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Merlo EM, Tutino R, Myles LAM, Lia MC, Minasi D. Alexithymia, intolerance to uncertainty and mental health difficulties in adolescents with Type 1 diabetes mellitus. Ital J Pediatr 2024; 50:99. [PMID: 38755698 PMCID: PMC11100042 DOI: 10.1186/s13052-024-01647-4] [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: 07/20/2023] [Accepted: 04/07/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Type 1 Diabetes Mellitus (T1DM) represents a serious chronic condition affecting a wide number of people. Discussion of the physical issues associated with T1DM pervades the literature, however, there is less discussion of the psychological consequences. Mental health difficulties, alexithymia and uncertainty are present in this population, and known to be harmful for the onset, maintenance and worsening of T1DM. This study aimed to evaluate the presence of these phenomena in people with T1DM. METHODS 105 participants aged between 11 and 17 years old (M: 13.88; SD: 2.16) affected by T1DM were included in the sample. To assess the presence of mental health difficulties, SAFA scales (Depression, Anxiety and Somatic symptoms) were included in the protocol together with TAS-20 and IUS-12, which evaluate the presence and role of alexithymia and intolerance to uncertainty in the sample, respectively. RESULTS A concerning presence of anxiety, depression and somatic symptoms was found in the sample. Mental health difficulties appeared to be consistently present in the sample, often overcoming pathological thesholds. Alexithymia and uncertainty were also common, highlighting their role in T1DM. CONCLUSIONS Active mental health difficulties together with high rates of alexithymia and intolerance to uncertainty were prevalent in the sample of adolescents with diabetes.
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Affiliation(s)
- Emanuele Maria Merlo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
| | - Rita Tutino
- Pediatric Unit of Ospedali Riuniti Presidium, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | | | - Maria Carmela Lia
- Pediatric Unit of Ospedali Riuniti Presidium, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | - Domenico Minasi
- Pediatric Unit of Ospedali Riuniti Presidium, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio Calabria, Italy
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Berger K, Schiefner F, Rudolf M, Awiszus F, Junne F, Vogel M, Lohmann CH. Long-term effects of doping with anabolic steroids during adolescence on physical and mental health. ORTHOPADIE (HEIDELBERG, GERMANY) 2024:10.1007/s00132-024-04498-3. [PMID: 38653791 DOI: 10.1007/s00132-024-04498-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/13/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Systematic doping programs like in the GDR were applied in adolescent competitive athletes to induce supramaximal athletic performance. The substances had adverse somatic and psychological effects. The psychological development of the young athletes was impaired and they suffered in adulthood from long-term effects and secondary diseases even years after the doping period. METHOD The study compared three groups: competitive athletes with doping (I), competitive athletes without doping (II) and persons with no sports activities (III). Somatic and psychological diseases were analyzed to identify the adverse effects of doping in the most vulnerable phase of development in adolescence. Participants were asked to supply a patient history and completed a questionnaire with standardized psychological tests. RESULTS The doping cohort had a higher rate of somatic diseases, psychological disorders and social and professional difficulties. The differences were gender-specific with males more often having impaired liver function, depression, tumors and difficulties associated with the workplace . The doping group reported more emotional and physical neglect during childhood. They proved to be less optimistic but more pessimistic, to perceive less social support and to be more depressive. The study identified less extraversion and more neuroticism. Posttraumatic stress disorder (PTSD) occurred in a small number of participants in the doping group. Doping is associated with psychiatric variables. Predictors were the subscale identifying feelings of the Toronto alexithymia scale 20 (TAS-20), the sense of coherence and the Beck depression inventory 2 (BDI-II) and the Beck depression inventory (BDI). CONCLUSION Physical and psychosocial effects imply correlation with the application of doping substances but might not only be due to the side effects of these substances but also caused by the system, which exerts great psychological pressure and stress during adolescence, a highly vulnerable phase.
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Affiliation(s)
- K Berger
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany.
| | - F Schiefner
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - M Rudolf
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - F Awiszus
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - F Junne
- Department for Psychosomatic and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - M Vogel
- Department for Psychosomatic and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - C H Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
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Brugnera A, Remondi C, La Tona A, Nembrini G, Lo Coco G, Compare A, Cardinali A, Scollato A, Marchetti F, Bonetti M, Pigozzi MG. Quality of Life and Its Psychosocial Predictors among Patients with Disorders of Gut-Brain Interaction: A Comparison with Age- and Sex-Matched Controls. Healthcare (Basel) 2024; 12:757. [PMID: 38610179 PMCID: PMC11011672 DOI: 10.3390/healthcare12070757] [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: 12/29/2023] [Revised: 02/07/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
The disorders of gut-brain interaction (DGBIs) are a heterogeneous group of chronic conditions that greatly reduce patients' quality of life (QoL). To date, biopsychosocial factors (such as gastrointestinal symptoms, alexithymia, and interpersonal problems) are believed to contribute to the development and maintenance of DGBIs, but their role in affecting patients' QoL is still under investigation. Out of 141 patients seeking treatment for their gastrointestinal symptoms, 71 were diagnosed with a DGBI (47 females, 66.2%; Mage: 41.49 ± 17.23 years) and were age- and sex-matched to 71 healthy controls (47 females, 66.2%; Mage: 40.45 ± 16.38 years) without any current gastrointestinal symptom or diagnosis. Participants completed a sociodemographic and clinical questionnaire and a survey investigating several psychosocial risk factors. We found greater symptom severity and difficulties in identifying feelings among patients compared to controls. Further, multiple linear regression analyses evidenced that, among patients, higher expressive suppression of emotions, difficulties in identifying feelings and interpersonal problems, and a lower cognitive reappraisal of emotions predicted lower QoL. Data suggest that the QoL of patients with DGBIs is affected not only by common risk factors (e.g., interpersonal problems) but also by specific difficulties in processing and regulating emotions. The implications of these findings are discussed.
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Affiliation(s)
- Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy
| | - Chiara Remondi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Antonino La Tona
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy
| | - Greta Nembrini
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy
| | - Gianluca Lo Coco
- Department of Psychological Sciences, University of Palermo, 90133 Palermo, Italy
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy
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Martino G, Viola A, Vicario CM, Bellone F, Silvestro O, Squadrito G, Schwarz P, Lo Coco G, Fries W, Catalano A. Psychological impairment in inflammatory bowel diseases: the key role of coping and defense mechanisms. RESEARCH IN PSYCHOTHERAPY (MILANO) 2023; 26:731. [PMID: 38224215 PMCID: PMC10849073 DOI: 10.4081/ripppo.2023.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/09/2023] [Indexed: 01/16/2024]
Abstract
A comprehensive investigation of psychological features in chronic patients is very important for tailoring effective treatments. In this study we tested anxiety, depression, health related quality of life (HR-QoL), alexithymia, coping styles, and defense mechanisms, in eighty-four patients with Crohn disease (CD) and ulcerative colitis (UC). Participants reported low to moderate HRQoL and anxiety, apart from alexithymia. Women experienced lower QoL and higher levels of anxiety and depressive symptoms. Coping and defense strategies were related to distress symptoms and QoL. Positive attitude and principalization, showed negative associations with depression, anxiety and alexithymia and were also found to be associated with mental health. CD patients used significantly more turning against objects (p=0.02) and projections (p=0.01) and UC patients used more reversal (p=0.04). Elderly women showed higher anxiety symptoms and lower perceived QoL. Multiple regression analysis revealed anxiety and depression were independently associated with QoL. Significant differences emerged in defense styles among CD and UC. CD participants used more maladaptive coping and defense styles which were related to mental distress, depression and anxiety, together with higher level of alexithymia. Findings suggest that psychological aspects play a key role in mental health in patients suffering from inflammatory bowel diseases. A multi-integrated clinical strategy including psychotherapeutic interventions should be considered in treating CD and UC.
