1
|
Matsuda Y, Hasuo H, Narita K, Matsuoka H, Morita R, Kiuchi D, Ikari T, Hori T, Okazaki K, Sakai K, Aiki S, Okabayashi H, Oyamada S, Ariyoshi K, Tokoro A, Fukunaga M. Relationship between dyspnoea and related factors in patients with cancer: a cross-sectional study. BMJ Support Palliat Care 2024; 13:e1126-e1132. [PMID: 38557730 DOI: 10.1136/bmjspcare-2021-003484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 04/15/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Dyspnoea is a common and distressing symptom in patients with cancer. We aimed to analyse the association between dyspnoea and related factors and to estimate their causal relationship. METHODS A cross-sectional study was conducted. Patients with cancer with dyspnoea and a mean Numerical Rating Scale (NRS) of ≥3 over 24 hours were enrolled at 10 institutions in Japan from December 2019 to February 2021. The outcomes included dyspnoea, cough and pain NRS over 24 hours, Eastern Cooperative Oncology Group Performance Status, Hospital Anxiety and Depression Scale, Somatosensory Amplification Scale, opioids for dyspnoea and respiratory failure. Path analyses were conducted to estimate the direct and indirect paths with reference to dyspnoea and related factors. RESULTS A total of 209 patients were enrolled and 208 patients were included in the analysis. Cough worsened dyspnoea (β=0.136), dyspnoea increased emotional distress (β=1.104), emotional distress increased somatosensory amplification (β=0.249) and somatosensory amplification worsened cough (β=0.053) according to path analysis. CONCLUSION There may be a vicious circle among dyspnoea and related factors: cough worsened dyspnoea, dyspnoea increased emotional distress, emotional distress increased somatosensory amplification and somatosensory amplification worsened cough. When treating dyspnoea in patients with cancer, managing these factors aimed at interrupting this vicious circle may be useful. TRIAL REGISTRATION NUMBER UMIN Clinical Trials Registry (UMIN000038820).
Collapse
Affiliation(s)
- Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan
| | - Keiichi Narita
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ryo Morita
- Department of Respiratory Medicine, Akita Kosei Medical Center, Akita, Japan
| | - Daisuke Kiuchi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Tomoo Ikari
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tetsuo Hori
- Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Koya Okazaki
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Kiyohiro Sakai
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine Hospital, Osakasayama, Japan
| | - Sayo Aiki
- Department of Palliative Care, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Hiroko Okabayashi
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | | | | | - Akihiro Tokoro
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Mikihiko Fukunaga
- Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan
| |
Collapse
|
2
|
Functional ear symptoms referred to an otology clinic: incidence, co-morbidity, aetiological factors and a new experience-driven clinical model. J Laryngol Otol 2023; 137:143-150. [PMID: 35801310 DOI: 10.1017/s0022215122001530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE This study aimed to review the incidence and co-morbidity of functional ear symptoms in new referrals to an adult otology clinic and present a clinical model based on neuroscientific concepts. METHOD This was a retrospective review of 1000 consecutive new referrals to an adult otology clinic. RESULTS Functional disorder was the primary diagnosis in 346 patients (34.6 per cent). Functional ear symptoms included tinnitus (69.7 per cent), imbalance (23.7 per cent), otalgia (22.8 per cent) and aural fullness (19.1 per cent), with more than one symptom occurring in 25.1 per cent of patients. Co-morbidities included sensorineural hearing loss (39 per cent), emotional stress (30 per cent) and chronic illness (22 per cent). CONCLUSION Functional disorders commonly present to the otology clinic, often in the presence of emotional stress or chronic illness. They occur because of adaptation of brain circuitry to experience, including adverse events, chronic illness and fear learning. This study presented an experience-driven clinical model based on these concepts. An understanding of these principles will significantly aid otolaryngologists who encounter patients with functional ear symptoms.
Collapse
|
3
|
Kim HJ, Shin SY, Jeong SH. Nature and Extent of Physical Comorbidities Among Korean Patients With Mental Illnesses: Pairwise and Network Analysis Based on Health Insurance Claims Data. Psychiatry Investig 2022; 19:488-499. [PMID: 35753688 PMCID: PMC9233950 DOI: 10.30773/pi.2022.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/29/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The nature of physical comorbidities in patients with mental illness may differ according to diagnosis and personal characteristics. We investigated this complexity by conventional logistic regression and network analysis. METHODS A health insurance claims data in Korea was analyzed. For every combination of psychiatric and physical diagnoses, odds ratios were calculated adjusting age and sex. From the patient-diagnosis data, a network of diagnoses was constructed using Jaccard coefficient as the index of comorbidity. RESULTS In 1,017,024 individuals, 77,447 (7.6%) were diagnosed with mental illnesses. The number of physical diagnoses among them was 11.2, which was 1.6 times higher than non-psychiatric groups. The most noticeable associations were 1) neurotic illnesses with gastrointestinal/pain disorders and 2) dementia with fracture, Parkinson's disease, and cerebrovascular accidents. Unexpectedly, the diagnosis of metabolic syndrome was only scarcely found in patients with severe mental illnesses (SMIs). However, implicit associations between metabolic syndrome and SMIs were suggested in comorbidity networks. CONCLUSION Physical comorbidities in patients with mental illnesses were more extensive than those with other disease categories. However, the result raised questions as to whether the medical resources were being diverted to less serious conditions than more urgent conditions in patients with SMIs.
