with psychosomatic complaints profile in adults: Results from SEPAHAN Cross-sectional study. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2020. [DOI: 10.3233/mnm-200426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: In spite of an obvious association between diet and mental health, there is only few report regarding the association between diet and psychosomatic complaints. OBJECTIVE: To investigate the association of the Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet with psychosomatic complaints profile in comparison with the Mediterranean diet (aMED). METHODS: In this cross-sectional study on 2818 Isfahanian adults, a validated dish-based food frequency questionnaire was used to assess dietary intakes. Psychosomatic complaints profile was evaluated through a self-administered Persian validated questionnaire by using exploratory factor analysis. RESULTS: After controlling for potential confounders, individuals in the highest quintile of the MIND diet had lower risk for experiencing psychological (odds ratio (OR) = 0.60, 95% confidence interval (CI): 0.42, 0.86; P trend < 0.0001), and pharyngeal-respiratory (OR = 0.57, 95% CI: 0.41, 0.79; P = 0.002). The association for neuro-skeletal complaints was marginally significant (OR = 0.66, 95% CI: 0.43, 1.03; P = 0.093). The aMED diet tended to lower gastrointestinal complaints (OR = 0.68, 95% CI: 0.46, 1.01; P = 0.062). CONCLUSION: The MIND diet was inversely associated with different psychosomatic complaints risk, but no evidence of such an association for the MED diet was observed.
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Affiliation(s)
- Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Biostatistics and Epidemiology Department, School of Health and Psychosomatic research center, Isfahan University of Medical Sciences, Isfahan, Iran
- Cardiac rehabilitation research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ammar Hassanzadeh Keshteli
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Cardiac rehabilitation research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Afshar
- Psychosomatic Research Center and Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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18
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Karaaslan Ö, Kantekin Y, Hacımusalar Y, Dağıstan H. Anxiety sensitivities, anxiety and depression levels, and personality traits of patients with chronic subjective tinnitus: a case-control study. Int J Psychiatry Clin Pract 2020; 24:264-269. [PMID: 32374199 DOI: 10.1080/13651501.2020.1757117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: Tinnitus is a condition that commonly affects individuals' daily activities. We aimed to evaluate the anxiety sensitivity, levels of anxiety and depression, and personality traits of patients with chronic subjective tinnitus.Methods: The study included 42 patients, who visited the Otorhinolaryngology Clinic, complained of having tinnitus for at least 1 year and did not have any previous peripheral vestibular diseases or psychiatric treatment history. Forty-five healthy individuals volunteered to be in the control group. We administered the Tinnitus-Severity-Index (TSI), Anxiety-Sensitivity-Index-3 (ASI-3), Beck-Anxiety Inventory (BAI), Beck-Depression-Inventory (BDI) and Eysenck-Personality- Questionnaire (EPQ) to the study participants.Results: The BDI score was significantly higher in the patient group. The ASI-3, EPQ, and BAI scores of the patients did not differ statistically. A positive correlation was found between the EPQ neuroticism subscale scores and the ASI-3, BDI, and BAI scores of the patient cases. There was also a positive correlation between the TSI scores and the BAI, ASI-3, and neuroticism scores of the tinnitus group.Conclusion: To the best of our knowledge, few studies have evaluated anxiety sensitivity, anxiety and depression levels, and personality traits and no studies evaluating patients and controls together. In cases where tinnitus and psychiatric diseases are comorbid, both conditions should be treated to achieve the best outcomes for the patients' quality of life.KEY POINTSAlthough patients with tinnitus were selected among cases without any psychiatric treatment history, we found that depressive symptoms in this group were high.The participants' anxiety sensitivity, anxiety, and neuroticism scores increased as the severity of their tinnitus increased.The anxiety sensitivity, anxiety, and depressive scores increased along with the increase in the neuroticism scores of the patients with chronic subjective tinnitus.
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Affiliation(s)
- Özgül Karaaslan
- Department of Psychiatry, Bozok University Faculty of Medicine, Yozgat, Turkey
| | - Yunus Kantekin
- Department of Otorhinolaryngology, Bozok University Faculty of Medicine, Yozgat, Turkey
| | - Yunus Hacımusalar
- Department of Psychiatry, Bozok University Faculty of Medicine, Yozgat, Turkey
| | - Hakan Dağıstan
- Department of Otorhinolaryngology, Bozok University Faculty of Medicine, Yozgat, Turkey
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19
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Höglund P, Hakelind C, Nordin S. Severity and prevalence of various types of mental ill-health in a general adult population: age and sex differences. BMC Psychiatry 2020; 20:209. [PMID: 32393209 PMCID: PMC7212684 DOI: 10.1186/s12888-020-02557-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 03/19/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Taking a broad approach, the aim of this study was to better understand severity and prevalence of various types of mental ill-health across age and sex groups in the general adult population. A first objective was to determine symptom severity of anxiety, depression, insomnia, burnout and somatization in combinations of different age groups and sex. A second objective was to determine prevalence of caseness of these types of mental ill-health in both absolute and relative terms in the combinations of age groups and sex. METHODS Cross-sectional data based on validated questionnaire instruments were used from the Västerbotten Environmental Health Study in Sweden. In total, 3406 participants, aged 18 to 79 years, constituted a random sample stratified for age and sex. RESULTS Severity and prevalence of anxiety, insomnia and burnout were high in women, in particular young women, and lower in older age groups. The prevalence rates for insomnia, burnout and somatization were particularly high based on the used cut-off scores. Men aged 30-49 years had the highest prevalence of mental ill-health compared to other age groups among men. Men and women aged 60-69 years had generally the lowest symptom severity and caseness. The prevalence of depression was similar in men and women in all age groups, whereas sex-related differences in extent in general were largest in the youngest age group, and gradually decreased with age. CONCLUSION The results suggest that focus in primary healthcare regarding mental ill-health should to be directed more towards insomnia, burnout and somatization, in particular in young women.
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Affiliation(s)
- Per Höglund
- Department of Psychology, Umeå University, 90187, Umeå, Sweden.
| | - Camilla Hakelind
- grid.12650.300000 0001 1034 3451Department of Psychology, Umeå University, 90187 Umeå, Sweden
| | - Steven Nordin
- grid.12650.300000 0001 1034 3451Department of Psychology, Umeå University, 90187 Umeå, Sweden
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20
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Boerner KE, Green K, Chapman A, Stanford E, Newlove T, Edwards K, Dhariwal A. Making Sense of "Somatization": A Systematic Review of its Relationship to Pediatric Pain. J Pediatr Psychol 2020; 45:156-169. [PMID: 32053181 DOI: 10.1093/jpepsy/jsz102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 12/04/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Pain and other physical symptoms commonly co-occur in childhood. There is debate about the relevance of somatization in understanding pain. The present review critically appraised and synthesized the extant literature on the relationship between pediatric pain and somatization. METHODS A systematic review (PROSPERO registration #95956) was conducted in Medline, PsycINFO, EMBASE, and CINAHL using search terms related to pain and somatization in children and adolescents. A total of 156 articles were eligible for inclusion in the review. For studies that measured somatization using a symptom questionnaire, descriptions of "somatization" were extracted. Data regarding the relationship between pain and somatization were extracted for studies measuring somatization using a diagnostic category (e.g., Somatic Symptom and Related Disorders [SSRDs]). RESULTS While many studies using somatic symptom questionnaires described somatization as having a psychological component, this was not always captured in measurement tools. Pain was reported as a common symptom in patients with an SSRD diagnosis, though rates varied depending on the specific diagnosis and pain location. Rates of SSRD diagnoses among pain patients were less frequent than rates of pain amongst SSRD patients. CONCLUSIONS SSRDs and pain commonly co-occur, though rates differ depending on diagnosis and pain location. Understanding the relationship between pain and somatization is complicated by the discrepancy between how somatization is defined and measured in questionnaire studies. A comprehensive and measurable definition of somatization is needed so researchers can better identify the shared and unique contributions of pain and somatization in pediatric populations.
