Somatic symptoms among US adolescent females: associations with sexual and physical violence exposure.

Science.gov (United States)

Halpern, Carolyn Tucker; Tucker, Christine M; Bengtson, Angela; Kupper, Lawrence L; McLean, Samuel A; Martin, Sandra L

2013-12-01

The objective of this study is to examine the association between physical and sexual violence exposure and somatic symptoms among female adolescents. We studied a nationally representative sample of 8,531 females, aged 11-21 years, who participated in the 1994-1995 Wave I of the National Longitudinal Study of Adolescent Health (Add Health). Female adolescents were asked how often they had experienced 16 specific somatic symptoms during the past 12 months. Two summary categorical measures were constructed based on tertiles of the distributions for the entire female sample: (a) total number of different types of symptoms experienced, and (b) number of frequent (once a week or more often) different symptoms experienced. Groups were mutually exclusive. We examined associations between adolescents' violence exposure and somatic symptoms using multinomial logistic regression analyses. About 5 % of adolescent females reported both sexual and non-sexual violence, 3 % reported sexual violence only, 36 % reported non-sexual violence only, and 57 % reported no violence. Adolescents who experienced both sexual and non-sexual violence were the most likely to report many different symptoms and to experience very frequent or chronic symptoms. Likelihood of high symptomatology was next highest among adolescents who experienced sexual violence only, followed by females who experienced non-sexual violence only. Findings support an exposure-response association between violence exposure and somatic symptoms, suggesting that symptoms can be markers of victimization. Treating symptoms alone, without addressing the potential violence experienced, may not adequately improve adolescents' somatic complaints and well-being.

Pattern of somatic symptoms in anxiety and depression

International Nuclear Information System (INIS)

Shah, M.

2011-01-01

To determine the pattern of somatic symptoms in anxiety and depressive disorders. Design: Cross Sectional Comparative study Place of Study: Department of Psychiatry Military Hospital Rawalpindi. Duration of Study: From May to November 2002. Patients and Methods: Patients were divided in Group I of anxiety and group II of depression. Fifty patients considered in each group by convenience sampling. The organic basis of their symptoms was ruled out. The patterns of their somatic symptoms and other information like educational and economic status were recorded on Semi Structured Proforma. The patient's diagnosis was made on schedule based ICD-10 research criteria. The severity of anxiety and depression was assessed by using HARS and HDRS respectively. The pattern of somatic symptoms in both groups was then analyzed by the urdu version of Bradford Somatic Inventory. Patterns of somatic complaints were then analyzed by chi square test. Results: Out of 100 patients we placed 50 each in group I (anxiety) and group II (Depression). Males were higher in depression whereas females were higher in anxiety disorder group. P-value for headache was 0.017 while in rest of the somatic symptoms it was insignificant ranging from 0.4 to 1. Conclusion: We found that the patterns of somatic symptoms are present in both the groups of anxiety and depression like symptoms related to musculoskeletal and gastrointestinal system were commonly observed in cases of depression whereas symptoms related to autonomic nervous system and cardiovascular system is more significantly somatized in patients of anxiety. A larger sample is required for further studies to get better results. (author)

From mental-physical comorbidity to somatic symptoms - insights gained from research on symptoms of mental disorders

OpenAIRE

Rodic, Donja

2015-01-01

Abstract in English Background: Mental health and physical health are substantially associated with each other. The early recognition of co-occurring mental-physical conditions, as well as the early recognition of pathophysiological mechanisms underlying somatic symptoms, might be of special relevance for a better understanding of early phases of disorder development and hence prevention. Aim: To examine associations between symptoms of mental disorders (depressive symptoms and gambli...

The Association of Sensory Responsiveness with Somatic Symptoms and Illness Anxiety.

Science.gov (United States)

Rodic, Donja; Meyer, Andrea Hans; Lieb, Roselind; Meinlschmidt, Gunther

2016-02-01

Somatoform Disorders or Somatic Symptom and Related Disorders are a major public health problem.The pathophysiology underlying these disorders is not yet understood. The aim of this study was to explore if sensory responsiveness could contribute to a better understanding of pathophysiological mechanisms underlying two key symptoms of Somatoform Disorders, namely somatic symptoms and illness anxiety. We measured vibrotactile perception thresholds with the HVLab Perception Meter and examined their association with somatic symptoms, illness anxiety and trait anxiety. A sample of 205 volunteers participated in the study. Sensory responsiveness was neither associated with somatic symptoms (β = -0.01; 95% confidence interval (CI), -0.37, 0.39) nor trait anxiety (β = -0.07; 95% CI, -0.30, 0.07). However, lower vibrotactile perception thresholds were associated with increased scores of the overall illness anxiety scale (β = -0.65; 95% CI, -1.21, -0.14) and its constituent subscale disease conviction (β = -2.07; 95% CI, -3.94, -0.43). Our results suggest that increased sensory responsiveness is associated with illness anxiety and hence should be examined further as potential target within the etiopathology of somatoform disorders.

Health Anxiety in Panic Disorder, Somatization Disorder and Hypochondriasis

OpenAIRE

Özgün Karaer KARAPIÇAK; Selçuk ASLAN; Çisem UTKU

2012-01-01

Objective: Health anxiety is the fear of being or getting seriously sick due to the misinterpretation of physical symptoms. Severe health anxiety is also named as hypochondriasis. Belief of having a disease due to the misinterpretation of physical symptoms is also seen in panic disorder and somatization disorder. The aim of this study is to search the health anxiety in panic disorder, somatization disorder and hypochondriasis and compare it with healthy volunteers. Method: SCID-I was used ...

Health Anxiety in Panic Disorder, Somatization Disorder and Hypochondriasis

Directory of Open Access Journals (Sweden)

Özgün Karaer KARAPIÇAK

2012-03-01

Full Text Available Objective: Health anxiety is the fear of being or getting seriously sick due to the misinterpretation of physical symptoms. Severe health anxiety is also named as hypochondriasis. Belief of having a disease due to the misinterpretation of physical symptoms is also seen in panic disorder and somatization disorder. The aim of this study is to search the health anxiety in panic disorder, somatization disorder and hypochondriasis and compare it with healthy volunteers. Method: SCID-I was used to determine psychiatric disorders in patient group. In order to assess the clinical state and disease severity of the patient group; Panic and Agoraphobia Scale, Hamilton Anxiety Rating Scale, Inventory of Depressive Symptomatology were used for patients with panic disorder and Symptom Interpretation Questionnaire, Hamilton Anxiety Rating Scale, Inventory of Depressive Symptomatology were used for patients with somatization disorder and hypochondriasis. Brief Symptom Inventory was used to assess psychopathology in healthy group. In order to evaluate health anxiety of both groups, Health Anxiety Inventory-Short Form was used. Results: Results of this study support that health anxiety is a significant major component of hypochondriasis. On the other hand, health anxiety seems to be common in panic disorder and somatization disorder. Health anxiety also may be a part of depression or present in healthy people. Conclusion: Further studies are needed in order to search how to manage health anxiety appropriately and which psychotherapeutic interventions are more effective.

Hypochondriasis, somatization, and perceived health and utilization of health care services.

Science.gov (United States)

Hollifield, M; Paine, S; Tuttle, L; Kellner, R

1999-01-01

The authors determined the different effects of hypochondriasis and somatization on health perceptions, health status, and service utilization in a primary care population. The subjects with hypochondriacal responses (HR) on the Illness Attitudes Scales or high somatic concern (HSC) on the Symptom Questionnaire had a worse perception of health and variably used more health services than the control subjects, even though the HR and HSC subjects had the same level of chronic medical disorders. Regression analyses determined that somatization contributed more to negative health perception and service utilization than did hypochondriasis, although an interaction between the two contributed to the use of psychiatric care. The authors discuss the boundary between hypochondriasis and somatization for its implications for research and clinical practice.

Somatic Symptom Disorder in Semantic Dementia: The Role of Alexisomia.

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Gan, Joanna J; Lin, Andrew; Samimi, Mersal S; Mendez, Mario F

Semantic dementia (SD) is a neurodegenerative disorder characterized by loss of semantic knowledge. SD may be associated with somatic symptom disorder due to excessive preoccupation with unidentified somatic sensations. To evaluate the frequency of somatic symptom disorder among patients with SD in comparison to comparably demented patients with Alzheimer׳s disease. A retrospective cohort study was conducted using clinical data from a referral-based behavioral neurology program. Fifty-three patients with SD meeting criteria for imaging-supported semantic variant primary progressive aphasia (another term for SD) were compared with 125 patients with clinically probable Alzheimer disease. Logistic regression controlled for sex, age, disease duration, education, overall cognitive impairment, and depression. The prevalence of somatic symptom disorder was significantly higher among patients with SD (41.5%) compared to patients with Alzheimer disease (11.2%) (odds ratio = 6:1; p Cotard syndrome or the delusion that unidentified somatic symptoms signify death or deterioration. SD, a disorder of semantic knowledge, is associated with somatic symptom disorder from impaired identification of somatic sensations. Their inability to read and name somatic sensations, or "alexisomia," results in disproportionate and persistent concern about somatic sensations with consequent significant disability. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Parental Criticism is an Environmental Influence on Adolescent Somatic Symptoms

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Horwitz, BN; Marceau, K; Narusyte, J; Ganiban, J; Spotts, EL; Reiss, D; Lichtenstein, P; Neiderhiser, JM

2015-01-01

Previous studies have suggested that parental criticism leads to more somatic symptoms in adolescent children. Yet this research has not assessed the direction of causation or whether genetic and/or environmental influences explain the association between parental criticism and adolescent somatic symptoms. As such, it is impossible to understand the mechanisms that underlie this association. The current study uses the Extended Children of Twins design to examine whether parents’ genes, adolescents’ genes, and/or environmental factors explain the relationship between parental criticism and adolescent somatic symptoms. Participants came from two twin samples, including the Twin and Offspring Study in Sweden (N = 868 pairs of adult twins and each twin’s adolescent child) and from the Twin Study of Child and Adolescent Development (N = 690 pairs of twin children and their parents). Findings showed that environmental influences account for the association between parental criticism and adolescent somatic symptoms. This suggests that parents’ critical behaviors exert a direct environmental effect on somatic symptoms in adolescent children. Results support the use of intervention programs focused on parental criticism to help reduce adolescents’ somatic symptoms. PMID:25844495

The Role of Somatic Symptoms in Sexual Medicine: Somatization as Important Contextual Factor in Male Sexual Dysfunction.

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Fanni, Egidia; Castellini, Giovanni; Corona, Giovanni; Boddi, Valentina; Ricca, Valdo; Rastrelli, Giulia; Fisher, Alessandra Daphne; Cipriani, Sarah; Maggi, Mario

2016-09-01

An important feature of somatic symptom disorder is the subjective perception of the physical symptoms and its maladaptive interpretation. Considering that psychological distress is often expressed through somatic symptoms, it is possible that they underlie at least a part of the symptoms in subjects complaining of sexual dysfunction. Nevertheless, studies on the impact of somatoform disorders in sexual dysfunction are scanty. To define the psychological, relational, and organic correlates of somatic symptoms in a large sample of patients complaining of sexual problems. A consecutive series of 2833 men (mean age 50.2 ± 13.5 years) was retrospectively studied. Somatic symptoms were assessed using the "somatized anxiety symptoms" subscale of the Middlesex Hospital Questionnaire (MHQ-S). Several clinical, biochemical, psychological, and relational parameters were studied. Patients were interviewed with the previously validated Structured Interview on Erectile Dysfunction (SIEDY), and ANDROTEST (a structured interview for the screening of hypogonadism in patients with sexual dysfunction). Among the 2833 patients studied, subjects scoring higher on somatic symptoms were older, more obese, reporting unhealthy lifestyle (current smoking, alcohol consumption), and a lower education (all P sexuality more often, including erectile problems (spontaneous or sexual-related), low sexual desire, decreased frequency of intercourse, and perceived reduction of ejaculate volume (all P sexual dysfunction. High levels of somatic symptoms in subjects with sexual dysfunction can be related to the sexual symptom itself. The consequences of this pattern have great clinical relevance in a sexual medicine setting, considering their severe impact on sexuality. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Somatic-Affective, But Not Cognitive-Depressive Symptoms are Associated With Reduced Health-Related Quality of Life in Patients With Congestive Heart Failure.

