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Huang WL, Chiu YT, Liao SC, Wu CS. Neuropsychological features of somatic symptom disorder and depression/anxiety in Taiwan: An analysis based on the comorbidity status. Psychiatry Res 2024; 340:116103. [PMID: 39106815 DOI: 10.1016/j.psychres.2024.116103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/10/2024] [Accepted: 07/23/2024] [Indexed: 08/09/2024]
Abstract
Individuals with somatic symptom disorder (SSD) often have comorbid depression or anxiety, but whether SSD is associated with specific neuropsychological functions has yet to be fully examined. We analyzed which neuropsychological features are more closely associated with SSD, anxiety, and depression. In this case-control study, we recruited 140 individuals with SSD, 104 individuals with affective disorders without SSD, and 159 healthy controls in Taiwan. We collected DSM-5 diagnoses, questionnaire scores, and performance on eight tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB) for each participant. Several CANTAB tasks involving attention, executive function, and social cognition showed significant group differences. In the adjusted analysis, the tasks significantly associated with SSD were the Match to Sample Visual Search (MTS) and the Emotion Recognition Task (ERT). Among the questionnaires, the Cognitions about Body and Health Questionnaire showed the most significant associations with the tasks, specifically with Rapid Visual Information Processing, MTS, Paired Associates Learning, Spatial Working Memory, Intra-Extra Dimensional Set Shift, and ERT. We conclude that the MTS and ERT tasks show significant relationships with both SSD diagnosis and related questionnaires. These tasks primarily involve selective attention and negative emotion regulation.
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Affiliation(s)
- Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Cerebellar Research Center, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Yi-Ting Chiu
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu Hospital, Hsinchu, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
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Mierzyńska A, Jaworska I, Piotrowicz R, Kowalik I, Pencina M, Opolski G, Zareba W, Banach M, Orzechowski P, Główczynska R, Szalewska D, Pluta S, Kalarus Z, Irzmanski R, Piotrowicz E. The Influence of Hybrid Comprehensive Telerehabilitation on Anxiety in Heart Failure Patients: The TELEREH-HF Randomized Clinical Trial. J Clin Psychol Med Settings 2024; 31:403-416. [PMID: 38108961 DOI: 10.1007/s10880-023-09985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/19/2023]
Abstract
Telerehabilitation for heart failure (HF) patients is beneficial for physical functioning, prognosis, and psychological status. The study aimed at evaluating the influence of hybrid comprehensive telerehabilitation (HCTR) on the level of anxiety in comparison to usual care (UC). The TELEREH-HF study was a multicenter prospective RCT in 850 clinically stable HF participants. Patients underwent clinical examinations, including the assessment of anxiety, at entry and after the 9-week training program (HCTR) or observation (UC). The State-Trait Anxiety Inventory (STAI) was used. 20.3% HCTR and 20.1% UC patients reported high level of anxiety as a state at baseline, with higher STAI results in younger participants (< 63 y.o.) (p = .048 for HCTR; p = .026 for UC). At both stages of the study, patients with lower level of physical capacity (measured by a peak VO2) had shown significantly higher level of anxiety. There were no significant changes in anxiety levels during the 9-week observation for the entire study population, although there were different patterns of change in anxiety (both trait and state) in younger and older groups,with the decrease in younger patients, and the increase-in the older group.Trial registry number NCT02523560 (Clinical Trials.gov), date of registration: August 14, 2015.
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Affiliation(s)
- Anna Mierzyńska
- National Institute of Cardiology, 04-628, Warsaw, Poland.
- Department of Cardiac Surgery, Military Institute of Medicine - National Research Institute, 04-141, Warsaw, Poland.