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Affiliation(s)
- Katelynn E Boerner
- Department of Psychiatry, University of British Columbia.,Department of Psychiatry, BC Children's Hospital
| | - Katherine Green
- Department of Psychiatry, BC Children's Hospital.,Department of Medicine, University of British Columbia
| | - Andrea Chapman
- Department of Psychiatry, University of British Columbia.,Department of Psychiatry, BC Children's Hospital
| | | | | | | | - Amrit Dhariwal
- Department of Psychiatry, University of British Columbia.,Department of Psychiatry, BC Children's Hospital
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21
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Haghighatdoost F, Feizi A, Esmaillzadeh A, Feinle-Bisset C, Hassanzadeh Keshteli A, Roohafza H, Afshar H, Adibi P. The relationship between dietary inflammatory index and psychosomatic complaints profiles: results from SEPAHAN cross-sectional study. Biopsychosoc Med 2019; 13:27. [PMID: 31719841 PMCID: PMC6836464 DOI: 10.1186/s13030-019-0169-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/14/2019] [Indexed: 11/21/2022] Open
Abstract
Background Although the dietary inflammatory index (DII) has been evaluated in relation to psychological disorders risk, the association between DII and psychosomatic complaints is unclear. This study aimed to determine the association between DII, as a proxy measure of the inflammatory potential of the diet, and psychosomatic complaints. Methods This cross-sectional study included 2818 people from the general population, aged 19 to 69 years, of Isfahan province in Iran. Dietary intake was assessed using a validated dish-based food-frequency questionnaire. Psychosomatic complaints were assessed using a self-administered validated Persian questionnaire. Twenty-seven nutrients or foods were included in the calculation of DII. Each of them received a score based on their inflammatory ability, thus, a higher DII score indicated a more pro-inflammatory diet. The risk of being in the top median of a psychosomatic complaints profile across the tertiles of DII was assessed using logistic regression. Results Four psychosomatic complaints profiles (psychological, gastrointestinal, neuro-skeletal and pharyngeal- respiratory) were identified. After controlling for potential confounders, individuals in the top tertile of DII had higher odds for experiencing high somatic complaints scores for the psychological (odds ratio (OR) = 1.44, 95% confidence interval (CI): 1.10, 1.89; P trend = 0.009), gastrointestinal (OR = 1.22, 95% CI: 0.99, 1.75; P = 0.058) or neuro-skeletal (OR = 1.56, 95% CI: 1.10, 2.22; P = 0.013) profile. The association for pharyngeal-respiratory complaints did not remain significant after adjustment for stressful life events, medical condition, and anti-psychotropic medicine use. Conclusion The significant positive link between DII and the various psychosomatic complaints profiles suggests that a diet with anti-inflammatory potential might be favourably related to psychosomatic complaints. Further studies, particularly clinical trials and longitudinal studies, are warranted to investigate the inflammatory potential of diet in relation to psychosomatic complaints.
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Affiliation(s)
- Fahimeh Haghighatdoost
- 1Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,2Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.,3Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- 3Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,4Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.,5Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- 6Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Christine Feinle-Bisset
- University of Adelaide, Discipline of Medicine and National Health and Medical Research Council Centre of Research Excellence of Translating Nutritional Science to Good Health, Adelaide, Australia
| | - Ammar Hassanzadeh Keshteli
- 5Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,8Department of Medicine, University of Alberta, Edmonton, Canada
| | - Hamidreza Roohafza
- 9Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Afshar
- 3Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- 8Department of Medicine, University of Alberta, Edmonton, Canada
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22
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Poloni N, Caselli I, Ielmini M, Mattia M, De Leo A, Di Sarno M, Isella C, Bellini A, Callegari C. Hospitalized Patients with Medically Unexplained Physical Symptoms: Clinical Context and Economic Costs of Healthcare Management. Behav Sci (Basel) 2019; 9:E80. [PMID: 31331103 PMCID: PMC6680508 DOI: 10.3390/bs9070080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/11/2019] [Accepted: 07/18/2019] [Indexed: 12/14/2022] Open
Abstract
Medically Unexplained Physical Symptoms (MUPS) are physical symptoms without a medical explanation. This study collected data from hospitalized patients presenting MUPS, aiming to draw a clinical and socio-demographic profile of patients with MUPS, to explore psychopathological correlations of Somatic Symptoms Disorder (SSD) diagnosis, and to estimate economic costs related to hospital management for MUPS. The cross-sectional study consisted in the evaluation of data referring to hospitalized patients admitted between 2008 and 2018 in a teaching hospital in Northern Italy. A total of 273 patients presenting MUPS have been hospitalized. The sample showed a prevalence of female, married and employed patients. The most frequent wards involved are Neurology, Internal Medicine and Short Unit Stay. The most common symptoms found are headache, pain, syncope and vertigo. There is no evidence that a history of medical disease is associated with a diagnosis of SSD. A personality disorder diagnosis in patients with MUPS was associated with increased probability of having a diagnosis of SSD. A marginally significant positive association emerged with anxiety disorders, but not with depressive disorder. The overall estimated cost of hospitalization for patients with MUPS is 475'409.73 €. The study provides the investigation of a large number of patients with MUPS and a financial estimate of related hospitalization costs.
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Affiliation(s)
- Nicola Poloni
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese (VA), Italy
| | - Ivano Caselli
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese (VA), Italy
| | - Marta Ielmini
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese (VA), Italy
| | - Michele Mattia
- Family Therapy Center, Via San Salvatore 7, 6902 Lugano, Switzerland
| | - Alessandra De Leo
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese (VA), Italy
| | - Marco Di Sarno
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan (MI), Italy
| | - Celeste Isella
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese (VA), Italy
| | - Alessandro Bellini
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese (VA), Italy
| | - Camilla Callegari
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese (VA), Italy.
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23
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Fortes S, Ziebold C, Reed GM, Robles-Garcia R, Campos MR, Reisdorfer E, Prado R, Goldberg D, Gask L, Mari JJ. Studying ICD-11 Primary Health Care bodily stress syndrome in Brazil: do many functional disorders represent just one syndrome? ACTA ACUST UNITED AC 2018; 41:15-21. [PMID: 30328962 PMCID: PMC6781705 DOI: 10.1590/1516-4446-2018-0003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 01/29/2018] [Indexed: 01/05/2023]
Abstract
Objective: Disorders characterized by “distressing unexplained somatic symptoms” are challenging. In the ICD-11 Primary Health Care (PHC) Guidelines for Diagnosis and Management of Mental Disorders (ICD-11 PHC), a new category, bodily stress syndrome (BSS), was included to diagnose patients presenting unexplained somatic symptoms. The present study investigated the association of BSS with anxiety, depression, and four subgroups of physical symptoms in a Brazilian primary health care (PHC) sample. Methodology: As part of the international ICD-11 PHC study, 338 patients were evaluated by their primary care physicians, followed by testing with Clinical Interview Schedule (CIS-R) and World Health Organization Disability Assessment Schedule, Version 2.0 (WHODAS 2.0). BSS was diagnosed in the presence of at least three somatic symptoms associated with incapacity. The association between anxiety, depression, and four subgroups of physical symptoms with being a BSS case was analyzed. Results: The number of somatic symptoms was high in the overall sample of 338 patients (mean = 8.4), but even higher in the 131 BSS patients (10.2; p < 0.001). Most BSS patients (57.3%) had at least three symptoms from two, three, or four subgroups, and these were associated with anxiety and depression in 80.9% of these patients. The symptom subgroup most strongly associated with “being a BSS” case was the non-specific group (OR = 6.51; 95%CI 1.65-24.34), followed by musculoskeletal (OR = 2,31; 95%CI 1.19-4.72). Conclusion: Somatic symptoms were frequent in a sample of PHC patients in Brazil. In the present sample, one third were BSS cases and met the criteria for at least two symptom subgroups, supporting the hypothesis that different functional symptoms are related to each other.