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Patron, Elisabetta; Messerotti Benvenuti, Simone; Lopriore, Vincenzo; Aratari, Jenny; Palomba, Daniela

Depression has been associated with poor health-related quality of life (HRQoL) in patients with congestive heart failure (CHF). However, to date, whether somatic-affective and cognitive-depressive symptoms differently contribute to poor HRQoL and behavioral functional capacity in patients with CHF has yet to be investigated. To examine the differential influence of somatic-affective vs cognitive-depressive symptoms on HRQoL and behavioral functional capacity in CHF patients. Overall, 55 patients with CHF completed a psychologic evaluation, including the Minnesota Living with Heart Failure Questionnaire, the Beck Depression Inventory-II, and the Beck Anxiety Inventory for HRQoL, depressive, and anxiety symptoms, respectively. The patients completed the Instrumental Activities of Daily Living Questionnaire and the 6-minute walk test for behavioral functional capacity. Hierarchical regression analyses were used to predict HRQoL and behavioral functional capacity from Beck Depression Inventory-II and Beck Anxiety Inventory scores. Somatic-affective depressive symptoms were associated with physical (β = 0.37, p = 0.005) and emotional (β = 0.39, p = 0.008) Minnesota Living with Heart Failure Questionnaire subscale scores. Likewise, somatic-affective depressive symptoms predicted Instrumental Activities of Daily Livings Scores (β = 0.43, p = 0.004) and distance ambulated during the 6-minute walk test (β = -0.36, p = 0.029). By contrast, cognitive-depressive symptoms and anxiety were unrelated to HRQoL and behavioral functional capacity (all p > 0.05). These findings showed that somatic-affective depressive symptoms, but not cognitive-depressive symptoms and anxiety, are associated with poor HRQoL and behavioral functional capacity independent of age, clinical functional status, and medical comorbidities. This study suggests that patients with CHF with somatic-affective rather than cognitive-depressive symptoms or anxiety may be at greater risk of poor HRQoL and

Clinical features of functional somatic symptoms in children and referral patterns to child and adolescent mental health services

DEFF Research Database (Denmark)

Tøt-Strate, Simone; Dehlholm-Lambertsen, Gitte; Lassen, Karin

2016-01-01

AIM: Functional somatic symptoms (FSS) are common in paediatric patients who are referred to Child and Adolescent Mental Health Service (CAMHS), but little is known about current referral practices. The aim of this study was to systematically investigate clinical features of paediatric inpatients...... who had been referred and 44 children who had not. RESULTS: Most paediatric records lacked information on psychosocial factors and symptoms. Referred children were significantly more multisymptomatic of FSS (p controls, had longer symptom duration, underwent more clinical...... reasons were generally vague and psychosocial information was frequently missing. Clinical guidelines are needed to improve and systematise mental health referrals for children with FSS....

Monitoring somatic symptoms in patients with mental disorders: Sensitivity to change and minimal clinically important difference of the Somatic Symptom Scale - 8 (SSS-8).

Science.gov (United States)

Gierk, Benjamin; Kohlmann, Sebastian; Hagemann-Goebel, Marion; Löwe, Bernd; Nestoriuc, Yvonne

2017-09-01

The SSS-8 is a brief questionnaire for the assessment of somatic symptom burden. This study examines its sensitivity to change and the minimal clinically important difference (MCID) in patients with mental disorders. 55 outpatients with mental disorders completed the SSS-8 and measures of anxiety, depression, and disability before and after receiving treatment. Effect sizes and correlations between the change scores were calculated. The MCID was estimated using a one standard error of measurement threshold and the change in disability as an external criterion. There was a medium decline in somatic symptom burden for the complete sample (n=55, d z =0.53) and a large decline in a subgroup with very high somatic symptom burden at baseline (n=11, d z =0.94). Decreases in somatic symptom burden were associated with decreases in anxiety (r=0.68, pSSS-8 is sensitive to change. A 3-point decrease reflects a clinically important improvement. Due to its brevity and sound psychometric properties, the SSS-8 is useful for monitoring somatic symptom burden. Copyright © 2017 Elsevier Inc. All rights reserved.

The association of work stress with somatic symptoms in Chinese working women: a large cross-sectional survey.

Science.gov (United States)

Li, Jian; Ding, Hui; Han, Wei; Jin, Lei; Kong, Ling-Na; Mao, Kang-Na; Wang, Hong; Wu, Jiang-Ping; Wu, Ying; Yang, Liu; Zhou, Yu; Wang, You-Xin; Wang, Wei; Loerbroks, Adrian; Angerer, Peter

2016-10-01

It has been suggested that the relationship between work stress and somatic symptoms (e.g., cardiopulmonary, gastrointestinal complaints, general pain, and fatigue) is particularly pronounced in women. As evidence from China is sparse, we used a large sample of Chinese working women to test those potential associations. Data were obtained from a cross-sectional study of 6826 working women in five urban areas in China who were free from major clinical disease. The sample was drawn from five occupations (physicians, nurses, school teachers, bank employees, and industrial workers). The Effort-Reward Imbalance Questionnaire and Patient Health Questionnaire-15 were used to measure work stress and somatic symptoms, respectively. Multivariate ordinal logistic regression was performed to analyze the associations. 52.6% participants reported high work stress in terms of concurrent high effort and low reward. The distribution of severity of somatic symptoms covered the full range from minimal (37.3%) and low (30.6%), to medium (19.7%) and high (12.4%). The adjusted odds ratio of somatic symptoms by high work stress was 2.45 (95% confidence interval=2.24-2.68), and all single psychosocial work factors (effort, reward, and over-commitment) exerted substantial effects on somatic symptoms (odds ratios>2.00). Work stress is strongly associated with somatic symptoms in Chinese working women. Future longitudinal studies and intervention studies are needed to understand and improve women's psychosocial work environment and their psychosomatic health in China and elsewhere. Copyright © 2016 Elsevier Inc. All rights reserved.

Development and Validation of the Somatic Symptom Disorder-B Criteria Scale (SSD-12).

Science.gov (United States)

Toussaint, Anne; Murray, Alexandra M; Voigt, Katharina; Herzog, Annabel; Gierk, Benjamin; Kroenke, Kurt; Rief, Winfried; Henningsen, Peter; Löwe, Bernd

2016-01-01

To develop and validate a new self-report questionnaire for the assessment of the psychological features of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition somatic symptom disorder. The Somatic Symptom Disorder-B Criteria Scale (SSD-12) was developed in several steps from an initial pool of 98 items. The SSD-12 is composed of 12 items; each of the three psychological subcriteria is measured by four items. In a cross-sectional study, the SSD-12 was administered to 698 patients (65.8% female, mean [standard deviation] age = 38.79 [14.15] years) from a psychosomatic outpatient clinic. Item and scale characteristics as well as measures of reliability and validity were determined. The SSD-12 has good item characteristics and excellent reliability (Cronbach α = .95). Confirmatory factor analyses suggested that a three-factorial structure that reflects the three psychological criteria interpreted as cognitive, affective, and behavioral aspects (n = 663, Comparative Fit Index > 0.99, Tucker-Lewis Index > 0.99, Root Mean Square Error of Approximation = 0.06, 90% confidence interval = 0.01-0.08). SSD-12 total sum score was significantly associated with somatic symptom burden (r = 0.47, p psychological symptom burden reported higher general physical and mental health impairment and significantly higher health care use. The SSD-12 is the first self-report questionnaire that operationalizes the new psychological characteristics of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition somatic symptom disorder. Initial assessment indicates that the SSD-12 has sufficient reliability and validity to warrant further testing in both research and clinical settings.

Mind-Body Interactions in Anxiety and Somatic Symptoms.

Science.gov (United States)

Mallorquí-Bagué, Núria; Bulbena, Antonio; Pailhez, Guillem; Garfinkel, Sarah N; Critchley, Hugo D

2016-01-01

Anxiety and somatic symptoms have a high prevalence in the general population. A mechanistic understanding of how different factors contribute to the development and maintenance of these symptoms, which are highly associated with anxiety disorders, is crucial to optimize treatments. In this article, we review recent literature on this topic and present a redefined model of mind-body interaction in anxiety and somatic symptoms, with an emphasis on both bottom-up and top-down processes. Consideration is given to the role played in this interaction by predisposing physiological and psychological traits (e.g., interoception, anxiety sensitivity, and trait anxiety) and to the levels at which mindfulness approaches may exert a therapeutic benefit. The proposed model of mind-body interaction in anxiety and somatic symptoms is appraised in the context of joint hypermobility syndrome, a constitutional variant associated with autonomic abnormalities and vulnerability to anxiety disorders.

Somatic symptoms beyond those generally associated with a whiplash injury are increased in self-reported chronic whiplash. A population-based cross sectional study: the Hordaland Health Study (HUSK

Directory of Open Access Journals (Sweden)

Myrtveit Solbjørg

2012-08-01

Full Text Available Abstract Background Chronic whiplash leads to considerable patient suffering and substantial societal costs. There are two competing hypothesis on the etiology of chronic whiplash. The traditional organic hypothesis considers chronic whiplash and related symptoms a result of a specific injury. In opposition is the hypothesis that chronic whiplash is a functional somatic syndrome, and related symptoms a result of society-induced expectations and amplification of symptoms. According to both hypotheses, patients reporting chronic whiplash are expected to have more neck pain, headache and symptoms of anxiety and depression than the general population. Increased prevalence of somatic symptoms beyond those directly related to a whiplash neck injury is less investigated. The aim of this study was to test an implication derived from the functional hypothesis: Is the prevalence of somatic symptoms as seen in somatization disorder, beyond symptoms related to a whiplash neck injury, increased in individuals self-reporting chronic whiplash? We further aimed to explore recall bias by comparing the symptom profile displayed by individuals self-reporting chronic whiplash to that among those self-reporting a non-functional injury: fractures of the hand or wrist. We explored symptom load, etiologic origin could not be investigated in this study. Methods Data from the Norwegian population-based “Hordaland Health Study” (HUSK, 1997–99; N = 13,986 was employed. Chronic whiplash was self-reported by 403 individuals and fractures by 1,746. Somatization tendency was measured using a list of 17 somatic symptoms arising from different body parts and organ systems, derived from the research criteria for somatization disorder (ICD-10, F45. Results Chronic whiplash was associated with an increased level of all 17 somatic symptoms investigated (p Conclusions The increased prevalence of somatic symptoms beyond symptoms expected according to the organic injury model

Prognostic significance of functional somatic symptoms in adolescence: a 15-year community-based follow-up study of adolescents with depression compared with healthy peers

Directory of Open Access Journals (Sweden)

Bohman Hannes

2012-07-01

Full Text Available Abstract Background There is a lack of population-based long-term longitudinal research on mental health status and functional physical/somatic symptoms. Little is known about the long-term mental health outcomes associated with somatic symptoms or the temporal relationship between depression and such symptoms. This 15-year study followed up adolescents with depression and matched controls, screened from a population-based sample, who reported different numbers of somatic symptoms. Methods The total population of 16–17-year-olds in Uppsala, Sweden, was screened for depression in 1991–1993. Adolescents who screened positive and an equal number of healthy controls took part in a semi-structured diagnostic interview. In addition, 21 different self-rated somatic symptoms were assessed. Sixty-four percent of those adolescents participated in a follow-up structured interview 15 years later. Results Somatic symptoms in adolescence predicted depression and other adult mental disorders regardless of the presence of adolescent depression. In adolescents with depression, the number of functional somatic symptoms predicted, in a dose response relationship, suicidal behavior, bipolar episodes, and psychotic episodes as well as chronic and recurrent depression. Contrary to expectations, the somatic symptoms of abdominal pain and perspiration without exertion better predicted depression than all DSM-IV depressive symptoms. Abdominal pain persisted as an independent strong predictor of depression and anxiety, even after controlling for other important confounders. Conclusions Somatic symptoms in adolescence can predict severe adult mental health disorders. The number of somatic symptoms concurrent with adolescent depression is, in a stepwise manner, linked to suicidal attempts, bipolar disorders, psychotic disorders, and recurrent and chronic depression. These findings can be useful in developing treatment guidelines for patients with somatic symptoms.

Multiple somatic symptoms in primary care

DEFF Research Database (Denmark)

Goldberg, D. P.; Reed, G. M.; Robles, R.

2016-01-01

Objective A World Health Organization (WHO) field study conducted in five countries assessed proposals for Bodily Stress Syndrome (BSS) and Health Anxiety (HA) for the Primary Health Care Version of ICD-11. BSS requires multiple somatic symptoms not caused by known physical pathology and associated...... with distress or dysfunction. HA involves persistent, intrusive fears of having an illness or intense preoccupation with and misinterpretation of bodily sensations. This study examined how the proposed descriptions for BSS and HA corresponded to what was observed by working primary care physicians (PCPs......) in participating countries, and the relationship of BSS and HA to depressive and anxiety disorders and to disability. Method PCPs referred patients judged to have BSS or HA, who were then interviewed using a standardized psychiatric interview and a standardized measure of disability. Results Of 587 patients...

The Relationship between Depression, Anxiety, Somatization, Personality and Symptoms of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia.

