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Luo J, Wang PC, Meng FQ, Yang XY, Zhang YB, Zu S, Cui FH, Mk Ng R, Li ZJ. Cognitive-behavioral therapy for patients with somatoform disorders: A pilot preliminary randomized controlled trial. Psychother Res 2024:1-11. [PMID: 38590020 DOI: 10.1080/10503307.2024.2335520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 03/19/2024] [Indexed: 04/10/2024] Open
Abstract
Background and objective: Cognitive-behavioral therapy (CBT) for somatoform disorders (SFDs) is understudied in China. Western findings may not be applicable to Chinese culture. This preliminary study evaluated the efficacy of CBT for patients in China, relative to treatment-as-usual (TAU). Methods: Seventy patients with SFDs randomly received either combined CBT and TAU (CBT + TAU), or TAU alone between January 2018 to May 2019. The CBT + TAU group received 12 weekly individual 50-minute CBT sessions. Participants were blindly assessed at 4 timepoints (baseline, week 6, end of treatment: week 12; 12 weeks post-treatment: week 24) using the following outcome measures: SQSS (Self-screening Questionnaire for Somatic Symptoms); PHQ-15 (Patient-Health-Questionnaire-15) and the WI (Whiteley Index); GAD-7 (General Anxiety Disorder-7); HAMD-17 (Hamilton Depression Rating Scale-17); Family Burden Interview Schedule (FBIS); Sheehan Disability Scale (SDS); and the Short Form of Quality-of-Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF). The primary endpoint was the difference between the SQSS total score at week 24 and the baseline. A mixed model for repeated measures was used to analyze inter- and intra-group changes from the baseline. Results: At week 24, The least-squares mean (LSM) change of the total score on the SQSS was -18.87 points and -9.69 points, respectively in the CBT + TAU group and in the TAU group (LSM difference, -9.18 points; 95% confidence interval, -15.72 to -2.64; P = 0.0068). At week 24, the LSM changes from baseline in the WI, HAMD, PHQ15, FBIS and SDS total scores were significantly different between the two groups, however, there was no significant difference in the Q-LES-Q-SF. The SQSS of group effect sizes were 0.63 at 24 weeks. The dropout rates of the CBT + TAU and TAU groups were comparable (22.9% and 19.3%). Conclusions: These preliminary findings suggest that CBT may be helpful for improving the symptoms of patients with SFDs in China.
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Affiliation(s)
- Jia Luo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People's Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China
- Department of Clinical Psychology, Capital Medical University, Beijing, People's Republic of China
| | - Peng-Chong Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People's Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China
| | - Fan-Qiang Meng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People's Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China
| | - Xiang-Yun Yang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People's Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China
| | - Yan-Bo Zhang
- Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Si Zu
- Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Fei-Huan Cui
- Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Roger Mk Ng
- Department of Clinical Psychology, Capital Medical University, Beijing, People's Republic of China
- Alpha Clinic of Hong Kong, Hong Kong, People's Republic of China
| | - Zhan-Jiang Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People's Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China
- Department of Clinical Psychology, Capital Medical University, Beijing, People's Republic of China
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Scamvougeras A, Castle D. Functional Neurological Disorders: Challenging the Mainstream Agnostic Causative Position. Can J Psychiatry 2024:7067437241245957. [PMID: 38584382 DOI: 10.1177/07067437241245957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Affiliation(s)
- Anton Scamvougeras
- Department of Psychiatry, UBC Neuropsychiatry Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - David Castle
- Department of Psychiatry, University of Tasmania, Hobart, Tasmania, Australia
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Abstract
BACKGROUND Since 2016, an array of claims and public discourse have circulated in the medical community over the origin and nature of a mysterious condition dubbed "Havana Syndrome," so named as it was first identified in Cuba. In March 2023, the United States intelligence community concluded that the condition was a socially constructed catch-all category for an array of health conditions and stress reactions that were lumped under a single label. AIMS To examine the history of "Havana Syndrome" and the many factors that led to its erroneous categorization as a novel clinical entity. METHOD A review of the literature. RESULTS/CONCLUSIONS Several factors led to the erroneous classification of "Havana Syndrome" as a novel entity including the failure to stay within the limitations of the data; the withholding of information by intelligence agencies, the prevalence of popular misconceptions about psychogenic illness, the inability to identify historical parallels; the role of the media, and the mixing of politics with science.
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Affiliation(s)
- Robert E Bartholomew
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Hüsing P, Smakowski A, Löwe B, Kleinstäuber M, Toussaint A, Shedden-Mora MC. Response to Commentary: The framework for systematic reviews on psychological risk factors for persistent somatic symptoms and related syndromes and disorders (PSY-PSS). Front Psychiatry 2024; 15:1359434. [PMID: 38389982 PMCID: PMC10881664 DOI: 10.3389/fpsyt.2024.1359434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Affiliation(s)
- Paul Hüsing
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Abigail Smakowski
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maria Kleinstäuber
- Department of Psychology, Utah State University, Logan, UT, United States
| | - Anne Toussaint
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Meike C Shedden-Mora
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
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Aneja J, Singh J, Udey B. Prevalence and clinical correlates of restless legs syndrome in psychiatric patients: A cross-sectional study from North India. Indian J Psychiatry 2024; 66:58-66. [PMID: 38419934 PMCID: PMC10898525 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_223_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 09/24/2023] [Accepted: 11/11/2023] [Indexed: 03/02/2024] Open
Abstract
Background Restless legs syndrome (RLS) is a neuro-sensorimotor disorder which is scarcely researched and is commonly missed in routine psychiatry practice. Aim To evaluate the prevalence of RLS and its correlates in patients with anxiety, depression, and somatoform disorders. Methods A cross-sectional single-center study was undertaken in patients aged 18-65 years suffering from ICD-10 (International Statistical Classification of Diseases-10th edition) diagnosis of anxiety, depressive, and somatoform disorders. RLS was evaluated by using diagnostic criteria of International Restless Legs Syndrome Study Group (IRLSSG) and severity measured on IRLSSG scale. Depression and anxiety were rated on Hamilton Depression and Anxiety Rating Scales respectively, insomnia severity measured by Insomnia Severity Index (ISI), and quality of life measured by WHO Quality of Life-Brief version (WHO-QOL BREF) scale. Serum ferritin levels were measured for evaluating iron deficiency. Results The rate of RLS was 66.7%, 50%, and 48% in patients with depressive, anxiety, and somatoform disorders, respectively, with no significant inter-group difference. Nearly one-third of patients suffered from severe to very severe symptoms of RLS, and quality of life was poorest in those with depressive disorders. RLS was significantly higher in females (P = 0.019), who were married (P = 0.040), diagnosed with severe depression (P = 0.029), and abused benzodiazepines (P = 0.045). On binary logistic regression, female gender and presence of clinical insomnia predicted occurrence of RLS. Conclusion The prevalence of RLS is very high in patients with common psychiatric disorders which is often missed. Clinical enquiry and examination for reversible causes such as iron deficiency may assist in its diagnosis and improve clinical outcome.
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Affiliation(s)
- Jitender Aneja
- Department of Psychiatry, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Jawahar Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Bharat Udey
- Department of Psychiatry, All India Institute of Medical Sciences, Bathinda, Punjab, India
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Pittar N, Firth F, Bennani H, Farella M. The effect of passive clear aligners on masticatory muscle activity in adults with different levels of oral parafunction. J Oral Rehabil 2023; 50:1409-1421. [PMID: 37615269 DOI: 10.1111/joor.13575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/13/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND There is limited knowledge of the possible side-effects of clear aligners on jaw function. OBJECTIVES To determine the short-term effect of passive clear aligners (PCAs) on masticatory muscle activity (MMA), occlusal discomfort (OD) and temporomandibular disorder (TMD) symptoms in adults with different levels of self-reported oral parafunction. MATERIALS AND METHODS Participants were screened for oral parafunctional behaviours using the oral behavioural checklist. Respondents in ≥85th and ≤15th percentiles were invited to participate and allocated to a high (HPF: N = 15) or low (lower parafunction [LPF]: N = 16) parafunction group. Participants underwent a TMD clinical examination; somatisation and somatosensory amplification were assessed by questionnaires; OD and stress were assessed by visual analogue scales. While wearing PCAs, awake-time MMA was assessed three times over 9 days using a wearable electromyography device, along with OD, stress and TMD symptoms. RESULTS The wearing of PCAs was associated with a significant decrease in mean contraction episode amplitude in both groups (p = 0.003). OD levels increased and remained raised in all participants after insertion of the PCAs (p < 0.001), more so in the HPF group (p = 0.048). The HPF group had higher somatisation scores (p = 0.006) and reported more TMD symptoms at all time points (p ≤ 0.004). No significant changes in stress or TMD symptoms were found in either group during the study period. CONCLUSIONS PCAs were associated with a decrease in MMA in all participants. HPF individuals had greater somatisation and reported greater discomfort when wearing PCAs than LPF individuals.
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Affiliation(s)
- Nicholas Pittar
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Fiona Firth
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Hamza Bennani
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Mauro Farella
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
- Discipline of Orthodontics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
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Teodoro T, Oliveira R. The conceptual field of medically unexplained symptoms and persistent somatic symptoms. CNS Spectr 2023; 28:526-527. [PMID: 36321347 DOI: 10.1017/s1092852922001031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Tomás Teodoro
- Early Intervention & First Episode Psychosis Unit, Department of Psychiatry, Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
- Adult ADHD & Neurodevelopmental Disorders Outpatient Service, Department of Psychiatry, Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
- Emergency Psychiatry Unit, Department of Emergency Medicine, Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
- Comprehensive Health Research Centre, NOVA Medical School, NOVA University Lisbon, Lisbon, Portugal
| | - Renato Oliveira
- Comprehensive Health Research Centre, NOVA Medical School, NOVA University Lisbon, Lisbon, Portugal
- Department of Neurology & Headache Centre, Hospital da Luz-Lisboa, Lisbon, Portugal
- Department of Mental Health and Neurosciences, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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Moneta ME, Kaechele H. A theoretical and clinical perspective of an embodied view in psychotherapy of somatic symptoms disorders. Res Psychother 2023; 26:605. [PMID: 37667890 PMCID: PMC10519280 DOI: 10.4081/ripppo.2023.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/26/2023] [Indexed: 09/06/2023]
Abstract
In this paper, we offer some ideas for the treatment of somatoform patients and related pathologies based on the concept of embodiment. Embodiment refers to the interplay between body and mind in behavior. The word refers to giving a body to something, "incarnate". Spinoza wrote extensively about the topic in the 17th century. In the 20th century, picking up on Spinoza's work, Damasio presented extensive and important neuro-scientific evidence that feelings can be direct perceptions of internal body states, substantiating the growing understanding of emotions and feelings as a core component of the embodied experience. Here, we summarize the evidence for the intersection of emotion and cognition in the body, which impinges on the effectiveness of using the body and movement in psychotherapy and the management of somatic symptoms and related disorders. We present evidence indicating that movement would be a way to reach unconscious processes dealing with body-mind interaction and body awareness.