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Affiliation(s)
- Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina.
| | - Anna Viola
- Department of Clinical and Experimental Medicine, University of Messina.
| | - Carmelo Mario Vicario
- Department of Cognitive Science, Psychology, Education and Cultural Studies, University of Messina.
| | | | - Orlando Silvestro
- Department of Health Sciences, University Magna Graecia of Catanzaro.
| | - Giovanni Squadrito
- Department of Clinical and Experimental Medicine, University of Messina.
| | - Peter Schwarz
- Department of Endocrinology and Metabolism, Rigshospitalet, Copenhagen.
| | - Gianluca Lo Coco
- Psychological, Pedagogical, Exercise and Training Sciences, University of Palermo.
| | - Walter Fries
- Department of Clinical and Experimental Medicine, University of Messina.
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University of Messina.
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Boudabbous M, Issa AB, Feki I, Gdoura H, Chtourou L, Moalla M, Sallemi R, Mnif L, Amouri A, Masmoudi J, Tahri N. Alexithymia impairs quality of life in irritable bowel syndrome. Future Sci OA 2023; 9:FSO881. [PMID: 37753356 PMCID: PMC10518833 DOI: 10.2144/fsoa-2023-0068] [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: 04/27/2023] [Accepted: 06/27/2023] [Indexed: 09/28/2023] Open
Abstract
Aim Our objectives were to compare the frequency of alexithymia and the alteration of quality of life in irritable bowel syndrome (IBS) and to determine the factors associated with alexithymia and quality of life deterioration. Method This is a comparative study which collected 80 IBS patients and 80 controls. Results Quality of life was impaired in 75% of patients vs 37.5% (p < 0.0001). The prevalence of alexithymia was 50% in patients vs 1.2% (p < 0.0001). In multivariate analysis, an impaired quality of life was associated with alexithymia (p = 0.003). The factors associated with impaired quality of life were anxiety and alexithymia. Conclusion Alexithymia was present in half of patients with IBS and its was associated with impaired quality of life.
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Affiliation(s)
- Mona Boudabbous
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | | | - Ines Feki
- Phsychiatric Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Héla Gdoura
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Lassad Chtourou
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Manel Moalla
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Rim Sallemi
- Phsychiatric Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - leila Mnif
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Ali Amouri
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Jaweher Masmoudi
- Phsychiatric Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Nabil Tahri
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
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Torunsky NT, Knauz S, Vilares I, Marcoulides KM, Koutstaal W. What is the relationship between alexithymia and experiential avoidance? A latent analysis using three alexithymia questionnaires. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023; 214:112308. [PMID: 37637074 PMCID: PMC10455047 DOI: 10.1016/j.paid.2023.112308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Alexithymia is a clinically relevant personality trait characterized by poor emotional awareness and associated with several psychological and physical health concerns. Individuals with high alexithymia tend to engage in experiential avoidance and this may mediate psychological distress. However, little is known about what specific processes of experiential avoidance are involved, and the nature of the relation between alexithymia, experiential avoidance, and psychological distress remains unclear at a latent construct level. To examine this relationship at the latent construct level, a representative sample of 693 U.S. adults completed alexithymia (TAS-20, BVAQ, PAQ), general distress (DASS-21), multi-dimensional experiential avoidance (MEAQ), and general health (PROMIS-G-10) questionnaires. Structural equation modeling revealed that alexithymia significantly predicted experiential avoidance (β = 0.966, t = 82.383, p < .01), experiential avoidance significantly predicted general distress (β = 0.810, t = 2.017, p < .05), and experiential avoidance fully mediated the relationship between alexithymia and general distress (βindirect = -0.159, t = -0.398, p > .05). Correlations between alexithymia and experiential avoidance subfactors revealed a strong relationship to the repression and denial subfactor. Experiential avoidance is a promising target for clinical interventions, though longitudinal research is necessary to elucidate how the relationship between alexithymia and experiential avoidance unfolds over time.
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Affiliation(s)
| | - Sara Knauz
- Department of Psychology, University of Minnesota – Twin Cities, USA
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Silvestro O, Ricciardi L, Catalano A, Vicario CM, Tomaiuolo F, Pioggia G, Squadrito G, Schwarz P, Gangemi S, Martino G. Alexithymia and asthma: a systematic review. Front Psychol 2023; 14:1221648. [PMID: 37609491 PMCID: PMC10441120 DOI: 10.3389/fpsyg.2023.1221648] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/17/2023] [Indexed: 08/24/2023] Open
Abstract
Growing evidence from scientific research elucidates the important role of alexithymia in chronic immune diseases. This Review aims to explore the presence of alexithymia in patients affected by asthma and clarify its associations with other involved psychological and physical factors. In January 2023, according to PRISMA guidelines, a systematic search using PubMed and Scopus was conducted. Twenty-six studies were eligible based on inclusion criteria. Alexithymia was significantly present in asthma patients, with most studies reporting a higher prevalence (from 9 to 62.8%) than in control groups (approximately 10%). The coexistence of asthma and alexithymia was associated with a worse quality of life, psychiatric comorbidity, poor symptom control, and difficulty in recognizing exacerbations of the disease. These results suggest that alexithymia can negatively impact the management of asthma. For this reason, we recommend an accuracy assessment in clinical settings and the implementation of psychological interventions to promote the emotional and physical wellbeing of asthmatic patients.
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Affiliation(s)
- Orlando Silvestro
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Luisa Ricciardi
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Carmelo Mario Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
| | - Francesco Tomaiuolo
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Giovanni Squadrito
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Peter Schwarz
- Department of Endocrinology, Research Centre for Ageing and Osteoporosis, Rigshospitalet-Glostrup Hospital, Copenhagen, Denmark
| | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
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Germani A, Lopez A, Martini E, Cicchella S, De Fortuna AM, Dragone M, Pizzini B, Troisi G, De Luca Picione R. The Relationships between Compulsive Internet Use, Alexithymia, and Dissociation: Gender Differences among Italian Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6431. [PMID: 37510663 PMCID: PMC10379441 DOI: 10.3390/ijerph20146431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/23/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
Internet Gaming Disorder, Internet Addiction, Problematic Internet Use and Compulsive Internet Use cause distress and significant impairment in important areas of a person's functioning, in particular among young people. The literature has indicated that males show higher levels of problematic internet use than females. People can use the internet to avoid or alleviate negative affects; in fact, problematic internet use is associated with alexithymia and dissociation. Few studies have focused on the different stages of adolescence, gender differences, and the relationships between the aforementioned variables. This research aims to fill this gap. Five hundred and ninety-four adolescents aged between 13 and 19 filled in the Compulsive Internet Use Scale, the Toronto Alexithymia Scale, the Adolescents Dissociative Experiences Scale, and other ad hoc measures. Surprisingly, females reported higher compulsive internet use compared with males. Moreover, they referred more difficulties/symptoms and greater levels of alexithymia than males. No differences across the stages of adolescence were found. Different strengths in the relationships between variables were found according to gender. Moderated mediation analyses indicated that dissociation is an important mediator in the relation between alexithymia and Compulsive Internet Use only among females. This study shed new light on gender differences around problematic internet use and some related risk factors, in order to identify and develop prevention and treatment programs to face this topical and relevant issue.