Science.gov (United States)

Koh, Jun Sung; Ko, Hyo Jung; Wang, Sheng-Min; Cho, Kang Joon; Kim, Joon Chul; Lee, Soo-Jung; Pae, Chi-Un

2015-04-01

This study investigated the relationship of personality, depression, somatization, anxiety with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the International Prostate Symptom Score (IPSS), 44-item Big Five Inventory (BFI), the Patient Health Questionnaire-9 (PHQ-9), the PHQ-15, and 7-item Generalized Anxiety Disorder Scale (GAD-7). The LUTS/BPH symptoms were more severe in patients with depression (p=0.046) and somatization (p=0.024), respectively. Neurotic patients were associated with greater levels of depression, anxiety and somatisation (p=0.0059, p=0.004 and p=0.0095, respectively). Patients with high extraversion showed significantly low depression (p=0.00481) and anxiety (p=0.035) than those with low extraversion. Our exploratory results suggest patients with LUTS/BPH may need careful evaluation of psychiatric problem including depression, anxiety and somatization. Additional studies with adequate power and improved designs are necessary to support the present exploratory findings.

[The relationship among depression, anxiety, and somatic symptoms in a sample of university students in northern Mexico].

Science.gov (United States)

González Ramírez, Mónica Teresa; Landero Hernández, René; García-Campayo, Javier

2009-02-01

To determine how anxiety, depression, and somatic symptoms are related in a sample of university students in northern Mexico. An exploratory study was conducted through self-administered questionnaires applied to a convenience sample of 506 psychology students at two universities in Monterrey, in the state of Nuevo León, Mexico. To evaluate somatic symptoms, the Patient Health Questionnaire was used; for depression, the Beck Depression Inventory; and for anxiety, the Social Anxiety Scale for Adolescents. Spearman's correlation was used to determine to what extent the associations among the variables were significant. The Kruskal-Wallis test was used to compare anxiety and depression levels between groups of students organized by severity of somatic symptoms. Of the participants, 129 (25.5%) presented somatic symptoms that were of medium intensity or severe; just 4 (0.8%) had severe depression; and only 2 (0.4%) students presented anxiety levels over 75% of the scale maximum. The severity of somatic symptoms increased in step with anxiety and depression levels. The somatic symptoms occurring most frequently and of greatest concern among the study sample were: headache, menstrual pain, and backache, as well as feeling tired and having difficulty sleeping. The direct association between the severity of somatic symptoms and depression and anxiety was confirmed. It is recommended that all treatment and/or prevention programs addressing one of these conditions, include the other two as well. Programs specifically aimed at university youth should be implemented.

Review of somatic symptoms in post-traumatic stress disorder.

Science.gov (United States)

Gupta, Madhulika A

2013-02-01

Post-traumatic stress disorder (PTSD) is associated with both (1) 'ill-defined' or 'medically unexplained' somatic syndromes, e.g. unexplained dizziness, tinnitus and blurry vision, and syndromes that can be classified as somatoform disorders (DSM-IV-TR); and (2) a range of medical conditions, with a preponderance of cardiovascular, respiratory, musculoskeletal, neurological, and gastrointestinal disorders, diabetes, chronic pain, sleep disorders and other immune-mediated disorders in various studies. Frequently reported medical co-morbidities with PTSD across various studies include cardiovascular disease, especially hypertension, and immune-mediated disorders. PTSD is associated with limbic instability and alterations in both the hypothalamic- pituitary-adrenal and sympatho-adrenal medullary axes, which affect neuroendocrine and immune functions, have central nervous system effects resulting in pseudo-neurological symptoms and disorders of sleep-wake regulation, and result in autonomic nervous system dysregulation. Hypervigilance, a central feature of PTSD, can lead to 'local sleep' or regional arousal states, when the patient is partially asleep and partially awake, and manifests as complex motor and/or verbal behaviours in a partially conscious state. The few studies of the effects of standard PTSD treatments (medications, CBT) on PTSD-associated somatic syndromes report a reduction in the severity of ill-defined and autonomically mediated somatic symptoms, self-reported physical health problems, and some chronic pain syndromes.

Somatic symptoms beyond those generally associated with a whiplash injury are increased in self-reported chronic whiplash. A population-based cross sectional study: the Hordaland Health Study (HUSK)

Science.gov (United States)

2012-01-01

Background Chronic whiplash leads to considerable patient suffering and substantial societal costs. There are two competing hypothesis on the etiology of chronic whiplash. The traditional organic hypothesis considers chronic whiplash and related symptoms a result of a specific injury. In opposition is the hypothesis that chronic whiplash is a functional somatic syndrome, and related symptoms a result of society-induced expectations and amplification of symptoms. According to both hypotheses, patients reporting chronic whiplash are expected to have more neck pain, headache and symptoms of anxiety and depression than the general population. Increased prevalence of somatic symptoms beyond those directly related to a whiplash neck injury is less investigated. The aim of this study was to test an implication derived from the functional hypothesis: Is the prevalence of somatic symptoms as seen in somatization disorder, beyond symptoms related to a whiplash neck injury, increased in individuals self-reporting chronic whiplash? We further aimed to explore recall bias by comparing the symptom profile displayed by individuals self-reporting chronic whiplash to that among those self-reporting a non-functional injury: fractures of the hand or wrist. We explored symptom load, etiologic origin could not be investigated in this study. Methods Data from the Norwegian population-based “Hordaland Health Study” (HUSK, 1997–99); N = 13,986 was employed. Chronic whiplash was self-reported by 403 individuals and fractures by 1,746. Somatization tendency was measured using a list of 17 somatic symptoms arising from different body parts and organ systems, derived from the research criteria for somatization disorder (ICD-10, F45). Results Chronic whiplash was associated with an increased level of all 17 somatic symptoms investigated (pwhiplash was more commonly reported than whiplash-injury a long time ago, and the association of interest weakly increased with time since whiplash

Immune-to-brain communication in functional somatic symptoms

NARCIS (Netherlands)

Lacourt, T.E.|info:eu-repo/dai/nl/313935068

2013-01-01

When a person presents with somatic symptoms that cannot (fully) be explained by a known organic pathology, these symptoms will be labeled ‘medically unexplained’ or ‘functional’. Often, more than one symptom is present and certain constellations of symptoms give way to a diagnosis of a specific

Further evidence for a broader concept of somatization disorder using the somatic symptom index.

Science.gov (United States)

Hiller, W; Rief, W; Fichter, M M

1995-01-01

Somatization syndromes were defined in a sample of 102 psychosomatic inpatients according to the restrictive criteria of DSM-III-R somatization disorder and the broader diagnostic concept of the Somatic Symptom Index (SSI). Both groups showed a qualitatively similar pattern of psychopathological comorbidity and had elevated scores on measures of depression, hypochondriasis, and anxiety. A good discrimination between mild and severe forms of somatization was found by using the SSI criterion. SSI use accounted for a substantial amount of comorbidity variance, with rates of 15%-20% for depression, 16% for hypochondriasis, and 13% for anxiety. The results provide further evidence for the validity of the SSI concept, which reflects the clinical relevance of somatization in addition to the narrow definition of somatization disorder.

When does hardship matter for health? Neighborhood and individual disadvantages and functional somatic symptoms from adolescence to mid-life in The Northern Swedish Cohort.

Science.gov (United States)

Gustafsson, Per E; San Sebastian, Miguel

2014-01-01

A large body of research has shown that health is influenced by disadvantaged living conditions, including both personal and neighborhood conditions. Little is however known to what degree the health impact of different forms of disadvantage differ along the life course. The present study aims to examine when, during the life course, neighborhood and individual disadvantages relate to functional somatic symptoms. Participants (n = 992) came from The Northern Swedish Cohort and followed from age 16, 21, 30 until 42 years. Functional somatic symptoms, socioeconomic disadvantage, and social and material adversity were measured through questionnaires and linked to register data on neighborhood disadvantage. Data was analyzed with longitudinal and cross-sectional multilevel models. Results showed that neighborhood disadvantage, social and material adversity and gender all contributed independently to overall levels of symptoms across the life course. Cross-sectional analyses also suggested that the impact of disadvantage differed between life course periods; neighborhood disadvantage was most important in young adulthood, and the relative importance of material versus social adversity increased as participants grew older. In summary, the study suggests that disadvantages from different contextual sources may affect functional somatic health across the life course, but also through life course specific patterns.

Somatization as a core symptom of melancholic type depression. Evidence from a cross-cultural study.

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Ebert, D; Martus, P

1994-12-01

The study questions whether different types of somatization may be a core symptom of melancholia, thus, being invariable across cultures and being a candidate for neurobiological research and diagnostic criteria. 51 Turkish patients and 51 education-matched German patients with melancholic depression were compared for two types of somatization. Turkish patients had higher frequencies of somatic preoccupation and hypochondriasis but they were not different in the perception and experience of somatic symptoms. It is concluded that: (1) somatization has to be differentiated psychopathologically; (2) it may be a neurobiological core symptom of melancholia in the well-defined sense of 'perceiving abnormal somatic symptoms'; and (3) it may be a culture-bound symptom in the sense of 'being abnormally concerned with somatic symptoms or hypochondrial fears'.

Cognitive-affective depression and somatic symptoms clusters are differentially associated with maternal parenting and coparenting.

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Lamela, Diogo; Jongenelen, Inês; Morais, Ana; Figueiredo, Bárbara

2017-09-01

Both depressive and somatic symptoms are significant predictors of parenting and coparenting problems. However, despite clear evidence of their co-occurrence, no study to date has examined the association between depressive-somatic symptoms clusters and parenting and coparenting. The current research sought to identify and cross-validate clusters of cognitive-affective depressive symptoms and nonspecific somatic symptoms, as well as to test whether clusters would differ on parenting and coparenting problems across three independent samples of mothers. Participants in Studies 1 and 3 consisted of 409 and 652 community mothers, respectively. Participants in Study 2 consisted of 162 mothers exposed to intimate partner violence. All participants prospectively completed self-report measures of depressive and nonspecific somatic symptoms and parenting (Studies 1 and 2) or coparenting (Study 3). Across studies, three depression-somatic symptoms clusters were identified: no symptoms, high depression and low nonspecific somatic symptoms, and high depression and nonspecific somatic symptoms. The high depression-somatic symptoms cluster was associated with the highest levels of child physical maltreatment risk (Study 1) and overt-conflict coparenting (Study 3). No differences in perceived maternal competence (Study 2) and cooperative and undermining coparenting (Study 3) were found between the high depression and low somatic symptoms cluster and the high depression-somatic symptoms cluster. The results provide novel evidence for the strong associations between clusters of depression and nonspecific somatic symptoms and specific parenting and coparenting problems. Cluster stability across three independent samples suggest that they may be generalizable. The results inform preventive approaches and evidence-based psychotherapeutic treatments. Copyright © 2017 Elsevier B.V. All rights reserved.

Somatic Symptoms in Traumatized Children and Adolescents

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Kugler, Brittany B.; Bloom, Marlene; Kaercher, Lauren B.; Truax, Tatyana V.; Storch, Eric A.

2012-01-01

Childhood exposure to trauma has been associated with increased rates of somatic symptoms (SS), which may contribute to diminished daily functioning. One hundred and sixty-one children residing at a residential treatment home who had experienced neglect and/or abuse were administered the Trauma Symptom Checklist for Children (TSCC), the…

Complexity assessed by the intermed in patients with somatic symptom disorder visiting a specialized outpatient mental health care setting: : A cross sectional study complexity of patients with ssd

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van Eck van der Sluijs, J.F.; de Vroege, L.; van Manen, A.S.; Rijnders, C.A.Th.; van der Feltz-Cornelis, C.F.

2017-01-01

Background Somatic symptom disorders (SSD), a new classification in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition is associated with problematic diagnostic procedures and treatment that lead to complex care. In somatic health care, the INTERMED has been used to assess

Depression, anxiety, and somatic symptoms in older cancer patients: a comparison across age groups.

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Cohen, Miri

2014-02-01

Previous studies have reported that older cancer patients experience lower psychological distress than younger patients, but most prior studies do not differentiate between age groups within the 'older' category. The aim of this study was to assess the intensity of the symptoms of depression, anxiety, and somatic symptoms among different age groups of older cancer patients. Participants were composed of 321 cancer patients 60 years and older, who were divided into three age groups: 60-69, 70-79, and 80+ years. The participants answered the Brief Symptom Inventory-18, which included subscales for depression, anxiety, and somatic symptoms and the cancer-related problem list, in addition to providing personal and cancer-related details. Depressive, anxiety, and somatic symptoms and cancer-related problems were lowest in the 70-79 years age group and highest in the 80+ years age group. Comparisons between pairs of groups showed significant differences between each of the groups in Brief Symptom Inventory total scores and between the 80+ years age group and the other two groups in regard to depressive symptoms and cancer-related problems. Differences, related to anxiety and somatic symptoms, were significant for the 70-79 year olds, in comparison with the youngest and oldest groups. Intensity of symptoms was explained by older age, higher number of cancer-related problems, female gender, and lower income. Nonlinear relations exist between age and psychological symptoms, which is in line with the postponement of age-related health and functional decline in the modern era. These results suggest that the study of psychological reactions to cancer should examine differences between age groups among older cancer patients. Copyright © 2013 John Wiley & Sons, Ltd.

