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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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Xu L, Shi J, Li C. Addressing psychosomatic symptom distress with mindfulness-based cognitive therapy in somatic symptom disorder: mediating effects of self-compassion and alexithymia. Front Psychiatry 2024; 15:1289872. [PMID: 38384594 PMCID: PMC10879322 DOI: 10.3389/fpsyt.2024.1289872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024] Open
Abstract
Objective This study explored the association between self-compassion, alexithymia, and psychosomatic symptom distress in a clinical sample of somatic symptom disorder (SSD) patients participating in a mindfulness-based cognitive therapy (MBCT) program. Methods One hundred sixteen SSD patients who had participated in an MBCT program and completed ≥4 intervention sessions were included in a retrospective study (76.7% women, mean age = 40.0, SD = 9.5). Psychometric measures of psychosomatic symptom distress [Brief Symptom Inventory-18 Global Severity Index (BSI-GSI)], self-compassion [Self-Compassion Scale (SCS)], and alexithymia [Toronto Alexithymia Scale (TAS)] were collected upon admission to the MBCT program and at 6-month follow-up following treatment inclusion. Results Serial mediation analysis (MBCT→ΔSCS→ΔTAS→ΔBSI-GSI) suggested that changes in both self-compassion and alexithymia had significant indirect effects on improvement in psychosomatic distress [ΔSCS β = -1.810, 95% bootstrap CI (-2.488, -1.160); ΔTAS β = -1.615, bootstrap 95% CI (-2.413, -0.896); ΔSCS→ΔTAS β = -0.621, bootstrap CI (-1.032, -0.315)]. Furthermore, a post-hoc analysis with a reverse sequence (MBCT→ΔTAS→ΔSCS→ΔBSI-GSI) revealed that reduction in alexithymia improved psychosomatic distress and that an increase in self-compassion was a subsequent outcome of alleviation of alexithymia [ΔTAS β = -2.235, bootstrap 95% CI (-3.305, -1.270); ΔSCS β = 0.013, 95% bootstrap CI (-0.600, 0.682); ΔTAS→ΔSCS β = -1.823, bootstrap CI (-2.770, -1.047)]. Conclusion Both alleviation of alexithymia and improvement in self-compassion play a mediating role in the reduction of psychosomatic distress in SSD patients following an MBCT program. Improvement in self-compassion might be a subsequent outcome of MBCT-related alleviation of alexithymia.
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Affiliation(s)
- Lianrong Xu
- Department of Pain Management, Jinxiang Hospital Affiliated to Jining Medical University, Jining, China
| | - Jihong Shi
- Department of Consultation Psychology, Jining First People's Hospital, Jining, China
| | - Chengwen Li
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Alkhowaiter SS, Alshahrani AH, Almarzouqi HF, Alonazi GK, Alhawassi TM, AlRasheed MM. Feasibility, and barriers to use escitalopram in functional gastrointestinal disorders. Front Pharmacol 2023; 14:1131354. [PMID: 37284319 PMCID: PMC10240913 DOI: 10.3389/fphar.2023.1131354] [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: 01/11/2023] [Accepted: 04/28/2023] [Indexed: 06/08/2023] Open
Abstract
Background and study aims: The feasibility and barriars of escitalopram use in patients with functional gastrointestinal disorders (FGIDs) are still debated. We aimed to evaluate the feasibility, safety and efficacy and barriars of escitalopram use in managing FGIDs in the Saudi population. Patients and Methods: We included 51 patients who received escitalopram for irritable bowel syndrome (n = 26), functional heartburn (n = 10), globus sensation (n = 10) or combined disorders (n = 5). We used an irritable bowel syndrome-severity scoring system IBS-SSS), GerdQ questionnaire and Glasgow Edinburg Throat Scale (GETS) to assess disease severity change before and after treatment. Results: The median age was 33 years (25th- 75th percentiles: 29-47), and 26 (50.98%) were males. Forty-one patients experienced side effects (80.39%), but most side effects were mild. The most common side effects were drowsiness/fatigue/dizziness (54.9%), xerostomia (23.53%), nausea/vomiting (21.57%) and weight gain (17.65%). IBS-SSS was 375 (255-430) and 90 (58-205) before and after treatment, respectively (p < 0.001). GerdQ score was 12 (10-13) before treatment and 7 (6-10) after treatment (p = 0.001). GETS score before treatment was 32.5 (21-46) and after treatment became 22 (13-31) (p = 0.002). Thirty-five patients refused to take the medications, and seven patients discontinued the medication. Possible causes of the poor compliance were fear of the medications and not being convinced of taking psychiatric medications for functional disorders (n = 15). Conclusion: Escitalopram could be a safe and effective treatment for functional gastrointestinal disorders. Targeting and managing factors leading to poor compliance could further improve the treatment outcome.
