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Cui X, Cao J, Rafanelli C, Zhu B, Gostoli S. Efficacy of group biofeedback treatment on hyperemesis gravidarum with psychosomatic symptoms diagnosed with the revised version of Diagnostic Criteria for Psychosomatic Research (DCPR-R): study protocol for a randomised controlled trial. BMJ Open 2022; 12:e051295. [PMID: 35361636 PMCID: PMC8971773 DOI: 10.1136/bmjopen-2021-051295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Hyperemesis gravidarum (HG) is a condition characterised by dehydration, electrolyte imbalance, lack of nutrition and at least 5% loss in body weight, occurring in the first half of pregnancy. The aim of this trial is to examine the efficacy of group biofeedback treatment on patients with HG with psychosomatic symptoms, which will be evaluated through the revised version of Diagnostic Criteria for Psychosomatic Research (DCPR-R). METHODS AND ANALYSIS In this single-blinded randomised controlled clinical trial, 68 patients with HG diagnosed with at least one psychosomatic syndrome according to DCPR-R and aged 18-40 years, will be recruited in a Chinese Maternal and Child Health Hospital. The sample will be randomised (1:1) into two arms: experimental group, which will undergo group biofeedback treatment, psycho-education and treatment as usual (TAU); and control group, which will undergo psycho-education and TAU only. The primary outcomes will be reduction of the frequency of psychosomatic syndromes, severity of nausea/vomiting, quality of life and heart rate variability. The secondary outcomes will include days of hospitalisation, repeated hospitalisation and laboratory investigations. ETHICS AND DISSEMINATION This study has received ethical approval from the Nanjing Medical University (No. 2019/491, granted 22 February 2019). All participants will be required to provide written informed consent. Study outcomes will be disseminated through peer-reviewed publications and academic conferences, and used to confirm a tailored biofeedback intervention for patients with HG with psychosomatic symptoms. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registry (ChiCTR2000028754).
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Affiliation(s)
- Xuelian Cui
- Department of Healthcare, Changzhou Maternity and Child Healthcare Hospital, Changzhou, China
| | - Jianxin Cao
- Department of Gastroenterology, Third Affiliated Hospital of Soochow University, Changzhou, China
- Soochow University Psychosomatic Gastroenterology Institute, Changzhou, People's Republic of China
| | - Chiara Rafanelli
- Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy
| | - Boheng Zhu
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sara Gostoli
- Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy
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Mohseny M, Derisi M, Nasiri M, Aryan A, Moosavi Jarrahi A, Amiri P. Prevalence of psychiatric disorders in patients with ischemic heart disease: A systematic review and meta-analysis. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:12. [PMID: 35342444 PMCID: PMC8943595 DOI: 10.4103/jrms.jrms_864_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 05/30/2021] [Accepted: 09/30/2021] [Indexed: 11/04/2022]
Abstract
Background: Materials and Methods: Results: Conclusion:
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A Psychosomatic Approach to Quality of Life in Patients with Epilepsy. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2020. [DOI: 10.21673/anadoluklin.778315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Somatization in Parkinson's Disease: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2017; 78:18-26. [PMID: 28522290 DOI: 10.1016/j.pnpbp.2017.05.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 04/25/2017] [Accepted: 05/13/2017] [Indexed: 11/21/2022]
Abstract
The current systematic review study is aimed at critically analyzing from a clinimetric viewpoint the clinical consequence of somatization in Parkinson's Disease (PD). By focusing on the International Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive electronic literature research strategy on ISI Web-of-Science, PsychINFO, PubMed, EBSCO, ScienceDirect, MEDLINE, Scopus, and Google Scholar databases. Out of 2.926 initial records, only a total of 9 studies were identified as clearly relevant and analyzed in this systematic review. The prevalence of somatization in PD has been found to range between 7.0% and 66.7%, with somatoform disorders acting as clinical factor significantly contributing to predict a progressive cognitive impairment. We highlighted that somatization is a highly prevalent comorbidity affecting PD. However, the clinical consequence of such psychiatric symptom should be further evaluated by replacing the clinically inadequate diagnostic label of psychogenic parkinsonism with the psychosomatic concept of persistent somatization as conceived by the Diagnostic Criteria for Psychosomatic Research (DCPR).