Symptom-specific associations between low cortisol responses and functional somatic symptoms : The TRAILS study

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Janssens, K.A.; Oldehinkel, A.J.; Verhulst, F.C.; Hunfeld, J.A.; Ormel, J.; Rosmalen, J.G.

Background: Functional somatic symptoms (FSS), like chronic pain and overtiredness, are often assumed to be stress-related. Altered levels of the stress hormone cortisol could explain the association between stress and somatic complaints. We hypothesized that low cortisol levels after awakening and

Extending a structural model of somatization to South Koreans: Cultural values, somatization tendency, and the presentation of depressive symptoms.

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Zhou, Xiaolu; Min, Seongho; Sun, Jiahong; Kim, Se Joo; Ahn, Joung-Sook; Peng, Yunshi; Noh, Samuel; Ryder, Andrew G

2015-05-01

Somatization refers to the tendency to emphasize somatic symptoms when experiencing a psychiatric disturbance. This tendency has been widely reported in patients from East Asian cultural contexts suffering from depression. Recent research in two Chinese samples have demonstrated that the local cultural script for depression, involving two aspects-the experience and expression of distress (EED) and conceptualization and communication of distress (CCD)-can be evoked to help explain somatization. Given the beliefs and practices broadly shared across Chinese and South Korean cultural contexts, the current study seeks to replicate this explanatory model in South Koreans. Our sample included 209 psychiatric outpatients from Seoul and Wonju, South Korea. Self-report questionnaires were used to assess somatization tendency, adherence to traditional values, and psychological and somatic symptoms of depression. Results from SEM showed that the EED and CCD factors of somatization tendency were differently associated with cultural values and somatic symptoms, replicating our previous findings in Chinese outpatients. The reliance on a brief self-report measure of somatization tendency, not originally designed to assess separate EED and CCD factors, highlights the need for measurement tools for the assessment of cultural scripts in cross-cultural depression research. The replication of the Chinese structural model of somatization in South Korea lends empirical support to the view that somatization can be understood as the consequence of specific cultural scripts. These scripts involve the experience and expression of distress as well as culturally meaningful ways in which this distress is conceptualized and communicated to others. Copyright © 2015 Elsevier B.V. All rights reserved.

Mental and somatic symptoms related to suicidal ideation in patients visiting a psychosomatic clinic in Japan

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Kouichi Yoshimasu

2009-08-01

Full Text Available Kouichi Yoshimasu1, Tetsuya Kondo2,4, Shoji Tokunaga3, Yoshio Kanemitsu2, Hideyo Sugahara2, Mariko Akamine2, Kanichiro Fujisawa2, Kazuhisa Miyashita1, Chiharu Kubo21Department of Hygiene, School of Medicine, Wakayama Medical University, Wakayama, Japan; 2Department of Psychosomatic Medicine, Graduate school of Medical Sciences, Kyushu University, Fukuoka, Japan; 3Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan; 4Department of Acupuncture and Moxibustion, Kansai University of Health Sciences, Osaka, JapanAbstract: Patients with suicidal ideation (SI have various mental or somatic symptoms. A questionnaire-based interview elicited details concerning mental and somatic symptoms in patients visiting a psychosomatic clinic in Japan. Univariate logistic regression analyses followed by multiple regression models using a stepwise method were selected for identifying the candidate symptoms. Overall, symptoms related to depression were associated with SI in both sexes. Although women showed more various somatic symptoms associated with SI than men, many of those associations were diminished once severity of the depression was controlled. The current results suggest that a variety of self-reported symptoms, mainly related to depression, might reveal suicidal risk in outpatients with an urban hospital clinical setting.Keywords: suicidal ideation, psychosomatic clinic, subjective symptoms

Personality traits influencing somatization symptoms and social inhibition in the elderly

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Wongpakaran T

2014-01-01

Full Text Available Tinakon Wongpakaran, Nahathai WongpakaranFaculty of Medicine, Chiang Mai University, Chiang Mai, ThailandPurpose: Somatization is a common symptom among the elderly, and even though personality disorders have been found to be associated with somatization, personality traits have not yet been explored with regard to this symptom. The aim of this study is to investigate the relationship between personality traits and somatization, and social inhibition.Patients and methods: As part of a cross-sectional study of a community sample, 126 elderly Thais aged 60 years or over completed self-reporting questionnaires related to somatization and personality traits. Somatization was elicited from the somatization subscale when using the Symptom Checklist SCL-90 instrument. Personality traits were drawn from the 16 Personality Factor Questionnaire and social inhibition was identified when using the inventory of interpersonal problems. In addition, path analysis was used to establish the influence of personality traits on somatization and social inhibition.Results: Of the 126 participants, 51% were male, 55% were married, and 25% were retired. The average number of years in education was 7.6 (standard deviation =5.2. “Emotional stability” and “dominance” were found to have a direct effect on somatization, as were age and number of years in education, but not sex. Also, 35% of the total variance could be explained by the model, with excellent fit statistics. Dominance was found to have an indirect effect, via vigilance, on social inhibition, which was also influenced by number of years in education and emotional stability. Social inhibition was not found to have any effect on somatization, although hypothetically it should.Conclusion: “Emotional stability”, “dominance”, and “vigilance”, as well as age and the number of years in education, were found to have an effect on somatization. Attention should be paid to these factors in the elderly

Somatic symptom disorder treated with electroconvulsive therapy.

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Borisovskaya, Anna; Augsburger, Jay Alan

2017-05-01

Somatic symptom disorder (SSD) is a challenging condition to treat with chronic pain, a common and disabling symptom. We present a patient who received electroconvulsive therapy (ECT) for SSD with significant improvement in pain and gastrointestinal symptoms. We also present a brief literature review of similar cases treated with ECT. Preliminary evidence suggests that ECT should be considered for treatment of SSD comorbid with major depressive disorder, when standard treatments fail. Further research is needed to clarify whether ECT can be used for SSD without associated depression.

Family therapy for children with functional somatic symptoms

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Hulgaard, Ditte Roth; Dehlholm-Lambertsen, Birgitte; Rask, Charlotte

Introduction: Functional somatic symptoms (FSS) can be defined as physical symptoms that cannot be fully explained by organic pathology. FSS are prevalent in children worldwide and in all medical settings, and when severe, pose a major burden on those with FSS and on society. In clinical practice...... and current research in child mental health, focus on family factors is increasing. The aim of this systematic review was to explore and describe the current family based approaches used for youngsters with FSS, and to evaluate the quality of the existing research in this area. Method: The review...... on family based CBT. Conclusions and implications: The family’s illness explanations are an important target for intervention and coordination between paediatric and CAMHS is important, when treating youngsters with FSS. Clinical implications of the findings and recommendations for future research...

Alexithymia and Somatosensory Amplification Link Perceived Psychosocial Stress and Somatic Symptoms in Outpatients with Psychosomatic Illness

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Mutsuhiro Nakao

2018-05-01

Full Text Available Background: Psychosomatic patients often complain of a variety of somatic symptoms. We sought to clarify the role of clinical predictors of complaints of somatic symptoms. Methods: We enrolled 604 patients visiting a psychosomatic outpatient clinic. The outcome was the total number of somatic symptoms, and the candidate clinical predictors were perceived psychosocial stress, alexithymia, somatosensory amplification, adaptation, anxiety, and depression. All participants completed questionnaires assessing the outcome and the predictors. Results: The average number of reported somatic symptoms was 4.8; the most frequent was fatigue (75.3%, followed by insomnia (56.1%, low-back pain (49.5%, headache (44.7%, and palpitations (43.1%. Multiple regression analysis showed that the total number of somatic symptoms was significantly associated with the degree of perceived psychosocial stress, alexithymia, somatosensory amplification, and depression. Also, structural equation models indicated links between excessive adaptation (via perceived psychosocial stress, alexithymia, and somatosensory amplification and the total number of somatic symptoms. Conclusion: The results suggested that the association between psychosocial stress and reported somatic symptoms is mediated by alexithymia and somatosensory amplification in psychosomatic patients.

Posttraumatic stress disorder and somatic symptoms among child and adolescent survivors following the Lushan earthquake in China: A six-month longitudinal study.

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Zhang, Jun; Zhu, Shenyue; Du, Changhui; Zhang, Ye

2015-08-01

To explore somatic conditions in a sample of 2299 child and adolescent survivors of an earthquake and their relationship to posttraumatic stress disorder (PTSD) symptoms. The Children's Revised Impact of Event Scale, the Patient Health Questionnaire (PHQ)-13 scale, a short version of PHQ-15 scale that omits two items involving sexual pain/problems and menstrual problems, and a project-developed questionnaire were administered to participants three and six months after the earthquake. Among child and adolescent survivors, the prevalence rates of probable PTSD were 37.4 and 24.2% three and six months, respectively, after the earthquake. The most common somatic symptoms were trouble sleeping (58.4 and 48.4%), feeling tired or having low energy (52.0 and 46.1%), and stomach pain (45.8 and 45.4%) after three and six months, respectively. Several specific somatic symptoms evaluated three months after the earthquake including trouble sleeping, headache, and shortness of breath were predictors of the overall PTSD symptoms evaluated six months after the earthquake. Additionally, the symptom of hyperarousal evaluated after three months could predict the overall somatic symptoms evaluated after six months. PTSD and somatic symptoms were common after the earthquake, and a longitudinal association between PTSD and somatic symptoms was detected among child and adolescent survivors. These findings have implications in China and possibly elsewhere. Copyright © 2015 Elsevier Inc. All rights reserved.

Effects and mediators of psychosocial work characteristics on somatic symptoms six years later: Prospective findings from the Mannheim Industrial Cohort Studies (MICS).

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Herr, Raphael M; Li, Jian; Loerbroks, Adrian; Angerer, Peter; Siegrist, Johannes; Fischer, Joachim E

2017-07-01

Ample evidence documented the adverse health effects of work stressors, and recent research has increasingly focused on somatic symptoms which are very common and costly. Prospective evidence is however sparse and yielded mixed findings. Furthermore, there is reason to assume that depression and anxiety might mediate the effects of adverse psychosocial work conditions on somatic symptoms. This study aimed to investigate longitudinal effects of work stressors on somatic symptoms and the potential mediation by anxiety and/or depression. Six year follow-up data from 352 individuals - free of potentially stress-related chronic disease - were utilized. Somatic symptoms were assessed by 19 items of an established list of complaints at baseline and follow-up. The effort-reward-imbalance (ERI) model measured adverse psychosocial work conditions and over-commitment (OC). Linear regressions adjusted for socio-demographics, social status, lifestyle, and baseline symptoms estimated the effects of the ERI ratio, effort, reward, OC, and the ERI ratio×OC interaction on somatic symptoms six years later. Furthermore, single and multiple mediation by anxiety and/or depression was investigated. There was a strong longitudinal effect of the ERI ratio, as well as of its subcomponents, and OC on somatic symptoms (all Bs≥|0.49|; p-values ≤0.004). Moreover, the ERI ratio×OC interaction was significant (p-value=0.047). Multiple mediation analyses revealed especially anxiety to mediate the effect of work stressors on somatic symptoms (Sobel test=0.007). Adverse psychosocial work conditions seem to longitudinally affect somatic symptoms, potentially moderated by OC, and mediated by anxiety. Copyright © 2017 Elsevier Inc. All rights reserved.

Family intervention for children with functional somatic symptoms

DEFF Research Database (Denmark)

Hulgaard, Ditte Roth; Dehlholm-Lambertsen, Birgitte; Rask, Charlotte Ulrikka

lidelser, Århus; Århus universitet Aim & Background: Functional somatic symptoms (FSS) can be defined as physical symptoms that cannot be fully explained by organic pathology. FSS are prevalent in children worldwide and in all medical settings, and when severe, pose a major burden on those with FSS...... and on society. In clinical practice and current research in child mental health, focus on family factors is increasing. The aim of this systematic review was to explore and describe the current family based approaches used for youngsters with FSS, and to evaluate the quality of the existing research...... quality scores on the POMRF. Many different outcome measures were employed, and the outcome measures chosen did not necessarily reflect what was targeted in the therapy. Focus on illness beliefs and shifting focus away from an organic explanation was agreed upon in all studies, with the alternative...

Cultural differences in symptom representation for depression and somatization measured by the PHQ between Vietnamese and German psychiatric outpatients.