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Affiliation(s)
| | - Antonella Lopez
- Faculty of Law, Giustino Fortunato University, 82100 Benevento, Italy
- Department of Educational Sciences, Psychology, Communication, University of Bari, 70122 Bari, Italy
| | - Elvira Martini
- Faculty of Law, Giustino Fortunato University, 82100 Benevento, Italy
| | - Sara Cicchella
- Faculty of Law, Giustino Fortunato University, 82100 Benevento, Italy
| | - Angelo Maria De Fortuna
- Department of Communication Sciences, Humanities and International Studies (DISCUI), University of Urbino, 61029 Urbino, Italy
| | - Mirella Dragone
- Faculty of Law, Giustino Fortunato University, 82100 Benevento, Italy
| | - Barbara Pizzini
- Faculty of Law, Giustino Fortunato University, 82100 Benevento, Italy
| | - Gina Troisi
- Faculty of Law, Giustino Fortunato University, 82100 Benevento, Italy
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Vinni E, Karaivazoglou K, Tourkochristou E, Tsounis E, Kalogeropoulou M, Konstantopoulou G, Lourida T, Kafentzi T, Lampropoulou E, Rodi M, Aggeletopoulou I, Diamantopoulou G, Theocharis G, Thomopoulos K, Gourzis P, Mouzaki A, Triantos C. Alexithymic characteristics and interoceptive abilities are associated with disease severity and levels of C-reactive protein and cytokines in patients with inflammatory bowel disease. Ann Gastroenterol 2023; 36:412-422. [PMID: 37396003 PMCID: PMC10304527 DOI: 10.20524/aog.2023.0813] [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: 09/11/2022] [Accepted: 05/12/2023] [Indexed: 07/04/2023] Open
Abstract
Background Alexithymia and atypical gut-brain signaling have been linked to the pathophysiology of inflammatory bowel disease (IBD). We herein assessed IBD patients' alexithymia levels and interoceptive abilities, and detected potential correlations with psychological distress, symptom severity and disease activity, and inflammation indices. Methods Adult IBD outpatients and healthy controls were recruited. Alexithymia was assessed using the Toronto Alexithymia Scale, interoceptive accuracy using the Heartbeat Counting Test (cardiac interoception) and the Water Load Test-II (gastric interoception), and interoceptive sensibility using the Multidimensional Assessment of Interoceptive Awareness (MAIA). Results Forty-one patients with Crohn's disease (CD), 16 with ulcerative colitis (UC), and 50 healthy controls were included. In CD patients, the level of externally oriented thinking and total alexithymia score were correlated with disease activity (P=0.027 and P=0.047, respectively), while in UC patients difficulties in identifying emotions were linked to disease activity (P=0.007). In CD patients, the Noticing, Not-Worrying and Emotional Awareness MAIA subscale score were correlated with C-reactive protein levels (P=0.005, P=0.048 and P=0.005), the Noticing subscale score with interleukin (IL)-1β levels (r=-0.350, P=0.039), the Not-Distracting subscale score with IL-6 levels (r=-0.402, P=0.017), and the Emotional Awareness subscale score with IL-1β (r=-0.367, P=0.030) and IL-6 (r=-0.379, P=0.025) levels. Finally, in UC patients, the Not-Worrying subscale score was significantly associated with IL-6 levels (r=-0.532, P=0.049), while difficulties in identifying emotions were linked to IL-8 levels (r=0.604, P=0.022). Conclusion Emotional and interoceptive processing is associated with IBD disease activity, suggesting a potential implication for IBD pathophysiology.
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Affiliation(s)
- Eleni Vinni
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Katerina Karaivazoglou
- Department of Psychiatry (Katerina Karaivazoglou, Maria Kalogeropoulou, Georgia Konstantopoulou, Philippos Gourzis)
| | - Evanthia Tourkochristou
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Efthymios Tsounis
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Maria Kalogeropoulou
- Department of Psychiatry (Katerina Karaivazoglou, Maria Kalogeropoulou, Georgia Konstantopoulou, Philippos Gourzis)
| | - Georgia Konstantopoulou
- Department of Psychiatry (Katerina Karaivazoglou, Maria Kalogeropoulou, Georgia Konstantopoulou, Philippos Gourzis)
| | - Theoni Lourida
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Theodora Kafentzi
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Efi Lampropoulou
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Maria Rodi
- Division of Hematology, Department of Internal Medicine, Medical School (Maria Rodi, Ioanna Aggeletopoulou, Athanasia Mouzaki), University of Patras, Greece
| | - Ioanna Aggeletopoulou
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
- Division of Hematology, Department of Internal Medicine, Medical School (Maria Rodi, Ioanna Aggeletopoulou, Athanasia Mouzaki), University of Patras, Greece
| | - Georgia Diamantopoulou
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Georgios Theocharis
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Konstantinos Thomopoulos
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Philippos Gourzis
- Department of Psychiatry (Katerina Karaivazoglou, Maria Kalogeropoulou, Georgia Konstantopoulou, Philippos Gourzis)
| | - Athanasia Mouzaki
- Division of Hematology, Department of Internal Medicine, Medical School (Maria Rodi, Ioanna Aggeletopoulou, Athanasia Mouzaki), University of Patras, Greece
| | - Christos Triantos
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
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Zhang H, Wang Y, Lou H, Zhu Y, Dong Z, Dong D, Chen P, Zhu X, Chen B, Zhang P. Prevalence of and factors associated with alexithymia among patients with chronic obstructive pulmonary disease in China: a cross-sectional study. BMC Pulm Med 2023; 23:40. [PMID: 36717796 PMCID: PMC9885611 DOI: 10.1186/s12890-023-02335-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/19/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Alexithymia is a common psychological disorder. However, few studies have investigated its prevalence and predictors in patients with chronic obstructive pulmonary disease (COPD). Therefore, we aimed to determine the prevalence and predictors of alexithymia in Chinese patients. METHODS This cross-sectional study included 842 COPD patients to assess the prevalence and predictors of alexithymia using the 20-item Toronto Alexithymia Scale (TAS-20). We used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression, the modified British Medical Research Council dyspnea Rating Scale (mMRC) to assess dyspnea, St. George's Respiratory Questionnaire (SGRQ) to assess quality of life, and the age-adjusted Charlson comorbidity index (ACCI) to assess comorbidities. Alexithymia-related predictors were identified using univariate and multivariate logistic regression analyses. RESULTS The prevalence of alexithymia in COPD patients was 23.6% (199/842). Multivariate analysis showed that age [odds ratio (OR) 0.886; 95% confidence interval (CI) 0.794-0.998], body mass index (OR 0.879; 95% CI 0.781-0.989), HADS-anxiety (OR 1.238; 95% CI 1.097-1.396), HADS-depression (OR 1.178; 95% CI 1.034-1.340), mMRC (OR 1.297; 95% CI 1.274-1.320), SGRQ (OR 1.627; 95% CI 1.401-1.890), ACCI (OR 1.165; 95% CI 1.051-1.280), and GOLD grade (OR 1.296; 95% CI 1.256-1.337) were independent predictors for alexithymia in patients with COPD. CONCLUSIONS The prevalence of alexithymia was high in Chinese COPD patients. Anxiety, depression, dyspnea, quality of life, comorbidities, and disease severity are independent risk factors, and age and BMI are predictive factors for alexithymia in COPD patients.
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Affiliation(s)
- Huaizhong Zhang
- grid.501121.6Department of Psychiatry, Xuzhou Cancer Hospital, Xuzhou, 221000 Jiangsu China
| | - Yixuan Wang
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221006 China
| | - Heqing Lou
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221006 China
| | - Yanan Zhu
- grid.413389.40000 0004 1758 1622Department of Respiratory Medicine of the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zongmei Dong
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221006 China
| | - Dong Dong
- grid.501121.6Department of Psychiatry, Xuzhou Cancer Hospital, Xuzhou, 221000 Jiangsu China
| | - Peipei Chen
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221006 China
| | - Xuan Zhu
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221006 China
| | - Bi Chen
- grid.413389.40000 0004 1758 1622Department of Respiratory Medicine of the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Pan Zhang
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221006 China
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Gori A, Topino E. The Association between Alexithymia and Social Media Addiction: Exploring the Role of Dysmorphic Symptoms, Symptoms Interference, and Self-Esteem, Controlling for Age and Gender. J Pers Med 2023; 13:jpm13010152. [PMID: 36675813 PMCID: PMC9865469 DOI: 10.3390/jpm13010152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Given the popularity of social media and the growing presence of these tools in the daily lives of individuals, research about the elements that can be linked to their problematic use appears to be of great importance. The objective of this study was to investigate the factors that may contribute to the levels of social media addiction, by focusing on the role of alexithymia, body image concern, and self-esteem, controlled for age and gender. A sample of 437 social media users (32.5% men, 67.5% women; Mage = 33.44 years, SD = 13.284) completed an online survey, including the Bergen Social Media Addiction Scale, Body Image Concern Inventory, Rosenberg Self-Esteem Scale, and Twenty-Item Toronto Alexithymia Scale, together with a demographic questionnaire. Results showed a significant association between alexithymia and social media addiction, with the total mediation of body image concern (and more in detail, body dissatisfaction) and the significant moderation of self-esteem. Gender and age showed significant effects in these relationships. Such findings may offer further insights into the field of clinical research on social media addiction and may provide useful information for effective clinical practice.