Collapse
Affiliation(s)
- Ho Joon Kim
- Department of Psychiatry, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - Sam Yi Shin
- Department of Psychiatry, The Healer's Hospital, Busan, Republic of Korea
| | - Seong Hoon Jeong
- Department of Psychiatry, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea
| |
Collapse
|
4
|
Blakey SM, Halverson TF, Evans MK, Patel TA, Hair LP, Meyer EC, DeBeer BB, Beckham JC, Pugh MJ, Calhoun PS, Kimbrel NA. Experiential avoidance is associated with medical and mental health diagnoses in a national sample of deployed Gulf War veterans. J Psychiatr Res 2021; 142:17-24. [PMID: 34314990 PMCID: PMC8429252 DOI: 10.1016/j.jpsychires.2021.07.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/17/2021] [Accepted: 07/21/2021] [Indexed: 12/14/2022]
Abstract
A substantial minority of deployed Gulf War veterans developed posttraumatic stress disorder (PTSD), depression, and several chronic illnesses. Although military combat and exposure to certain nuclear, biological, and chemical agents (NBCs) increase risk for post-deployment health problems, they do not fully explain many Gulf War veteran health diagnoses and are not viable treatment targets. Experiential avoidance (EA; one's unwillingness to remain in contact with unpleasant internal experiences) is a modifiable psychosocial risk factor associated with PTSD and depression in veterans as well as pain and gastrointestinal diseases in the general population. In this study, we recruited a national sample of deployed Gulf War veterans (N = 454) to test the hypothesis that greater EA would be significantly associated with higher lifetime odds of PTSD, depression, "Gulf War Illness" (GWI/CMI), and other chronic illnesses common in this veteran cohort. Participants completed a self-report battery assessing demographic, military-related, and health-related information. Multivariate analyses showed that after adjusting for age, sex, race, combat exposure, and NBC exposure, worse EA was associated with higher lifetime odds of PTSD, depression GWI/CMI, gastrointestinal problems, irritable bowel syndrome, arthritis, fibromyalgia, and chronic fatigue syndrome (ORs ranged 1.25 to 2.89; effect sizes ranged small to large), but not asthma or chronic obstructive pulmonary disease. Our findings suggest medical and mental health providers alike should assess for EA and potentially target EA as part of a comprehensive, biopsychosocial approach to improving Gulf War veterans' health and wellbeing. Study limitations and future research directions are also discussed.
Collapse
Affiliation(s)
- Shannon M Blakey
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA.
| | - Tate F Halverson
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA.
| | - Mariah K Evans
- Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| | - Tapan A Patel
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA.
| | - Lauren P Hair
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| | - Eric C Meyer
- University of Pittsburgh Department of Rehabilitation Science and Technology, 4028 Forbes Tower, Pittsburgh, PA, 15260, USA.
| | - Bryann B DeBeer
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center, 1700 N Wheeling St, G-3-116M, Aurora, CO, 80045, USA; Department of Physical Medicine and Rehabilitation, Anschutz Medical Campus, University of Colorado, 12631 E 17th Ave, Aurora, CO, 80045, USA.
| | - Jean C Beckham
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| | - Mary J Pugh
- VA Salt Lake City Healthcare System, 500 Foothill Dr, Salt Lake City, UT, 84148, USA; University of Utah School of Medicine Department of Medicine, 30 N. 1900 E, Salt Lake City, UT, 84132, USA.
| | - Patrick S Calhoun
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| | - Nathan A Kimbrel
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| |
Collapse
|
5
|
DEMİR B, AKALTUN MS, ALTINDAĞ Ö, KARAOGLAN H, ALTINDAĞ A, GÜRSOY S, GÜR A. Anxiety, health anxiety and somatosensory amplification levels in individuals with carpal tunnel syndrome with normal electromyography. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.903677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
6
|
Çolak B, Eken A, Kuşman A, Sayar Akaslan D, Kızılpınar SÇ, Çakmak IB, Bal NB, Münir K, Öner Ö, Baskak B. The relationship of cortical activity induced by pain stimulation with clinical and cognitive features of somatic symptom disorder: A controlled functional near infrared spectroscopy study. J Psychosom Res 2021; 140:110300. [PMID: 33248397 DOI: 10.1016/j.jpsychores.2020.110300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The neurobiological correlates of Somatic Symptom Disorder (SSD) introduced in the DSM-5 has been the focus of a limited investigation. We aimed to examine the cortical response to painful stimuli and its relationship to symptom severity as well as cognitive and psychological characteristics in proposed models of somatoform disorders. METHODS We measured hemodynamic responses by 52-channel functional near-infrared spectroscopy. We compared the cortical response to painful stimuli in index patients with SSD (N = 21) versus age, and gender matched healthy control subjects (N = 21). We used brush stimulation as the control condition. We analyzed the relationship of cortical activity with SSD symptom severity as well as somatosensory amplification (SSA), alexithymia, dysfunctional illness behaviour, worry, and neuroticism. RESULTS Patients with SSD had higher somatic symptom severity, SSA, alexithymia, neuroticism, illness-related worry, and behaviour. Somatic symptom severity was predicted by a model including SSA and subjective feeling of pain in the index patients. Activity in the left-angular and right-middle temporal gyri was higher in the SSD subjects than the controls during pain stimulation. Positive correlations were detected between mean pain threshold levels and left middle occipital gyrus activity, as well as between SSA-scores and right-angular gyrus activity during pain condition in the index patients with SSD. CONCLUSION We present the first evidence that representation of pain in terms of cortical activity is different in subjects with SSD than healthy controls. SSA has functional neuroanatomic correlates and predicts symptom severity in SSD and therefore is involved as a valid intermediate phenotype in SSD pathophysiology.