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Dreher, Annegret; Hahn, Eric; Diefenbacher, Albert; Nguyen, Main Huong; Böge, Kerem; Burian, Hannah; Dettling, Michael; Burian, Ronald; Ta, Thi Minh Tam

2017-11-01

Despite an extensive body of research on somatic symptom presentation among people of East- and Southeast-Asian descent, results are still inconclusive. Examining and comparing symptom presentation in clinically and ethnically well-characterized populations may constitute a step towards understanding symptom presentation between patients with a different cultural background. This study aims to compare Vietnamese and German patients regarding cultural dynamics of symptom presentation upon first admission to a psychiatric outpatient service. 110 Vietnamese and 109 German patients seeking psychiatric treatment at two outpatient clinics completed the Patient Health Questionnaire (PHQ). The somatic symptom subscale (PHQ-15), the depression subscale (PHQ-9) and PHQ-subscales examining anxiety and psychosocial stress levels were analyzed and compared for both groups using multivariate analysis of covariance. Regression analysis was utilized to examine the influences of sociodemographic and migration specific factors. Vietnamese and German patients showed comparable Cronbach's alpha for all subscales. Vietnamese patients endorsed significantly higher levels of somatic symptoms overall and on certain items (as pain-related items, dizziness, and fainting spells) despite similar levels of depression severity in comparison with German patients. Vietnamese patients with poor German language skills showed a significantly higher focus on somatic symptoms. Raising awareness for cultural dynamics of symptom presentation in patients with depression is indispensable. Cross-cultural symptom assessment using the PHQ seems feasible and expands our understanding of depressive and psychosomatic symptoms when assessed by clinicians. Copyright © 2017. Published by Elsevier Inc.

Unexplained somatic symptoms during major depression: prevalence and clinical impact in a national sample of Italian psychiatric outpatients.

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Perugi, Giulio; Canonico, Pier Luigi; Carbonato, Paolo; Mencacci, Claudio; Muscettola, Giovanni; Pani, Luca; Torta, Riccardo; Vampini, Claudio; Fornaro, Michele; Parazzini, Fabio; Dumitriu, Arina

2011-01-01

The aim of this study was to explore the prevalence and impact of unexplained somatic symptoms during major depression. A total of 560 consecutive outpatients with a major depressive episode according to the DSM-IV (text revision) were evaluated in 30 psychiatric facilities throughout Italy. 'Unexplained' somatic symptoms were evaluated using the 30-item Somatic Symptoms Checklist (SSCL-30). Somatic symptoms were considered explained if they were best accounted for as coming from a concomitant physical illness or side effects. Patients evaluated their own mood symptomatology using the Zung questionnaires for depression and anxiety and the Hypomania Checklist-32. According to the SSCL-30, only 90 subjects (16.1%) had no unexplained somatic symptoms, while 231 (41.3%) had 1-5 unexplained symptoms and 239 (42.7%) had more than 5. Asthenia was the most commonly observed unexplained somatic symptom (53% of patients). Unexplained somatic symptoms were more common in females and among those suffering from major depression and depression not otherwise specified rather than in patients with recurrent major depression and bipolar disorders. No relationship between unexplained somatic symptoms and hypomanic features was observed. The presence of a large number of unexplained somatic symptoms is associated with more severe depression and higher rates of misdiagnosis and inappropriate treatment. Copyright © 2011 S. Karger AG, Basel.

The black box in somatization: unexplained physical symptoms, culture, and narratives of trauma.

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Waitzkin, H; Magaña, H

1997-09-01

Stimulated by our clinical work with patients who manifest unexplained "somatoform" symptoms in the primary care setting, this article addresses a theoretical black box in our understanding of somatization: how does culture mediate severe stress to produce symptoms that cannot be explained by the presence of physical illness? Despite various problems in his explanation of hysteria, Freud broke new ground by emphasizing narratives of traumatic experiences in the development and treatment of unexplained physical symptoms. Except in anthropologically oriented cultural psychiatry, contemporary psychiatry has traveled away from a focus on narrative in the study of somatization. On the other hand, recent interest in narrative has spread across many intellectual disciplines, including the humanities and literary criticism, psychology, history, anthropology, and sociology. We operationally define narratives as attempts at storytelling that portray the interrelationships among physical symptoms and the psychologic, social, or cultural context of these symptoms. Regarding somatization and trauma, we focus on the ways that narrative integrates the cultural context with traumatic life events. In explaining the black box, we postulate that extreme stress (torture, rape, witnessing deaths of relatives, forced migration, etc.) is processed psychologically as a terrible, largely incoherent narrative of events too awful to hold in consciousness. Culture patterns the psychologic and somatic expression of the terrible narrative. Methodologically, we have developed some techniques for eliciting narratives of severe stress and somatic symptoms, which we illustrate with observations from an ongoing research project. In designing interventions to improve the care of somatizing patients, we are focusing on the creation of social situations where patients may feel empowered to express more coherent narratives of their prior traumatic experiences.

The relationship of PTSD to key somatic complaints and cultural syndromes among Cambodian refugees attending a psychiatric clinic: the Cambodian Somatic Symptom and Syndrome Inventory (CSSI).

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Hinton, Devon E; Kredlow, M Alexandra; Pich, Vuth; Bui, Eric; Hofmann, Stefan G

2013-06-01

This article describes a culturally sensitive questionnaire for the assessment of the effects of trauma in the Cambodian refugee population, the Cambodian Somatic Symptom and Syndrome Inventory (CSSI), and gives the results of a survey with the instrument. The survey examined the relationship of the CSSI, the two CSSI subscales, and the CSSI items to posttraumatic stress disorder (PTSD) severity and self-perceived functioning. A total of 226 traumatized Cambodian refugees were assessed at a psychiatric clinic in Lowell, MA, USA. There was a high correlation of the CSSI, the CSSI somatic and syndrome scales, and all the CSSI items to the PTSD Checklist (PCL), a measure of PTSD severity. All the CSSI items varied greatly across three levels of PTSD severity, and patients with higher levels of PTSD had very high scores on certain CSSI-assessed somatic items such as dizziness, orthostatic dizziness (upon standing), and headache, and on certain CSSI-assessed cultural syndromes such as khyâl attacks, "fear of fainting and dying upon standing up," and "thinking a lot." The CSSI was more highly correlated than the PCL to self-perceived disability assessed by the Short Form-12 Health Survey (SF-12). The study demonstrates that the somatic symptoms and cultural syndromes described by the CSSI form a central part of the Cambodian refugee trauma ontology. The survey indicates that locally salient somatic symptoms and cultural syndromes need be profiled to adequately assess the effects of trauma.

Mental and somatic health and pre- and post-migration factors among older Somali refugees in Finland.

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Mölsä, Mulki; Punamäki, Raija-Leena; Saarni, Samuli I; Tiilikainen, Marja; Kuittinen, Saija; Honkasalo, Marja-Liisa

2014-08-01

Mental and somatic health was compared between older Somali refugees and their pair-matched Finnish natives, and the role of pre-migration trauma and post-migration stressors among the refugees. One hundred and twenty-eight Somalis between 50-80 years of age were selected from the Somali older adult population living in the Helsinki area (N = 307). Participants were matched with native Finns by gender, age, education, and civic status. The BDI-21 was used for depressive symptoms, the GHQ-12 for psychological distress, and the HRQoL was used for health-related quality of life. Standard instruments were used for sleeping difficulties, somatic symptoms and somatization, hypochondria, and self-rated health. Clinically significant differences in psychological distress, depressive symptoms, sleeping difficulties, self-rated health status, subjective quality of life, and functional capacity were found between the Somali and Finnish groups. In each case, the Somalis fared worse than the Finns. No significant differences in somatization were found between the two groups. Exposure to traumatic events prior to immigrating to Finland was associated with higher levels of mental distress, as well as poorer health status, health-related quality of life, and subjective quality of life among Somalis. Refugee-related traumatic experiences may constitute a long lasting mental health burden among older adults. Health care professionals in host countries must take into account these realities while planning for the care of refugee populations. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

The relation between the patient health questionnaire-15 and DSM somatic diagnoses

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Shih-Cheng Liao

2016-10-01

Full Text Available Abstract Background Our purpose was to examine the reliability and validity of the Chinese version of the Patient Health Questionnaire-15 (PHQ-15 in Taiwan, and to explore its relation to somatoform disorders (DSM-IV and to somatic symptom and related disorders (DSM-5. Methods We recruited 471 individuals, 151 with somatoform disorders and 200 with somatic symptom and related disorders. Subjects completed the Chinese version of the PHQ-15, Beck Depression Inventory-II (BDI-II, Beck Anxiety Inventory (BAI, and received a DSM-IV- and DSM-5-based diagnostic interview. We performed exploratory factor analysis and assessed test-retest reliability, internal consistency, and correlation with BDI-II/BAI to confirm reliability and validity, and carried out ROC curve analysis to determine suitability for evaluation or screening purposes. PHQ-15 scores were compared between patients with various DSM-IV psychiatric diagnoses (such as DSM-IV somatoform disorders, panic disorder, other anxiety/depressive disorders or no DSM-IV diagnosis and patients with DSM-5 somatic symptom and related disorders or no DSM-5 diagnosis. Results The Chinese version identified cardiopulmonary, pain-fatigue, and gastrointestinal as major factors and had good reliability (0.803–0.930, internal consistency (0.637–0.861, and correlation coefficients with BDI-II/BAI (0.407–0.619, 0.536–0.721, respectively. The PHQ-15 scores were similar in patients with somatoform disorders and patients with panic disorder; higher in patients with somatoform disorders and panic disorder than in patients with other anxiety/depressive disorders; and significantly higher in patients with somatic symptom and related disorders than in patients without this diagnosis. The AUC of the PHQ-15 was 0.678 (cutoff 6/7 for screening somatoform disorders (DSM-IV and 0.725 (cutoff 4/5 for screening somatic symptom and related disorders (DSM-5. Conclusions The Chinese version of the PHQ-15 is suitable for

The health preoccupation diagnostic interview: inter-rater reliability of a structured interview for diagnostic assessment of DSM-5 somatic symptom disorder and illness anxiety disorder.

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Axelsson, Erland; Andersson, Erik; Ljótsson, Brjánn; Wallhed Finn, Daniel; Hedman, Erik

2016-06-01

Somatic symptom disorder (SSD) and illness anxiety disorder (IAD) are two new diagnoses introduced in the DSM-5. There is a need for reliable instruments to facilitate the assessment of these disorders. We therefore developed a structured diagnostic interview, the Health Preoccupation Diagnostic Interview (HPDI), which we hypothesized would reliably differentiate between SSD, IAD, and no diagnosis. Persons with clinically significant health anxiety (n = 52) and healthy controls (n = 52) were interviewed using the HPDI. Diagnoses were then compared with those made by an independent assessor, who listened to audio recordings of the interviews. Ratings generally indicated moderate to almost perfect inter-rater agreement, as illustrated by an overall Cohen's κ of .85. Disagreements primarily concerned (a) the severity of somatic symptoms, (b) the differential diagnosis of panic disorder, and (c) SSD specifiers. We conclude that the HPDI can be used to reliably diagnose DSM-5 SSD and IAD.

Somatic and cognitive-affective depressive symptoms among patients with heart disease: differences by sex and age

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Carina Aparecida Marosti Dessotte

2015-04-01

Full Text Available OBJECTIVE: this study investigated the association of somatic and cognitive-affective symptoms with sex and age, among patients hospitalized with heart disease. METHOD: this study was a secondary analysis of two previous observational studies totaling 531 patients with heart disease, hospitalized from 2005 to 2011 in two public hospitals in Ribeirão Preto, state of São Paulo, Brazil. Somatic and cognitive-affective symptoms were assessed using the subscales of the Beck Depression Inventory - I (BDI-I. RESULTS: of 531 participants, 62.7% were male, with a mean age 57.3 years (SD= 13.0 for males and 56.2 years (SD= 12.1 for females. Analyses of variance showed an effect of sex (p<0.001 for somatic and p=0.005 for cognitive-affective symptoms, but no effect of age. Women presented with higher mean values than men in both BDI-I subscales: 7.1 (4.5 vs. 5.4 (4.3 for somatic, and 8.3 (7.9 vs. 6.7 (7.2 for cognitive-affective symptoms. There were no differences by age for somatic (p=0.84 or cognitive-affective symptoms (p=0.84. CONCLUSION: women hospitalized with heart disease had more somatic and cognitive-affective symptoms than men. We found no association of somatic and cognitive-affective symptoms with age. Future research for these patients could reveal whether these differences according to sex continue throughout the rehabilitation process.

Can agonistic striving lead to unexplained illness? Implicit goals, pain tolerance, and somatic symptoms in adolescents and adults.