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Affiliation(s)
- Alessio Gori
- Department of Health Sciences, University of Florence, Via di San Salvi 12, Pad. 26, 50135 Firenze, Italy
- Integrated Psychodynamic Psychotherapy Institute (IPPI), Via Ricasoli 32, 50122 Florence, Italy
- Correspondence:
| | - Eleonora Topino
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina 21, 00193 Rome, Italy
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Benfante A, Romeo A. Alexithymia Among People Living with HIV: A Scoping Review. AIDS Behav 2022; 27:1926-1941. [PMID: 36367612 DOI: 10.1007/s10461-022-03926-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
Abstract
The present scoping review aimed to identify studies that investigated alexithymia, defined as a difficulty in identifying and describing one's own emotions, in people living with HIV (PLWH).A literature search, in line with the guidelines of PRISMA-ScR, was conducted in the following bibliographic databases: PubMed, PsycINFO, and Web of Science. The databases were queried using the following strings (using Boolean operators): ("alexithymia" OR "alexithymic") AND ("HIV" OR "Human Immunodeficiency Virus"). In line with the eligibility criteria, fourteen articles were found.Ten studies showed the involvement of alexithymia in disease severity (e.g., viral load levels), and adherence to antiretroviral therapy. Three studies revealed an association between alexithymia and cardiovascular disease, and three studies highlighted the implication of alexithymia in cognitive impairment.This review revealed the complex role of alexithymia in HIV disease. A careful clinical assessment of the emotional regulation process of PLWH can provide useful prognostic information.
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Affiliation(s)
- Agata Benfante
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Annunziata Romeo
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy.
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Pojatić Đ, Nikić D, Tolj I, Pezerović D, Šantić A, Degmečić D. Alexithymia, Phosphorus Levels, and Sleep Disorders in Patients on Hemodialysis. J Clin Med 2022; 11:jcm11113218. [PMID: 35683604 PMCID: PMC9181024 DOI: 10.3390/jcm11113218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/28/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023] Open
Abstract
Alexithymia, or the inability to distinguish between bodily feelings and emotions, has been linked to poor sleep quality in some studies. Rare studies examined the associations between electrolyte phosphorus in patients on hemodialysis and their sleep quality, daytime sleepiness, and alexithymia with inflammatory factors. Hemodialysis is a treatment method for terminal renal patients that involves the diffusion of unwanted metabolic products through the dialyzer membrane. Our study aimed to examine whether there was a difference in phosphorus levels, inflammatory factors, and daytime sleepiness according to the hemodialysis patients’ levels of alexithymia. The study involved 170 HD patients that had been treated with chronic dialysis for more than three months. Prior to the hemodialysis procedure, laboratory findings were sampled. Respondents completed the Pittsburgh Sleep Quality Index, the Toronto Alexithymia Scale 26, and the Epworth Sleepiness Scale, and were questioned about depression. The results showed that alexithymic HD patients exhibited significantly higher leukocyte counts, lower predialysis phosphorus values, and more pronounced daily sleepiness than the alexithymia-free group (Mann−Whitney U test, p = 0.02, p = 0.005, and p < 0.001, respectively). We concluded that alexithymia was an independent predictor of high daytime sleepiness in HD patients (OR = 1.05, 95% CI 1.02 to 1.09).
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Affiliation(s)
- Đorđe Pojatić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (Đ.P.); (I.T.); (D.P.); (A.Š.)
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Department of Internal Medicine, General County Hospital Vinkovci, 32 100 Vinkovci, Croatia
| | - Dajana Nikić
- Department of Plant Sciences, Faculty of Biosciences, Norwegian University of Life Sciences, P.O. Box 5003, N-1432 As, Norway;
| | - Ivana Tolj
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (Đ.P.); (I.T.); (D.P.); (A.Š.)
- Department of Internal Medicine, University Hospital Osijek, 31 000 Osijek, Croatia
| | - Davorin Pezerović
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (Đ.P.); (I.T.); (D.P.); (A.Š.)
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Department of Internal Medicine, General County Hospital Vinkovci, 32 100 Vinkovci, Croatia
| | - Andrijana Šantić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (Đ.P.); (I.T.); (D.P.); (A.Š.)
- Department of Psychiatry, University Hospital Osijek, 31 000 Osijek, Croatia
| | - Dunja Degmečić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (Đ.P.); (I.T.); (D.P.); (A.Š.)
- Department of Psychiatry, University Hospital Osijek, 31 000 Osijek, Croatia
- Correspondence: ; Tel.: +385-31-511794
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Bos P, Oude Voshaar RC, Hanssen DJC. Prevalence and correlates of alexithymia in older persons with medically (un)explained physical symptoms. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5736. [PMID: 35584287 PMCID: PMC9325002 DOI: 10.1002/gps.5736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/03/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Much is unknown about the combination of Medically Unexplained Symptoms (MUS) and alexithymia in later life, but it may culminate in a high disease burden for older patients. In the present study we assess the prevalence of alexithymia in older patients with either MUS or Medically Explained Symptoms (MES) and we explore physical, psychological and social correlates of alexithymia. METHODS AND DESIGN A case control study was performed. We recruited older persons (>60 years) with MUS (N = 118) or MES (N = 154) from the general public, general practitioner clinics and hospitals. Alexithymia was measured by the 20-item Toronto Alexithymia Scale, correlates were measured by various questionnaires. RESULTS Prevalence and severity of alexithymia were higher among older persons with MUS compared to MES. Alexithymia prevalence in the MUS subgroup was 23.7%. We found no association between alexithymia and increasing age. Alexithymia was associated with depressive symptoms, especially in the MUS population. CONCLUSIONS Alexithymia prevalence was lower than generally found in younger patients with somatoform disorder, but comparable to studies with similar diagnostic methods for MUS. Considering the high prevalence and presumed etiological impact of alexithymia in older patients with MUS, as well as its association with depression, this stresses the need to develop better understanding of the associations between alexithymia, MUS and depression in later life.
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Affiliation(s)
- Pauline Bos
- Department of PsychiatryUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
| | - Richard C. Oude Voshaar
- Department of PsychiatryUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
| | - Denise J. C. Hanssen
- Department of PsychiatryUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
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Esmael A, Belal T, Amer IF, Samra E, Elmongui A, Shawki S. Predictive value of P300 event-related potential component in early cognitive impairment in patients with uncomplicated newly diagnosed hepatitis C virus. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00450-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cognitive impairment in patients with hepatitis C virus (HCV) is reported in the early onset of HCV infection without hepatic cirrhosis or marked liver impairment. Methods currently available to identify the risk for early cognitive impairment in hepatitis C virus (HCV) infection do not combine enough sensitivity and specificity. The present study aimed to evaluate the P 300 components of event-related potential (ERP) abnormalities as valid biomarkers for prediction and diagnosis of the cognitive impairment in newly diagnosed hepatitis C virus infection. This study is a case–control involved fifty patients newly diagnosed HCV and fifty age and sex-matched healthy controls. Assessments of cognitive functions were carried out by the Mini-mental State Examination, Wechsler Memory Scale Revised short form, and The Wechsler Adult Intelligence Scale, in addition to estimation of the amplitude and the latency of the P300 by the event-related potentials.
Results
Neuropsychological scales suggested the early incidence of cognitive impairment among hepatitis C virus patients. The electrophysiological study showed significant prolongation of P300 latency and decreased amplitude in HCV patients group compared with the control group. A binary logistic regression detected that P 300 latency ≥ 369 ms was significantly accompanied by a threefold increased risk of impaired cognition (OR 3.09, 95% CI 1.59–5.72, P < 0.01), while P 300 amplitude ≤ 8.2 μv was significantly accompanied by a twofold increased risk of impaired cognition (OR 2.18, 95% 1.43–4.05, P < 0.01).
Conclusion
This study concluded that the P300 event-related potentials components are valid biomarker as easy, noninvasive assessment and cost-effective method of early cognitive impairment in patients with uncomplicated newly diagnosed hepatitis C virus.