Collapse
Affiliation(s)
- Burçin Çolak
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
| | - Aykut Eken
- Pompeu Fabra University, Center for Brain and Cognition, Barcelona, Spain
| | - Adnan Kuşman
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
| | - Damla Sayar Akaslan
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
| | | | - Işık Batuhan Çakmak
- University of Health Sciences, Ankara City Hospital, Department of Psychiatry, Ankara, Turkey
| | - Neşe Burcu Bal
- University of Health Sciences, Ankara Oncology Hospital, Department of Psychiatry, Ankara, Turkey
| | - Kerim Münir
- Harvard Medical School, Developmental Medicine Center, Boston Children's Hospital, Boston, USA
| | - Özgür Öner
- Bahçeşehir University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey
| | - Bora Baskak
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara, Turkey; Ankara University Brain Research Center (AUBAUM), Ankara, Turkey; Neuroscience and Neurotechnology Center of Excellence (NÖROM), Ankara, Turkey.
| |
Collapse
|
7
|
The PAP-NAP one decade later: patient risk factors, indications, and clinically relevant emotional and motivational influences on PAP use. Sleep Breath 2020; 24:1427-1440. [DOI: 10.1007/s11325-019-01988-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/12/2019] [Accepted: 11/29/2019] [Indexed: 01/02/2023]
|
8
|
Cengiz GF, Sacmaci H, Aktürk T, Hacimusalar Y. Comparison of patients with migraine and tension-type headache in terms of somatosensory amplification and health anxiety. ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:768-774. [PMID: 31826132 DOI: 10.1590/0004-282x20190132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/19/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Although it is known that anxiety and depressive disorders frequently accompany migraine and TTH, the role of somatic amplification (SSA) and health anxiety in these diseases is not adequately known. OBJECTIVE The aim of this study is to compare SSA and health anxiety in patients with migraine or TTH, and healthy controls and to investigate the relationships between SSA, health anxiety, headache characteristics, anxiety and depressive symptoms. METHODS Fifty-four migraine, 50 TTH patients from the outpatient unit of the neurology department and 53 healthy volunteers were recruited for the study. The somatosensory amplification scale (SSAS), health anxiety inventory, Beck depression (BDI) and anxiety inventory (BAI) were administered to all participants. RESULTS The SSAS scores were significantly higher in migraineurs compared with the healthy controls. The health anxiety scores were significantly higher in both migraine and TTH groups. The BDI and BAI scores were also significantly higher in migraine and TTH groups compared with the controls. A significant positive correlation was found between headache frequency and BAI scores, the visual analogue scale scores and SSAS and BDI scores in migraineurs. The SSAS scores were also significantly correlated with the BDI and BAI scores in both of the headache groups. A similar correlation was determined with the health anxiety scores. CONCLUSIONS While patients with migraine and TTH evalute, taking into account the SSA and health anxiety may contribute to the prognosis and treatment of these diseases.
Collapse
Affiliation(s)
- Gül Ferda Cengiz
- Bozok Üniversites Tip Fakültesi, Psikiyatri Anabilim Dali, Yozgat, Turkey
| | - Hikmet Sacmaci
- Bozok Üniversites Tip Fakültesi, Nöroloji Anabilim Dali, Yozgat, Turkey
| | - Tülin Aktürk
- Bozok Üniversites Tip Fakültesi, Nöroloji Anabilim Dali, Yozgat, Turkey
| | - Yunus Hacimusalar
- Bozok Üniversites Tip Fakültesi, Psikiyatri Anabilim Dali, Yozgat, Turkey
| |
Collapse
|
9
|
Nakao M. Somatic manifestation of distress: clinical medicine, psychological, and public health perspectives. Biopsychosoc Med 2017; 11:33. [PMID: 29270213 PMCID: PMC5735955 DOI: 10.1186/s13030-017-0119-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 11/08/2017] [Indexed: 01/14/2023] Open
Affiliation(s)
- Mutsuhiro Nakao
- Teikyo University Graduate School of Medicine, Tokyo, Japan
- Division of Psychosomatic Medicine, Teikyo University Hospital, Tokyo, Japan
| |
Collapse
|