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Affiliation(s)
- Sandra Fortes
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Carolina Ziebold
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Geoffrey M Reed
- World Health Organization (WHO), Geneva, Switzerland.,Global Mental Health Program, Columbia University Medical Center, New York, NY, USA
| | - Rebeca Robles-Garcia
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, CDMX, Mexico
| | - Monica R Campos
- Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil
| | | | - Ricardo Prado
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - David Goldberg
- Institute of Psychiatry, King's College London,Institute of Psychiatry, King's College London, United Kingdom
| | - Linda Gask
- University of Manchester, Manchester, United Kingdom
| | - Jair J Mari
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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24
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Kalibatseva Z, Leong FTL. Cultural Factors, Depressive and Somatic Symptoms Among Chinese American and European American College Students. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2018. [DOI: 10.1177/0022022118803181] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study seeks to fill a gap in the existing empirical literature about the relationship between somatic and depressive symptoms and their associations with cultural factors among Chinese American and European American college students. In particular, the study examined how three culturally relevant psychological constructs, self-construal, loss of face, and emotion regulation, associate with depressive and somatic symptoms among Chinese American and European American college students and if they can explain possible group differences in depressive symptoms. The sample consisted of 204 Chinese American and 315 European American college students who completed an online survey. Based on multiple regression analyses, European American students reported higher levels of somatic symptoms on the Patient Health Questionnaire–15 (PHQ-15) than Chinese Americans. There was no initial group difference in depressive symptoms based on Center for Epidemiologic Studies–Depression Scale (CES-D) scores. Correlations between depressive and somatic symptoms, independent and interdependent self-construal, and cognitive reappraisal and independent self-construal were stronger for European Americans than Chinese Americans. Somatic symptoms, loss of face, and expressive suppression were positively associated with depressive symptoms, whereas independent self-construal and cognitive reappraisal were negatively associated with depressive symptoms for both groups. When controlling for gender and somatic symptoms, being Chinese American and male was significantly and positively associated with depressive symptoms measured with the CES-D. These ethnic and gender differences in depressive symptoms were explained by independent self-construal, loss of face, cognitive reappraisal, and expressive suppression. Clinical implications include the incorporation of specific culturally relevant constructs and avoidance of race-, ethnicity-, and gender-based stereotypes to reduce health disparities in depression treatment.
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25
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Haghighatdoost F, Feizi A, Esmaillzadeh A, Hassanzadeh Keshteli A, Roohafza H, Afshar H, Adibi P. Dietary patterns in relation with psychosomatic complaints profile: Results from SEPAHAN study among a large sample of general adults. Nutr Neurosci 2018; 23:190-200. [PMID: 29914310 DOI: 10.1080/1028415x.2018.1485611] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: Although dietary patterns have been evaluated in relation to psychological disorders, their associations with psychosomatic complaints are unclear. We investigated relations of dietary patterns with psychosomatic complaints profiles.Methods: In this cross-sectional study, a total of 3363 adults were included. Dietary intakes and psychosomatic complaints were assessed using self-administered Persian validated questionnaires. Dietary patterns and psychosomatic symptom profiles were identified using exploratory factor analysis.Results: Three dietary patterns and four psychosomatic complaints profiles were identified. Individuals in the top tertile of traditional diet had lower odds for gastrointestinal somatic complaints (odds ratio (OR)= 0.68, 95% confidence interval (CI): 0.50, 0.91). Individuals in the top tertile of healthy diet had lower odds for psychological (OR= 0.68, 95% CI: 0.51, 0.90), gastrointestinal (OR= 0.65, 95% CI: 0.49, 0.87), neuro-skeletal (OR= 0.66, 95% CI: 0.45, 0.96), and pharyngeal- respiratory somatic complaints (OR= 0.61, 95% CI: 0.47, 0.79). Individuals in the top tertile of Western diet had greater odds for psychological somatic complaints (OR= 1.50, 95% CI: 1.13, 2.00) than those in the first tertile.Discussion: The healthy dietary pattern is inversely related to the risk of psychosomatic complaints, whereas the Western diet might be associated with increased risk of psychosomatic complaints.
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Affiliation(s)
- Fahimeh Haghighatdoost
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.,Psychosomatic research center, Isfahan University of Medical Sciences, Isfahan, Iran.,Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ammar Hassanzadeh Keshteli
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Medicine, University of Alberta, Edmonton, Canada
| | - Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Afshar
- Psychosomatic research center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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26
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Kani HT, Dural U, Sakalli Kani A, Yanartas O, Kiziltas S, Yilmaz Enc F, Atug O, Deyneli O, Kuscu K, Imeryuz N. Evaluation of depression, anxiety, alexithymia, attachment, social support and somatization in functional dyspepsia. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1480081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Haluk Tarik Kani
- Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey
| | - Uzay Dural
- Department of Psychology, Istanbul Medipol University, Istanbul, Turkey
| | - Ayse Sakalli Kani
- Department of Psychiatry, Marmara University School of Medicine, Istanbul, Turkey
| | - Omer Yanartas
- Department of Psychiatry, Marmara University School of Medicine, Istanbul, Turkey
| | - Safak Kiziltas
- Department of Gastroenterology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Feruze Yilmaz Enc
- Department of Gastroenterology, Goztepe Education and Research Hospital, Istanbul, Turkey
| | - Ozlen Atug
- Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey
| | - Oguzhan Deyneli
- Department of Endocrinology and Metabolism, Marmara University School of Medicine, Istanbul, Turkey
| | - Kemal Kuscu
- Department of Psychiatry, Marmara University School of Medicine, Istanbul, Turkey
| | - Nese Imeryuz
- Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey
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27
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Grinsvall C, Törnblom H, Tack J, Van Oudenhove L, Simrén M. Relationships between psychological state, abuse, somatization and visceral pain sensitivity in irritable bowel syndrome. United European Gastroenterol J 2018; 6:300-309. [PMID: 29511560 PMCID: PMC5833221 DOI: 10.1177/2050640617715851] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 05/22/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Psychological states may interfere with visceral sensitivity. Here we investigate associations between psychosocial factors and visceral sensitivity in irritable bowel syndrome (IBS). METHODS Two IBS patient cohorts (Cohort 1: n = 231, Rome II; Cohort 2: n = 141, Rome III) underwent rectal barostat testing, and completed questionnaires for anxiety, depression, somatization, and abuse. The associations between questionnaire measures and visceral sensitivity parameters were analyzed in three-step general linear models (step1: demographic and abuse variables; step 2: anxiety and depression; step 3: somatization). RESULTS Cohort 1. Pain threshold was positively associated with age and female gender, and negatively with adult sexual abuse and somatization. Pain referral area was negatively associated with age and positively with somatization and GI-specific anxiety, the latter effect mediated by somatization. Cohort 2. Pain threshold was positively associated with age and male gender, and negatively with adult sexual abuse. Pain intensity ratings were positively associated with somatization, female gender and depression, the latter effect mediated by somatization. CONCLUSION Somatization is associated with most visceral sensitivity parameters, and mediates the effect of some psychological factors on visceral sensitivity. It may reflect a psychobiological sensitization process driving symptom generation in IBS. In addition, abuse history was found to independently affect some visceral sensitivity parameters.