Registration of Clinical Trial Research
ClinicalTrials.gov ID: NCT04389268. https://clinicaltrials.gov/ct2/show/NCT04389268
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Rady A, Alamrawy RG, Ramadan I, El Raouf MA. Prevalence of Alexithymia in Patients with Medically Unexplained Physical Symptoms: A Cross-sectional Study in Egypt. Clin Pract Epidemiol Ment Health 2021; 17:136-145. [PMID: 34880925 PMCID: PMC8595980 DOI: 10.2174/1745017902117010136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is a high incidence of alexithymia in people who report medically unexplained symptoms. There have been limited studies on the prevalence of alexithymia in patients with medically unexplained physical symptoms (MUPS) in various ethnic and cultural backgrounds. OBJECTIVE This study aimed to estimate the prevalence of alexithymia in patients with MUPS and examine their socio-demographic data. METHODS In this cross-sectional study, 196 patients with MUPS were recruited from tertiary care internal medicine and neuropsychiatry clinics during the first quarter of 2019. Patients completed a structured interview; socio-demographic and medical history data were collected. Somatic symptom severity was assessed using the Arabic version of the Patient Health Questionnaire (PHQ-15). Alexithymia was assessed using the Arabic version of the Toronto Alexithymia Scale. RESULTS General fatigue was the most common complaint observed, followed by headache and dyspepsia. In addition, 73.5% of patients had a high Patient Health Questionnaire score, 17.9% had somatic symptoms of medium severity, while 8% and 0.5% had low and marginal somatic symptoms, respectively. Alexithymia was presented in 49.5%, 22.9% had no alexithymia, and 27.6% had borderline/intermediate alexithymia.A weak positive correlation (r<0.4) was found between somatic symptom severity and alexithymic psychopathology (r=0.277;p<0.05). Only the 'difficulty identifying feelings' dimension of alexithymic psychopathology was positively correlated with the severity of somatic symptoms (r=0.271;p<0.05). CONCLUSION Alexithymia is associated with the development of MUPS.
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Affiliation(s)
- Ahmed Rady
- Department of Psychiatry, Alexandria University, School of Medicine, Alexandria, Egypt
| | - Roa Gamal Alamrawy
- Mamoura Psychiatric Hospital, Secretariat of Mental Health and Addiction Treatment, Alexandria, Egypt
| | - Ismail Ramadan
- Department of Neurology, Alexandria University School of Medicine, Alexandria, Egypt
| | - Mervat Abd El Raouf
- Department of Neurology, Alexandria University School of Medicine, Alexandria, Egypt
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Berens S, Schaefert R, Ehrenthal JC, Baumeister D, Gauss A, Eich W, Tesarz J. The Validity of Somatic Symptom Disorder in Patients With Gastrointestinal Complaints. J Clin Gastroenterol 2021; 55:e66-e76. [PMID: 33780221 DOI: 10.1097/mcg.0000000000001505] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/15/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND GOAL The current diagnostic concept of somatic symptom disorder (SSD) aims to capture psychological burden due to bodily complaints independent of the medical cause. The aim of this study was to compare patients with chronic gastrointestinal (GI) complaints with SSD (SSD+) and without SSD (SSD-) along sociodemographic, clinical, and psychological characteristics. STUDY This cross-sectional study included 199 patients (n=92 SSD+ and n=107 SSD-) with distressing and chronic abdominal/lower GI complaints (≥6 mo) recruited from several primary, secondary, and tertiary medical care units. SSD+ patients were separated from SSD- patients by psychobehavioral positive criteria. Psychological distress (somatization, depression, anxiety, and illness anxiety) and risk factors (adverse childhood experiences, insecure attachment, mentalizing capacity, and levels of personality functioning) were measured. Nonparametric group comparisons were performed to analyze the differences of sociodemographic, clinical, and psychological characteristics between SSD+ and SSD- patients. RESULTS About half of the SSD+ patients had a functional GI disorder and a third had an inflammatory bowel disease. SSD+ patients reported higher GI pain severity, higher health-related and work-related impairment, and higher psychological distress, especially illness anxiety, as well as higher mentalizing and personality functioning deficits. CONCLUSIONS Overall, psychobehavioral positive criteria of SSD seem to be a valid identifier of patients exhibiting a high psychological burden, independent of the medical explanation of the GI complaints. There is a substantial overlap of SSD and general mental burden, but also evidence for a specific disease entity.
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Affiliation(s)
- Sabrina Berens
- Institute of Psychology
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg University
| | - Rainer Schaefert
- Department of Psychosomatic Medicine, Division of Internal Medicine, University Hospital Basel
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | | | - David Baumeister
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg University
| | - Annika Gauss
- Department of Gastroenterology and Hepatology, University Hospital Heidelberg, Heidelberg
| | - Wolfgang Eich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg University
| | - Jonas Tesarz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg University
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Tian P, Ma Y, Hu J, Zhou C, Liu X, Chen Q, Dang H, Zou H. Clinical and psychobehavioral features of outpatients with somatic symptom disorder in otorhinolaryngology clinics. J Psychosom Res 2021; 148:110550. [PMID: 34175726 DOI: 10.1016/j.jpsychores.2021.110550] [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: 07/18/2020] [Revised: 06/14/2021] [Accepted: 06/14/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE In the Otorhinolaryngology Department, patients exhibiting somatic symptoms without a medical cause are frequently neglected and left untreated. The aim of this study was to characterize the psychosomatic features of outpatients with somatic symptom disorder (SSD) to better identify patients needing treatment. METHODS This cross-sectional study enrolled 883 consecutive patients with medically unexplained symptoms. A semistructured clinical interview was employed to confirm the diagnosis of SSD. Data, including sociodemographic and clinical measures, were collected. The Patient Health Questionnaire-15 (PHQ-15) and Somatic Symptom Scale-China (SSS-CN) were used to assess the severity of somatic symptoms; the Patient Health Questionnaire-9 (PHQ-9) was used to assess depression; the General Anxiety Disorder-7 (GAD-7) was used to assess anxiety; and the 12-item Short-form Health Survey (SF-12) was used to assess quality of life (QoL). RESULTS Based on the DSM-5 criteria, 641 patients were placed in the SSD group, and 212 were placed in the normal group. Compared with the normal group, the SSD group had significantly more doctor visits, longer symptom durations, higher GAD-7 and PHQ-9 scores, and lower physical composite scores (PCSs) and mental composite scores (MCSs). Spearman's correlation analysis and multiple linear regression analyses showed that the SSS-CN score, PHQ-15 score and the patient's subjective feeling that his or her daily life was affected by the disorder were significant risk factors for low PCSs; the SSS-CN, PHQ-15, PHQ-9, and GAD-7 scores were independent risk factors for low MCSs. CONCLUSION Our findings demonstrated that SSD patients are not rare in otorhinolaryngology clinics in China and that their QoL is significantly affected by SSD. Otolaryngologists should thoroughly evaluate these patients from the perspective of psychosomatic medicine.
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Affiliation(s)
- Peng Tian
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Haizhu District, Guangzhou, Guangdong 510120, People's Republic of China
| | - Yun Ma
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Haizhu District, Guangzhou, Guangdong 510120, People's Republic of China
| | - Junwu Hu
- Department of Psychology, School of Public Health, Southern Medical University, No. 1023. South Shatai Road, Baiyun District, Guangzhou, Guangdong 510515, People's Republic of China
| | - Chao Zhou
- Guangzhou Psychiatric Hospital, No. 36, Ming Xin Road, Fangcun, Liwan District, Guangzhou, Guangdong 510120, People's Republic of China
| | - Xiang Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Haizhu District, Guangzhou, Guangdong 510120, People's Republic of China
| | - Qiujian Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Haizhu District, Guangzhou, Guangdong 510120, People's Republic of China
| | - Hua Dang
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Haizhu District, Guangzhou, Guangdong 510120, People's Republic of China.
| | - Hua Zou
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Haizhu District, Guangzhou, Guangdong 510120, People's Republic of China.