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Doering S, Herpertz S, Pape M, Hofmann T, Rose M, Imbierowicz K, Geiser F, Bierling AL, Weidner K, Rademacher J, Michalek S, Morawa E, Erim Y, Teigelack P, Teufel M, Hartmann A, Lahmann C, Peters EMJ, Kruse J, von Boetticher D, Herrmann-Lingen C, Nöhre M, de Zwaan M, Dinger U, Friederich HC, Niecke A, Albus C, Zwerenz R, Beutel M, Sattel HC, Henningsen P, Stein B, Waller C, Hake K, Spitzer C, Stengel A, Zipfel S, Weimer K, Gündel H, Kessler H. The multicenter effectiveness study of inpatient and day hospital treatment in departments of psychosomatic medicine and psychotherapy in Germany. Front Psychiatry 2023; 14:1155582. [PMID: 37608994 PMCID: PMC10440687 DOI: 10.3389/fpsyt.2023.1155582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
Background Reliable outcome data of psychosomatic inpatient and day hospital treatment with a focus on psychotherapy are important to strengthen ecological validity by assessing the reality of mental health care in the field. This study aims to evaluate the effectiveness of inpatient and day hospital treatment in German university departments of Psychosomatic Medicine and Psychotherapy in a prospective, naturalistic, multicenter design including structured assessments. Methods Structured interviews were used to diagnose mental disorders according to ICD-10 and DSM-IV at baseline. Depression, anxiety, somatization, eating disorder and posttraumatic stress disorder (PTSD) symptoms, as well as personality functioning were assessed by means of questionnaires on admission and at discharge. Results 2,094 patients recruited by 19 participating university hospitals consented to participation in the study. Effect sizes for each of the outcome criteria were calculated for 4-5 sub-groups per outcome domain with differing severity at baseline. Pre-post effect sizes for patients with moderate and high symptom severity at baseline ranged from d = 0.78 to d = 3.61 with symptoms of PTSD, depression, and anxiety showing the largest and somatization as well as personality functioning showing somewhat smaller effects. Conclusions Inpatient and day hospital treatment in German university departments of Psychosomatic Medicine and Psychotherapy is effective under field conditions. Clinical trial registration https://drks.de/search/de/trial/DRKS00016412, identifier: DRKS00016412.
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Affiliation(s)
- Stephan Doering
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Comprehensive Clinical Center for Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Vienna, Austria
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Magdalena Pape
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Tobias Hofmann
- Charité Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Rose
- Charité Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katrin Imbierowicz
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany
| | - Antonie Louise Bierling
- Department of Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität, Dresden, Germany
- Institute for Material Science and Nanotechnology, Technical University of Dresden, Dresden, Germany
- Department of Clinical Psychology, Friedrich-Schiller University, Jena, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität, Dresden, Germany
| | - Jörg Rademacher
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Silke Michalek
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Per Teigelack
- Clinic of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Armin Hartmann
- Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Claas Lahmann
- Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Eva Milena Johanne Peters
- Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University of Giessen, Giessen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University of Giessen, Giessen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Dirk von Boetticher
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Ulrike Dinger
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of General Internal Medicine and Psychosomatics, University Hospital, Heidelberg University, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital, Heidelberg University, Heidelberg, Germany
| | - Alexander Niecke
- Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Christian Albus
- Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Heribert Christian Sattel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Munich, Germany
| | - Peter Henningsen
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Munich, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - Karsten Hake
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Andreas Stengel
- Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Katja Weimer
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Campus Fulda, University of Marburg, Marburg, Germany
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Chaudhry HA, Okonkwo CC, Inban P, Intsiful TA, Ezenagu UE, Odoma VA, Kumar S, Mahjabeen SS, Patra SS, Modi NM, Fewajesuyan AT, Nabeel Makkiyah SF, Abdefatah Ali M, Khan A. Factors in the Development of Somatoform Disorders Among Children: A Case-Control Study. Cureus 2023; 15:e43238. [PMID: 37692659 PMCID: PMC10491496 DOI: 10.7759/cureus.43238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Somatoform disorders (SFDs) are a spectrum of diseases mainly manifesting with physical symptoms of no recognizable etiology. These disorders are believed to be primarily influenced and exacerbated by psychological factors. Given the connection between parental sociodemographics and psychological factors and SFDs, there is a pressing need to investigate this area further, particularly concerning parents and their children affected by somatoform disorders. Aims and objectives The aims and objectives of this study are as follows: i) study the determinants of SFDs, namely, parent handling of child, parent-child relationship, parenting with respect to attending to the needs of children, and intelligence quotient (IQ) of parents, and ii) compare host factors to the factors matched in control subjects. Materials and methods We adopted purposive sampling in our case-control study. The study sample was obtained from the psychiatry department of the Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, India, from September 2020 to December 2022, once a week, every Monday. Children manifesting SFD manifestations that are among the chief complaints were included in our study. Results A total of 115 cases were included in our study based on inclusion criteria. The study compared sociodemographic characteristics, intelligence quotient (IQ), parental characteristics, parental handling, parent-child relationships, and parenting practices between a patient group and a control group. The results showed no significant differences in sex, religion, occupation, domicile, and socioeconomic status in both control and patient groups. However, significant differences were found in parental characteristics, such as lower mean age, education, and IQ, in the patient group. This difference between the patient and control groups with respect to the parental handling questionnaire was statistically significant for the domain of "praise," "talk," "feel better," "comes to you," "unduly strict" items, "frequently reprimanded," "tried to control everything," creative activities, protectiveness, education, neglecting, objective punishment, housing, medical care, demanding, symbolic reward, loving, objective reward, food, parent-to-child communication, clothing, support, routine, recreation, social activities, rules, managing problem behavior, guidance for career, and security. Conclusion Parents were deficient in terms of years of education, occupational status, IQ, parental handling, parent-child relationship, and parenting with respect to the children's needs. These findings offer insights into the sociodemographic and psychological factors contributing to the patient group's condition.
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Affiliation(s)
- Hassan A Chaudhry
- Biological Sciences, Temple University, Philadelphia, USA
- Medicine, Medical University of Lublin, Lublin, POL
| | - Chinwe C Okonkwo
- Family Medicine, Caribbean Medical University School of Medicine, Willemstad, CUW
| | | | | | | | - Victor A Odoma
- Cardiology/Oncology, Indiana University (IU) Health, Bloomington, USA
| | - Sumit Kumar
- Internal Medicine, Armed Forces Medical College, Pune, IND
| | - Syeda Sarah Mahjabeen
- Pathology and Laboratory Medicine, Madinah Maternity and Children Hospital, Al-Madinah al-Munawwarah, SAU
- Pathology and Laboratory Medicine, Nandamuri Taraka Rama Rao University of Health Sciences (NTRUHS), Hyderabad, IND
| | | | - Nishi M Modi
- Medicine, Government Medical College, Surat, IND
| | | | | | | | - Aadil Khan
- Internal Medicine, Lala Lajpat Rai (LLR) Hospital, Kanpur, IND
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Wu H, Manglike A, Chen Y, Liu Z, Fritzsche K, Lu Z. Scoping review update on somatic symptom disorder that includes additional Chinese data. Gen Psychiatr 2023; 36:e100942. [PMID: 37337547 PMCID: PMC10277133 DOI: 10.1136/gpsych-2022-100942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/23/2023] [Indexed: 06/21/2023] Open
Abstract
Somatic symptom disorder (SSD) is a new diagnosis introduced into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is expected to solve the diagnostic difficulties of patients with medically unexplained symptoms. Based on the previous work, this review aims to comprehensively synthesise updated evidence related to SSD from recent years in English publications and, more extensively, from data published in Chinese language journals. The scoping review update was based on an earlier scoping review and included Chinese language publication data from China National Knowledge Internet (CNKI), WANFANG and WEIPU between January 2013 and May 2022 and data from PubMed, PsycINFO, and Cochrane Library between June 2020 and May 2022. Initially, 2 984 articles were identified, of which 63 full texts were included for analysis. In China, SSD is mainly applied in scientific research, but it also shows good predictive validity and clinical application potential. The mean frequency of SSD was 4.5% in the general population, 25.2% in the primary care population and 33.5% in diverse specialised care settings. Biological factors, such as brain region changes and heart rate variability, are associated with the onset of SSD. Psychological impairment related to somatic symptoms is the best predictor of prognosis. While adolescent SSD was significantly associated with family function, SSD overall is associated with an increased dysfunction of cognition and emotion, decreased quality of life, and high comorbidity with anxiety and depressive disorders. Further research is needed on suicide risk and cultural and gender-related issues. Updating the data of Chinese language studies, our research enriches the evidence-based findings related to the topics addressed in the text sections of the SSD chapter of DSM-5. However, research gaps remain about SSD reliability, population-based prevalence, suicide risk, and cultural and gender-related issues.
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Affiliation(s)
- Heng Wu
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ayinuer Manglike
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yixiao Chen
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ziming Liu
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
| | - Zheng Lu
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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12
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Shanker G, Sharma I. Study of Determinants of Somatoform Disorders in Children. Cureus 2023; 15:e36447. [PMID: 37090357 PMCID: PMC10118218 DOI: 10.7759/cureus.36447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
INTRODUCTION Somatoform disorders constitute a group of illnesses that present with predominant physical symptoms for which there is no demonstrable etiology, and psychological factors are implicated in initiating, exacerbating, and maintaining the disorder. AIM AND OBJECTIVES The aim of this study was to study a host of factors, namely, the I.Q. of children, scholastic performance in the last three years, the past history of medical illness, psychiatric disorders in the family, and life stress in the last year, and to compare these factors with those in matched control subjects. This study looked at the effects of somatoform disorders on children's I.Q., scholastic performance in the previous three years, a history of medical illness, psychiatric disorders in the family, and life stress in the previous year. MATERIALS AND METHODS In this case-control study, a sample was selected from the child guidance clinic of the psychiatry outpatient department (OPD) of the University Hospital, Banaras Hindu University, Varanasi, India. The time period of study was from January 2011 to June 2012. All the patients who presented to the child guidance clinic of the psychiatry OPD with one or more somatic symptoms as among their chief complaints were screened. All subjects fulfilling the selection criteria were recruited into the study. An I.Q. test was administered to the children, and the raw score for the verbal and performance tests was calculated. Children above the age of 16 years were assessed with the Wechsler Adult Performance Intelligence Scale. RESULTS One hundred fifteen cases that fulfilled the selection criteria were studied. About 14.6% (N = 11) of the patients had a history of significant physical illness as opposed to 12.5% (N = 5) in healthy controls. The scholastic performance in the last three years of the patients group was poorer than that of the control group. The mean number of stressful life events in the patients group was 5.95±1.77 (range: 1-10), and in the control group, it was 1.25±0.43 (range: 1-3). CONCLUSION Compared to controls, patients had a significantly lower I.Q. and poorer scholastic performance in the last three years, a more frequent past history of medical illness, and a greater frequency of life stress in the areas of studies, health, family-related issues, and interpersonal issues.
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Affiliation(s)
- Ganesh Shanker
- Department of Psychiatry, G.S.V.M. (Ganesh Shankar Vidyarthi Memorial) Medical College, Kanpur, IND
| | - Indira Sharma
- Department of Psychiatry, Institute of Medical Sciences, BHU (Banaras Hindu University), Varanasi, IND
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13
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Cammisuli DM, Castelnuovo G. Neuroscience-based psychotherapy: A position paper. Front Psychol 2023; 14:1101044. [PMID: 36860785 PMCID: PMC9968886 DOI: 10.3389/fpsyg.2023.1101044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/11/2023] [Indexed: 02/15/2023] Open
Abstract
In the recent years, discoveries in neuroscience have greatly impacted upon the need to modify therapeutic practice starting from the evidence showing some cerebral mechanisms capable of coping with mental health crisis and traumatic events of the individual's life history by redesigning the narrative plot and the person's sense of the Self. The emerging dialogue between neuroscience and psychotherapy is increasingly intense and modern psychotherapy cannot ignore the heritage deriving from studies about neuropsychological modification of memory traces, neurobiology of attachment theory, cognitive mechanisms involved in psychopathology, neurophysiology of human empathy, neuroimaging evidence about psychotherapeutic treatment, and somatoform disorders connecting the brain and the body. In the present article, we critically examined sectorial literature and claimed that psychotherapy has to referred to a neuroscience-based approach in order to adopt the most tailored interventions for specific groups of patients or therapy settings. We also provided recommendations for care implementation in clinical practice and illustrated challenges of future research.