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Subsyndromal psychosomatic concepts and personality traits in community adults. Compr Psychiatry 2017; 75:110-116. [PMID: 28347882 DOI: 10.1016/j.comppsych.2017.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 01/26/2017] [Accepted: 03/05/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To investigate the prevalence of features of the Diagnostic Criteria for Psychosomatic Research (DCPR) in the Taiwanese community and to explore their relationships with psychological states and personality traits. METHOD The participants were 153 individuals without a DSM-5 psychiatric diagnosis who were grouped according to whether they had a DCPR diagnosis (at least one DCPR diagnosis, DCPR(+): n=66; no DCPR diagnosis, DCPR(-): n=87). The groups were compared with respect to psychological states (measured with Patient Health Questionnaire-15 [PHQ-15], Health Anxiety Questionnaire [HAQ], Beck Depression Inventory-II [BDI-II], Beck Anxiety Inventory [BAI)]) and personality (measured with Tridimensional Personality Questionnaire). Multiple logistic and linear regressions were used to examine associations among demographic, personality, DCPR, and psychological states. RESULTS The DCPR(+) group had higher BDI-II, BAI, PHQ-15 and HAQ scores than the DCPR(-) group and also had a higher anticipatory worry. The most common DCPR diagnoses were health anxiety (42.42%) and alexithymia (37.88%). Anticipatory worry was the variable most closely associated with all the DCPR diagnoses. Health anxiety was related to anticipatory worry and age, whereas alexithymia was associated with dependence and fatiguability. PHQ-15, HAQ, and BDI-II scores were related to health anxiety but not alexithymia. CONCLUSION DCPR has clinical utility in the community samples without DSM-5 diagnoses. DCPR may be a valid mediator between psychological trait and state.
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Vertigo “In the Pink”: The Impact of Female Gender on Psychiatric-Psychosomatic Comorbidity in Benign Paroxysmal Positional Vertigo Patients. PSYCHOSOMATICS 2014; 55:280-8. [DOI: 10.1016/j.psym.2013.02.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 02/06/2013] [Accepted: 02/07/2013] [Indexed: 11/20/2022]
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Grassi L, Caruso R, Nanni MG. Somatization and somatic symptom presentation in cancer: a neglected area. Int Rev Psychiatry 2013; 25:41-51. [PMID: 23383666 DOI: 10.3109/09540261.2012.731384] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Abstract The recognition of somatization process in cancer patients is a challenging and neglected area, for the extreme difficulty in differentiating and assessing the psycho(patho)logical components from those biologically determined and related to cancer and cancer treatment, as well as for the scarce usefulness of rigid categorical DSM criteria. However, several dimensions of somatization (and the interconnected concept of abnormal illness behaviour) have been shown to be diagnosable in cancer patients and to negatively influence coping and quality of life outcomes. An integration of the formal DSM-ICD nosology with a system specifically taking into account the patients' emotional responses to cancer and cancer treatment, such as the Diagnostic Criteria for Psychosomatic Research (DCPR), is suggested. More data on some specific symptom dimensions, including pain, fatigue and sexual disorders, are needed to examine their possible psychological components. More research is also needed regarding the association of somatization with personality traits (e.g. type D distressed personality, alexithymia), developmental dimensions (e.g. attachment), and cultural issues (e.g. culturally mediated attributional styles to somatic symptoms). Also, the impact and effectiveness of specific therapeutic intervention in 'somatizing' cancer patients is necessary.
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Affiliation(s)
- Luigi Grassi
- Section of Psychiatry, Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy.
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Abstract
The Diagnostic Criteria for Psychosomatic Research (DCPR) were introduced in 1995 by an international group of investigators to expand the traditional domains of the disease model. The DCPR are a set of 12 'psychosomatic syndromes' which provide operational tools for psychosocial variables with prognostic and therapeutic implications in clinical settings. Eight syndromes concern the main manifestations of abnormal illness behaviour: somatization, hypochondriacal fears and beliefs, and illness denial. The other four syndromes (alexithymia, type A behaviour, demoralization and irritable mood) refer to the domain of psychological factors affecting medical conditions. This review describes the conceptual bases of the DCPR and the main findings concerning their application, with particular reference to the incremental information they added to the customary psychiatric classification. The DCPR were also compared with the provisional DSM-5 somatic symptom disorders. The DCPR were found to be more sensitive than DSM-IV in identifying subthreshold psychological distress and characterizing patients' psychological response to medical illness. DSM-5 somatic symptom disorders seem to neglect important clinical phenomena, such as illness denial, resulting in a narrow view of patients' functioning. The additional information provided by the DCPR may enhance the decision-making process.