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Zhang X, Bai X, Bian L, Wang M. The influence of personality, alexithymia and work engagement on burnout among village doctors in China: a cross-sectional study. BMC Public Health 2021; 21:1507. [PMID: 34348678 PMCID: PMC8335472 DOI: 10.1186/s12889-021-11544-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 07/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In China, as the "gatekeepers"of rural residents' health, the primary-level village doctors, play a very crucial role in ensuring and serving the health level of rural residents. However, the burnout of village doctors is gravely threatening the stability of rural primary medical system step by step. This study systematically evaluated the effects of personality, work engagement and alexithymia on burnout of village doctors, and further measured and assessed the mediating effect of alexithymia and work engagement in the association between personality and burnout. METHODS The subjects were 2684 village doctors in Jining, Shandong Province, China, from May to June 2019. Sociodemographic characteristics, alexithymia, personality, work engagement and job burnout were quantitated by self-completed questionnaire and measured by Likert 5-7 scale. One-way ANOVA, Person correlation analysis, and Structural Equation Modelling (SEM) were used for statistical analysis and mediating effect evaluation. RESULTS 2693 questionnaires were collected in total, of which 2684 were valid, with an effective rate of 96.2%. 65.2% of village doctors were diagnosed with burnout, and 54.3% showed moderate to severe emotional exhaustion, 61.6% showed moderate to severe low sense of personal achievement, and 33.9% showed moderate to severe depersonalization burnout. Personality had a direct positive effect on work engagement (β = 0.50, p < 0.001), a direct negative effect on alexithymia (β = - 0.52, p < 0.001) and burnout (β = - 0.50, p < 0.001) respectively. Work engagement had a direct negative effect on burnout (β = - 0.10, p < 0.001), while alexithymia had a direct positive effect on burnout (β = 0.16, p < 0.001). In the path between personality and burnout, both work engagement 95%CI:(- 0.17)-(- 0.08), and alexithymia 95%CI:(- 0.36)-(- 0.09), have significant mediating effects. These results strongly confirm that personality, alexithymia, and work engagement are early and powerful predicators of burnout. CONCLUSION According to the results, medical administrators should pay attention to the personality characteristics of village doctors in vocational training, practice selection and job assignment, encourage village doctors to reflect on their own personality actively, and to reduce job burnout by obtaining necessary social support, constructing reasonable achievable career expectations, improving time management ability, and participating in psychological counselling programs.
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Affiliation(s)
- Xuewen Zhang
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067 China
| | - Xue Bai
- School of the First Clinical Medicine, Jining Medical University, Jining, 272067 China
| | - Liyan Bian
- School of the First Clinical Medicine, Jining Medical University, Jining, 272067 China
| | - Min Wang
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067 China
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Systematic Review of Alexithymia in the Population of Hemodialysis Patients. J Clin Med 2021; 10:jcm10132862. [PMID: 34203282 PMCID: PMC8268782 DOI: 10.3390/jcm10132862] [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: 05/10/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022] Open
Abstract
Alexithymia is a construct defined as the inability to differentiate between emotional experiences and bodily sensations. According to existing knowledge, alexithymia may have a major effect on the process of treatment and the outcome of the hemodialysis disease. The objective of this literature review was to determine the significance that alexithymia has for compliance and variables of clinical and mental health in the population of hemodialysis patients. For the above purpose, bibliographic databases “MEDLINE” and “Web of Science” were searched. The matrix method was used in analysis of articles. Searching both databases resulted in 248 articles. After applying exclusion and inclusion criteria, we included results of 13 articles in the literature review. The results of the search are findings regarding the prevalence and correlation of alexithymia with variables of clinical and mental health in hemodialysis patients. Alexithymia is significantly more common in the population of hemodialysis patients, and it has a negative effect on their mental and somatic health. Alexithymia levels in hemodialysis patients are more pronounced in cases where there is a greater number of comorbidities. Alexithymia is the predictor of high mortality rate in the population of hemodialysis patients, independent of other comorbidities.
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21
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Ancona A, Petito C, Iavarone I, Petito V, Galasso L, Leonetti A, Turchini L, Belella D, Ferrarrese D, Addolorato G, Armuzzi A, Gasbarrini A, Scaldaferri F. The gut-brain axis in irritable bowel syndrome and inflammatory bowel disease. Dig Liver Dis 2021; 53:298-305. [PMID: 33303315 DOI: 10.1016/j.dld.2020.11.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 02/06/2023]
Abstract
Research increasingly demonstrates the bidirectional communication between gut microbiota and the brain, enhancing the role of gut microbiota modulation in the treatment of central nervous system (CNS) disorders. The first five years of life are extremely important as it affects the development of gut microbiota, immune system and, consequently, the onset of psychometric alterations, particularly in genetically predisposed individuals. In this review, we focus on the link between specific microbial genera, gastrointestinal (GI) disorders, anxiety and depression and on the effects of different therapeutic strategies for mood disorders on gut microbiota.
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Affiliation(s)
- Angela Ancona
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze Mediche e Chirurgiche, 00168 Roma, Italia
| | - Claudia Petito
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Unità Operativa Semplice di Psicologia Clinica Ospedaliera, 00168 Roma, Italia
| | - Irene Iavarone
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze Mediche e Chirurgiche, 00168 Roma, Italia
| | - Valentina Petito
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Dipartimento di Medicina e Chirurgia Traslazionale, 00168 Roma, Italia.
| | - Linda Galasso
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze Mediche e Chirurgiche, 00168 Roma, Italia
| | - Alessia Leonetti
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze Mediche e Chirurgiche, 00168 Roma, Italia
| | - Laura Turchini
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze Mediche e Chirurgiche, 00168 Roma, Italia
| | - Daniela Belella
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Unità Operativa Semplice di Psicologia Clinica Ospedaliera, 00168 Roma, Italia
| | - Daniele Ferrarrese
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Unità Operativa Semplice di Psicologia Clinica Ospedaliera, 00168 Roma, Italia
| | - Giovanni Addolorato
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze Mediche e Chirurgiche, 00168 Roma, Italia; Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Dipartimento di Medicina e Chirurgia Traslazionale, 00168 Roma, Italia
| | - Alessandro Armuzzi
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze Mediche e Chirurgiche, 00168 Roma, Italia; Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Dipartimento di Medicina e Chirurgia Traslazionale, 00168 Roma, Italia
| | - Antonio Gasbarrini
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze Mediche e Chirurgiche, 00168 Roma, Italia; Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Dipartimento di Medicina e Chirurgia Traslazionale, 00168 Roma, Italia
| | - Franco Scaldaferri
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze Mediche e Chirurgiche, 00168 Roma, Italia; Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Dipartimento di Medicina e Chirurgia Traslazionale, 00168 Roma, Italia
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22
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Kreiter D, Drukker M, Mujagic Z, Vork L, Rutten BPF, van Os J, Masclee AAM, Kruimel JW, Leue C. Symptom-network dynamics in irritable bowel syndrome with comorbid panic disorder using electronic momentary assessment: A randomized controlled trial of escitalopram vs. placebo. J Psychosom Res 2021; 141:110351. [PMID: 33412422 DOI: 10.1016/j.jpsychores.2020.110351] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/15/2020] [Accepted: 12/22/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Momentary ecological assessment indicated alleviated abdominal pain in escitalopram treatment of irritable bowel syndrome (IBS) with comorbid panic disorder. Hitherto, little is known about symptom formation, i.e., how psychological impact physical symptoms, and vice versa, and about the effect of SSRI-treatment on symptom formation. OBJECTIVE To investigate how psychological and somatic symptoms co-vary over time in IBS patients with comorbid panic disorder and how they are affected by escitalopram treatment. METHODS Experience sampling data from 14 IBS patients with panic disorder were obtained from a single-centre, double-blind, parallel-group, randomized controlled trial on escitalopram versus placebo. At baseline, after three and six months, multilevel time-lagged linear regression analysis was used to construct symptom networks. Network connections represented coefficients between various affect and gastrointestinal items. RESULTS Connectivity increased up to 3 months in both groups. Between 3 and 6 months, connectivity decreased for placebo and further increased in the escitalopram group. Additionally, a steep increase in node strength for negative affect nodes was observed in the escitalopram network and the opposite for positive affect nodes. Over time, group symptom networks became increasingly different from each other. Anxious-anxious and enthusiastic-relaxed became significantly different between groups at 6 months. The connection that changed significantly in all analyses was anxious-anxious. CONCLUSIONS Escitalopram treatment was associated with changes in the symptom networks in IBS patients with panic disorder. While mood and physical symptoms improve over time, mainly connectivity between mood nodes changed, possibly pointing towards a healthier emotion regulation resulting in alleviation of physical symptoms.