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Ewart, Craig K; Elder, Gavin J; Laird, Kelsey T; Shelby, Grace D; Walker, Lynn S

2014-09-01

We tested the social action theory hypotheses that (a) psychological stress induced by struggling to control others (agonistic striving) is associated with higher levels of subjective somatic symptoms than stress induced by struggling to control the self (transcendence striving); (b) the association between agonistic striving and symptoms is moderated by the ability to tolerate pain; and (c) associations among agonistic goals, pain tolerance, and subjective symptoms are not explained by personality and affective traits or negative emotional responses to personal stressors. Implicit motives and negative emotional reactivity to recurring personal stressors were assessed by Social Competence Interview in 333 adolescents and adults who participated in longitudinal research on functional abdominal pain at a university medical center. Pain tolerance was assessed by graduated thermal pain protocol; subjective somatic symptoms, and personality/affective traits assessed by questionnaires. The primary outcome measure was the self-reported severity of 35 somatic symptoms often experienced in the absence of diagnosable disease. All hypotheses were supported. Nonconscious agonistic strivings may increase the perceived frequency and severity of subjective somatic symptoms; this tendency is greatly magnified by difficulty in self-regulating responses to painful stimuli. Implicit agonistic motives and their associations with symptoms are not explained by individual differences in trait neuroticism, anxiety, depression, anger, or low self-esteem or by negative emotional reactivity to a personal stressor. These findings may afford fruitful insights into mechanisms by which stressful social environments undermine health and suggest promising directions for clinical intervention. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

The Association Between Headaches and Temporomandibular Disorders is Confounded by Bruxism and Somatic Symptoms.

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van der Meer, Hedwig A; Speksnijder, Caroline M; Engelbert, Raoul H H; Lobbezoo, Frank; Nijhuis-van der Sanden, Maria W G; Visscher, Corine M

2017-09-01

The objective of this observational study was to establish the possible presence of confounders on the association between temporomandibular disorders (TMD) and headaches in a patient population from a TMD and Orofacial Pain Clinic. Several subtypes of headaches have been diagnosed: self-reported headache, (probable) migraine, (probable) tension-type headache, and secondary headache attributed to TMD. The presence of TMD was subdivided into 2 subtypes: painful TMD and function-related TMD. The associations between the subtypes of TMD and headaches were evaluated by single regression models. To study the influence of possible confounding factors on this association, the regression models were extended with age, sex, bruxism, stress, depression, and somatic symptoms. Of the included patients (n=203), 67.5% experienced headaches. In the subsample of patients with a painful TMD (n=58), the prevalence of self-reported headaches increased to 82.8%. The associations found between self-reported headache and (1) painful TMD and (2) function-related TMD were confounded by the presence of somatic symptoms. For probable migraine, both somatic symptoms and bruxism confounded the initial association found with painful TMD. The findings of this study imply that there is a central working mechanism overlapping TMD and headache. Health care providers should not regard these disorders separately, but rather look at the bigger picture to appreciate the complex nature of the diagnostic and therapeutic process.

Is there an Asian idiom of distress? Somatic Symptoms in Female Japanese and Korean Students

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Arnault, Denise Saint; Kim, Oksoo

2007-01-01

The term “idiom of distress” is used to describe culturally-specific experiences of suffering. Most of these studies have been conducted with small groups, making comparison of symptom profiles difficult. Female undergraduate and graduate students in Japan (N=50) and Korea (N=61) completed Beck Depression Inventory (BDI) and seven-day dairy reports of their experiences of 46 somatic symptoms. Between-culture comparisons revealed that BDI scores did not differ; however, Korean women had significantly higher somatic distress means than the Japanese women. Despite the higher Korean distress mean, regression analysis showed that somatic distress explained 30% of the variance of BDI score for the Japanese, but only 22% of the variance for the Koreans. Within-culture comparisons showed that both the High BDI Japanese and Koreans had 19 somatic distress symptoms with significantly higher means than their Low BDI counterparts; eleven somatic symptoms were shared by the two groups. Multidimensional Scaling matrices were used to compare symptom proximities and revealed cultural differences. The problems with using broad racial categories in clinical research, the clinical significance of these findings, and implications for psychiatric nursing assessment and practice are discussed. PMID:18207054

The PHQ-12 Somatic Symptom scale as a predictor of symptom severity and consulting behaviour in patients with irritable bowel syndrome and symptomatic diverticular disease

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Spiller , Robin; Humes , David; Campbell , Eugene; Hastings , Margaret; Neal , Keith; Dukes , George; Whorwell , Peter

2010-01-01

Abstract BACKGROUND Anxiety, depression and non-gastrointestinal symptoms are often prominent in IBS but their relative value in patient management has not been quantitatively assessed. We modified the Patient Health Questionnaire 15 (PHQ-15) by excluding the 3 gastrointestinal items to create the PHQ-12 Somatic Symptom scale (PHQ-12 SS). AIMS To compare the value of the PHQ-12 SS scale to the Hospital Anxiety and Depression (HAD) scale in predicting symptoms and patient beha...

A review of somatoform disorders in DSM-IV and somatic symptom disorders in proposed DSM-V.

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Ghanizadeh, Ahmad; Firoozabadi, Ali

2012-12-01

Psychiatric care providers should be trained to use current changes in the somatoform disorders criteria. New diagnostic criteria for Somatic Symptom disorders in the proposed DSM-V is discussed and compared with its older counterpart in DSM-IV. A new category called Somatic Syndrome Disorders is suggested. It includes new subcategories such as "Complex Somatic Symptom Disorder" (CSSD) and "Simple Somatic Symptom Disorder" (SSSD). Some of the subcategories of DSM-IV derived disorders are included in CSSD. While there are some changes in diagnostic criteria, there are concerns and limitations about the new classification needed to be more discussed before implementation. Functional somatic disturbance, the counterpart of converion disorder in DSM-IV, can be highly dependet on the developmental level of children. However, the role of developmental level needs to be considered.

The effect of somatic symptom attribution on the prevalence rate of depression and anxiety among nursing home patients.

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Smalbrugge, Martin; Pot, Anne Margriet; Jongenelis, Lineke; Beekman, Aartjan T F; Eefsting, Jan A

2005-01-01

The validity of diagnostic psychiatric instruments for depression and anxiety disorders may be compromised among patients with complex physical illness and disability. The objective of this study was to determine the effect on the prevalence rate of depression and anxiety in a nursing home population of attributing somatic symptoms of depression and anxiety to either somatic or psychiatric disorder. Symptoms of major depression (MD), generalized anxiety disorder (GAD) and panic disorder (PD) were measured using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Somatic symptoms of MD, GAD and PD were attributed to somatic causes when the interviewer was not sure about a psychiatric cause. To analyse the effect of this attribution on the prevalence rate of MD, GAD and PD, a sensitivity analysis was undertaken in which symptoms that were attributed to somatic causes were recoded as symptoms attributed to psychiatric disorder. Prevalence rates of MD, GAD and PD were calculated before and after recoding. The prevalence of MD after recoding rose from 7.5% to 8.1%. The prevalence of GAD did not change. The prevalence of PD rose from 1.5% to 1.8%. Attribution of somatic symptoms to either somatic or psychiatric disorder when the interviewer was not sure about a psychiatric cause of the somatic symptoms had only a very modest effect on the prevalence rate of major depression, generalized anxiety disorder and panic disorder in a nursing home population.

Somatic symptoms, peer and school stress, and family and community violence exposure among urban elementary school children.

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Hart, Shayla L; Hodgkinson, Stacy C; Belcher, Harolyn M E; Hyman, Corine; Cooley-Strickland, Michele

2013-10-01

Somatic symptoms are a common physical response to stress and illness in childhood. This study assessed 409, primarily African American (85.6 %), urban elementary school children to examine the association between: (1) somatic symptoms and potential external stressors (school and peer stress, family conflict, and community violence) and (2) parent and child agreement on children's self-report of somatic symptoms. The odds of self-report of somatic complaints were significantly associated with family conflict, school and peer stress, and community violence exposure (OR = 1.26, 95 % CI: 1.05-1.50; OR = 1.18, 95 % CI 1.08-1.28; and OR = 1.02, 95 % CI: 1.00-1.05, respectively). Identifying the associations between social, family, and community based stress and somatic symptoms may improve the quality of life for children living in urban environments through early identification and treatment.

Gender Differences in Somatic Symptoms and Current Suicidal Risk in Outpatients with Major Depressive Disorder.

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Jeon, Hong Jin; Woo, Jong-Min; Kim, Hyo-Jin; Fava, Maurizio; Mischoulon, David; Cho, Seong Jin; Chang, Sung Man; Park, Doo-Heum; Kim, Jong Woo; Yoo, Ikki; Heo, Jung-Yoon; Hong, Jin Pyo

2016-11-01

Although somatic symptoms are common complaints of patients with major depressive disorder (MDD), their associations with suicide are still unclear. A total of 811 MDD outpatients of aged between 18 to 64 years were enrolled nationwide in Korea with the suicidality module of the Mini-International Neuropsychiatric Interview (MINI) and the Depression and Somatic Symptom Scale (DSSS). On stepwise regression analysis, current suicidality scores were most strongly associated with chest pain in men, and neck or shoulder pain in women. Severe chest pain was associated with higher current suicidality scores in men than in women, whereas severe neck or shoulder pain showed no significant differences between the genders. In conclusion, MDD patients of both sexes with suicidal ideation showed significantly more frequent and severe somatic symptoms than those without. Current suicidal risk was associated with chest pain in men, and neck or shoulder pain in women. We suggest that clinicians pay attention to patients' somatic symptoms in real world practice.

Comparing Cognitive and Somatic Symptoms of Depression in Myocardial Infarction Patients and Depressed Patients in Primary and Mental Health Care

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Groenewold, Nynke A.; Doornbos, Bennard; Zuidersma, Marij; Vogelzangs, Nicole; Penninx, Brenda W. J. H.; Aleman, Andre; de Jonge, Peter

2013-01-01

Depression in myocardial infarction patients is often a first episode with a late age of onset. Two studies that compared depressed myocardial infarction patients to psychiatric patients found similar levels of somatic symptoms, and one study reported lower levels of cognitive/affective symptoms in

Case complexity in outpatients in a centre of excellence for somatic symptom disorder : A cross-sectional study

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van Eck van der Sluijs, J.F.; de Vroege, L.; van Manen, A.S.; van der Thiel, E.; Timmermans, A.; Pouwer, F.; van der Feltz-Cornelis, C.M.

2016-01-01

Background: At the Clinical Centre of Excellence for Body, Mind and Health, integrated care models are used to provide treatment to patients with Somatic Symptom and Related Disorders (SSD). The aim of this study is to describe complexity of SSD patients using the INTERMED. This instrument has been

Somatic Expression of Psychological Problems (Somatization: Examination with Structural Equation Model

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Tugba Seda Çolak

2014-09-01

Full Text Available The main purpose of the research is to define which psychological symptoms (somatization, depression, obsessive ‐ compulsive, hostility, interpersonal sensitivity, anxiety, phobic anxiety, paranoid ideation and psychoticism cause somatic reactions at most. Total effect of these psychological symptoms on somatic symptoms had been investigated. Study was carried out with structural equation model to research the relation between the psychological symptoms and somatization. The main material of the research is formed by the data obtained from 492 people. SCL‐90‐R scale was used in order to obtain the data. As a result of the structural equation analysis, it has been found that 1Psychoticism, phobic anxiety, and paranoid ideation do not predict somatic symptoms.2There is a negative relation between interpersonal sensitivity level mand somatic reactions.3Anxiety symptoms had been found as causative to occur the highest level of somatic reactions.

Parent-child Communication-centered Rehabilitative Approach for Pediatric Functional Somatic Symptoms.

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Gerner, Maya; Barak, Sharon; Landa, Jana; Eisenstein, Etzyona

2016-01-01

Functional somatic symptoms (FSS) are a type of somatization phenomenon. Integrative rehabilitation approaches are the preferred treatment for pediatric FSS. Parental roles in the treatment process have not been established. to present 1) a parent-focused treatment (PFT) for pediatric FSS and 2) the approach's preliminary results. The sample included 50 children with physical disabilities due to FSS. All children received PFT including physical and psychological therapy. A detailed description of the program's course and guiding principles is provided. FSS extinction and age-appropriate functioning. Post-program, 84% of participants did not exhibit FSS and 94% returned to age-appropriate functioning. At one-year follow-up, only 5% of participants experienced symptom recurrence. No associations were found between pre-admission symptoms and intervention duration. PFT is beneficial in treating pediatric FSS. Therefore, intensive parental involvement in rehabilitation may be cardinal.

The Contribution of High Levels of Somatic Symptom Severity to Sickness Absence Duration, Disability and Discharge

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Hoedeman, Rob; Blankenstein, Annette H.; Krol, Boudien; Koopmans, Petra C.; Groothoff, Johan W.

Introduction: The primary objectives were to compare the duration of sickness absence in employees with high levels of somatic symptom severity (HLSSS) with employees with lower levels of somatic symptom severity, and to establish the long-term outcomes concerning return to work (RTW), disability

The association of experience of violence and somatization, depression, and alexithymia: a sample of women with medically unexplained symptoms in Turkey.