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Affiliation(s)
- Saad S. Alkhowaiter
- Department of Medicine- Gastroenterology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amani H. Alshahrani
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Hala F. Almarzouqi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Gadah K. Alonazi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Tariq M. Alhawassi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Maha M. AlRasheed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Yan L, Zhang X, Li Y, Liu C, Yang H, Yang C. The role of psychological factors in functional gastrointestinal disorders: a systematic review and meta-analysis. Int J Colorectal Dis 2023; 38:65. [PMID: 36894717 DOI: 10.1007/s00384-023-04333-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2023] [Indexed: 03/11/2023]
Abstract
PURPOSE To systematically reevaluate the role of psychological factors in functional gastrointestinal disorders (FGIDs) and thus provide a scientific basis for the psychological treatment of FGIDs. METHODS A literature search was conducted using the PubMed, Embase, Web of Science, and Cochrane Library databases from January 2018 to August 2022 for researches on psychological factors affecting patients with functional gastrointestinal disorders. Meta-analysis was carried out with Stata17.0 after the screening, extraction, and evaluation of article quality. RESULTS The search included 22 articles with 2430 patients in the FGIDs group and 12,397 patients in the healthy controls. Meta-analysis showed anxiety [(pooled SMD = 0.74, 95%CI: 0.62 ~ 0.86, p < 0.000) (pooled OR = 3.14, 95%CI: 2.47 ~ 4.00, p < 0.000)], depression [(pooled SMD = 0.79, 95%CI: 0.63 ~ 0.95, p < 0.000) (pooled OR = 3.09, 95%CI: 2.12 ~ 4.52, p < 0.000)], mental disorders (pooled MD = -5.53, 95%CI: -7.12 ~ -3.95, p < 0.05), somatization (pooled SMD = 0.92, 95%CI: 0.61 ~ 1.23, p < 0.000), and sleep disorders (pooled SMD = 0.69, 95%CI: 0.04 ~ 1.34, p < 0.05) are risk factors for functional gastrointestinal disorders. CONCLUSION There is a significant association between psychological factors and FGIDs. Interventions such as anti-anxiety drugs, antidepressants, and behavioral therapy are of great clinical significance in reducing FGIDs risk and improving prognosis.
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Affiliation(s)
- Liyanran Yan
- School of Public Health, Hebei Medical University, Hebei, China
| | - Xueli Zhang
- Department of Gastroenterology, The First Hospital of Hebei Medical University, Donggang Road 89, Shijiazhuang, 050031, Hebei, China
| | - Yan Li
- Student Career Center, Peking University, Beijing, China
| | - Chengjiang Liu
- Department of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, Anhui, China
| | - Hua Yang
- Department of Pulmonary and Critical Care Medicine, Henan Province People's Hospital, Henan, China
| | - Chunchun Yang
- Department of Gastroenterology, The First Hospital of Hebei Medical University, Donggang Road 89, Shijiazhuang, 050031, Hebei, China.