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Affiliation(s)
- Daniël Kreiter
- Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Marjan Drukker
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Zlatan Mujagic
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, the Netherlands
| | - Lisa Vork
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, the Netherlands
| | - Bart P F Rutten
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Ad A M Masclee
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, the Netherlands
| | - Joanna W Kruimel
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, the Netherlands
| | - Carsten Leue
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, the Netherlands.
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23
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Wagner-Skacel J, Dalkner N, Bengesser S, Ratzenhofer M, Fink N, Kahn J, Pilz R, Mörkl S, Lenger M, Fazekas C, Matzer F, Butler M, Reininghaus EZ, Müller H, Kniepeiss D. COVID-19 Pandemic Stress-Induced Somatization in Transplant Waiting List Patients. Front Psychiatry 2021; 12:671383. [PMID: 34295270 PMCID: PMC8291906 DOI: 10.3389/fpsyt.2021.671383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/31/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has resulted in widespread socioeconomic restrictions including quarantine, social distancing and self-isolation. This is the first study investigating the psychological impact of the pandemic on patients waiting for liver or kidney transplantation, a particularly vulnerable group. Methods: Twenty-seven patients on the transplantation waiting list and 43 healthy controls took part in an online survey including the Beck Depression Inventory (BDI-2), the Brief Symptom Inventory-18 (BSI-18), the Pittsburgh Sleep Quality Index (PSQI), the Alcohol Use Identification Test (AUDIT-C), the 12-item Operationalized Psychodynamic Diagnosis Structure Questionnaire (OPD-SQS) and a questionnaire to determine cognitions and beliefs, attitude and fear related to COVID-19. Results: BSI-18 Somatization was increased in waiting list patients compared to controls. Correlation analyses indicated a relationship between Somatization and the fear of contracting the coronavirus in the patient group; however this association was weak. In patients and controls, other psychologicial symptoms (depression, anxiety) correlated highly with emotional distress due to social distancing. There were no differences between patients and controls in depression scores and sleep disturbances. Alcohol consumption and personality structure were not related to COVID-19 fears. Conclusion: In times of the first lockdown during the COVID-19 pandemic, patients on the transplantation waiting list have high somatization symptoms associated with COVID-19 fears. As vulnerable group, they need psychological counseling to improve mental well-being during times of crisis.
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Affiliation(s)
- Jolana Wagner-Skacel
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Michaela Ratzenhofer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Nadja Fink
- General, Visceral and Transplant Surgery, Medical University of Graz, Graz, Austria
| | - Judith Kahn
- General, Visceral and Transplant Surgery, Medical University of Graz, Graz, Austria.,Transplant Center Graz, Graz, Austria
| | - Rene Pilz
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Sabrina Mörkl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Christian Fazekas
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Franziska Matzer
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Mary Butler
- Department of Psychiatry, University College Cork, Cork, Ireland
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Helmut Müller
- General, Visceral and Transplant Surgery, Medical University of Graz, Graz, Austria.,Transplant Center Graz, Graz, Austria
| | - Daniela Kniepeiss
- General, Visceral and Transplant Surgery, Medical University of Graz, Graz, Austria.,Transplant Center Graz, Graz, Austria
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24
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Porcelli P, De Carne M, Leandro G. Distinct associations of DSM-5 Somatic Symptom Disorder, the Diagnostic Criteria for Psychosomatic Research-Revised (DCPR-R) and symptom severity in patients with irritable bowel syndrome. Gen Hosp Psychiatry 2020; 64:56-62. [PMID: 32199282 DOI: 10.1016/j.genhosppsych.2020.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/26/2020] [Accepted: 03/09/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The clinical management of high symptom severity is a challenging task with patients with functional somatic disorders. We investigated the extent to which DCPR-revised (DCPR-R) syndromes and the DSM-5 category of Somatic Symptom Disorder (SSD) were able to predict symptom severity in 203 consecutive tertiary care patients with irritable bowel syndrome (IBS). METHOD Semistructured interview were used for assessing DCPR-R and validated scales for SSD (combining PHQ-12 and WI-7), severity of symptoms (IBS-SSS), psychological distress (HADS), and psychosocial functioning (SF-12). RESULTS Compared to moderate severity (IBS-SSS = 175-300), patients in the high range of severity (IBS-SSS > 300) had significantly more DCPR-R syndromes (particularly alexithymia and persistent somatization), higher psychological distress, and poorer psychosocial functioning, but showed no difference for SSD. DCPR-R, particularly alexithymia and persistent somatization, significantly and independently predicted IBS severity by explaining 18.5% of the IBS-SSS variance with large effect size (d = 1.18), after controlling for covariables. Conversely, SSD was not able to significantly predict IBS severity. CONCLUSIONS This study highlights the need of an integrative approach in the medical setting. Psychosomatic factors play a relevant role in the individual perception of symptom severity and should be carefully evaluated for clinical management of functional syndromes.
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Affiliation(s)
- Piero Porcelli
- Department of Psychological, Health, and Territorial Sciences, University of Chieti, Italy.
| | - Massimo De Carne
- Department of Gastroenterology, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Castellana Grotte, Italy
| | - Gioacchino Leandro
- Department of Gastroenterology, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Castellana Grotte, Italy
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25
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Xu X, Zhang Y, Wang W, Zhang Y, Yang N. Effects of Patients' Perceptions of Physician-Patient Relational Empathy on an Inflammation Marker in Patients with Crohn's Disease: The Intermediary Roles of Anxiety, Self-Efficacy, and Sleep Quality. Psychol Res Behav Manag 2020; 13:363-371. [PMID: 32425624 PMCID: PMC7196771 DOI: 10.2147/prbm.s221435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 02/11/2020] [Indexed: 01/14/2023] Open
Abstract
Background Physician-patient empathy is inextricably linked with outcomes of patients. The purpose of this study was to test whether anxiety, self-efficacy, and sleep quality played intermediary roles in relationships between patients' perceptions of physician-patient relational empathy and an inflammation marker in Crohn's disease patients. Methods The study included 187 patients. At admission (T1) and 3 months after admission (T2), anxiety, self-efficacy, sleep, and the inflammatory marker IL6 of patients were tested and compared. Patients' perceptions of physician-patient relational empathy (CARE scale) was measured at T2. Correlations among patients' anxiety, self-efficacy, sleep quality, IL6, and CARE scores were explored by Pearson's correlation analysis and a structural equation model. Results Compared with T1, patients showed higher self-efficacy and sleep quality and lower anxiety and IL6 at T2. Patients' perceptions of physician-patient relational empathy were negatively related to anxiety and IL6 and connected to self-efficacy and sleep quality positively. Patients' anxiety, self-efficacy, and sleep quality played intermediary roles incorrelations between empathy and IL6. Conclusion In correlations of patients' perceptions of physician-patient relational empathy and IL6 in patients with Crohn's disease, patients' anxiety, self-efficacy, and sleep quality acted as intermediary effects. Therefore, medical staff should empathize with patients.