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Anuk, Dilek; Bahadır, Güler

2018-02-01

The aim of the study was to examine the relationship between the levels of somatization, depression as well as alexithymia, and MUS in women going through violence experience in three contexts (childhood, adulthood, and both childhood and adulthood). The study was performed on 180 patients attending the Internal Medicine Department of Istanbul University Medical Faculty. The data of women with MUS (n = 50) were compared those of women with acute physical conditions (n = 46) and chronic physical conditions (n = 84). Semi-structured Interview Form, Childhood Abuse and Neglect Inventory, Brief Symptom Inventory, Beck Depression Inventory, and the Toronto Alexithymia Scale were administered. The levels of somatization and depression were found to be higher in women who were exposed to emotional abuse (EA) and physical abuse (PA) in adulthood in the MUS group compared with those of the women exposed to EA and PA in adulthood in the other groups. The levels of somatization, depression, and alexithymia in the MUS group exposed to childhood emotional abuse (CEA) were also higher than those in the controls exposed to CEA. The levels of somatization and alexithymia in the MUS group who were exposed to childhood physical abuse (CPA) were higher than those in the controls exposed to CPA. The levels of somatization and depression in the MUS group who were exposed to violence both in childhood and in adulthood were higher than those in the controls who experienced violence both in childhood and in adulthood. Most women exposed to domestic violence present to health care institutions with various physical and psychological symptoms in Turkey. So, it is important that health caregivers also ask questions about experiences of violence and psychological symptoms in women presenting with medically unexplained symptoms.

Depression and Dissociation as Predictors of Physical Health Symptoms Among Female Rape Survivors with PTSD

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Scioli-Salter, Erica R.; Johnides, Benjamin D.; Mitchell, Karen S.; Smith, Brian N.; Resick, Patricia A.; Rasmusson, Ann M.

2016-01-01

Objective To investigate the relative contributions of depression and dissociation, as well as PTSD, to physical health symptoms and to examine the relationships among somatic symptoms, PTSD, depression, and dissociation in relation to childhood and adult trauma exposure. Method Cross-sectional data are from 132 female rape survivors with PTSD assessed prior to engaging in a study of trauma-focused cognitive therapy for PTSD. Measures included the Pennebaker Inventory of Limbic Languidness, Clinician Administered PTSD Scale, Beck Depression Inventory, Trauma Symptom Inventory-Dissociation Subscale, Childhood Sexual Abuse Exposure Questionnaire, and Assessing Environments-III-Physical Punishment Scale. Results Hierarchical regression analyses revealed that only dissociative and depression symptoms contributed significantly to physical health symptoms. Similarly, among the subsample of women with either childhood sexual or physical abuse, depression and dissociation were significant predictors of somatic symptoms. However, among women without childhood abuse, only dissociation significantly predicted somatic symptoms. Conclusion Understanding the psychological and biological mechanisms that link childhood versus adult trauma exposure, PTSD, and comorbid depression or dissociation to physical health symptoms may aid development of individualized treatments for the physical and psychological consequences of trauma. PMID:27149157

Psychological distress, job dissatisfaction, and somatic symptoms in office workers in 6 non-problem buildings in the Midwest.

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Black, Donald W; Manlick, Christopher F; Fuortes, Laurence J; Stein, Matthew A; Subramanian, P; Thorne, Peter S; Reynolds, Stephen J

2014-08-01

Researchers examined office worker characteristics and reports of non-specific somatic symptoms in 6 non-problem buildings in the Midwestern United States. We assessed office workers for demographic characteristics and somatic symptoms that occurred in the workplace. Sampling was conducted over a 1-week period in each building over 4 seasons. Our team administered the Medical Outcome Survey questionnaire, the Brief Symptom Inventory, and the Job Content Questionnaire to individuals at each site, comparing office workers reporting no symptoms to those reporting ≥4 symptoms. Self-reported nonspecific somatic symptoms were frequent in office workers in non-problem buildings. High symptom levels were associated with younger age, female sex, psychological distress, impaired quality of life, and poor job satisfaction. The findings suggest that office workers frequently report somatic symptoms they believe are related to the workplace even in buildings considered non-problematic. People with high symptom levels perceived as related to the workplace are psychologically distressed, have impaired quality of life, and feel dissatisfied and powerless in the workplace.

Family disruption increases functional somatic symptoms in late adolescence : the TRAILS study

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van Gils, Anne; Janssens, Karin A. M.; Rosmalen, Judith G. M.

2014-01-01

OBJECTIVE: Functional somatic symptoms (FSSs) are physical symptoms that cannot be (fully) explained by organic pathology. FSSs are very common among children and adolescents, yet their etiology is largely unknown. We hypothesize that (a) the experience of family disruption due to parental divorce

DSM-5 illness anxiety disorder and somatic symptom disorder: Comorbidity, correlates, and overlap with DSM-IV hypochondriasis.

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Newby, Jill M; Hobbs, Megan J; Mahoney, Alison E J; Wong, Shiu Kelvin; Andrews, Gavin

2017-10-01

To investigate the reliability, validity and utility of DSM-5 illness anxiety disorder (IAD) and somatic symptom disorder (SSD), and explore their overlap with DSM-IV Hypochondriasis in a health anxious sample. Treatment-seeking patients with health anxiety (N=118) completed structured diagnostic interviews to assess DSM-IV Hypochondriasis, DSM-5 IAD, SSD, and comorbid mental disorders, and completed self-report measures of health anxiety, comorbid symptoms, cognitions and behaviours, and service utilization. IAD and SSD were more reliable diagnoses than Hypochondriasis (kappa estimates: IAD: 0.80, SSD: 0.92, Hypochondriasis: 0.60). 45% of patients were diagnosed with SSD, 47% with IAD, and 8% with comorbid IAD/SSD. Most patients with IAD fluctuated between seeking and avoiding care (61%), whereas care-seeking (25%) and care-avoidant subtypes were less common (14%). Half the sample met criteria for DSM-IV Hypochondriasis; of those, 56% met criteria for SSD criteria, 36% for IAD, and 8% for comorbid IAD/SSD. Compared to IAD, SSD was characterized by more severe health anxiety, somatic symptoms, depression, and higher health service use, and higher rates of major depressive disorder, panic disorder and agoraphobia. DSM-5 IAD and SSD classifications reliably detect more cases of clinically significant health anxiety than DSM-IV Hypochondriasis. The differences between IAD and SSD appear to be due to severity. Future research should explore the generalizability of these findings to other samples, and whether diagnostic status predicts treatment response and long-term outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

Correlations between sexual dysfunction, depression, anxiety, and somatic symptoms among patients with major depressive disorder.

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Lin, Chiao-Fan; Juang, Yeong-Yuh; Wen, Jung-Kwang; Liu, Chia-Yih; Hung, Ching-I

2012-01-01

The purpose of this study was to investigate the degree of correlation between sexual dysfunction and depression, anxiety, and somatic symptoms among patients with major depressive disorder (MDD) and to identify the dimension most predictive of sexual dysfunction. One-hundred and thirty-five outpatients with MDD were enrolled and were treated with open-label venlafaxine 75 mg daily for one month. The Arizona Sexual Experience Scale-Chinese Version (ASEX-CV), Depression and Somatic Symptoms Scale (DSSS), Hamilton Depression Rating Scale, and Hospital Anxiety and Depression Scale (HADS) were administered at baseline and at one-month follow-up and the improvement percentage (IP) of each scale posttreatment was calculated. Multiple linear regression was used to determine the dimension most predictive of the total ASEX-CV score. Seventy subjects (20 men, 50 women) completed the one-month pharmacotherapy and the four scales. The depression subscale of the HADS was most strongly correlated with the ASEX-CV scale and was the only subscale to independently predict the total ASEX-CV score at the two points. However, the somatic subscale of the DSSS was not correlated with any ASEX-CV item. At the endpoint, depression, anxiety, and somatic symptoms were significantly improved (IP 48.5% to 26.0%); however, very little improvement was observed in the total ASEX-CV score (IP -1.6%). The severity of sexual dysfunction among patients with MDD was most correlated with the severity of the depressive dimension, but not the severity of the somatic dimension. Further studies are indicated to explore the relationships between sexual dysfunction, depression, anxiety, and somatic symptoms.

Cortisol and somatization.

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Rief, W; Auer, C

2000-05-01

Somatization symptoms are frequently associated with depression, anxiety, and feelings of distress. These features interact with the activity of the HPA-axis. Therefore we investigated relationships between somatization symptoms and cortisol. Seventy-seven participants were classified into three groups: somatization syndrome (at least eight physical symptoms from the DSM-IV somatization disorder list), somatization syndrome combined with major depression, and healthy controls. The following data were collected: salivary cortisol at three time points (morning, afternoon, evening), nighttime urinary cortisol, serum cortisol after the dexamethasone suppression test (DST), and psychological variables such as depression, anxiety, somatization, and hypochondriasis. Salivary cortisol showed typical diurnal variations. However, the groups did not differ on any of the cortisol variables. A possible explanation may be counteracting effects of somatization and depression. Exploratory correlational analyses revealed that associations between cortisol and psychopathological variables were time-dependent. DST results correlated with psychological aspects of somatization, but not with the number of somatoform symptoms per se.

The impact of the duration of an untreated episode on improvement of depression and somatic symptoms

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Hung CI

2015-08-01

Full Text Available Ching-I Hung,1,2 Nan-Wen Yu,1,2 Chia-Yih Liu,1,2 Kuan-Yi Wu,1,2 Ching-Hui Yang3 1Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan, 2Chang Gung University College of Medicine, Tao-Yuan, Taiwan; 3Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan Purpose: The aim of this study was to investigate the impact of the duration of an untreated episode (DUE on the improvement of depression and somatic symptoms among patients with major depressive disorder (MDD, after the patients had received 4 weeks of pharmacotherapy. Methods: In this open-label study, there were 155 participants with MDD who were treated daily with 75 mg of venlafaxine for 4 weeks. DUE was defined as the interval between the onset of the index major depressive episode and the start of pharmacotherapy. The Depression and Somatic Symptoms Scale (DSSS, composed of the depression subscale (DS and the somatic subscale (SS, was used. The SS included the pain subscale (PS and the nonpain somatic subscale (NPSS. Multiple linear regressions were used to test the impacts of DUE on the improvement percentages (IPs of depression and somatic symptoms. Results: Eighty-five subjects completed the 4-week treatment. The IPs of the DS, SS, and NPSS were significantly negatively correlated with DUE. A shorter DUE was related to higher IPs. DUE was an independent factor, predicting the IPs of the DS, SS, and NPSS. DUE <1 month was the most powerful time-point to predict the IPs of the DS, SS, and NPSS. However, DUE was unable to predict the IP of the PS at all time-points. Conclusion: A shorter DUE might be one of the factors related to greater improvement of depression and somatic symptoms. DUE should be considered as an important factor when investigating the prognosis of depression and somatic symptoms. Keywords: early intervention, somatization, treatment response, prognosis, outcome

From culture to symptom: Testing a structural model of "Chinese somatization".

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Zhou, Xiaolu; Peng, Yunshi; Zhu, Xiongzhao; Yao, Shuqiao; Dere, Jessica; Chentsova-Dutton, Yulia E; Ryder, Andrew G

2016-02-01

"Chinese somatization" has been frequently discussed over the past three decades of cultural psychiatry, and has more recently been demonstrated in cross-national comparisons. Empirical studies of potential explanations are lacking, however. Ryder and Chentsova-Dutton (2012) proposed that Chinese somatization can be understood as a cultural script for depression, noting that the literature is divided on whether this script primarily involves felt bodily experience or a stigma-avoiding communication strategy. Two samples from Hunan province, China-one of undergraduate students (n = 213) and one of depressed psychiatric outpatients (n = 281)-completed the same set of self-report questionnaires, including a somatization questionnaire developed in Chinese. Confirmatory factor analysis demonstrated that Chinese somatization could be understood as two correlated factors: one focusing on the experience and expression of distress, the other on its conceptualization and communication. Structural equation modeling demonstrated that traditional Chinese cultural values are associated with both of these factors, but only bodily experience is associated with somatic depressive symptoms. This study takes a first step towards directly evaluating explanations for Chinese somatization, pointing the way to future multimethod investigations of this cultural script. © The Author(s) 2015.

Sexual abuse predicts functional somatic symptoms : An adolescent population study

NARCIS (Netherlands)

Bonvanie, Irma J.; van Gils, Anne; Janssens, Karin A. M.; Rosmalen, Judith G. M.

The main aim of this study was to investigate the effect of childhood sexual abuse on medically not well explained or functional somatic symptoms (FSSs) in adolescents. We hypothesized that sexual abuse predicts higher levels of FSSs and that anxiety and depression contribute to this relationship.

Depression and dissociation as predictors of physical health symptoms among female rape survivors with posttraumatic stress disorder.