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Affiliation(s)
- Cecilia Grinsvall
- Department of Internal Medicine &
Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
| | - Hans Törnblom
- Department of Internal Medicine &
Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
| | - Jan Tack
- Translational Research Center for
Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium
| | - Lukas Van Oudenhove
- Translational Research Center for
Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium
| | - Magnus Simrén
- Department of Internal Medicine &
Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
- Center for Functional Gastrointestinal
and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill,
NC, USA
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28
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Melidis C, Denham SL, Hyland ME. A test of the adaptive network explanation of functional disorders using a machine learning analysis of symptoms. Biosystems 2017; 165:22-30. [PMID: 29278731 DOI: 10.1016/j.biosystems.2017.12.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 12/12/2017] [Accepted: 12/19/2017] [Indexed: 12/21/2022]
Abstract
The classification and etiology of functional disorders is controversial. Evidence supports both psychological and biological (disease) models that show, respectively, that functional disorders should be classified as one (bodily distress syndrome) and many (e.g., irritable bowel syndrome (IBS), fibromyalgia syndrome (FMS), and chronic fatigue syndrome (CFS)). Two network models (symptom network and adaptive network) can explain the specificity and covariation of symptomatology, but only the adaptive network model can explain the covariation of the somatic symptoms of functional disorders. The adaptive network model is based on the premise that a network of biological mechanisms has emergent properties and can exhibit adaptation. The purpose of this study was to test the predictions that symptom similarity increases with pathology and that network connection strengths vary with pathology, as this would be consistent with the notion that functional disorder pathology arises from network adaptation. We conducted a symptom internet survey followed by machine learning analysis. Participants were 1751 people reporting IBS, FMS or CFS diagnosis who completed a 61-item symptom questionnaire. Eleven symptom clusters were identified. Differences in symptom clusters between IBS, FMS and CFS groups decreased as overall symptom frequency increased. The strength of outgoing connections between clusters varied as a function of symptom frequency and single versus multiple diagnoses. The findings suggest that the pathology of functional disorders involves an increase in the activity and causal connections between several symptom causing mechanisms. The data provide support for the proposal that the body is capable of complex adaptation and that functional disorders result when rules that normally improve adaptation create maladaptive change.
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Affiliation(s)
- Christos Melidis
- School of Computing, Electronics and Mathematics, United Kingdom; University of Plymouth, United Kingdom
| | - Susan L Denham
- School of Psychology, United Kingdom; University of Plymouth, United Kingdom
| | - Michael E Hyland
- School of Psychology, United Kingdom; University of Plymouth, United Kingdom.
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29
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[Psychosomatic symptoms as an expression of the deterioration of the health-related quality of life in adolescents]. Aten Primaria 2017; 50:493-499. [PMID: 29217115 PMCID: PMC6837139 DOI: 10.1016/j.aprim.2017.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/05/2017] [Accepted: 06/07/2017] [Indexed: 11/21/2022] Open
Abstract
Objetivo Analizar, en una población de adolescentes escolarizados, la relación entre síntomas psicosomáticos y calidad de vida relacionada con la salud (CVRS) diferenciando por sexo y grupo de edad. Diseño Estudio transversal. Emplazamiento Cinco Institutos de Educación Secundaria. Participantes Ochocientos cuarenta y cuatro adolescentes de entre 15 y 18 años que cursaban 3.° y 4.° de Educación Secundaria Obligatoria y Bachillerato. Mediciones principales CVRS mediante KIDSCREEN-52 y síntomas psicosomáticos con la escala de problemas psicosomáticos (PSP). Resultados Las chicas y los adolescentes de 17-18 años presentaron síntomas psicosomáticos significativamente más altos, ambos grupos también puntuaron peor en todas las dimensiones de CVRS aunque solo alcanzaron significación las dimensiones relacionadas con bienestar físico, bienestar mental y estado de ánimo y estrés. Todos los síntomas psicosomáticos se asociaron de forma inversa con las 10 dimensiones del KIDSCREEN-52. Los modelos de regresión realizados mostraron que tristeza, dificultad de concentración y dificultad para dormir fueron los predictores de peor CVRS en ambos sexos y grupos de edad, y estas variables explicaron entre un 30 y un 41% de la varianza de la CVRS de los adolescentes. Conclusiones Los síntomas psicosomáticos son más frecuentes en las chicas y en los adolescentes mayores, y predictores de peor CVRS. Es importante diferenciarlos de afecciones médicas para evitar intervenciones innecesarias. Como expresiones de malestar emocional deben ser evaluados y tratados de forma integral porque interfieren en la vida cotidiana y aumentan la vulnerabilidad propia de la adolescencia.
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30
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Verhaeghe P, Vanheule S, Rick A. Actual Neurosis as the Underlying Psychic Structure of Panic Disorder, Somatization, and Somatoform Disorder: an Integration of Freudian and Attachment Perspectives. THE PSYCHOANALYTIC QUARTERLY 2017; 76:1317-50. [DOI: 10.1002/j.2167-4086.2007.tb00306.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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31
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Carlehed G, Katz J, Nordin S. Somatic symptoms of anxiety and depression: A population-based study. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.mhp.2017.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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32
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Dehoust MC, Schulz H, Härter M, Volkert J, Sehner S, Drabik A, Wegscheider K, Canuto A, Weber K, Crawford M, Quirk A, Grassi L, DaRonch C, Munoz M, Ausin B, Santos‐Olmo A, Shalev A, Rotenstein O, Hershkowitz Y, Strehle J, Wittchen H, Andreas S. Prevalence and correlates of somatoform disorders in the elderly: Results of a European study. Int J Methods Psychiatr Res 2017; 26:e1550. [PMID: 28150357 PMCID: PMC6877225 DOI: 10.1002/mpr.1550] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 09/08/2014] [Accepted: 10/10/2014] [Indexed: 11/12/2022] Open
Abstract
Somatoform disorders have rarely been addressed in epidemiological and health care services studies of the elderly. The few existing studies vary considerably in their methodologies limiting comparability of findings. Data come from the MentDis_ICF65+ study, in which a total of 3142 community-dwelling respondents aged 65-84 years from six different countries were assessed by the Composite International Diagnostic Interview adapted to the needs of the elderly (CIDI65+). The 12-month prevalence rate for any somatoform disorders was found to be 3.8, whereby the prevalence for somatization disorder according to DSM-IV was 0%, the prevalence for abridged somatization was 1.7% and the rate for 12-months somatoform pain disorder was 2.6%. We found a significant variation by study centre (p < 0.005). There was a significant gender difference for pain disorder, but not for abridged somatization. Significant age-related effects revealed for both disorder groups. Somatoform disorders were found to be associated with other mental disorders [odds ratio (OR) anxiety =4.8, OR affective disorders 3.6], as well as with several impairments and disabilities. Somatoform disorders are prevalent, highly impairing conditions in older adults, which are often associated with other mental disorders and should receive more research and clinical attention.