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Affiliation(s)
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University, Milan, Italy,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy,*Correspondence: Gianluca Castelnuovo ✉
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14
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Nehme A, Barakat M, Malaeb D, Obeid S, Hallit S, Haddad G. Association between COVID-19 symptoms, COVID-19 vaccine, and somatization among a sample of the Lebanese adults. Pharm Pract (Granada) 2023; 21:2763. [PMID: 37090451 PMCID: PMC10117341 DOI: 10.18549/pharmpract.2023.1.2763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/03/2022] [Indexed: 04/25/2023] Open
Abstract
Objectives Long COVID syndrome, the poorly defined illness, has been increasingly mentioned in recent studies yet is still poorly understood especially when it comes to precipitating and modulating factors, the high prevalence of mental health problems associated with the COVID-19 pandemic has brought to light the hypothesis of the existence of a psychological component associated with the persistence of symptoms and if vaccination may serve as a modulating factor. This study aims to examine the prevalence of somatization disorders and association between persistent COVID-19 symptoms and COVID-19 vaccine with somatization among a sample of the Lebanese general population. Methods A cross-sectional study was carried out between September and October 2021. The snowball sampling technique was picked to choose a sample that addressed all Lebanese Mohafazat. Patient Health Questionnaire-15 (PHQ-15) was used to assess somatization. Results A total of 403 participants was enrolled in this study, with a mean age of 32.76 ± 13.24 years, 108 (26.8%) had medium somatization symptoms (PHQ-15 scores ≥10). Having persistent COVID symptoms (β=2.15) was significantly associated with more somatization, whereas the intake of COVID vaccine (β=-1.17) was significantly associated with less somatization. Conclusion Long lasting COVID-19 symptoms were closely related to somatization, although the administration of the COVID-19 vaccine was associated with less somatization. However, further studies are needed to provide a better understanding of the relationship between long COVID and somatization, on one hand, and the modulating factors on the other hand.
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Affiliation(s)
- Antonio Nehme
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
| | - Muna Barakat
- Department of Clinical Pharmacy and therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, 11931, Jordan.
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates.
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Georges Haddad
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Psychiatry Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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15
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Schröder L, Regnath F, Glasauer S, Hackenberg A, Hente J, Weilenmann S, Pohl D, von Känel R, Lehnen N. Altered sensorimotor processing in irritable bowel syndrome: Evidence for a transdiagnostic pathomechanism in functional somatic disorders. Front Neurosci 2022; 16:1029126. [PMID: 36440279 PMCID: PMC9682240 DOI: 10.3389/fnins.2022.1029126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/10/2022] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVE A recent hypothesis suggests that functional somatic symptoms are due to altered information processing in the brain, with rigid expectations biasing sensorimotor signal processing. First experimental results confirmed such altered processing within the affected symptom modality, e.g., deficient eye-head coordination in patients with functional dizziness. Studies in patients with functional somatic symptoms looking at general, trans-symptomatic processing deficits are sparse. Here, we investigate sensorimotor processing during eye-head gaze shifts in irritable bowel syndrome (IBS) to test whether processing deficits exist across symptom modalities. METHODS Study participants were seven patients suffering from IBS and seven age- and gender-matched healthy controls who performed large gaze shifts toward visual targets. Participants performed combined eye-head gaze shifts in the natural condition and with experimentally increased head moment of inertia. Head oscillations as a marker for sensorimotor processing deficits were assessed. Bayes statistics was used to assess evidence for the presence or absence of processing differences between IBS patients and healthy controls. RESULTS With the head moment of inertia increased, IBS patients displayed more pronounced head oscillations than healthy controls (Bayes Factor 10 = 56.4, corresponding to strong evidence). CONCLUSION Patients with IBS show sensorimotor processing deficits, reflected by increased head oscillations during large gaze shifts to visual targets. In particular, patients with IBS have difficulties to adapt to the context of altered head moment of inertia. Our results suggest general transdiagnostic processing deficits in functional somatic disorders.
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Affiliation(s)
- Lena Schröder
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar of the Technical University of Munich, Munich, Germany
- Computational Neuroscience, Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität München, Planegg, Germany
| | - Franziska Regnath
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar of the Technical University of Munich, Munich, Germany
- Department of Sport and Health Sciences, TUM Graduate School, Technical University of Munich, Munich, Germany
| | - Stefan Glasauer
- Computational Neuroscience, Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Anna Hackenberg
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar of the Technical University of Munich, Munich, Germany
| | - Juliane Hente
- Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sonja Weilenmann
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Daniel Pohl
- Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nadine Lehnen
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar of the Technical University of Munich, Munich, Germany
- Insititute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
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16
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Mewes R. Recent developments on psychological factors in medically unexplained symptoms and somatoform disorders. Front Public Health 2022; 10:1033203. [PMID: 36408051 PMCID: PMC9672811 DOI: 10.3389/fpubh.2022.1033203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Somatic symptoms which are not fully explained by a medical condition (medically unexplained symptoms) have a high relevance for the public health. They are very common both in the general population and in patients in health care, and may develop into chronic impairing conditions such as somatoform disorders. In recent years, the relevance of specific negative psychological factors for the diagnosis and the stability of somatoform disorders and for the impairment by medically unexplained symptoms gained more and more attention. This resulted-among others- in core changes in the diagnostic classification criteria of somatoform disorders. Against this background, the present "Perspective" will outline recent developments and findings in the area of medically unexplained somatic symptoms and somatoform disorders. Moreover, it will lay a special focus on evidence on specific negative psychological factors that may influence the course of unexplained somatic symptoms and disorders and the impairment caused by these symptoms.
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17
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Lamb M, Bacon DR, Zeatoun A, Onourah P, Thorp BD, Abramowitz J, Ebert CS, Kimple AJ, Senior BA. Mental health burden of empty nose syndrome compared to chronic rhinosinusitis and chronic rhinitis. Int Forum Allergy Rhinol 2022; 12:1340-1349. [PMID: 35333009 DOI: 10.1002/alr.22997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Empty nose syndrome (ENS) is characterized by the paradoxical perception of nasal obstruction despite patent sinonasal anatomy after surgery. We investigated the relationship between ENS, and anxiety, depression, obsessive-compulsive disorder, and somatic symptom disorder (SSD) compared to individuals with chronic rhinitis (CR) and chronic rhinosinusitis (CRS). METHODS This cross-sectional survey study compared ENS and CR and CRS patients. A total of 116 patients participated: 58 ENS patients from digital support groups, and 58 CRS and CR patients from tertiary rhinology clinics. Study participants completed four validated surveys: (1) Empty Nose Syndrome 6-Item Questionnaire, (2) Rhinosinusitis Disability Index (RSDI), (3) Obsessive Compulsive Inventory - Revised (OCI-R), and (4) PRIME MD Patient Health Questionnaire (PHQ). RESULTS ENS patients exhibited a mean RSDI of 78.6, 95% confidence interval [CI] 72.8-84.5, compared to 25.2, 95% CI 18.6-31.8 for CRS/CR patients (p < 0.0001). This difference was seen across all subdomains. Using the PHQ, 53% of ENS patients met diagnostic thresholds for SSD compared to 14% of CRS patients (p < 0.0001). In relation to obsessive compulsive disorder (OCD), 18.37% of ENS patients compared to 8.62% of CRS/CR patients scored above the diagnostic threshold (>21) on the OCI-R questionnaire (p = 0.159). CONCLUSION ENS patients had diminished sinonasal quality of life and a higher prevalence of comorbid anxiety and depression, compared to CR and CRS. ENS patients were more likely to exceed thresholds for OCD and SSD compared to controls. Future studies are needed to assess the role of SSD in ENS to help optimize treatment for these complex patients.
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Affiliation(s)
- Meredith Lamb
- Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA
| | - Daniel R Bacon
- Department of Otolaryngology-Head & Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Abdullah Zeatoun
- Department of Otolaryngology-Head & Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Princess Onourah
- Department of Otolaryngology-Head & Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brian D Thorp
- Department of Otolaryngology-Head & Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jonathon Abramowitz
- Department of Psychology at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Charles S Ebert
- Department of Otolaryngology-Head & Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Adam J Kimple
- Department of Otolaryngology-Head & Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brent A Senior
- Department of Otolaryngology-Head & Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
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18
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Omondi H, Freysteinson W. The mirror and obesity: A systematic review on the effects of mirror exposure on behaviour and obese individuals. J Clin Nurs 2022; 31:2367-2376. [PMID: 34741363 DOI: 10.1111/jocn.16107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/21/2021] [Accepted: 10/12/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To review the literature regarding the effects of mirror exposure on behaviour and obese patients. The review explored how mirror exposure influences behaviour in obese patients in terms of activity level, psychology and eating habits. BACKGROUND Obesity is a major epidemic that affects people worldwide but is more predominant in the Western world. Many health issues are directly linked to obesity, and current therapies have failed to provide a sustainable resolution to this problem. Mirror exposure has been used in eating disorders such as anorexia nervosa, bulimia and binge eating; however, there exists a gap in the use of mirrors in obese patients. The literature review focuses on the effects of mirror exposure on behaviour and obese patients. METHOD A literature review of articles published between 2006 and 2020 related to mirror exposure in obese patients and the related effects. RESULTS Literature that explicitly discussed mirror exposure in obese patients was included; five research articles were reviewed. CONCLUSIONS Mirror exposure can influence behaviour modification in obese patients. Therefore, the use of mirrors should be considered as an adjunct therapy in this group of patients. RELEVANCE TO CLINICAL PRACTICE Mirror exposure can positively alter behaviour in obese patients and can be used as an intervention in clinical practice to assist in weight loss and improve health outcomes.
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19
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English JV. Efficacy of several statistical methods in differentiating TBI and co-occurring conditions: A replication study. Appl Neuropsychol Adult 2022:1-12. [PMID: 35984307 DOI: 10.1080/23279095.2022.2109028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVES (1) Cross-validation of neuropsychological test data sets of moderate-severe TBI (N = 30) with test data from moderate-severe (N = 74); somatization (N = 24) and PCS (N = 22) cases in a database, (2) Determine if cognitive test data sets alone differentiated TBI from other groups, and (3) Evaluate the efficacy of measures in comparisons: Kullback-Leibler, Correlation, Patterns, Cohen's d, and MNB. MATERIALS AND METHODS Meyer's Neuropsychological System; Comparison groups -TBI sample with structural evidence of brain injury (CT/MRI); comparison of 5 statistical measures' efficacy in test data analysis comparing a community sample of moderate TBI (N=30) with a data base containing moderate-severe TBI (N = 74) + co-occurring groups (PCS N = 22) + Somatization (N = 24). Measures utilized: Correlation, Kullbeck-Leibler divergence, Cohen's d, MNB code, Configuration. RESULTS Combining the five measures most accurately matched the TBI sample (30/30 cases) with MNB comparison groups of similar TBI severity while differentiating those cases from PCS and Somatoform cognitive testdata. Both Kullback Leibler & Cohens' d reduced false positive errors in comparison with the other measures.