| | - Izabela Jaworska
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Silesian Medical University, 41-800, Zabrze, Poland
| | - Ryszard Piotrowicz
- National Institute of Cardiology, 04-628, Warsaw, Poland
- College of Rehabilitation, 01-234, Warsaw, Poland
| | - Ilona Kowalik
- National Institute of Cardiology, 04-628, Warsaw, Poland
| | - Michael Pencina
- Duke University's School of Medicine, Durham, NC, 27710, USA
| | - Grzegorz Opolski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Wojciech Zareba
- University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Maciej Banach
- Department of Hypertension, Medical University of Łódź, 90-419, Łódź, Poland
| | - Piotr Orzechowski
- Telecardiology Center, National Institute of Cardiology, 04-628, Warsaw, Poland
| | - Renata Główczynska
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Dominika Szalewska
- Department of Rehabilitation Medicine, Medical University of Gdańsk, 80-210, Gdańsk, Poland
| | - Sławomir Pluta
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Silesian Medical University, 41-800, Zabrze, Poland
| | - Zbigniew Kalarus
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Silesian Medical University, 41-800, Zabrze, Poland
| | - Robert Irzmanski
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Łódź, 90-419, Łódź, Poland
| | - Ewa Piotrowicz
- Telecardiology Center, National Institute of Cardiology, 04-628, Warsaw, Poland
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Bertele N, Wendling C, Reinken V, Gross JJ, Talmon A. Somatic symptom profiles are associated with pre-treatment depression and anxiety symptom severity but not inpatient therapy outcomes. Psychother Res 2023; 33:211-221. [PMID: 35729846 DOI: 10.1080/10503307.2022.2090870] [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: 10/17/2022] Open
Abstract
OBJECTIVE. Although somatic symptoms are common among mental health patients, their association with symptom severity and inpatient treatment outcomes is not yet well understood. METHODS. Using a pre-post design and latent class analysis (LCA), 641 inpatients (63.4% female) were classified based on their self-reported somatic symptoms. We examined how the resulting somatic symptom classes related to depression and anxiety symptom severity pre-treatment (T1) and to symptom reduction post-treatment (T2). RESULTS. Our results suggest four somatic symptom classes, namely (1) unspecific/low somatic symptom burden, (2) sexual problems, (3) gastrointestinal symptoms with pain syndrome, and (4) cardiopulmonary symptoms. While class 1 indicated the lowest pre-treatment depression and anxiety symptom severity, class 2 reported high depressive symptoms coupled with low anxiety, class 3 reported moderate depressive and anxiety symptom severity, and class 4 reported the highest depressive and anxiety symptom burden. Somatic symptom classes, however, did not predict the degree of reduction in either depression or anxiety symptoms post-treatment. CONCLUSIONS. These findings demonstrate somatic heterogeneity in mental health patients and reveal the relationship of somatic symptom patterns to affective symptom severity. Clinical implications are discussed.
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Affiliation(s)
- Nina Bertele
- Psychology Department, Stanford University, Stanford, CA, USA
| | | | | | - James J Gross
- Psychology Department, Stanford University, Stanford, CA, USA
| | - Anat Talmon
- Psychology Department, Stanford University, Stanford, CA, USA
- Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel
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Swainston K, Thursby S, Bell B, Poulter H, Dismore L, Copping L. What psychological interventions are effective for the management of persistent physical symptoms (PPS)? A systematic review and meta-analysis. Br J Health Psychol 2023; 28:80-97. [PMID: 35837827 PMCID: PMC10084386 DOI: 10.1111/bjhp.12613] [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: 02/08/2022] [Accepted: 06/17/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Presentation of persistent physical symptoms is associated with increased health care utilization, yet clinical outcomes often remain suboptimal. This systematic review aimed to determine whether psychological interventions are effective for the management of PPS and if so, what are the features of the interventions and at what level of care are they delivered. The review also set out to establish which symptoms in those diagnosed with PPS can be effectively managed with psychological intervention. METHODS Studies were included if they clearly reported a psychological intervention, specified the study sample as adults with a diagnosis of persistent physical symptoms, included a comparator and as a minimum an outcome measure of somatic symptoms. Risk of bias was assessed using the EPHPP. Meta-analysis was conducted to estimate the overall effect of interventions on somatic symptoms (the primary outcome), anxiety and depression (secondary outcomes). RESULTS Seventeen papers of varying quality indicated that psychological interventions can be effective for the management of somatic symptoms reported by individuals with PPS within a primary care setting. Psychological interventions were also found to be effective at reducing depression symptoms in individuals with PPS in twelve of the included studies. However, the meta-analysis results suggest that the psychological interventions utilized within eleven of the included studies did not significantly impact anxiety symptoms. CONCLUSIONS Psychological interventions have some success in managing somatic symptoms in PPS patients within primary care settings although their effects on other psychological symptoms is more mixed. The review highlights the importance of establishing a clearer diagnostic classification to inform treatment trajectories and the need for appropriate training and support within a multi-disciplinary team to enable the provision of such therapies.