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Symptom perceptions in functional disorders, major health conditions, and healthy controls: A general population study. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e7739. [DOI: 10.32872/cpe.7739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 08/14/2022] [Indexed: 12/24/2022] Open
Abstract
Background
The present study investigated differences in symptom perceptions between individuals with functional disorders (FD), major health conditions, and FDs + major health conditions, respectively, and a group of healthy individuals. Furthermore, it investigated the relevance of FDs among other health-related and psychological correlates of symptom perceptions in the framework of the Common Sense Model of Self-Regulation (CMS).
Method
This cross-sectional study used epidemiological data from the Danish Study of Functional Disorders part two (N = 7,459 participants, 54% female, 51.99 ± 13.4 years). Symptom perceptions were assessed using the Brief Illness Perception Questionnaire (B-IPQ) and compared between the four health condition groups. Multiple regression analyses were performed to examine associations between symptom perceptions, FDs, and other health-related and psychological correlates from the CMS framework.
Results
Individuals with FDs (n = 976) and those with FDs + major health conditions (n = 162) reported less favorable symptom perceptions compared to the other two groups, particularly regarding perceived consequences, timeline, and emotional representations (effect size range Cohen’s d = 0.12-0.66). The presence of a FD was significantly associated with all B-IPQ items, even in the context of 16 other relevant health-related and psychological correlates from the CMS framework, whereas symptom presence last year or last week was not.
Conclusion
In the general population, symptom perceptions seem to play a more salient role in FD than in individuals with well-defined physical illness. Symptom perceptions should therefore be targeted in both primary and secondary interventions for FDs.
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Liu Y, Liu W, Ma Y, Yang X, Zhou H, Zhang T, Shao S. Research on body image cognition, social support and illness perception in breast cancer patients with different surgical methods. Front Psychol 2022; 13:931679. [PMID: 36211874 PMCID: PMC9540219 DOI: 10.3389/fpsyg.2022.931679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
In parallel with the rapid rise in breast cancer incidence, there is also a noticeable rise in the number of patients who experience persistent negative body image cognition after breast cancer surgery. This study aimed to explore the differences in illness perception, social support, and body image cognition among breast cancer patients with different surgical methods, and the correlation, regression, and mediation among the three variables. The Brief Illness Perception Questionnaire (BIPQ), the Social Support Rating Scale (SSRS) and the Body Image Cognition after Breast Cancer Questionnaire (BIBCQ) were used to evaluate breast cancer patients’ illness perception, social support and body image cognition. Data analyses were performed by descriptive statistics, independent samples t-test, analysis of variance (ANOVA), Pearson correlation, and linear regression. The mediation was explored by the PROCESS V3.3. The study found that breast cancer patients undergoing radical mastectomy (RM) and modified radical mastectomy (MRM) demonstrated more negative illness perception, body image cognition, and lower social support compared with the patients receiving nipple-sparing mastectomy (NSM; p < 0.05). The subscale cognitive representation (CR) of BIPQ was strongly positively correlated with BIBCQ (p < 0.05). Illness perception positively predicted body image cognition (p < 0.01), while social support negatively predicted body image cognition. Social support partially mediated illness perception and body image cognition, exhibiting a positive role in post-operative body image cognition.