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Affiliation(s)
- James V English
- Department of Neuroscience, Mesa View Regional Hospital, Mesquite, NV, USA
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20
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Gumus YY, Senturk E. Anxiety, depressive, and somatoform disorders in children and adolescents referred to paediatric cardiology with somatic symptoms. Cardiol Young 2022; 33:1-6. [PMID: 35856274 DOI: 10.1017/s1047951122001949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Chest pain, palpitations, and syncope are among the most common referrals to paediatric cardiology. These symptoms generally have a non-cardiac aetiology in children and adolescents. The aim of this study was to investigate the rate of common psychiatric disorders in children and adolescents referred to the paediatric cardiology clinic with chest pain, palpitations, and syncope and the relationship between cardiological symptoms and psychiatric disorders. METHODS Children and adolescents aged 8-16 years who presented at the paediatric cardiology clinic with primary complaints of chest pain, palpitation, or syncope were included in the study. After a detailed cardiology examination, psychiatric disorders were assessed using the DSM IV-TR diagnostic criteria and a semi-structured interview scale (KSADS-PL). The Child Depression Inventory and Spielberger's State-Trait Anxiety Inventory for Children were also applied to assess the severity of anxiety and depression. RESULTS The study participants comprised 73 (68.90%) girls and 33 (31.10%) boys with a mean age of 12.5 ± 2.4 years. Psychiatric disorders were determined in a total of 48 (45.3%) participants; 24 (38.7%) in the chest pain group, 12 (48.0%) in the palpitation group, and 12 (63.2%) in the syncope group. Cardiological disease was detected in 17% of the cases, and the total frequencies of psychiatric disorders (p = 0.045) were higher in patients with cardiological disease. CONCLUSION It is clinically important to know that the frequency of psychiatric disorders is high in patients presenting at paediatric cardiology with chest pain, palpitations, and syncope. Physicians should be aware of patients' psychiatric problems and take a biopsychosocial approach in the evaluation of somatic symptoms.
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Affiliation(s)
- Yusuf Yasin Gumus
- Department of Child Psychiatry, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey
| | - Ekrem Senturk
- Department of Child Psychiatry, Health Sciences University Derince Training and Research Hospital, Kocaeli, Turkey
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21
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Kim ST, Seo JH, Lee S, Jeon S, Park CI, Kim SJ, Kang JI. Dysfunctional coronavirus anxiety in nonpsychotic psychiatric outpatients during the COVID-19 pandemic: A network analysis. Depress Anxiety 2022; 39:556-563. [PMID: 35344625 PMCID: PMC9087144 DOI: 10.1002/da.23256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/09/2022] [Accepted: 03/16/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The 2019 coronavirus disease (COVID-19) pandemic has had a profound impact on the mental health of people worldwide. This study examined dysfunctional coronavirus anxiety in nonpsychotic psychiatric outpatients during the pandemic using the coronavirus anxiety scale (CAS) and examined the relationship between coronavirus anxiety and clinical symptoms using network analysis. METHODS In this cross-sectional study, 192 patients who first visited the psychiatric outpatient clinic of Severance Hospital during the COVID-19 pandemic with chief complaints of depressed mood, anxiety, somatic symptoms, or insomnia were included. We compared the clinical characteristics of patients with and without dysfunctional coronavirus anxiety. Network analysis was conducted to estimate the network of coronavirus anxiety and depressive, anxious, and hypochondriacal psychopathology. RESULTS The results showed that 7.8% of patients exhibited dysfunctional coronavirus anxiety (CAS ≥ 5). Patients with dysfunctional coronavirus anxiety showed higher levels of health worry, somatic preoccupation, and subjective anxiety compared to patients without dysfunctional coronavirus anxiety. In the network analysis, the health worry node (Item 6 of the WI) showed the greatest number of connections with coronavirus anxiety nodes. CONCLUSIONS These findings suggest that health worry may be an important bridge symptom that connects coronavirus anxiety and other clinical psychopathology. Patients with elevated health worries should be carefully monitored during the COVID-19 pandemic for exacerbation of previous symptoms and COVID-19-related psychopathology. Understanding the psychological factors in the face of the pandemic and their relationships with clinical psychiatric symptoms would help people prevent and overcome mental health problems during the pandemic.
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Affiliation(s)
- Shin Tae Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jun Ho Seo
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Kangwon, Republic of Korea
| | - Sangmin Lee
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sumoa Jeon
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chun Il Park
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Se Joo Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jee In Kang
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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22
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Pimentel LH, Mutarelli EG. Diagnostic pitfalls in functional neurological disorders. Arq Neuropsiquiatr 2022; 80:324-327. [PMID: 35976310 PMCID: PMC9491422 DOI: 10.1590/0004-282x-anp-2022-s120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
The diagnosis of functional neurological disorders is a major challenge in neurologist practice. Some clinical strategies can facilitate the recognition of functional disorders, but several pitfalls make their diagnosis difficult. Here we highlight the following points of attention during evaluation of patients with functional disorder: not all bizarre behavior is functional; not every event triggered by an emotional factor is a functional disorder; not every topographic incongruity is a functional disorder; patients may present functional and organic symptoms at the same time; psychiatric comorbid condition is not always evident in the history of a functional disorder; problematic communication at the time of diagnosis can compromise treatment and prognosis. In conclusion, we emphasize that special attention to these possible pitfalls facilitate the correct diagnosis and management of functional neurological disorders.
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Affiliation(s)
- Lucio Huebra Pimentel
- Universidade Federal de São Paulo, Departamento de Psicobiologia, São Paulo SP, Brazil
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Brinkers M, Pfau G, Ritz W, Meyer F, Kretzschmar M. What does low psychological distress mean in patients with no mental disorders and different pains of the musculoskeletal system? Scand J Pain 2022; 22:298-304. [PMID: 34655513 DOI: 10.1515/sjpain-2021-0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 09/30/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study is to define the different levels of psychological distress in patients suffering from pain and functional disorders of the musculoskeletal system. METHODS This investigation was conducted as a retrospective study of 60 patients randomly selected of a German specialized orthopaedic hospital within the year 2016, whose therapeutic approaches are based on a non-surgical orthopaedic multimodal approach of manual therapy. All patients were suffering from pain and functional disorders of the musculoskeletal system. Two groups were formed: one without and one with additional mental disorders according to ICD-10. The impairment score (ISS) according to Schepank was determined. RESULTS The somatic sub score of the ISS was the highest sub score in both patient groups. The cumulative value of the ISS score of patients with both a mental disorder and pain in the musculoskeletal system was higher than for patients without concomitant mental disorder. For patients without concomitant mental disorder, the cumulative ISS exceeded the test criteria for mentally healthy individuals. CONCLUSIONS Patients without mental disorder but with chronic pain of the locomotoric system receive a psychological pain management program, as it is part of the billing code OPS 8-977 to the health insurance companies in Germany. However, the data show that these patients also have a substantial somatic subscore and a cumulative ISS above the level of healthy individuals. The absence of psychological disorders (according to ICD-10) in patients with pain of the musculoskeletal system should not lead to the assumption that these patients are psychologically inconspicuous. Subsyndromal mental findings (below ICD-10) can be one aspect of a mental disorder presenting with primarily somatic symptoms. In this case, patients would benefit from a psychotherapeutic program in a similar way as the patients with mental disorders according to ICD-10.
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Affiliation(s)
- Michael Brinkers
- Department of Anaesthesiology and Intensive Care Medicine, Division of Pain Therapy, University Hospital at Magdeburg, Magdeburg, Germany
| | - Giselher Pfau
- Department of Anaesthesiology and Intensive Care Medicine, Division of Pain Therapy, University Hospital at Magdeburg, Magdeburg, Germany
| | - Wolfgang Ritz
- Department of Manual Medicine, "Sana Kliniken Sommerfeld", Kremmen, Germany
| | - Frank Meyer
- Department of General, Abdominal, Vascular, and Transplant Surgery, University Hospital at Magdeburg, Magdeburg, Germany
| | - Moritz Kretzschmar
- Department of Anaesthesiology and Intensive Care Medicine, Division of Pain Therapy, University Hospital at Magdeburg, Magdeburg, Germany
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Alalawi NM, Al Salmani AA, Aljabri MK, Azmi IS, Aljardani MM, Al Mandhari SS, Al Kindi YS, Al Omrani NH. Epidemiology and Prevalence of Somatic Symptom Disorder at the Primary Care Level in Muscat, Oman: A Cross-Sectional Study. Int J Psychiatry Med 2022; 58:284-294. [PMID: 35430921 DOI: 10.1177/00912174221088263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Somatic symptom disorder (SSD) is a diagnostic classification to describe the occurrence of physical symptoms without organic cause. This study aimed to identify prevalence rates and associated characteristics of SSD among adults in primary care settings. METHODS This cross-sectional study took place between July 2020 and March 2021 and included a random selection of 3383 Omani adults attending 12 primary healthcare centres in Muscat Governorate. Screening was conducted using an Arabic version of the Somatic Symptom Scale-8 (SSS-8). RESULTS A total of 2000 adults participated in the study (response rate: 67.3%), of which most were female (71.7%) and under 50 years old (86.2%). Based on their SSS-8 scores, 602 participants (17.8%) had SSD, resulting in an overall prevalence estimate of 30.1% (95% confidence interval: 28.13-32.15). Significant associations were observed between SSD and age (p = 0.002), gender (p < 0.001), marital status (p = 0.030) and chronic comorbidities (p = 0.001). In addition, adjusted odds ratio estimates revealed SSD to be significantly associated with gender (p < 0.001), education level (p < 0.001) and chronic comorbidities (p = 0.001). CONCLUSION The estimated prevalence of SSD in primary care settings is high compared to reports from elsewhere in the Gulf region. There is an urgent need to enhance the diagnosis of SSD at the primary care level in order to reduce healthcare service overutilisation and patient dissatisfaction. Moreover, healthcare practitioners should be aware of the effect of age, gender, educational status and chronic comorbidities on somatic symptoms.
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Affiliation(s)
| | - Asma A Al Salmani
- Department of Family Medicine and public health, 37611Sultan Qaboos University Hospital, Muscat, Oman
| | - Maha K Aljabri
- Department of Family Medicine and public health, 37611Sultan Qaboos University Hospital, Muscat, Oman
| | - Imran S Azmi
- Department of Family Medicine and public health, 37611Sultan Qaboos University Hospital, Muscat, Oman
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25
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Löwe B, Levenson J, Depping M, Hüsing P, Kohlmann S, Lehmann M, Shedden-Mora M, Toussaint A, Uhlenbusch N, Weigel A. Somatic symptom disorder: a scoping review on the empirical evidence of a new diagnosis. Psychol Med 2022; 52:632-648. [PMID: 34776017 PMCID: PMC8961337 DOI: 10.1017/s0033291721004177] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND In 2013, the diagnosis of somatic symptom disorder (SSD) was introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This review aims to comprehensively synthesize contemporary evidence related to SSD. METHODS A scoping review was conducted using PubMed, PsycINFO, and Cochrane Library. The main inclusion criteria were SSD and publication in the English language between 01/2009 and 05/2020. Systematic search terms also included subheadings for the DSM-5 text sections; i.e., diagnostic features, prevalence, development and course, risk and prognostic factors, culture, gender, suicide risk, functional consequences, differential diagnosis, and comorbidity. RESULTS Eight hundred and eighty-two articles were identified, of which 59 full texts were included for analysis. Empirical evidence supports the reliability, validity, and clinical utility of SSD diagnostic criteria, but the further specification of the psychological SSD B-criteria criteria seems necessary. General population studies using self-report questionnaires reported mean frequencies for SSD of 12.9% [95% confidence interval (CI) 12.5-13.3%], while prevalence studies based on criterion standard interviews are lacking. SSD was associated with increased functional impairment, decreased quality of life, and high comorbidity with anxiety and depressive disorders. Relevant research gaps remain regarding developmental aspects, risk and prognostic factors, suicide risk as well as culture- and gender-associated issues. CONCLUSIONS Strengths of the SSD diagnosis are its good reliability, validity, and clinical utility, which substantially improved on its predecessors. SSD characterizes a specific patient population that is significantly impaired both physically and psychologically. However, substantial research gaps exist, e.g., regarding SSD prevalence assessed with criterion standard diagnostic interviews.