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Affiliation(s)
| | - Holger Schulz
- Department of Medical PsychologyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Martin Härter
- Department of Medical PsychologyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Jana Volkert
- Department of Medical PsychologyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Susanne Sehner
- Department of Medical Biometry and EpidemiologyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Anna Drabik
- Department of Medical Biometry and EpidemiologyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Karl Wegscheider
- Department of Medical Biometry and EpidemiologyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Alessandra Canuto
- Division of Liaison Psychiatry and Crisis InterventionUniversity Hospitals of Geneva and Faculty of Medicine of the University of GenevaGenevaSwitzerland
| | - Kerstin Weber
- Division of Liaison Psychiatry and Crisis InterventionUniversity Hospitals of Geneva and Faculty of Medicine of the University of GenevaGenevaSwitzerland
| | - Mike Crawford
- Royal College of PsychiatristsCollege Centre for Quality ImprovementLondonUK
| | - Alan Quirk
- Royal College of PsychiatristsCollege Centre for Quality ImprovementLondonUK
| | - Luigi Grassi
- Section of Psychiatry, Department of Biomedical and Specialty Surgical SciencesUniversity of FerraraFerraraItaly
| | - Chiara DaRonch
- Section of Psychiatry, Department of Biomedical and Specialty Surgical SciencesUniversity of FerraraFerraraItaly
| | - Manuel Munoz
- School of PsychologyComplutense University of MadridMadridSpain
| | - Berta Ausin
- School of PsychologyComplutense University of MadridMadridSpain
| | | | - Arieh Shalev
- Department of PsychiatryHadassah University Medical CentreJerusalemIsrael
| | - Ora Rotenstein
- Department of PsychiatryHadassah University Medical CentreJerusalemIsrael
| | - Yael Hershkowitz
- Department of PsychiatryHadassah University Medical CentreJerusalemIsrael
| | - Jens Strehle
- Institute of Clinical Psychology and PsychotherapyTechnical University of DresdenDresdenGermany
| | - Hans‐Ulrich Wittchen
- Institute of Clinical Psychology and PsychotherapyTechnical University of DresdenDresdenGermany
| | - Sylke Andreas
- Department of Medical PsychologyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
- Institute for PsychologyAlpen‐Adria Universität KlagenfurtKlagenfurt am WörtherseeAustria
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Heidari Z, Keshteli AH, Feizi A, Afshar H, Adibi P. Somatic Complaints Are Significantly Associated with Chronic Uninvestigated Dyspepsia and Its Symptoms: A Large Cross-sectional Population Based Study. J Neurogastroenterol Motil 2017; 23:80-91. [PMID: 27503912 PMCID: PMC5216638 DOI: 10.5056/jnm16020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 06/10/2016] [Accepted: 07/04/2016] [Indexed: 12/26/2022] Open
Abstract
Background/Aims Somatization may influence persistence and severity of symptoms in gastrointestinal diseases. Some studies suggest that somatization is associated with chronic uninvestigated dyspepsia (CUD); however, the association is unclear. We aimed to determine the association between the profiles of somatic complaints with CUD and its symptoms. Methods In a cross-sectional study conducted on 4763 Iranian adults, somatic complaints were assessed using a comprehensive 31-items questionnaire. Patients with CUD were identified by the Rome III diagnostic criteria. Profiles of somatic complaints were derived from factor analysis. Logistic regression analysis was used to assess the relationship between extracted profiles with CUD and its symptoms. Results CUD, bothersome postprandial fullness, early satiation, and epigastric pain or burning was identified in 723 (15.2%), 384 (8.1%), 302 (6.3%), and 371 (7.8%) of the study population. The frequency of all 31 somatic complaints was significantly higher in patients with CUD compared with controls (P < 0.001), and the most frequent was severe fatigue (45.1%). The profiles of somatic complaints were extracted in 4 domains, including “psychological”, “gastrointestinal”, “neuro-skeletal”, and “pharyngeal-respiratory”. The psychological (OR, 1.49; 95% CI, 1.44–1.54), gastrointestinal (OR, 2.22; 95% CI, 2.09–2.37), neuro-skeletal (OR, 1.52; 95% CI, 1.44–1.59), and pharyngeal-respiratory (OR, 2.09; 95% CI, 1.94–2.25) profiles were significantly associated with greater odds of CUD. Conclusions CUD and its symptoms are strongly associated with higher levels of somatic complaints and their related extracted profiles. This perhaps explains that why it can be difficult to treat, however further prospective investigations are required to confirm these associations.
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Affiliation(s)
- Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ammar Hassanzadeh Keshteli
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.,Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.,Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Afshar
- Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Payman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine Isfahan University of Medical Sciences, Isfahan, Iran
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Scharf M, Mayseless O, Rousseau S. When somatization is not the only thing you suffer from: Examining comorbid syndromes using latent profile analysis, parenting practices and adolescent functioning. Psychiatry Res 2016; 244:10-8. [PMID: 27455145 DOI: 10.1016/j.psychres.2016.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 07/07/2016] [Accepted: 07/07/2016] [Indexed: 11/15/2022]
Abstract
Understanding somatization presents a challenge to clinicians because it is often associated with other syndromes. We addressed somatization's comorbidity with other internalizing syndromes (anxiety, depression, withdrawal) using latent profile analysis. A representative sample of 3496 Israeli middle and high-school youths reported their internalizing symptoms, perceived parenting practices, psychosocial functioning, and health behaviors. Four profiles, similar across age and gender, were identified: overall-low (65.4%), moderately-high anxiety/depression/withdrawal (24.4%), high somatization (4.8%), and overall-high (5.4%). MANOVAs and follow-up ANOVAs revealed that for the most part the overall-high profile evinced the worst parenting, psychosocial functioning, and health behaviors (smoking and drinking), while the overall-low group evinced the best. For most variables the high somatization and moderately high profiles displayed midway results. However, the moderately-high profile reported higher levels of harsh parenting than the high somatization profile. The high somatization profile reported similar or higher levels of smoking, risk taking, vandalism, and rule violation than the overall-high group. High somatization, either alone or alongside anxiety, depression, and withdrawal, was associated with disruptive and risk-taking behaviors. This link might reflect problems in emotion and anger regulation and become stronger in adolescence because of dysregulation processes characterizing this period. Implications for practice are discussed.
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Affiliation(s)
- Miri Scharf
- Department of Counseling and Human Development, University of Haifa, Haifa 3498838, Israel.
| | - Ofra Mayseless
- Department of Counseling and Human Development, University of Haifa, Haifa 3498838, Israel.
| | - Sofie Rousseau
- Department of Counseling and Human Development, University of Haifa, Haifa 3498838, Israel.
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35
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Boeckxstaens GE, Drug V, Dumitrascu D, Farmer AD, Hammer J, Hausken T, Niesler B, Pohl D, Pojskic L, Polster A, Simren M, Goebel-Stengel M, Van Oudenhove L, Vassallo M, Wensaas KA, Aziz Q, Houghton LA. Phenotyping of subjects for large scale studies on patients with IBS. Neurogastroenterol Motil 2016; 28:1134-47. [PMID: 27319981 DOI: 10.1111/nmo.12886] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 05/17/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a complex condition with multiple factors contributing to its aetiology and pathophysiology. Aetiologically these include genetics, life-time events and environment, and physiologically, changes in motility, central processing, visceral sensitivity, immunity, epithelial permeability and gastrointestinal microflora. Such complexity means there is currently no specific reliable biomarker for IBS, and thus IBS continues to be diagnosed and classified according to symptom based criteria, the Rome Criteria. Carefully phenotyping and characterisation of a 'large' pool of IBS patients across Europe and even the world however, might help identify sub-populations with accuracy and consistency. This will not only aid future research but improve tailoring of treatment and health care of IBS patients. PURPOSE The aim of this position paper is to discuss the requirements necessary to standardize the process of selecting and phenotyping IBS patients and how to organise the collection and storage of patient information/samples in such a large multi-centre pan European/global study. We include information on general demographics, gastrointestinal symptom assessment, psychological factors, quality of life, physiological evaluation, genetic/epigenetic and microbiota analysis, biopsy/blood sampling, together with discussion on the organisational, ethical and language issues associated with implementing such a study. The proposed approach and documents selected to be used in such a study was the result of a thoughtful and thorough four-year dialogue amongst experts associated with the European COST action BM1106 GENIEUR (www.GENIEUR.eu).