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Affiliation(s)
- Yuhan Liu
- Department of Medical Psychology, Binzhou Medical University, Yantai, Shandong, China
- The First School of Clinical Medicine of Binzhou Medical University, Binzhou, Shandong, China
| | - Wanli Liu
- Department of Medical Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Yinglu Ma
- Department of Breast Surgery, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Xiaoyue Yang
- Department of Medical Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Han Zhou
- Department of Psychology, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Tingting Zhang
- Department of Medical Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Shuhong Shao
- Department of Medical Psychology, Binzhou Medical University, Yantai, Shandong, China
- *Correspondence: Shuhong Shao,
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Woodham A, David AL, Cooper M, Cordwell J. The experiences of adolescents diagnosed with functional gastrointestinal disorders: An interpretative phenomenological analysis. Clin Child Psychol Psychiatry 2022; 27:336-350. [PMID: 34852661 DOI: 10.1177/13591045211055077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The aim of this study was to provide a qualitative perspective of adolescents' experiences of functional gastrointestinal disorders. In-depth semi structured interviews were conducted with eleven adolescents aged 11-16. The transcripts were analysed using Interpretative Phenomenological Analysis. Three superordinate themes were identified: 1) The journey to diagnosis: the good, the bad and the unknown; 2) Making sense of 'functional': the search for meaning; and 3) To share or conceal?: the impact of anticipated stigma on peer disclosure. The themes highlighted a complex process of meaning-making, with limited information about their diagnosis impacting on approaches to self-management and peer disclosure. Findings suggest adolescents would benefit from developmentally appropriate information and resources about the biopsychosocial aetiology of their presentation. It is considered that this may lead to greater self-efficacy in self-management of symptoms and reduce potential for perceived and self-stigma. Further implications for clinical practice and future research are discussed.
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Affiliation(s)
- Amy Woodham
- 8955Oxford Institute of Clinical Psychology Training and Research, Isis Education Centre, Warneford Hospital, Headington, Oxford, UK
| | - Annabel L David
- 6397Children's Psychological Medicine, Oxford Children's Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Myra Cooper
- 8955Oxford Institute of Clinical Psychology Training and Research, Isis Education Centre, Warneford Hospital, Headington, Oxford, UK
| | - Jacinta Cordwell
- 6397Children's Psychological Medicine, Oxford Children's Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Zhang L, Wang J, Chen T, Tian M, Zhou Q, Ren J. Symptom Clusters and Quality of Life in Cervical Cancer Patients Receiving Concurrent Chemoradiotherapy: The Mediating Role of Illness Perceptions. Front Psychiatry 2021; 12:807974. [PMID: 35173639 PMCID: PMC8841507 DOI: 10.3389/fpsyt.2021.807974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/23/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES Although studies shows that symptom clusters and illness perceptions are negatively associated with quality of life (QoL), it is unclear how these variables of cervical cancer patients who receive concurrent chemoradiotherapy (CCRT) relate to each other. This study aimed to identify the symptom clusters in cervical cancer patients who receive CCRT and evaluate the mediating effect of illness perceptions on the relationship between symptom clusters and QoL. METHODS A cross-sectional survey was conducted on 286 cervical cancer patients receiving CCRT from October 2019 to October 2020. M.D. Anderson Symptom Inventory, Brief Illness Perception Questionnaire, and Functional Assessment Cancer Therapy-Cervix were applied to investigate the symptom clusters, illness perceptions and QoL of the participants, respectively. Exploratory factor analysis was conducted to identify symptom clusters. The relationships among symptom clusters, illness perceptions, and QoL were analyzed with the structural equation modeling. RESULTS A total of four symptom clusters were identified, including psychological status symptom cluster, therapy side-effect symptom cluster, sickness symptom cluster, and gastrointestinal symptom cluster (χ2 = 1,552.282, Df = 78, P < 0.001). Symptom clusters, illness perceptions, and QoL were significantly correlated. Symptom clusters had significant direct (β = -0.38, P < 0.001) and indirect effects (β = -0.21, P < 0.001) on QoL. CONCLUSION Illness perceptions played a significant mediating role between symptom clusters and QoL in cervical cancer patients receiving CCRT. Strategies like prompting effective symptom management for the purposes of alleviating illness perceptions may contribute to improving their QoL.
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Affiliation(s)
- Lan Zhang
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.,Department of Health Psychology, School of Nursing, Shandong University, Jinan, China
| | - Jia Wang
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Tangzhen Chen
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Min Tian
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Qimin Zhou
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Jianhua Ren
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
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