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Affiliation(s)
- Laura Sirri
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
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Abbate-Daga G, Delsedime N, Nicotra B, Giovannone C, Marzola E, Amianto F, Fassino S. Psychosomatic syndromes and anorexia nervosa. BMC Psychiatry 2013; 13:14. [PMID: 23302180 PMCID: PMC3556145 DOI: 10.1186/1471-244x-13-14] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 01/03/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In spite of the role of some psychosomatic factors as alexithymia, mood intolerance, and somatization in both pathogenesis and maintenance of anorexia nervosa (AN), few studies have investigated the prevalence of psychosomatic syndromes in AN. The aim of this study was to use the Diagnostic Criteria for Psychosomatic Research (DCPR) to assess psychosomatic syndromes in AN and to evaluate if psychosomatic syndromes could identify subgroups of AN patients. METHODS 108 AN inpatients (76 AN restricting subtype, AN-R, and 32 AN binge-purging subtype, AN-BP) were consecutively recruited and psychosomatic syndromes were diagnosed with the Structured Interview for DCPR. Participants were asked to complete psychometric tests: Body Shape Questionnaire, Beck Depression Inventory, Eating Disorder Inventory-2, and Temperament and Character Inventory. Data were submitted to cluster analysis. RESULTS Illness denial (63%) and alexithymia (54.6%) resulted to be the most common syndromes in our sample. Cluster analysis identified three groups: moderate psychosomatic group (49%), somatization group (26%), and severe psychosomatic group (25%). The first group was mainly represented by AN-R patients reporting often only illness denial and alexithymia as DCPR syndromes. The second group showed more severe eating and depressive symptomatology and frequently DCPR syndromes of the somatization cluster. Thanatophobia DCPR syndrome was also represented in this group. The third group reported longer duration of illness and DCPR syndromes were highly represented; in particular, all patients were found to show the alexithymia DCPR syndrome. CONCLUSIONS These results highlight the need of a deep assessment of psychosomatic syndromes in AN. Psychosomatic syndromes correlated differently with both severity of eating symptomatology and duration of illness: therefore, DCPR could be effective to achieve tailored treatments.
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Affiliation(s)
- Giovanni Abbate-Daga
- Department of Neuroscience, Section of Psychiatry, Eating Disorders Centre, University of Turin, Turin, Italy.
| | - Nadia Delsedime
- Department of Neuroscience, Section of Psychiatry, Eating Disorders Centre, University of Turin, Turin, Italy
| | - Barbara Nicotra
- Department of Neuroscience, Section of Psychiatry, Eating Disorders Centre, University of Turin, Turin, Italy
| | - Cristina Giovannone
- Department of Neuroscience, Section of Psychiatry, Eating Disorders Centre, University of Turin, Turin, Italy
| | - Enrica Marzola
- Department of Neuroscience, Section of Psychiatry, Eating Disorders Centre, University of Turin, Turin, Italy
| | - Federico Amianto
- Department of Neuroscience, Section of Psychiatry, Eating Disorders Centre, University of Turin, Turin, Italy
| | - Secondo Fassino
- Department of Neuroscience, Section of Psychiatry, Eating Disorders Centre, University of Turin, Turin, Italy
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Rafanelli C, Offidani E, Gostoli S, Roncuzzi R. Psychological correlates in patients with different levels of hypertension. Psychiatry Res 2012; 198:154-60. [PMID: 22386218 DOI: 10.1016/j.psychres.2011.09.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 06/20/2011] [Accepted: 09/17/2011] [Indexed: 11/18/2022]
Abstract
The evidence linking essential systemic arterial hypertension (SAH) with psychological characteristics remains equivocal. The aims of this study were to assess clinical and subclinical distress, psychosocial aspects and psychological well-being in treated hypertensive patients and to evaluate the psychosocial variables associated with higher levels of blood pressure according to guidelines for hypertension management. A consecutive series of 125 hypertensive patients were evaluated using both self- and observer-rated reliable measures. Generalized anxiety disorder, minor depression, demoralization and alexithymia were the most frequent diagnoses. Cluster analysis revealed an association of three distinct symptomatological groups such as the Anxiety-Depression, the Alexithymia and the Somatization groups, with different levels of hypertension. In particular, patients with moderate to severe hypertension were more frequently in the Anxiety-Depression and the Alexithymia groups, whereas the Somatization cluster has been shown to be associated with isolated systolic hypertension. The results provide new insight into the psychosocial characteristics among patients with different levels of SAH according to recent guidelines of the management of hypertension. They also outline the need to monitor the clinical course of hypertensive patients characterized by these specific clinical and subclinical psychological conditions.