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Affiliation(s)
- G E Boeckxstaens
- Translational Research Center for Gastrointestinal Disorders, KULeuven & Department of Gastroenterology and Hepatology, University Hospital Leuven, Leuven, Belgium
| | - V Drug
- Gastroenterology Department, University Hospital "St Spiridon", Gr. T.Popa University of Medicine and Pharmacy, Iasi, Romania
| | - D Dumitrascu
- 2nd Medical Dept., Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - A D Farmer
- Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, London, UK.,Department of Gastroenterology, University Hospitals of North Midlands, Stoke on Trent, UK
| | - J Hammer
- Medizinische Universität Wien, Universitätsklinik für Innere Medizin 3, Vienna, Austria
| | - T Hausken
- Department of Medicine, Unit of Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - B Niesler
- Department of Human Molecular Genetics, University of Heidelberg, Heidelberg, Germany
| | - D Pohl
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - L Pojskic
- Institute for Genetic Engineering and Biotechnology, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - A Polster
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - M Simren
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Goebel-Stengel
- Department of Internal Medicine, Martin-Luther-Krankenhaus, Berlin, Germany
| | - L Van Oudenhove
- Translational Research Center for Gastrointestinal Disorders, KULeuven & Department of Gastroenterology and Hepatology, University Hospital Leuven, Leuven, Belgium
| | - M Vassallo
- Department of Medicine, Mater Dei Hospital, Tal-Qroqq, Malta
| | - K-A Wensaas
- Uni Research Health, Research Unit for General Practice, Bergen, Norway
| | - Q Aziz
- Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, London, UK
| | - L A Houghton
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds and Leeds Gastroenterology Institute, Leeds Teaching Hospitals Trust, Leeds, UK.,Centre for Gastrointestinal Sciences, University of Manchester, Manchester, UK.,Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
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Rizou I, De Gucht V, Papavasiliou A, Maes S. The contribution of illness perceptions to fatigue and sleep problems in youngsters with epilepsy. Eur J Paediatr Neurol 2016; 20:93-9. [PMID: 26497901 DOI: 10.1016/j.ejpn.2015.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 09/10/2015] [Accepted: 10/04/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE The present study aims to explore the extent to which gender, epilepsy severity and illness perceptions predict fatigue and sleep problems in youngsters with epilepsy. METHOD Structured interviews were conducted in 100 young patients (Mage = 13,9, SD = 2.21; 41% girls) and data were analyzed by means of multiple hierarchical regression analyses. RESULTS Most patients (91%) were well controlled by anti-epileptics; 3% had infrequent seizures and 6% were pharmacoresistant. At a multivariate level it appeared that youngsters with epilepsy who believe that they have less personal control over their illness and who feel that the illness has a high emotional impact on their lives reported higher levels of fatigue. In addition, more sleep problems were reported by youngsters who think they have less personal control over the disease, who believe that treatment controls epilepsy and report that the disease has a high emotional impact on their lives. CONCLUSION Given the importance of illness perceptions, it is suggested that they are targets for future interventions that aim to reduce fatigue and sleep problems in youngsters with epilepsy.
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Affiliation(s)
- Ioanna Rizou
- Child Psychiatry Department, Mental Health Center of General Hospital of Athens "G. Gennimatas", Athens, Greece.
| | - Veronique De Gucht
- Health, Medical and Neuropsychology Department, Leiden University, Leiden, The Netherlands.
| | | | - Stan Maes
- Health, Medical and Neuropsychology Department, Leiden University, Leiden, The Netherlands.
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Alves VLP, Lima DD. Percepção e Enfrentamento do Psicossomático na Relação Médico-Paciente. PSICOLOGIA: TEORIA E PESQUISA 2016. [DOI: 10.1590/0102-3772e323225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Com o objetivo de compreender a vivência de médicos no atendimento a pacientes psicossomáticos, foi realizada uma pesquisa qualitativa e fenomenológica com quatro profissionais da medicina. A compreensão das entrevistas mostra que as condutas perfazem um percurso iniciado por um diagnóstico, seguido de uma mobilização pessoal que os conduz a tentativas de reorganizar a relação médico-paciente e a utilizar algumas terapêuticas, bem como demonstram seu despreparo na abordagem do tema. Esse percurso é compreendido de acordo com o modelo biomédico que rege as concepções e práticas apreendidas desde a graduação. No entanto, essa formação gera dificuldades no manejo de aspectos psicológicos, e não apenas dos referidos como elementos psicogênicos do adoecimento, típicos das compreensões psicossomáticas. Evidencia-se uma aprendizagem médica em que se dá mais atenção à doença do que ao ser que adoece.
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Gracie DJ, Bercik P, Morgan DG, Bolino C, Pintos-Sanchez MI, Moayyedi P, Ford AC. No increase in prevalence of somatization in functional vs organic dyspepsia: a cross-sectional survey. Neurogastroenterol Motil 2015; 27:1024-31. [PMID: 25931163 DOI: 10.1111/nmo.12578] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/07/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Psychological factors are associated with functional gastrointestinal (GI) disorders. Literature suggests that somatization is associated with functional dyspepsia (FD). However, the relationship between organic dyspepsia (OD), FD, and FD subtypes and somatization is poorly described. We aimed to examine this issue in a cross-sectional study of secondary care patients. METHODS Demographic and GI symptom data were collected from 4224 adult patients via the Rome III questionnaire. Somatization data were collected using the patient health questionnaire-12. Mean somatization score and number of somatic symptoms were compared between patients with organic and FD, and between FD subtypes using analysis of variance. The same comparison was undertaken for the proportion of patients reporting individual somatic symptoms. KEY RESULTS Exactly, 783 patients met criteria for dyspepsia, of whom 231 (29.5%) had organic disease following upper GI endoscopy. Mean somatization scores and number of somatic symptoms were no higher in functional vs OD (p = 0.23; p = 0.19). In addition, while the prevalence of somatization in FD was relatively high, there was no difference in severity of somatization in FD subgroups. CONCLUSIONS & INFERENCES Somatization is associated with functional and OD to the same degree. Overall severity of somatization did not appear to vary according to FD subtype.
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Affiliation(s)
- D J Gracie
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK.,Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK
| | - P Bercik
- Farncombe Family Digestive Health Research Institute, Gastroenterology Division, McMaster University, Health Sciences Center, Hamilton, ON, Canada
| | - D G Morgan
- Gastroenterology Department, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - C Bolino
- Farncombe Family Digestive Health Research Institute, Gastroenterology Division, McMaster University, Health Sciences Center, Hamilton, ON, Canada
| | - M I Pintos-Sanchez
- Farncombe Family Digestive Health Research Institute, Gastroenterology Division, McMaster University, Health Sciences Center, Hamilton, ON, Canada
| | - P Moayyedi
- Farncombe Family Digestive Health Research Institute, Gastroenterology Division, McMaster University, Health Sciences Center, Hamilton, ON, Canada
| | - A C Ford
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK.,Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK
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Rousseau S, Grietens H, Vanderfaeillie J, Hoppenbrouwers K, Desoete A, Van Leeuwen K. The relation between parenting stress and adolescents' somatisation trajectories: a growth mixture analysis. J Psychosom Res 2014; 77:477-83. [PMID: 25262498 DOI: 10.1016/j.jpsychores.2014.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 09/02/2014] [Accepted: 09/02/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The impact of somatisation in adolescence is substantial. Knowledge on (predictors of) individual-level development of somatisation is necessary to develop tailored treatment. The current study assessed individual-level development of somatisation by means of latent mixed modelling. Parenting stress was included as a predictor of somatisation trajectory membership and within-trajectory variation. METHODS A total of 1499 adolescents and one of their parents (mostly the mother) agreed to participate. Questionnaires were administered when the adolescents were respectively 12-13 (T1), 13-14 (T2), and 14-15 (T3) years old. Adolescents reported on their somatisation, parents on their parenting stress. RESULTS Four individual somatisation trajectories were found: increased, long-term low, long-term high, and decreased. Higher early parenting stress (T1) significantly predicted less favourable trajectory membership (increased and long-term high). The relation between later parenting stress (T2 and T3) and somatisation depended on trajectory membership. For adolescents in the long-term high and decreased somatisation trajectories, lower T2 and T3 parenting stress was related to higher somatisation, while for adolescents in the long-term low and increased trajectories, higher T2 and T3 parenting stress was related to higher somatisation. CONCLUSIONS The results support a general recommendation to prevent the onset of high levels of parenting stress. In addition, for families in which high levels of parenting stress already exist, clinicians should be aware of natural fluctuations in parenting stress, its associated features (e.g., aspects of overall care, like looking for professional help) and of the consequences this might have for the adolescent.