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Affiliation(s)
- Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - James Levenson
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Miriam Depping
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Paul Hüsing
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Kohlmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Marco Lehmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Meike Shedden-Mora
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
| | - Anne Toussaint
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Natalie Uhlenbusch
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Angelika Weigel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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26
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Iuzbashian PG, Lvov AN, Tereshenko AV, Volel BA, Satrudinova RR, Romanov DV. [Pain syndromes and insomnia: the role of association with comorbid mental disorders (on the model of glossalgia)]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:13-18. [PMID: 34874649 DOI: 10.17116/jnevro202112110113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To test the association between pain severity and anxiety, depression, and somatoform symptoms in burning sleep syndrome (BMS). MATERIAL AND METHODS The study included 36 patients (33 women, 3 men), mean age 58.0±14.8 years. Psychopathological, clinical-dermatological, parametric, statistical methods were used. Psychometric examination included the Visual Analogue Scale (VAS) for assessment of pain (severity of glossalgia), PHQ-4 for self-assessment of severity of anxiety (GAD-2) and depression (PHQ-2), the Hospital Anxiety and Depression Scale (HADS), the Screening for Somatoform Symptoms-2 (SOMS-2), the Pittsburgh Sleep Quality Index (PSQI), the EQ-5D-5L quality of life assessment scale. RESULTS AND CONCLUSION Insomnia in chronic pain is very common. On the one hand, studies show that sleep deprivation can enhance pain perception. On the other hand, chronic pain can trigger a variety of sleep disorders. One of the localizations of chronic pain syndrome is the oral mucosa. Somatoform pain disorder related to oral mucosa called «glossalgia» or «burning mouth syndrome» (BMS). The prevalence of insomnia in the study sample was 61.1%. The statistically significant positive correlation was found between the severity of insomnia (PSQI) and the severity of anxiety on both GAD-2 and HADS, while insomnia showed no correlation with depression and pain severity. At the same time, the severity of anxiety showed statistically significant positive correlation with the severity of pain assessed by VAS.
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Affiliation(s)
- P G Iuzbashian
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A N Lvov
- Central State Medical Academy of Department of Presidential Affairs, Moscow, Russia.,Lomonosov Moscow State University, Moscow, Russia
| | - A V Tereshenko
- Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology, Moscow, Russia
| | - B A Volel
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Mental Health Research Center, Moscow, Russia
| | - R R Satrudinova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - D V Romanov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Mental Health Research Center, Moscow, Russia
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Abstract
BACKGROUND Very few Indian studies have explored disability among patients with somatoform disorder and the burden experienced by their caregivers. We aimed to assess the levels of disability among patients with somatoform disorder and the levels of burden among their caregivers and compare these parameters against patients with schizophrenia. METHODS Participants included adults with a diagnosis of somatoform disorders (F45.0-F 45.9) (n = 28) or schizophrenia (F20.0-F20.9) (n = 28) diagnosed as per the International Classification of Diseases, Tenth Revision (ICD-10), clinical descriptions, and diagnostic guidelines, as well as their caregivers. The WHO Disability Assessment Schedule 2.0 and Family Burden Interview Schedule were used to assess patient disability and caregiver burden, respectively. Independent Student's t-test or chi-square test was used to compare relevant sociodemographic and clinical parameters. RESULTS Out of 56 patients, the mean (±SD) age of the sample was 38.6 (±10.5) years. Females constituted a slender majority of the sample (n = 29, 51.8%). The mean disability score of patients with somatoform disorders was slightly higher (83.6 ±20.9) than that of patients with schizophrenia (82.3 ±16.7). Similarly, the mean burden score of caregivers of patients with somatoform disorders was nominally higher (18.96 ±9.9) than that of caregivers of patients with schizophrenia (15.7 ±9.7). Neither of these differences approached statistical significance (P > 0.05). CONCLUSION Patients with somatoform disorders experience considerable levels of disability, and their caregivers go through various levels of burden in their daily life that is comparable to schizophrenia.
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Affiliation(s)
| | - Padmavathi Nagarajan
- Dept. of Psychiatric Nursing, College of Nursing, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pudhucherry, India
| | - Vikas Menon
- Dept. of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pudhucherry, India
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28
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Rogers MAW, Au Yeung J. Curing somatisation-induced paraplegia with experimental dice-based affective modulation. BMJ Case Rep 2021; 14:e227285. [PMID: 34645622 PMCID: PMC8515472 DOI: 10.1136/bcr-2018-227285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2021] [Indexed: 11/04/2022] Open
Abstract
Following a minor meniscal injury to his right knee, a previously fit and well 58-year-old man developed profound somatisation leading to paraplegia. The patient developed a deep-seated belief that any exercise or walking would cause irreparable damage to his knee. Over the course of 2 years his, mobility reduced from active mountaineering to walking a short distance, and finally to paraplegia. Medical investigations were normal and organic causes were ruled out. Conventional therapy was exhausted, a number of medications were trialled over 5 years, including selective serotonin reuptake inhibitors (SSRIs) and antipsychotics without success. Eventually, with a combination of cognitive behavioural therapy, physiotherapy and a novel experimental therapy where the patient rolled dice and acted according to the roll results, the patient was able to literally and metaphorically get back on his feet.
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Affiliation(s)
- Miles Alexander William Rogers
- General Medicine, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
- Psychiatry, Royal Oldham Hospital, Oldham, UK
| | - Joshua Au Yeung
- Clinical Pharmacology, Guy's and St Thomas' Hospitals NHS Trust, London, UK
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29
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Shahini N, Ghasemzadeh M, Javan M, Salimi Z. Evaluation of the COVID-19 pandemic effect on the development of somatic symptoms in patients with mood disorders: a case-control study. New Microbes New Infect 2021; 43:100917. [PMID: 34603735 PMCID: PMC8463032 DOI: 10.1016/j.nmni.2021.100917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/21/2021] [Accepted: 07/05/2021] [Indexed: 12/28/2022] Open
Abstract
Somatic symptoms are one of the most common complaints among patients with psychiatric disorders and are considered as one of the most common psychiatric disorders in the new coronavirus pandemic. This study aimed to evaluate the effect of the COVID-19 pandemic on the physical symptoms in patients with mood disorders and compare it with healthy individuals. In this case-control study, 67 patients with mood disorders were referred to the psychiatric clinic of 5 Azar Hospital in Gorgan, who met the inclusion criteria, and 68 healthy individuals as control group were entered into the study. For all participants after informed consent, a demographic information questionnaire was completed along with Screening for Somatic Symptoms-7 (SOMS7) and Patient Health Questionnaire-15 (PHQ-15), and the data were analysed by SPSS software version 25. The mean score obtained for the SOMS-7 questionnaire for the group of patients with mood disorders and the control group was 32.37 ± 8.19 and 35.42 ± 11.3, respectively. The mean obtained for the PHQ-15 questionnaire for the mood disorders group and the control group was 8.56 ± 5.93 and 5.86 ± 4.63, respectively. In the mood disorder group, 26.9% of patients had no risk for physical symptoms, 31.3% of patients had a low risk, 25.4% of patients had a moderate risk, and 16.4% of patients had a high risk for physical symptoms. The statistical test showed that although the risk of physical symptoms was high in both groups, this rate was higher in the group with mood disorders, and there is a significant difference between the two groups (P < 0.05). The results also showed a significant and direct relationship between the two questionnaires (P < 0.05). According to the results, although the prevalence of somatic symptoms increased in both groups, the prevalence of somatic symptoms is significantly higher in the mood disorder group.
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Affiliation(s)
- N. Shahini
- Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, GorganIran
| | | | - M. Javan
- Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, GorganIran
| | - Z. Salimi
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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30
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Smulevich AB, Lvov AN, Iuzbashian PG, Tereshenko AV, Michenko AV, Bobko SI, Voronova EI, Romanov DV. [Glossalgia as a psychodermatological syndrome]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:7-13. [PMID: 34460151 DOI: 10.17116/jnevro20211210717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To study clinical characteristics of burning mouth syndrome or glossalgia is a functional disorder with painful sensations in the oral cavity with verification of the psychopathological structure, typology and nosology of the syndrome within the continuum of neurotic/psychotic disorders and dermatological pathology, i.e. lichen planus (LP). MATERIAL AND METHODS The study sample (n=30, 27 female, mean age 59.3±15.6 years) was examined by dermatologist, neurologist and psychiatrist both clinically and psychometrically. The patients met the diagnostic criteria for glossalgia according to the IASP classification and ICD-10 for glossodynia (code K14.6). In 7 subjects, there was comorbidity with LP of the oral mucosa. RESULTS The psychopathological picture of glossalgia syndrome has a binary structure. Basic coenesthesiopathies, ranging in severity from homonomous sensations (isteralgias) to heteronomic sensopathies (senestopathies, senesthesia), are associated with secondary hypochondriacal phenomena: from health anxiety and monopatophobia to mastery of ideas and somatopsychic confusion, respectively. According to the psychopathological register (neurotic/psychotic) and the fact of objective verification of a dermatological disease (hypochondria sine materia/cum materia), there are three types of glossalgic syndrome: 1) organo-neurotic; 2) somatopsychotic; 3) dermatological (stress-induced somatic reactions). CONCLUSION BMS is a local syndrome limited to the oral cavity, however, in fact, it covers the entire clinical spectrum of psychosomatic pathology from mental diseases to psychodermatological ones.
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Affiliation(s)
- A B Smulevich
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Mental Health Research Center, Moscow, Russia
| | - A N Lvov
- Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology of Moscow City Health Department, Moscow, Russia
| | - P G Iuzbashian
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A V Tereshenko
- Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology of Moscow City Health Department, Moscow, Russia
| | - A V Michenko
- Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology of Moscow City Health Department, Moscow, Russia
| | - S I Bobko
- Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology of Moscow City Health Department, Moscow, Russia
| | - E I Voronova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Mental Health Research Center, Moscow, Russia
| | - D V Romanov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Mental Health Research Center, Moscow, Russia
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31
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Goel A, Ranjan P, Klanidhi KB, Deb KS, Sarkar S, Kaur T, Sahu A, Baitha U, Chakrawarty A, Kumar A. Comprehensive Treatment Module for Medically Unexplained Physical Symptoms - A Guide for General Practitioners. Cureus 2021; 13:e16263. [PMID: 34414039 PMCID: PMC8364782 DOI: 10.7759/cureus.16263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 11/19/2022] Open
Abstract
Purpose: This study was aimed to develop a comprehensive treatment module that the general physician can use to manage patients with Medically Unexplained Physical Symptoms (MUPS) at a primary care level. Methods: This comprehensive module was developed after a literature review followed by its validation by a two-step Delphi technique with experts from internal medicine, psychiatry, and clinical psychology. Results: The developed module for the patients with MUPS includes case diagnosis, initial evaluation, strategy for referral, and a comprehensive treatment module. The comprehensive treatment module includes symptom discussion, rapport establishment, physical health counselling, stress management, cognitive strategies for symptom control, comorbidities treatment, and medical management. Conclusion: The developed module has unique features, such as intensive sessions with these patients, a patient-specific treatment strategy, and a holistic approach incorporating pharmacological and non-pharmacological interventions. General Practitioners across the world can use this comprehensive treatment module for the management of patients with MUPS.