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Affiliation(s)
- Katherine Swainston
- Faculty of Medical Sciences, School of Psychology, Newcastle University, Newcastle-upon-Tyne, UK
| | - Stacie Thursby
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - Blossom Bell
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - Hannah Poulter
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - Lorelle Dismore
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - Lee Copping
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
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Huang J, Zhong Y, Duan Y, Sun J. Case report: New insights into persistent chronic pelvic pain syndrome with comorbid somatic symptom disorder. Front Psychiatry 2023; 14:1119938. [PMID: 36741109 PMCID: PMC9895083 DOI: 10.3389/fpsyt.2023.1119938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023] Open
Abstract
Chronic pelvic pain syndrome (CPPS) is generally defined as pain in the pelvic area that persisted for 3-6 months or longer. The pain can be constant or episodic and functionally disabling. Any dysfunction of the central nervous system can lead to central sensitization, which enhances and maintains pain as well as other symptoms that are mediated by the central nervous system. It occurs in subgroups of nearly every chronic pain condition and is characterized by multifocal pain and co-occurring somatic symptoms. Somatic symptom disorder (SSD) is defined as a condition in which having one or more somatic symptoms, such as excessive worries, pressure, and catastrophic events. These symptoms can be very disruptive to a patient's life and can cause significant distress. SSD cases with severe symptoms frequently undergo repeated medical investigations and the symptoms often lead patients to seek emergency medical treatment and consult with specialists repeatedly, which is a source of frustration for patients and clinicians. Here we report a case that Asian female with persistent CPPS with comorbid SSD, who got in trouble for up to 8 years. This case reminds clinicians to pay excessive attention to the diagnosis of CPPS with comorbid SSD after recovery from acute COVID-19, with hope of raising awareness in the identification of SSD and present new insight into appropriate treatment for each woman who suffers from it.
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Affiliation(s)
- JiChao Huang
- Affiliated Shuyang Hospital of Nanjing University of Chinese Medicine, Suqian, Jiangsu, China
| | - Yi Zhong
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Institute of Mental Health, Peking University Sixth Hospital, Peking University, Beijing, China.,Department of Neuroscience, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yu Duan
- Yangzhou University, Yangzhou, China
| | - Jie Sun
- Pain Medicine Center, Peking University Third Hospital, Beijing, China
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Unresolved Systemic Inflammation, Long COVID, and the Common Pathomechanisms of Somatic and Psychiatric Comorbidity. J Clin Med 2022; 11:jcm11175114. [PMID: 36079040 PMCID: PMC9457285 DOI: 10.3390/jcm11175114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
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Galffy M, Bichler C, Mohr T, Egeter J, Neu L, Oberhammer M, Högl B, Deisenhammer EA, Sperner-Unterweger B, Hüfner K. Adhoc Setup of an Online Mental Health Self-Help Program During the COVID-19 Pandemic: Description of the Development and Implementation Processes and Analysis of Its Users’ and Usage Profiles. Front Psychol 2022; 13:853371. [PMID: 35936283 PMCID: PMC9350598 DOI: 10.3389/fpsyg.2022.853371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/24/2022] [Indexed: 12/20/2022] Open
Abstract
BackgroundThe COVID-19 pandemic hit Austria in March 2020. This led to a considerable reduction in outpatient psychiatric therapies. People with mental disorders as well as with newly emerging mental health issues found themselves with very limited treatment options. Within only a few days our hospital set up an online mental health self-help program which went online in its first version on the first day of the lockdown in Austria. The process of this development and implementation process alongside with the user’s and usage data for the program are presented here.MethodsA small core team initiated the development of the program on a low-budget basis and using mostly freely available digital resources. The program had to be free of costs for its users and easy to navigate. Each self-help module contains a text description of the topic, a self-rating questionnaire and several psychoeducational 2–5 min videos. These videos explain, e.g., interactions of mental stress and the immune system or the vicious circle of anxiety. Additional videos provide easy to learn techniques like breathing and relaxation exercises.ResultsWe illustrate the implementation of this program following the replicating effective program (REP) model. We provide a detailed description of the implementation process starting from a simple website to a smartphone-based application with registered user area and instantaneous reporting of self-rating questionnaire results to users. The described process could be used as a model for the setup of similar programs in a very short time. As an indicator of acceptance, we report 46,100 unique video views and 3,937 completed questionnaires in the first year of use. The most accessed videos were those on anxiety, relaxation and resilience. Analysis of the sociodemographic user data indicate that they were mostly young (< 45 years; 59.7%), females (77.5%) and previously mentally healthy individuals (74.5%). An example of the collected psychometric questionnaire data over time is given.ConclusionWe show that it is possible to set up an online mental health self-help program ad hoc and without extensive prior planning, which enabled us to dynamically respond to a new situation. We are now planning on keeping the program active for a longer period of time to supplement and expand traditional treatment settings also outside the COVID-19 pandemic.
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Affiliation(s)
- Matyas Galffy
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Carina Bichler
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Thomas Mohr
- Center for Cancer Research, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Jonas Egeter
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Leonie Neu
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Maria Oberhammer
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry I, Innsbruck Medical University, Innsbruck, Austria
| | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Eberhard A. Deisenhammer
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
- *Correspondence: Katharina Hüfner,
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