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Affiliation(s)
- Sofie Rousseau
- Parenting and Special Education Research Unit, L. Vanderkelenstraat 32, 3000 Leuven, Belgium.
| | - Hans Grietens
- Centre for Special Needs Education and Youth Care, Grote Rozenstraat 38, 9712 TJ Groningen, The Netherlands
| | - Johan Vanderfaeillie
- Department of Clinical and Life Span Psychology, Pleinlaan 2, 1050 Brussels, Belgium
| | | | - Annemie Desoete
- Department of Experimental Clinical and Health Psychology, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Karla Van Leeuwen
- Parenting and Special Education Research Unit, L. Vanderkelenstraat 32, 3000 Leuven, Belgium
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Williams GC, Halvari H, Niemiec CP, Sørebø Ø, Olafsen AH, Westbye C. Managerial support for basic psychological needs, somatic symptom burden and work-related correlates: A self-determination theory perspective. WORK AND STRESS 2014. [DOI: 10.1080/02678373.2014.971920] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Altınöz AE, Taşkıntuna N, Altınöz ST, Ceran S. A cohort study of the relationship between anger and chronic spontaneous urticaria. Adv Ther 2014; 31:1000-7. [PMID: 25209876 DOI: 10.1007/s12325-014-0152-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Anger plays a major role in psychodermatological diseases. Researchers have reported that anger and other psychological factors play a role in the etiology of chronic urticaria. This study aimed to examine symptoms of anger, anger-related behavioral patterns, thoughts associated with anger, situations that cause anger and experiences of interpersonal anger in patients with chronic spontaneous urticaria (CSU). The authors hypothesized that patients with CSU react to more situations with anger and experience more anger symptoms as compared to alopecia areata (AA) patients and healthy controls. METHODS The cohort study population consisted of literate adult patients aged <65 years that were diagnosed with CSU at the outpatient dermatology clinics of Başkent and Gazi University, Ankara, Turkey, between September 2011 and October 2012. The first control group included individuals without any physical or mental disorders and the second one included literate adult patients diagnosed with AA. The patients and controls were matched according to age, gender, and level of education. A sociodemographic data form, and the Hospital Anxiety and Depression Scale and Multi-Dimensional Anger Inventory were administered to the participants. Data were analyzed using SPSS v.17.0 for Windows. The primary outcome was to determine whether there was a relationship between anger and CSU. RESULTS The CSU group consisted of 30 participants; AA group consisted of 30 participants; and the healthy group consisted of 39 participants. Anxiety and depression scores in the CSU group were significantly higher than those in the healthy control group. Symptoms of anger, situations that cause anger, and thoughts associated with anger were significantly more common in the CSU group compared to AA group and healthy group. CONCLUSION More of the CSU patients were observed to respond with excessive anger to most situations, to have high levels of anxiety anger and passive aggressive interpersonal relationships.
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Affiliation(s)
- Ali Ercan Altınöz
- Ankara Penal Institution Campus State Hospital, Psychiatry, Ankara Ceza Infaz Kurumları Kampüs Devlet Hastanesi Adalet Mh. Adalet Cd. Yenikent Sincan Ankara Sincan, Ankara, PK:06900, Turkey,
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Rousseau S, Grietens H, Vanderfaeillie J, Hoppenbrouwers K, Wiersema JR, Baetens I, Vos P, Van Leeuwen K. The association between parenting behavior and somatization in adolescents explained by physiological responses in adolescents. Int J Psychophysiol 2014; 93:261-6. [PMID: 24862009 DOI: 10.1016/j.ijpsycho.2014.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 05/01/2014] [Accepted: 05/17/2014] [Indexed: 01/30/2023]
Abstract
INTRODUCTION This study adds to the knowledge on somatization in adolescents by exploring its relation with parenting behavior and the mediating/moderating role of physiological responses in adolescents to parenting behavior. METHOD Eighteen adolescents with high and 18 adolescents with low somatization scores and their mothers completed a discussion task, from which observed parenting behavior scores were derived. Skin conductance in adolescents was measured before and during the discussion. RESULTS For adolescents with high levels of physiological responses, unadaptive parenting was related to a higher chance of high somatization scores. For low physiologically responsive adolescents, the relation between parenting behavior and somatization was not significant. CONCLUSION Parenting behavior is not univocally related to somatization in adolescents, but the association depends on physiological responses in adolescents.
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Affiliation(s)
- Sofie Rousseau
- Parenting and Special Education Research Unit, University of Leuven, L. Vanderkelenstraat 32, 3000 Leuven, Belgium.
| | - Hans Grietens
- Centre for Special Needs Education & Youth Care, University of Groningen, Grote Rozenstraat 38, 9712 TJ Groningen, the Netherlands.
| | - Johan Vanderfaeillie
- Department of Clinical & Life Span Psychology, University of Brussels, Pleinlaan 2, 1050 Brussels, Belgium.
| | - Karel Hoppenbrouwers
- Centre of Youth Health Care, University of Leuven, Kapucijnenvoer 35 blok d, Belgium.
| | - Jan R Wiersema
- Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium.
| | - Imke Baetens
- Clinical Psychology Research Unit, University of Leuven, Tiensestraat 102, 3000, Leuven, Belgium.
| | - Pieter Vos
- Parenting and Special Education Research Unit, University of Leuven, L. Vanderkelenstraat 32, 3000 Leuven, Belgium.
| | - Karla Van Leeuwen
- Parenting and Special Education Research Unit, University of Leuven, L. Vanderkelenstraat 32, 3000 Leuven, Belgium.
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Hasvik E, Iordanova Schistad E, Grøvle L, Julsrud Haugen A, Røe C, Gjerstad J. Subjective health complaints in patients with lumbar radicular pain and disc herniation are associated with a sex - OPRM1 A118G polymorphism interaction: a prospective 1-year observational study. BMC Musculoskelet Disord 2014; 15:161. [PMID: 24884878 PMCID: PMC4038376 DOI: 10.1186/1471-2474-15-161] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 05/09/2014] [Indexed: 01/25/2023] Open
Abstract
Background Earlier observations show that development of persistent pain may be associated with the genetic variability in the gene encoding for the μ-opioid receptor 1, the OPRM1 A118G (rs1799971). The aim of this study was to investigate the association between OPRM1 genotype and subjective health complaints in patients with radicular pain and disc herniation. Methods A prospective, 1-year observational study was conducted at a hospital back clinic, including 118 Caucasian patients with lumbar radicular pain and MRI confirmed disc herniation. Single nucleotide polymorphism genotyping regarding the OPRM1 A118G was performed. The data of individuals with AA versus AG or GG were analysed separately by linear mixed models. The Subjective Health Complaints Inventory (0-81) including 27 common complaints experienced the previous month on a scale from not at all (0) to severe (3) was used as outcome. Pain, prior duration of leg pain, age, smoking status, and lumbar disc surgery were considered as covariates. Results In total 23 of 118 patients were carriers of the OPRM1 G-allele. All patients except female carriers of the G-allele reported a decrease in pain from baseline to 1 year. Female carriers of the G-allele reported significantly higher subjective health complaints score during the study time span than male carriers of the G-allele when controlling for pain and pain duration. Conclusion The present data indicate that, when controlling for pain intensity and duration, subjective health complaints are associated with a sex - OPRM1 A118G polymorphism interaction in patients with radicular pain.