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Affiliation(s)
- Aastha Goel
- Internal Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Piyush Ranjan
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Kamal B Klanidhi
- Internal Medicine: Geriatrics, All India Institute of Medical Sciences, New Delhi, IND
| | | | - Siddharth Sarkar
- Psychiatry, All India Institute of Medical Sciences, New Delhi, IND
| | - Tanveer Kaur
- Psychology, All India Institute of Medical Sciences, New Delhi, IND
| | - Anamika Sahu
- Psychiatry, All India Institute of Medical Sciences, New Delhi, IND
| | - Upendra Baitha
- Internal Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Avinash Chakrawarty
- Internal Medicine • Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Arvind Kumar
- Internal Medicine, All India Institute of Medical Sciences, New Delhi, IND
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Orzechowska A, Maruszewska P, Gałecki P. Cognitive Behavioral Therapy of Patients with Somatic Symptoms-Diagnostic and Therapeutic Difficulties. J Clin Med 2021; 10:jcm10143159. [PMID: 34300324 PMCID: PMC8307926 DOI: 10.3390/jcm10143159] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/08/2021] [Accepted: 07/14/2021] [Indexed: 12/16/2022] Open
Abstract
In every somatic disease we can find a psychological element, just as it is not uncommon for numerous physical symptoms to occur in a mental disease. Nowadays, the patient is no longer just the “owner” of the sick organ but is considered and treated as a “whole”. The interpenetration of somatic manifestations with mental health problems forces patients who experience subjective suffering, including mental suffering, from current symptoms to visit specialists from different fields of medicine, and their treatment does not bring about any improvement. Cognitive behavioral psychotherapy (CBT) is one form of therapy that attempts to respond to the needs of an increasing—in recent years—number of patients who demonstrate somatic disorders of a multifaceted nature. The co-occurrence of physical and mental disorders repeatedly makes it impossible to determine which symptoms were the cause and which were the effect; hence, it is difficult to establish clear boundaries between the categories of these disorders and diseases. The therapist, to whom the patient with somatic diseases is eventually referred, may be faced with a diagnostic dilemma, the solution of which will give direction to further psychotherapeutic work. The common feature of this group of patients is a strong focus on physical ailments, while omitting or almost completely ignoring the psychological factors involved. The purpose of this paper is to present the causally diverse circumstances in which a patient with physical symptoms needs diagnosis and therapeutic support from the perspective of a cognitive behavioral approach.
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Abstract
We report on Phase 1 efforts of the Hierarchical Taxonomy of Psychopathology (HiTOP) measurement subgroup tasked with developing provisional scales for the somatoform spectrum and eating disorders. In Study 1, items were written to assess five somatoform spectrum constructs (bodily distress symptoms, conversion symptoms, health anxiety, disease conviction, and somatic preoccupation). Scale development analyses were conducted on 550 university students. The conversion symptom items were too infrequently endorsed and were set aside for Phase 2. Analyses of the other items yielded four scales corresponding closely to their hypothesized structure. In Study 2, we delineated 15 specific feeding and eating disorder constructs. A sample of 400 university students were administered candidate items and several eating disorder questionnaires for criterion validity. Analyses yielded six scales capturing previously described constructs, tapping content related to body image and weight concerns, restricting and purging, cognitive restraint, binging, excessive exercise, and muscle building. Two scales representing additional constructs deemed to be of high clinical import-negative attitude towards obesity and avoidant/restrictive food intake disorder-were retained for Phase 2, for a total of eight scales. Overall, we concluded that Phase 1 had been successful at generating a comprehensive set of provisional scales for inclusion in Phase 2.
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Božanić Urbančič N, Vozel D, Urbančič J, Battelino S. Unraveling the Etiology of Pediatric Vertigo and Dizziness: A Tertiary Pediatric Center Experience. ACTA ACUST UNITED AC 2021; 57:475. [PMID: 34064850 DOI: 10.3390/medicina57050475] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Numerous authors have reported that the commonest type of vertigo in children is migraine-associated vertigo (vestibular migraine and benign paroxysmal vertigo of childhood—BPV). We aimed to provide the possible etiological background of vertigo and dizziness in Slovenian children. Materials and Methods: A retrospective case series of pediatric vertigo and dizziness children referred to the tertiary pediatric otorhinolaryngology center from 2015 to 2020. Children received a complete audiological and vestibular workup and were referred to pediatric specialists depending on the clinical presentation. Results: Of 257 children (42% male, 58% female) aged 1–17 years (M = 10.9, SD = 4.3 years) in 19.1% vertigo and dizziness were classified as central, in 12.4% as a peripheral vestibular, in 10.9% as a hemodynamic, in 5.8% as a psychological and none as visual by pediatric neurologists, otorhinolaryngologists, cardiologists, psychologists or ophthalmologists, respectively. 40.8% (20) children with central vertigo had BPV (7.8% of all children) and 8.2% (4) migrainous vertigo. In 43.6% (112 children), the etiology remained unclassified. Conclusions: After a thorough multidisciplinary workup, the etiology of vertigo and dizziness was unraveled in the majority of children referred to our tertiary otorhinolaryngology center. The most common cause was central; however, in a considerable number, the etiology remained unclassified. The latter could be attributed to the self-limiting nature of vertigo spells. Hence, a child presenting with dizziness and vertigo requires a multidisciplinary approach, in which referral to a neurologist is, in most cases, essential.
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Schwilk N, Klöppel S, Schmidtke K, Metternich B. Functional cognitive disorder in subjective cognitive decline-A 10-year follow-up. Int J Geriatr Psychiatry 2021; 36:677-683. [PMID: 33166421 DOI: 10.1002/gps.5466] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/19/2020] [Accepted: 11/01/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVES In memory clinics, patients with significant memory complaints without objective neuropsychological findings are common. They are classified as subjective cognitive decline (SCD) and, as a group, face a heightened risk for future dementia. However, the SCD group is heterogeneous and comprises patients suffering from a somatoform condition, namely functional cognitive disorder (FCD). These patients make up at least 11% of memory clinics' attendees. The aim of this long-term follow-up study was to investigate if patients diagnosed with FCD also face a higher risk of developing dementia. METHODS Forty-two Patients were recruited at a university hospital memory clinic. FCD was diagnosed according to the Schmidtke criteria (see Table 1). Ten years later, all were invited again. Participants were interviewed, screened for depression and given neuropsychological tests of verbal memory and information processing speed. Cognitive impairment was defined as performance below 1.5 standard deviations (SD) of the age-related mean. RESULTS Twenty-eight of 42 patients (67%) took part in this follow-up. The group's mean results in both cognitive measures were stable over time. All individual performances were within 1.5 SD. With 10 patients (24%), brief contact was successful and manifest dementia could be excluded. Four patients (10%) could not be contacted. CONCLUSIONS In retrospect, the Schmidtke criteria for FCD safely identified memory clinic attendees with SCD who did not proceed to Mild Cognitive Impairment or dementia. None of the patients who could be contacted for this follow-up after a decade (90% of baseline participants) showed signs of dementia.
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Affiliation(s)
- Nora Schwilk
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | | | - Birgitta Metternich
- Department of Neurosurgery, Epilepsy Center, Medical Center-University of Freiburg, Freiburg, Germany
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36
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Kuriyama A. Bodily Distress Syndrome After Routine Vaccination: A Case Report. J Acad Consult Liaison Psychiatry 2021; 62:557-558. [PMID: 34059489 DOI: 10.1016/j.jaclp.2021.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Akira Kuriyama
- Emergency and Critical Care Center, Kurashiki Central Hospital, Okayama, Japan.
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37
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BAYKARA S, BAYKARA M, MERMİ O, YILDIRIM H, ATMACA M. Magnetic resonance imaging histogram analysis of corpus callosum in a functional neurological disorder. Turk J Med Sci 2021; 51:140-147. [PMID: 32892546 PMCID: PMC7991863 DOI: 10.3906/sag-2004-252] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/29/2020] [Indexed: 02/02/2023] Open
Abstract
Background/aim The aim of the present study was to examine and compare the corpus callosum (CC) via histogram analysis (HA) on T1-weighted MR images of patients diagnosed with Functional Neurological Disorder (FND) and healthy controls. Materials and methods The study group included 19 female patients diagnosed with FND, and the control group included 20 healthy subjects. All participants were scanned with a 1.5 T MR scanner. A high-resolution structural image of the entire brain was obtained with sagittal 3D spiral fast spin echo T1-weighted images. Gray level intensity, standard deviation of the histogram, entropy, uniformity, skewness, and kurtosis values were determined with texture analysis. A student’s t-test was used to compare the group data. P < 0.05 was accepted as statistically significant. Results It was determined that the mean gray level intensity, standard deviation of the histogram, entropy calculated by the maximum, median and variance and size M percentage values were higher in patients with FND. Kurtosis and size U percentages values were lower in patients with FND. Conclusion In the present study, analysis of CC with T1-weighted MR image HA demonstrated significant differences between FND patients and healthy controls. The study findings indicated that HA is a beneficial technique for demonstrating textural variations between the CCs of patients with FND and healthy controls using MR images.
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Affiliation(s)
- Sema BAYKARA
- Department of Psychiatry, Faculty of Medicine, Fırat University, ElazığTurkey
| | - Murat BAYKARA
- Department of Radiology, Faculty of Medicine, Fırat University, ElazığTurkey
| | - Osman MERMİ
- Department of Psychiatry, Faculty of Medicine, Fırat University, ElazığTurkey
| | - Hanefi YILDIRIM
- Department of Radiology, Faculty of Medicine, Fırat University, ElazığTurkey
| | - Murad ATMACA
- Department of Psychiatry, Faculty of Medicine, Fırat University, ElazığTurkey
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38
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Tint NP, Hussain H. Near miss abdominal pain. BMJ Case Rep 2021; 14:14/2/e238883. [PMID: 33541988 PMCID: PMC7868178 DOI: 10.1136/bcr-2020-238883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
An 18-year-old adolescent with intermittent colicky abdominal pain for 4 months was admitted to a Medical Emergency Assessment Unit for further investigation of possible colitis, after being reviewed by a surgeon in Accident and Emergency. Initially he was treated for a urinary tract infection, however a CT of the abdomen revealed appendicular perforation with pelvic abscess formation. The patient required an urgent laparoscopy and was discharged without complications. Typically, appendicitis is an acute surgical problem whereas chronic abdominal pain is routinely considered a medical problem. This case demonstrates the importance of maintaining acute causes as part of the differentials list in young patients with unexplained recurrent abdominal pain as well as justifying the early use of CT when there is ambiguity surrounding a diagnosis.
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Affiliation(s)
- Nyan Phone Tint
- Acute Medicine, United Lincolnshire Hospitals NHS Trust, Lincoln, UK
| | - Hamzah Hussain
- University of Nottingham, Nottingham, Nottinghamshire, UK
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39
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Bottemanne H, Gouraud C, Hulot JS, Blanchard A, Ranque B, Lahlou-Laforêt K, Limosin F, Günther S, Lebeaux D, Lemogne C. Do Anxiety and Depression Predict Persistent Physical Symptoms After a Severe COVID-19 Episode? A Prospective Study. Front Psychiatry 2021; 12:757685. [PMID: 34858230 PMCID: PMC8631493 DOI: 10.3389/fpsyt.2021.757685] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/01/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Persistent physical symptoms are common after a coronavirus disease 2019 (COVID-19) episode, but their pathophysiological mechanisms remain poorly understood. In this study, we aimed to explore the association between anxiety and depression at 1-month after acute infection and the presence of fatigue, dyspnea, and pain complaints at 3-month follow-up. Methods: We conducted a prospective study in patients previously hospitalized for COVID-19 followed up for 3 months. The Hospital Anxiety and Depression Scale (HAD-S) was administered by physicians at 1-month follow-up, and the presence of fatigue, dyspnea, and pain complaints was assessed at both 1 month and 3 months. Multivariable logistic regressions explored the association between anxiety and depression subscores and the persistence of each of the physical symptom at 3 months. Results: A total of 84 patients were included in this study (Median age: 60 years, interquartile range: 50.5-67.5 years, 23 women). We did not find any significant interaction between anxiety and the presence of fatigue, dyspnea, or pain complaints at 1 month in predicting the persistence of these symptoms at 3 months (all p ≥ 0.36). In contrast, depression significantly interacted with the presence of pain at 1 month in predicting the persistence of pain at 3 months (OR: 1.60, 95% CI: 1.02-2.51, p = 0.039), with a similar trend for dyspnea (OR: 1.51, 95% CI: 0.99-2.28, p = 0.052). Discussion and Conclusion: Contrary to anxiety, depression after an acute COVID-19 episode may be associated with and increased risk of some persistent physical symptoms, including pain and dyspnea.