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Affiliation(s)
- Chiara Rafanelli
- Department of Psychology, University of Bologna, Bologna, Italy.
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Fava GA, Guidi J, Porcelli P, Rafanelli C, Bellomo A, Grandi S, Grassi L, Mangelli L, Pasquini P, Picardi A, Quartesan R, Rigatelli M, Sonino N. A cluster analysis-derived classification of psychological distress and illness behavior in the medically ill. Psychol Med 2012; 42:401-407. [PMID: 24438853 DOI: 10.1017/s0033291711001231] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The classification of psychological distress and illness behavior in the setting of medical disease is still controversial. Current psychiatric nosology does not seem to cover the spectrum of disturbances. The aim of this investigation was to assess whether the joint use of DSM-IV categories and the Diagnostic Criteria for Psychosomatic Research (DCPR), that provide identification of syndromes related to somatization, abnormal illness behavior, irritable mood, type A behavior, demoralization and alexithymia, could yield subtyping of psychosocial variables in the medically ill. METHOD A cross-sectional assessment using both DSM-IV and the DCPR was conducted in eight medical centers in the Italian Health System. Data were submitted to cluster analysis. Participants were consecutive medical out-patients and in-patients for whom a psychiatric consultation was requested. A total of 1700 subjects met eligibility criteria and 1560 agreed to participate. RESULTS Three clusters were identified: non-specific psychological distress, irritability and affective disturbances with somatization. CONCLUSIONS Two-step cluster analysis revealed clusters that were found to occur across clinical settings. The findings indicate the need of expanding clinical assessment in the medically ill to include the various manifestations of somatization, illness behavior and subclinical distress encompassed by the DCPR.
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Affiliation(s)
- G A Fava
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - J Guidi
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - P Porcelli
- Psychosomatic Unit, IRCCS De Bellis Hospital, Castellana Grotte, Bari, Italy
| | - C Rafanelli
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - A Bellomo
- Section of Psychiatry and Clinical Psychology, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - S Grandi
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - L Grassi
- Section of Psychiatry, Department of Medical Sciences of Communication and Behavior, University of Ferrara, Ferrara, Italy
| | - L Mangelli
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - P Pasquini
- Clinical Epidemiology Unit, Istituto Dermapatico dell'Immacolata (IDI-IRCCS), Roma, Italy
| | - A Picardi
- Mental Health Unit, Italian National Institute of Health Center of Epidemiology, Surveillance and Health Promotion, Roma, Italy
| | - R Quartesan
- Section of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy
| | - M Rigatelli
- Department of Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - N Sonino
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA
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Abstract
The Diagnostic Criteria for Psychosomatic Research (DCPR) represent a diagnostic and conceptual framework that aims to translate psychosocial variables derived from psychosomatic research into operational tools whereby individual patients can be identified. A set of 12 syndromes was developed: disease phobia, thanatophobia, health anxiety, illness denial, persistent somatization, functional somatic symptoms secondary to a psychiatric disorder, conversion symptoms, anniversary reaction, irritable mood, type A behavior, demoralization, and alexithymia. The aim of this article is to survey the research evidence that has accumulated on the DCPR in several clinical settings (cardiology, oncology, gastroenterology, endocrinology, primary care, consultation psychiatry, nutrition, and community), to examine prevalence and specific diagnostic clusters of the more prevalent DCPR syndromes, and to review their clinical utility in terms of clinical decision, prediction of psychosocial functioning, and treatment outcomes. The implications for classification purposes (DSM-V) are also discussed.
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