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Affiliation(s)
- Eivind Hasvik
- National Institute of Occupational Health, Oslo, Norway.
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Rousseau S, Grietens H, Vanderfaeillie J, Hoppenbrouwers K, Wiersema JR, Van Leeuwen K. Parenting stress and dimensions of parenting behavior: cross-sectional and longitudinal links with adolescents' somatization. Int J Psychiatry Med 2014; 46:243-70. [PMID: 24741833 DOI: 10.2190/pm.46.3.b] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study explored direct and indirect associations between adolescents' somatization, parenting stress, and three parenting dimensions (warmth, psychological control, and harsh punishment). First, the associations were explored cross-sectionally. Second, significant cross-sectional links were further examined longitudinally in order to decide upon temporality. METHOD A total of 1499 adolescents and one of their parents (mostly the mother) agreed to participate. Questionnaires were administered when the child was respectively 12-13 (T1), 13-14 (T2), and 14-15 (T3) years old. Adolescents reported on their somatization, parents on their parenting behavior and parenting stress. RESULTS Cross-sectionally, indirect links were found between all parenting dimensions and adolescents' somatization, through parenting stress. Longitudinal examination revealed two key aspects. First, parenting stress significantly predicted somatization. Higher T1 parenting stress was predictive for higher T2 and T3 somatization. When controlled for T1 parenting stress, higher T2 parenting stress (or in other words increased parenting stress at T2) was predictive for lower T3 somatization. Second, parenting stress was found to significantly predict parenting behaviors. Higher T1 parenting stress was predictive for higher T2 and T3 harsh punishment but increased parenting stress at T2 was predictive for lower harsh punishment one year later. Higher T1 parenting stress significantly predicted higher T2 psychological control. CONCLUSIONS Clinicians should be aware that parenting stress may be a risk factor for the development of somatization in early adolescence. However, in later adolescence, increased parenting stress might be protective.
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Abstract
Somatic manifestation is common in the Asian population. The frequent occurrence of somatic symptom and related disorders among Asians could well be explained by an overt emphasis on 'somatic' idioms of distress on the one hand, and unacceptability and stigma attached to psychological expression of distress on the other. Assessment and diagnosis of somatoform disorders is complicated by the scarcity of cross-culturally validated instruments. Likewise, management is also based on Western literature in which psychological interventions override pharmacological treatment. DSM-5 has broadened the scope of somatoform disorders and emphasizes the concept rather than simply counting symptoms. These changes are expected to have a positive impact cross-culturally.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Abhishek Ghosh
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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Mixed emotional and physical symptoms in general practice: what diagnoses do GPs use to describe them? Prim Health Care Res Dev 2014; 16:207-13. [PMID: 24451149 DOI: 10.1017/s1463423613000558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIMS To determine what diagnostic terms are utilized by general practitioners (GPs) when seeing patients with mixed emotional and physical symptoms. METHOD Prototype cases of depression, anxiety, hypochondriasis, somatization and undifferentiated somatoform disorders were sourced from the psychiatric literature and the author's clinical practice. These were presented, in paper form, to a sample of GPs and GP registrars who were asked to provide a written diagnosis. RESULTS Fifty-two questionnaires were returned (30% response rate). The depression and anxiety cases were identified correctly by most participants. There was moderate identification of the hypochondriasis and somatization disorder cases, and poor identification of the undifferentiated somatoform case. CONCLUSION Somatization and undifferentiated somatoform disorders were infrequently recognized as diagnostic categories by the GPs in this study. Future research into the language and diagnostic reasoning utilized by GPs may help develop better diagnostic classification systems for use in primary care in this important area of practice.
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Somatisation and functional impairment in adolescents: longitudinal link with mothers’ reactions. Psychol Belg 2014. [DOI: 10.5334/pb.ah] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Yu JH, Crouch J, Jamal SM, Tabor HK, Bamshad MJ. Attitudes of African Americans toward return of results from exome and whole genome sequencing. Am J Med Genet A 2013; 161A:1064-72. [PMID: 23610051 DOI: 10.1002/ajmg.a.35914] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 02/04/2013] [Indexed: 12/22/2022]
Abstract
Exome sequencing and whole genome sequencing (ES/WGS) present patients and research participants with the opportunity to benefit from a broad scope of genetic results of clinical and personal utility. Yet, this potential for benefit also risks disenfranchising populations such as African Americans (AAs) that are already underrepresented in genetic research and utilize genetic tests at lower rates than other populations. Understanding a diverse range of perspectives on consenting for ES/WGS and receiving ES/WGS results is necessary to ensure parity in genomic health care and research. We conducted a series of 13 focus groups (n = 76) to investigate if and how attitudes toward participation in ES/WGS research and return of results from ES/WGS differ between self-described AAs and non-AAs. The majority of both AAs and non-AAs were willing to participate in WGS studies and receive individual genetic results, but the fraction not interested in either was higher in AAs. This is due in part to different expectations of health benefits from ES/WGS and how results should be managed. Our results underscore the need to develop and test culturally tailored strategies for returning ES/WGS results to AAs.
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Affiliation(s)
- Joon-Ho Yu
- Department of Pediatrics, University of Washington, Seattle, WA 98195, USA.
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Jones MP, Coppens E, Vos R, Holvoet L, Luyten P, Tack J, Van Oudenhove L. A multidimensional model of psychobiological interactions in functional dyspepsia: a structural equation modelling approach. Gut 2013; 62:1573-80. [PMID: 22917658 DOI: 10.1136/gutjnl-2012-302634] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Gastric sensorimotor function, abuse history, 'trait' and 'state' psychological factors and 'somatisation' all play a role in functional dyspepsia (FD) and its associated impaired quality of life (QoL), but their interplay remains poorly understood. We aimed to test a comprehensive, a priori hypothesised model of interactions between these dimensions in FD. DESIGN In 259 FD patients, we studied gastric sensitivity with a barostat. We measured abuse history (sexual/physical, childhood/adulthood), 'trait' (alexithymia, trait anxiety) and 'state' (positive/negative affect, depression, panic disorder) psychological factors, somatic symptom reporting (somatic symptom count, dyspepsia, irritable bowel syndrome and fatigue symptoms) and QoL (physical, mental) using validated questionnaires. Confirmatory factor analysis (CFA) was used to assess whether four a priori hypothesised latent variables ('abuse', 'trait affectivity', 'state affect' and 'somatic symptom reporting') were adequately supported by the data. Structural equation modelling (SEM) was used to test the a priori hypothesised relationships between these latent variables and the observed variables gastric sensitivity and QoL. RESULTS Both the CFA and SEM models fitted the data adequately. Abuse exerted its effect directly on 'somatic symptom reporting', rather than indirectly through psychological factors. A reciprocal relationship between 'somatic symptom reporting' and 'state affect' was found. Gastric sensitivity influences 'somatic symptom reporting' but not vice versa. 'Somatic symptom reporting' and 'trait affectivity' are the main determinants of physical and mental QoL, respectively. CONCLUSIONS We present the first comprehensive model elucidating the complex interactions between multiple dimensions (gastric sensitivity, abuse history, 'state' and 'trait' psychological factors, somatic symptom reporting and QoL) in FD.
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Affiliation(s)
- Michael P Jones
- Department of Psychology, Macquarie University, Sydney, Australia
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Abstract
Somatic symptoms may be classified as either 'medically explained' or 'medically unexplained' - the former being considered medical and the latter psychiatric. In healthcare systems focused on disease, this distinction has pragmatic value. However, new scientific evidence and psychiatric classification urge a more integrated approach with important implications for psychiatry.
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Affiliation(s)
- Michael Sharpe
- Michael Sharpe, FRCPsych, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.
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