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Affiliation(s)
- Hugo Bottemanne
- Paris Brain Institute - Institut du Cerveau et de la Moelle Épiniére, UMR 7225, UMR_S 1127, CNRS, INSERM, Sorbonne University, Service de Psychiatrie de l'Adulte, Hôpital de la Pitié-Salpêtriére, DMU Neurosciences, Assistance Publique-Hôpitaux De Paris, Paris, France
| | - Clément Gouraud
- Service de Psychiatrie de l'Adulte, DMU Psychiatrie et Addictologie, Hôpital Hôtel-Dieu, Université de Paris, Assistance Publique-Hopitaux de Paris, Paris, Paris, France
| | - Jean-Sébastien Hulot
- CIC 1418 and DMU CARTE, Assistance Publique Hopitaux De Paris, Hôpital Européen Georges-Pompidou, Paris, France
| | - Anne Blanchard
- Service de Néphrologie, Assistance Publique Hopitaux De Paris, Hôpital Européen-Georges Pompidou, Université de Paris, Paris, France
| | - Brigitte Ranque
- Service de Médecine Interne, Assistance Publique Hopitaux De Paris, Hôpital Européen-Georges Pompidou, Université de Paris, Paris, France
| | - Khadija Lahlou-Laforêt
- DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'Adulte, Assistance Publique Hopitaux De Paris, Hôpital Européen-Georges Pompidou, Université de Paris, Paris, France
| | - Frédéric Limosin
- DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'Adulte, Assistance Publique Hopitaux De Paris, Hôpital Corentin Celton, Université de Paris, Paris, France
| | - Sven Günther
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France.,Service de Physiologie, Assistance Publique Hopitaux De Paris, Georges Pompidou European Hospital, Paris, France
| | - David Lebeaux
- Service de Microbiologie, Unité Mobile d'Infectiologie, Assistance Publique Hopitaux De Paris, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France
| | - Cédric Lemogne
- Service de Microbiologie, Unité Mobile d'Infectiologie, Assistance Publique Hopitaux De Paris, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France.,Service de Psychiatrie de l'Adulte, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Assistance Publique Hopitaux De Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Université de Paris, Paris, France
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40
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Yang F, Xie XH, Li X, Liao HN, Zou B. Analysis of Psychological and Gut Microbiome Characteristics in Patients With Non-erosive Reflux Disease. Front Psychiatry 2021; 12:741049. [PMID: 35095588 PMCID: PMC8793911 DOI: 10.3389/fpsyt.2021.741049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To assess the correlation between the incidence of non-erosive reflux disease (NERD) and psychological factors, especially somatoform disorders. To investigate the characteristics of gut microbiome in NERD patients. Methods: We enrolled 24 NERD patients and 24 healthy controls. All patients were evaluated via GerdQ, SOMS-7, SAS, HAMA, and HAMD. Fecal samples were collected and 16S rRNA sequencing was performed to evaluate the gut microbiome composition. Results: The main symptoms of the NERD patients were regurgitation (87.5%), belching (66.7%), pharyngeal discomfort (50%), and heartburn (37.5%). The average score of GerdQ was 13.42 ± 3.41. In 15 patients (62.5%), the total score of the last two items was <3 points, while the average score of 24 patients was 3.63 ± 2.32. NERD patients with somatoform disorders accounted for 50%. There were 17 patients without anxiety, 6 patients with mild anxiety (25%), 1 patient with moderate anxiety (4.2%), and no patient with severe anxiety. There were 22 patients (91.7%) without depression, 2 patients (8.3%) with mild depression, and no patient with moderate or severe depression. The alpha diversity of NERD group was higher than HC, which showed significant difference (P < 0.05). The beta-diversity was significantly different between HC and NERD patients (P = 0.026), male and female patients (P = 0.009). The beta-diversity was also significantly different between male and female patients (P = 0.009). There were several bacteria with significant differences between HC and NERD group, and NERD patients with or without somatoform disorders, such as Firmicutes, TM7 were enriched in the NERD group compared with the healthy control group, while Bacteroidetes were enriched in the healthy controls. Conclusions: NERD symptoms overlap with somatoform disorders. NERD symptoms have an impact on the daily life quality of patients. Some of them are accompanied by anxiety and depression of different degrees, and the two are significantly correlated. The diversity of gut microbiome in patients with NERD is significantly higher than healthy controls, which has its characteristics. The predominant bacteria in gut microbiome of patients with NERD are similar to the healthy population, with Firmicutes and Bacteroidetes as the main ones. The composition of gut microbiome in NERD patients with or without somatoform disorder is significantly different, which may be related to the interaction of microbiome-brain-gut axis.
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Affiliation(s)
- Fan Yang
- Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xin-Hui Xie
- Department of Psychiatry, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China.,Brain Function and Psychosomatic Medicine Institute, Second People's Hospital of Huizhou, Huizhou, China.,Center of Acute Psychiatry Service, Second People's Hospital of Huizhou, Huizhou, China
| | - Xi Li
- Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hui-Na Liao
- Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Bing Zou
- Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, China
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Abstract
Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.
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Affiliation(s)
- Eric Garrels
- Psychiatric Liaison Service (Queen's Hospital), NELFT NHS Foundation Trust, Romford, Essex, UK
| | - Fawziya Huq
- Psychiatric Liaison Service (Queen's Hospital), NELFT NHS Foundation Trust, Romford, Essex, UK
| | - Gavin McKay
- Psychiatric Liaison Service (Queen's Hospital), NELFT NHS Foundation Trust, Romford, Essex, UK
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Adamson J, Ali S, Santhouse A, Wessely S, Chalder T. Cognitive behavioural therapy for chronic fatigue and chronic fatigue syndrome: outcomes from a specialist clinic in the UK. J R Soc Med 2020; 113:394-402. [PMID: 32930040 PMCID: PMC7583448 DOI: 10.1177/0141076820951545] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Cognitive behavioural therapy is commonly used to treat chronic fatigue syndrome and has been shown to be effective for reducing fatigue and improving physical functioning. Most of the evidence on the effectiveness of cognitive behavioural therapy for chronic fatigue syndrome is from randomised control trials, but there are only a few studies in naturalistic treatment settings. Our aim was to examine the effectiveness of cognitive behavioural therapy for chronic fatigue syndrome in a naturalistic setting and examine what factors, if any, predicted outcome. DESIGN Using linear mixed effects analysis, we analysed patients' self-reported symptomology over the course of treatment and at three-month follow-up. Furthermore, we explored what baseline factors were associated with improvement at follow-up. SETTING Data were available for 995 patients receiving cognitive behavioural therapy for chronic fatigue syndrome at an outpatient clinic in the UK. PARTICIPANTS Participants were referred consecutively to a specialist unit for chronic fatigue or chronic fatigue syndrome. MAIN OUTCOME MEASURES Patients were assessed throughout their treatment using self-report measures including the Chalder Fatigue Scale, 36-item Short Form Health Survey, Hospital Anxiety and Depression Scale and Global Improvement and Satisfaction. RESULTS Patients' fatigue, physical functioning and social adjustment scores significantly improved over the duration of treatment with medium to large effect sizes (|d| = 0.45-0.91). Furthermore, 85% of patients self-reported that they felt an improvement in their fatigue at follow-up and 90% were satisfied with their treatment. None of the regression models convincingly predicted improvement in outcomes with the best model being (R2 = 0.137). CONCLUSIONS Patients' fatigue, physical functioning and social adjustment all significantly improved following cognitive behavioural therapy for chronic fatigue syndrome in a naturalistic outpatient setting. These findings support the growing evidence from previous randomised control trials and suggest that cognitive behavioural therapy could be an effective treatment in routine treatment settings.
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Affiliation(s)
- James Adamson
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London SE5 8AF, UK
| | - Sheila Ali
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London SE5 8AF, UK
| | - Alastair Santhouse
- Persistent Physical symptoms Research and Treatment Unit, South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - Simon Wessely
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London SE5 8AF, UK.,Persistent Physical symptoms Research and Treatment Unit, South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London SE5 8AF, UK.,Persistent Physical symptoms Research and Treatment Unit, South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
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Nakkas C, Annen H, Brand S. Somatization and Coping in Ethnic Minority Recruits. Mil Med 2020; 184:e680-e685. [PMID: 30793179 DOI: 10.1093/milmed/usz014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/09/2018] [Accepted: 01/16/2019] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Military service can have beneficial social effects on minorities. However, minority groups are also often at greater risk of somatizing psychological distress and coping maladaptively. In military training this would result in lower mental health of minorities and contribute to higher drop-out rates. We thus examined if recruits with different ethnocultural backgrounds report different somatization levels and coping styles. MATERIALS AND METHODS Seven hundred and forty male recruits of the Swiss Armed Forces aged 18-26 took part in a cross-sectional study during basic training. Participants filled out self-rating questionnaires covering sociodemographics, somatization (SCL-90-R), coping styles (INCOPE-2), and social support (F-SozU). The recruits' ethnic self-identification was used to compare three groups: native Swiss (89%); Turkish or Balkan minority (5%); heterogeneous ethnic minority (6%). Group differences in somatization scores were tested with a Kruskal-Wallis test; group differences in coping styles were tested with a multivariate ANCOVA, controlling for the level of social support experienced. RESULTS Recruits from the heterogeneous ethnic minority group reported significantly greater levels of somatization than their native Swiss comrades. Coping styles did not differ between the three ethnic groups, but higher levels of social support were associated with better coping. CONCLUSION Military doctors ought to place importance on the differential diagnosis of medically unexplained physical symptoms in ethnic minority recruits. This would contribute to minimize the risk of misdiagnosis. Military mental health professionals who counsel recruits reporting somatic symptoms are advised to be sensitized to an ethnic minority status. Physical complaints could mask affective problems or be part of an adjustment disorder symptomatology.
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Affiliation(s)
- Can Nakkas
- Psychologic-Pedagogic Service of the Swiss Armed Forces (PPD A), Waffenplatz, Gebäude 338, Thun, Switzerland
| | - Hubert Annen
- Department of Military Psychology Studies, Military Academy at ETH Zurich, Birmensdorf, Switzerland
| | - Serge Brand
- University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Wilhelm Klein-Strasse 27, Basel, Switzerland
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Abstract
Functional neurological disorder (FND) describes various neurological symptoms that are not explained by an organic aetiology. The condition has a poor prognosis. Despite this, there is sparse research that informs clinical interventions for FND, particularly when treating functional fixed dystonia. Our article has outlined an intervention for a patient with a treatment-resistant functional fixed dystonia that was informed by a biopsychosocial model, which aimed to rehabilitate the patient's functional motor symptoms. This led to favourable outcomes including restoring full range of movement in the patient's right foot and improvements in routine outcome measurement scores. The patient also described the programme as life-changing and was able to re-engage in meaningful and purposeful activities.