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Affiliation(s)
- Xianlin Xu
- Department of Gastroenterology, Huiyang Sanhe Hospital, Huizhou, Guangdong, People's Republic of China
| | - Yan Zhang
- College of Humanities and Social Sciences, Harbin Engineering University, Harbin, Heilongjiang, People's Republic of China
| | - Wei Wang
- School of Health Sciences, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Yin Zhang
- Department of Gastroenterology, Huiyang Sanhe Hospital, Huizhou, Guangdong, People's Republic of China
| | - Ningxi Yang
- College of Humanities and Social Sciences, Harbin Engineering University, Harbin, Heilongjiang, People's Republic of China
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26
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Neuroimaging Findings in Chronic Hepatitis C Virus Infection: Correlation with Neurocognitive and Neuropsychiatric Manifestations. Int J Mol Sci 2020; 21:ijms21072478. [PMID: 32252497 PMCID: PMC7177498 DOI: 10.3390/ijms21072478] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/26/2020] [Accepted: 03/31/2020] [Indexed: 01/18/2023] Open
Abstract
Chronic hepatitis C virus (HCV) infection is commonly associated with neurocognitive dysfunction, altered neuropsychological performance and neuropsychiatric symptoms. Quantifiable neuropsychological changes in sustained attention, working memory, executive function, verbal learning and recall are the hallmark of HCV-associated neurocognitive disorder (HCV-AND). This constellation is at variance with the neuropsychological complex that is seen in minimal hepatic encephalopathy, which is typified by an array of alterations in psychomotor speed, selective attention and visuo-constructive function. Noncognitive symptoms, including sleep disturbances, depression, anxiety and fatigue, which are less easily quantifiable, are frequently encountered and can dominate the clinical picture and the clinical course of patients with chronic HCV infection. More recently, an increased vulnerability to Parkinson’s disease among HCV-infected patients has also been reported. The degree to which neurocognitive and neuropsychiatric changes are due to HCV replication within brain tissues or HCV-triggered peripheral immune activation remain to be determined. Without absolute evidence that clearly exonerates or indicts HCV, our understanding of the so-called “HCV brain syndrome”, relies primarily on clinical and neuropsychological assessments, although other comorbidities and substance abuse may impact on neurocognitive function, thus confounding an appropriate recognition. In recent years, a number of functional and structural brain imaging studies have been of help in recognizing possible biological markers of HCV-AND, thus providing a rationale for guiding and justifying antiviral therapy in selected cases. Here, we review clinical, neuroradiological, and therapeutic responses to interferon-based and interferon-free regimens in HCV-related cognitive and neuropsychiatric disorder.
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27
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Settineri S, Frisone F, Alibrandi A, Merlo EM. Emotional Suppression and Oneiric Expression in Psychosomatic Disorders: Early Manifestations in Emerging Adulthood and Young Patients. Front Psychol 2019; 10:1897. [PMID: 31481915 PMCID: PMC6710394 DOI: 10.3389/fpsyg.2019.01897] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 08/01/2019] [Indexed: 01/08/2023] Open
Abstract
Background The function of emotions, beginning from the proto-emotions, is the adaptation to the environment. This is based on the Homeorhesis, the equilibrium due to the adaptive operation of excitement and the dissipation of emotions. The object relations of the participants foresee the practice of defense mechanisms in a continuum that goes from the consciousness to the oneiric activities. The predominant and maladaptive use of defense mechanisms in the psychosomatic phenomenology, can be identified with deficits in emotional awareness, with the impossibility to manage excitement and dissipation of emotions foreseen by the oneiric phenomena. Methods The observation group is composed by 140 participants, 56 males (43%) and 84 females (57%),with pathological-functional disorders of psychosomatic domain. The study had been conducted with the use of measures related to the conscious defense of suppression (Suppression Mental Questionnaire), to the emotional awareness linked to the psychosomatic phenomena (Diagnostic Criteria for Psychosomatic Research Structured Interview-DCPR-SI) and to the states of perturbation and conservation of oneiric activities (The Manheim Dream Questionnaire-MADRE). Results Significant inverse correlations emerged among rationalization, repressive function and illness Denial, as for the suppression mental questionnaire factors and irritable mood, but for Regression in the service of the Ego; inverse and significant correlations emerged among suppression, repressive function, rationalization and gastrointestinal psychosomatic outcomes and among suppression, repression and cardiological psychosomatic outcomes. Regarding alexithymia, a positive correlation emerged with rationalization and inverse with Regression in the service of the Ego. Positive correlations emerged between illness denial and overall emotional tone, for disease phobia and meaningfulness and for cardiological psychosomatic outcomes and nightmare distress and recurring nightmares. Conclusion The study of such outcomes due to a prevalent defensive style based on suppression, suggest the identification of a key phenomenon, which translates into maladjustment that goes from functional disorders to parasomnia. The bridge established by the obfuscation of conscious contents until the manifestations of disturbance of ancient activities such as oneiric ones, expresses the need to transform an emotional maladaptive style, in line with classic literature and the current state of art.
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Affiliation(s)
- Salvatore Settineri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Fabio Frisone
- Department of Cognitive Sciences, Psychology, Educational and Cultural Studies (COSPECS), University of Messina, Messina, Italy.,CRISCAT (International Research Center for Theoretical and Applied Cognitive Sciences) University of Messina and Universitary Consortium of Eastern Mediterranean, Noto (CUMO), University of Messina, Messina, Italy
| | - Angela Alibrandi
- Department of Economics, Unit of Statistical and Mathematical Sciences, University of Messina, Messina, Italy
| | - Emanuele Maria Merlo
- Department of Cognitive Sciences, Psychology, Educational and Cultural Studies (COSPECS), University of Messina, Messina, Italy.,CRISCAT (International Research Center for Theoretical and Applied Cognitive Sciences) University of Messina and Universitary Consortium of Eastern Mediterranean, Noto (CUMO), University of Messina, Messina, Italy
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28
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Li SH, Wu QF. Emotional dysfunction and inflammatory bowel disease. Shijie Huaren Xiaohua Zazhi 2019; 27:727-733. [DOI: 10.11569/wcjd.v27.i12.727] [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: 02/06/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a group of inflammatory conditions which arise as a result of the interactions of susceptible genetic factors, environment, and intestinal microbiota, which lead to abnormal immunological responses and inflammation in the colon and small intestine. The exact pathogenesis of IBD is still unclear. Studies have shown that the existence of emotional dysfunction such as depression or anxiety contributes to the onset and development of IBD. It has been proposed that emotional changes may mediate or influence the gut microbiota-brain axis, thereby influencing intestinal motility, hormone secretion, and immunity, aggravating the intestinal immune inflammatory response, and increasing the clinical symptoms and recurrent risk of IBD. Giving psychological treatments when necessary will be beneficial to patients with IBD. In this paper, we discuss the relationship between emotional dysfunction and IBD.
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Affiliation(s)
- Si-Hui Li
- College of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China,Institute of Acupuncture and Internal Steady State Adjustment, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
| | - Qiao-Feng Wu
- College of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China,Institute of Acupuncture and Internal Steady State Adjustment, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
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29
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Schauer B, Grabe HJ, Ittermann T, Lerch MM, Weiss FU, Mönnikes H, Völzke H, Enck P, Schwille-Kiuntke J. Irritable bowel syndrome, mental health, and quality of life: Data from a population-based survey in Germany (SHIP-Trend-0). Neurogastroenterol Motil 2019; 31:e13511. [PMID: 30444067 DOI: 10.1111/nmo.13511] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/08/2018] [Accepted: 10/17/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is associated with reduced quality of life and high healthcare costs. This study aimed to assess the prevalence and risk factors for IBS in a general adult population. METHODS The Study of Health in Pomerania (SHIP) is a population-based cohort study in northeastern Germany. SHIP-Trend-0 participants enrolled from 2008 to 2012 were grouped according to Rome III criteria (main criteria: abdominal discomfort or crampy or bloating pain for at least six months plus 2/3 additional criteria). Factors associated with IBS were assessed using survey-weighted backward stepwise logistic regression. KEY RESULTS The final data set included 4194 records. IBS prevalence was 3.5% (3.0%-4.2%). Unemployment (OR: 2.02, 1.26-3.21), headaches (OR: 2.37, 1.59-3.52), mental quality of life (OR: 0.95 per unit increase, 0.93-0.97), and interactions between gender and physical quality of life (P = 0.004) and gender and alexithymia (P = 0.002) predicted IBS probability. The model resulted in a good discrimination (area under the curve = 75.4%) and model fit (F = 0.72, P = 0.69). History of depression (OR: 2.77, 1.94-3.95), back pain (OR: 2.38, 1.69-3.35), early trauma (OR: 1.03, 1.02-1.04), and duration of inpatient treatment within the last twelve months (OR: 1.02, 1.01-1.04) lost their significance in multivariable analysis. CONCLUSIONS & INFERENCES IBS prevalence was relatively low compared to other studies. Factors predicting IBS were of biological, psychological, and social nature. The association between IBS and pain in different areas of the body indicates a potential underlying complex somatic symptom disorder.
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Affiliation(s)
- Birgit Schauer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Markus M Lerch
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Frank U Weiss
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | | | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Paul Enck
- Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Juliane Schwille-Kiuntke
- Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
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