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Affiliation(s)
- Yvonne Hsieh
- Neuropsychiatry Outpatient, South London and Maudsley NHS Foundation Trust, Kent, UK
| | - Shaunak Deshpande
- Neuropsychiatry Outpatient, South London and Maudsley NHS Foundation Trust, Kent, UK
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Patel S, Akhtar A, Malins S, Wright N, Rowley E, Young E, Sampson S, Morriss R. The Acceptability and Usability of Digital Health Interventions for Adults With Depression, Anxiety, and Somatoform Disorders: Qualitative Systematic Review and Meta-Synthesis. J Med Internet Res 2020; 22:e16228. [PMID: 32628116 PMCID: PMC7381032 DOI: 10.2196/16228] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/20/2020] [Accepted: 03/23/2020] [Indexed: 12/20/2022] Open
Abstract
Background The prevalence of mental health disorders continues to rise, with almost 4% of the world population having an anxiety disorder and almost 3.5% having depression in 2017. Despite the high prevalence, only one-third of people with depression or anxiety receive treatment. Over the last decade, the use of digital health interventions (DHIs) has risen rapidly as a means of accessing mental health care and continues to increase. Although there is evidence supporting the effectiveness of DHIs for the treatment of mental health conditions, little is known about what aspects are valued by users and how they might be improved. Objective This systematic review aimed to identify, appraise, and synthesize the qualitative literature available on service users’ views and experiences regarding the acceptability and usability of DHIs for depression, anxiety, and somatoform disorders. Methods A systematic search strategy was developed, and searches were run in 7 electronic databases. Qualitative and mixed methods studies published in English were included. A meta-synthesis was used to interpret and synthesize the findings from the included studies. Results A total of 24 studies were included in the meta-synthesis, and 3 key themes emerged with descriptive subthemes. The 3 key themes were initial motivations and approaches to DHIs, personalization of treatment, and the value of receiving personal support in DHIs. The meta-synthesis suggests that participants’ initial beliefs about DHIs can have an important effect on their engagement with these types of interventions. Personal support was valued very highly as a major component of the success of DHIs. The main reason for this was the way it enabled individual personalization of care. Conclusions Findings from the systematic review have implications for the design of future DHIs to improve uptake, retention, and outcomes in DHIs for depression, anxiety, and somatoform disorders. DHIs need to be personalized to the specific needs of the individual. Future research should explore whether the findings could be generalized to other health conditions.
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Affiliation(s)
- Shireen Patel
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Athfah Akhtar
- School of Social Sciences, Birmingham City University, Birmingham, United Kingdom
| | - Sam Malins
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Nicola Wright
- Faculty of Medicine, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Emma Rowley
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Emma Young
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom
| | - Stephanie Sampson
- NIHR MindTech MedTech Co-operative, University of Nottingham, Nottingham, United Kingdom
| | - Richard Morriss
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom.,NIHR MindTech MedTech Co-operative, University of Nottingham, Nottingham, United Kingdom
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Scamvougeras A, Howard A. Somatic Symptom Disorder, Medically Unexplained Symptoms, Somatoform Disorders, Functional Neurological Disorder: How DSM-5 Got It Wrong. Can J Psychiatry 2020; 65:301-305. [PMID: 32191123 PMCID: PMC7265612 DOI: 10.1177/0706743720912858] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Anton Scamvougeras
- UBC Neuropsychiatry Program, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Howard
- UBC Neuropsychiatry Program, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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47
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Kessler U, Rekkedal GÅ, Rø Ø, Berentsen B, Steinsvik EK, Lied GA, Danielsen Y. Association between gastrointestinal complaints and psychopathology in patients with anorexia nervosa. Int J Eat Disord 2020; 53:532-536. [PMID: 32040232 DOI: 10.1002/eat.23243] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/10/2020] [Accepted: 01/22/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Gastrointestinal (GI) symptoms appear frequently in patients with anorexia nervosa (AN), but the associations between psychopathological, GI, and eating disorder (ED) symptoms remain unclear. This study aimed to determine the relationships of GI complaints with psychopathological measures, ED symptoms, and body mass index (BMI) in patients with AN. METHOD Thirty outpatients with AN aged >16 years were included. Psychopathological measures (Symptom Checklist-90-Revised, Beck Depression Inventory-II, and Beck Anxiety Inventory), ED symptoms (Eating Disorder Examination Questionnaire), ED-associated impairment (Clinical Impairment Assessment Questionnaire), GI complaints (Irritable Bowel Syndrome Severity Scoring System [IBS-SSS]), and BMI were assessed prior to starting treatment, and correlation and multiple regression analyses were applied to data from 19 patients. RESULTS IBS-symptoms were significantly correlated only with ED symptoms (r = 0.583, p = .009) and somatization (r = 0.666, p = .002). Multiple regression analysis revealed that somatization significantly predicted worse IBS symptoms (beta = 0.5, p = .04), while ED symptoms did not. DISCUSSION Higher IBS-SSS scores were associated with higher severities of other somatic complaints. GI complaints and somatization should be addressed in treatments for AN in order to prevent these factors impeding the establishment of healthy eating patterns. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02745067.
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Affiliation(s)
- Ute Kessler
- Department of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Guro Å Rekkedal
- Department of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Øyvind Rø
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Birgitte Berentsen
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,National Center for Functional Gastrointestinal Disorders, Medical Department, Haukeland University Hospital, Bergen, Norway
| | - Elisabeth K Steinsvik
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,National Center for Functional Gastrointestinal Disorders, Medical Department, Haukeland University Hospital, Bergen, Norway
| | - Gülen A Lied
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,National Center for Functional Gastrointestinal Disorders, Medical Department, Haukeland University Hospital, Bergen, Norway
| | - Yngvild Danielsen
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
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48
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Axelsson E, Hedman-Lagerlöf M, Hedman-Lagerlöf E, Ljótsson B, Andersson E. Symptom Preoccupation in Fibromyalgia: Prevalence and Correlates of Somatic Symptom Disorder in a Self-Recruited Sample. Psychosomatics 2020; 61:268-276. [PMID: 32169307 DOI: 10.1016/j.psym.2020.01.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Somatic symptom disorder (SSD) is characterized by a persistent and distressing psychological reaction to somatic symptoms. In pain disorders, the preoccupation with physical symptoms is associated with poor long-term outcomes. SSD may therefore be of use to identify and help chronic pain patients with particular needs. OBJECTIVE To test the hypothesis that in fibromyalgia, SSD is associated with higher anxiety sensitivity, health anxiety, and reactivity to pain, in addition to lower nonreactivity to inner experiences. In addition, to investigate if individuals with SSD report a larger impact of fibromyalgia core symptoms, more somatic symptoms, and higher psychiatric comorbidity. METHODS Using data from a clinical trial involving self-referred individuals with fibromyalgia, we compared participants with SSD to participants without SSD using t-tests and logistic regression. RESULTS Forty-nine out of 140 participants (35%) had SSD. Most findings corroborate that individuals with fibromyalgia who also meet criteria for SSD are worse off in terms of traits previously found to be predictive of a poor course in pain disorders. Post hoc analyses indicated that this could not be explained merely by a higher level of fibromyalgia core symptoms. CONCLUSION SSD appears to be associated with a higher symptom burden in fibromyalgia, but further research is needed to draw firm conclusions regarding the reliability, acceptability, and utility of the SSD diagnosis in the clinic.
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Affiliation(s)
- Erland Axelsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Maria Hedman-Lagerlöf
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Erik Hedman-Lagerlöf
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Brjánn Ljótsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Erik Andersson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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49
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Abstract
Background. General population data on associations between mental disorders and total mortality are rare. The aim was to analyze whether the number of mental disorders, single substance use, mood, anxiety, somatoform or eating disorders during the lifetime and whether treatment utilization may predict time to death 20 years later in the general adult population. Methods. We used data from the Composite International Diagnostic Interview, which includes DSM-IV diagnoses for substance use, mood, anxiety, somatoform, and eating disorders, for a sample of 4,075 residents in Germany who were 18–64 years old in 1996. Twenty years later, mortality was ascertained using the public mortality database for 4,028 study participants. Cox proportional hazards models were applied for disorders that existed at any time in life before the interview. Results. The data revealed increased hazard ratios (HRs) for number of mental disorders (three or more; HR 1.4; 95% confidence interval [CI] 1.1–1.9) and for single disorders (alcohol dependence, dysthymia, panic disorder with agoraphobia, and hypochondriasis), with the reference group being study participants who had not suffered from any of the mental disorders analyzed and with adjustments made for age, sex, and education. Among individuals with any mental disorder during their lifetimes, having been an inpatient in treatment for a mental disorder was related to a higher HR (2.2; CI 1.6–3.0) than was not having been in any treatment for a mental disorder. Conclusions. In this sample of adults in the general population, three or more mental disorders, alcohol dependence, dysthymia, panic disorder with agoraphobia, and hypochondriasis were related to premature death.
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Affiliation(s)
- Ulrich John
- Department of Social Medicine and Prevention, Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany.,German Center for Cardiovascular Research, Greifswald, Germany
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, Research Group S:TEP, University of Lübeck, Lübeck, Germany
| | - Monika Hanke
- Department of Social Medicine and Prevention, Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christian Meyer
- Department of Social Medicine and Prevention, Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany.,German Center for Cardiovascular Research, Greifswald, Germany
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50
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Toussaint A, Hüsing P, Kohlmann S, Löwe B. Detecting DSM-5 somatic symptom disorder: criterion validity of the Patient Health Questionnaire-15 (PHQ-15) and the Somatic Symptom Scale-8 (SSS-8) in combination with the Somatic Symptom Disorder - B Criteria Scale (SSD-12). Psychol Med 2020; 50:324-333. [PMID: 30729902 DOI: 10.1017/s003329171900014x] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced somatic symptom and related disorders (SSD) to improve the diagnosis of somatoform disorders. It is unclear whether existing questionnaires are useful to identify patients with SSD. Our study investigates the diagnostic accuracy of the Patient Health Questionnaire-15 (PHQ-15) and the Somatic Symptom Scale-8 (SSS-8) in combination with the Somatic Symptom Disorder - B Criteria Scale (SSD-12). METHODS For this cross-sectional study, participants were recruited from a psychosomatic outpatient clinic. PHQ-15, SSS-8, and SSD-12 were administered and compared with SSD criteria from a diagnostic interview. Sensitivity and specificity were calculated for optimal individual and combined cutpoints. Receiver operator curves were created and area under the curve (AUC) analyses assessed. RESULTS Data of n = 372 patients [31.2% male, mean age: 39.3 years (s.d. = 13.6)] were analyzed. A total of 56.2% fulfilled the SSD criteria. Diagnostic accuracy was moderate for each questionnaire (PHQ-15: AUC = 0.70; 95% CI = 0.65-0.76; SSS-8: AUC = 0.71; 95% CI = 0.66-0.77; SSD-12: AUC = 0.74; 95% CI = 0.69-0.80). Combining questionnaires improved diagnostic accuracy (PHQ-15 + SSD-12: AUC = 0.77; 95% CI = 0.72-0.82; SSS-8 + SSD-12: AUC = 0.79; 95% CI = 0.74-0.84). Optimal combined cutpoints were ⩾9 for the PHQ-15 or SSS-8, and ⩾23 for the SSD-12 (sensitivity and specificity = 69% and 70%). CONCLUSIONS The combination of the PHQ-15 or SSS-8 with the SSD-12 provides an easy-to-use and time- and cost-efficient opportunity to identify persons at risk for SSD. If systematically applied in routine care, effective screening and subsequent treatment might help to improve quality of life and reduce health care excess costs.
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Affiliation(s)
- Anne Toussaint
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Paul Hüsing
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Kohlmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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