Science.gov (United States)

Scioli-Salter, Erica R; Johnides, Benjamin D; Mitchell, Karen S; Smith, Brian N; Resick, Patricia A; Rasmusson, Ann M

2016-09-01

To investigate the relative contributions of depression and dissociation, as well as posttraumatic stress disorder (PTSD), to physical health symptoms and to examine the relationships among somatic symptoms, PTSD, depression, and dissociation in relation to childhood and adult trauma exposure. Cross-sectional data are from 132 female rape survivors with PTSD assessed before engaging in a study of trauma-focused cognitive therapy for PTSD. Measures included the Pennebaker Inventory of Limbic Languidness, Clinician Administered PTSD Scale, Beck Depression Inventory, Trauma Symptom Inventory-Dissociation Subscale, Childhood Sexual Abuse Exposure Questionnaire, and Assessing Environments-III-Physical Punishment Scale. Hierarchical regression analyses revealed that only dissociative and depression symptoms contributed significantly to physical health symptoms. Similarly, among the subsample of women with either childhood sexual or physical abuse, depression and dissociation were significant predictors of somatic symptoms. However, among women without childhood abuse, only dissociation significantly predicted somatic symptoms. Understanding the psychological and biological mechanisms that link childhood versus adult trauma exposure, PTSD, and comorbid depression or dissociation to physical health symptoms may aid development of individualized treatments for the physical and psychological consequences of trauma. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Parental Overprotection Predicts the Development of Functional Somatic Symptoms in Young Adolescents

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Janssens, Karin A. M.; Oldehinkel, Albertine J.; Rosmalen, Judith G. M.

2009-01-01

Objective To examine whether parental overprotection contributes to die development of functional somatic symptoms (FSS) in young adolescents. In addition, we aimed to study whether this potential effect of parental overprotection is mediated by parenting distress and/or moderated by the adolescent's sex. Study design FSS were measured in 2230 adolescents (ages 10 to 12 years from the Tracking Adolescents' Individual Lives Survey) by the Somatic Complaints subscale of the Youth Self Report at...

Bilateral Orchidopexy in a Hypochondriacal (Somatic Symptom Disorder) Patient and Determination of Fitness for Bilateral Orchidectomy

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Nwaopara, A. U.; Allagoa, Erefagha Leonardo P.

2016-01-01

Introduction. DSM-5 identifies two disorders: somatic symptom disorder and illness anxiety disorder, to replace hypochondriasis in DSM-IV. Patients with both disorders are intensely anxious about the possibility of an undiagnosed illness or devote excessive time and energy to health concerns and are not easily reassured. Both disorders cause considerable distress and life disruption, even at moderate levels. However, hypochondriasis (DSM-IV) is an indication for neither orchidopexy nor orchid...

Symptoms of depression, anxiety, and somatization in female victims and perpetrators of intimate partner violence in Maputo City, Mozambique

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Soares JJ

2012-09-01

Full Text Available Antonio Eugenio Zacarias,1,2 Gloria Macassa,3 Joaquim JF Soares,1 Leif Svanström,1 Diddy Antai1,41Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, Stockholm, Sweden; 2Eduardo Mondlane University, Faculty of Medicine, Maputo, Mozambique; 3University of Gävle, Department of Occupational and Health Sciences, Gävle, Sweden; 4Division of Global Health and Inequalities, The Angels Trust – Nigeria, Abuja, NigeriaBackground: Little knowledge exists in Mozambique and sub-Saharan Africa about the mental health (symptoms of depression, anxiety, and somatization of women victims and perpetrators of intimate partner violence (IPV by type of abuse (psychological aggression, physical assault without/with injury, and sexual coercion. This study scrutinizes factors associated with mental health among women victims and perpetrators of IPV over the 12 months prior to the study.Methods and materials: Mental health data were analyzed with bivariate and multiple regression methods for 1442 women aged 15–49 years who contacted Forensic Services at Maputo Central Hospital (Maputo City, Mozambique for IPV victimization between April 1, 2007 and March 31, 2008.Results: In bivariate analyses, victims and perpetrators of IPVs scored higher on symptoms of mental health than their unaffected counterparts. Multiple regressions revealed that controlling behaviors, mental health comorbidity, social support, smoking, childhood abuse, sleep difficulties, age, and lack of education were more important in explaining symptoms of mental health than demographics/socioeconomics or life-style factors. Victimization and perpetration across all types of IPV were not associated with symptoms of mental health.Conclusion: In our sample, victimization and perpetration were not important factors in explaining mental ill health, contrary to previous findings. More research into the relationship between women’s IPV victimization and perpetration

Cumulative contextual and individual disadvantages over the life course and adult functional somatic symptoms in Sweden.

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Gustafsson, Per E; Hammarström, Anne; San Sebastian, Miguel

2015-08-01

Disadvantage, originating in one's residential context or in one's past life course, has been shown to impact on health in adulthood. There is however little research on the accumulated health impact of both neighbourhood and individual conditions over the life course. This study aims to examine whether the accumulation of contextual and individual disadvantages from adolescence to middle-age predicts functional somatic symptoms (FSS) in middle-age, taking baseline health into account. The sample is the age 16, 21, 30 and 42 surveys of the prospective Northern Swedish Cohort, with analytical sample size n = 910 (85% of the original cohort). FSS at age 16 and 42, and cumulative socioeconomic disadvantage, social adversity and material adversity between 16 and 42 years were operationalized from questionnaires, and cumulative neighbourhood disadvantage between 16 and 42 years from register data. Results showed accumulation of disadvantages jointly explained 9-12% of FSS variance. In the total sample, cumulative neighbourhood and socioeconomic disadvantage significantly predicted FSS at age 42 in the total sample. In women, neighbourhood disadvantage but not socioeconomic disadvantage contributed significantly, whereas in men, socioeconomic but not neighbourhood disadvantage contributed significantly. In all analyses, associations were largely explained by the parallel accumulation of social and material adversities, but not by symptoms at baseline. In conclusion, the accumulation of diverse forms of disadvantages together plays an important role for somatic complaints in adulthood, independently of baseline health. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Family based treatment for children with functional somatic symptoms: A systematic literature review

DEFF Research Database (Denmark)

Hulgaard, Ditte Roth; Dehlholm-Lambertsen, Birgitte; Rask, Charlotte

2015-01-01

Background: Young patients with Functional Somatic Symptoms (FSS) are common and may present in all clinical settings. Clinical presentation varies from self–limiting to severe and disabling symptoms with impairment in several domains of daily life. In daily clinical practice there is no consensus...... on which treatment to offer children and adolescents with FSS. Research in adults shows that different FSS respond to the same kind of treatment, with the effect of cognitive behavioural therapy being well established. In the understanding of mental health issues in children, it is well established...... is broadly defined and encompasses a wide range of interventions. Aims: As part of a PhD study on family based treatment for children with FSS a systematic review of the literature will be performed in which the type and characteristics of existing family based psychological interventions for children...

Cognitive-behavioral therapy for somatization and symptom syndromes: a critical review of controlled clinical trials.

Science.gov (United States)

Kroenke, K; Swindle, R

2000-01-01

Few treatments for somatization have been proven effective. In the past decade, however, clinical trials of cognitive-behavioral therapy (CBT) have been promising. Our aim was to critically review and synthesize the evidence from these trials. A search of the Medline database from 1966 through July 1999 was conducted to identify controlled trials designed to evaluate the efficacy of CBT in patients with somatization or symptom syndromes. A total of 31 controlled trials (29 randomized and 2 nonrandomized) were identified. Twenty-five studies targeted a specific syndrome (e.g. chronic fatigue, irritable bowel, pain) while 6 focused on more general somatization or hypochondriasis. Primary outcome assessment included physical symptoms, psychological distress and functional status in 28, 26 and 19 studies, respectively. Physical symptoms appeared the most responsive: CBT-treated patients improved more than control subjects in 71% of the studies and showed possibly greater improvement (i.e., a trend) in another 11% of the studies. A definite or possible advantage of CBT for reducing psychological distress was demonstrated in only 38 and 8% of studies, and for improving functional status in 47 and 26%. Group therapy and interventions as brief as 5 sessions proved efficacious. Benefits were sustained for up to 12 months. CBT can be an effective treatment for patients with somatization or symptom syndromes. Benefits can occur whether or not psychological distress is ameliorated. Since chronic symptoms are exceptionally common and most studies were conducted in referral populations, the optimal sequencing of CBT in treating primary care patients and the identification of those most likely to accept and respond to therapy should be further evaluated. Copyright 2000 S. Karger AG, Basel.

[Hypochondriac symptoms in late-onset depression: the relationship between hypochondria and somatic state of patients].

Science.gov (United States)

Ivanets, N N; Avdeeva, T I; Kinkul'kina, M A

2013-01-01

Authors studied 276 women with late-onset depression. Concomitant chronic somatic diseases were identified in 90%. The presence of disease and its nosological definition did not impact on the development of hypochondriac symptoms in patients with late-onset depression. Patients with hypochondriac late-onset depression more often had disability pension due to somatic disease because they more often referred to internists in case of similar objective severity of somatic pathology. It was singled out three variants of the relationship between hypochondria and somatic state: hypernosognostic (a complete coincidence of hypochondria content with actual somatic pathology; anosognostic (a lack of coincidence) and disharmonic (a partial coincidence). The themes of hypochondria in late-nset depressions were correlated with a total number of somatic diseases and their severity. At the same time, there was no correlation between the content of hypochondria and the character of somatic disease.

Parental Overprotection Predicts the Development of Functional Somatic Symptoms in Young Adolescents

NARCIS (Netherlands)

Janssens, Karin A. M.; Oldehinkel, Albertine J.; Rosmalen, Judith G. M.

Objective To examine whether parental overprotection contributes to die development of functional somatic symptoms (FSS) in young adolescents. In addition, we aimed to study whether this potential effect of parental overprotection is mediated by parenting distress and/or moderated by the

Life Course Pathways of Adversities Linking Adolescent Socioeconomic Circumstances and Functional Somatic Symptoms in Mid-Adulthood: A Path Analysis Study.

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Frida Jonsson

Full Text Available While research examining the health impact of early socioeconomic conditions suggests that effects may exist independently of or jointly with adult socioeconomic position, studies exploring other potential pathways are few. Following a chain of risk life course model, this prospective study seeks to examine whether pathways of occupational class as well as material and social adversities across the life course link socioeconomic disadvantage in adolescent to functional somatic symptoms in mid-adulthood. Applying path analysis, a multiple mediator model was assessed using prospective data collected during 26 years through the Northern Swedish Cohort. The sample contained 987 individuals residing in the municipality of Luleå, Sweden, who participated in questionnaire surveys at age 16, 21, 30 and 42. Socioeconomic conditions (high/low in adolescence (age 16 were operationalized using the occupation of the parents, while occupational class in adulthood (manual/non-manual was measured using the participant's own occupation at age 21 and 30. The adversity measurements were constructed as separate age specific parcels at age 21 and 30. Social adversity included items pertaining to stressful life events that could potentially harm salient relationships, while material adversity was operationalized using items concerning unfavorable financial and material circumstances. Functional somatic symptoms at age 42 was a summary measure of self-reported physical symptoms, palpitation and sleeping difficulties that had occurred during the last 12 months. An association between socioeconomic conditions at age 16 and functional somatic symptoms at age 42 (r = 0.068 which was partially explained by people's own occupational class at age 21 and then material as well as social adversity at age 30 was revealed. Rather than proposing a direct and independent health effect of the socioeconomic conditions of the family, the present study suggests that growing up in an

Children of people with somatization disorder.

Science.gov (United States)

Livingston, R

1993-05-01

The author investigated psychopathology, suicidal behavior, child abuse, somatization, and health care utilization in 34 children with a parent who has somatization disorder (SD-P) and two comparison groups: 41 children with a somatizing parent (SOM) (fewer symptoms than required for diagnosis of SD-P), and 30 pediatrically ill controls (CON). Child and parent versions of the Diagnostic Interview for Children and Adolescents were scored for diagnosis and symptom counts in specified categories. Medical records were obtained and abstracted. Children of SD-P had significantly more psychiatric disorders and suicide attempts than did children of SOM or the CON. SD-P and CON had significantly more unexplained physical symptoms than SOM. SD-P showed a trend toward more hospitalizations and experienced significantly more maltreatment. Children of SD-P are at significant risk in several respects. Clinical implications of these findings include a need for awareness and cooperation among general psychiatrists, primary care physicians, and child and adolescent psychiatrists to facilitate detection and treatment of these children's problems.

Parent and Child Psychological Factors in Pediatric Syncope and Other Somatic Symptoms

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Blount, Ronald L.; Morris, Julie A. B.; Cheng, Patricia S.; Campbell, Robert M.; Brown, Ronald T.

2004-01-01

The authors examined associations among parental and child adjustment, child syncope, somatic, and school problems. Participants were children (N = 56) ages 7-18 years with syncope. Measures included syncope severity, parental distress, and children's internalizing symptoms. For children diagnosed negative for neurocardiogenic syncope (NCS), their…

Loneliness and its association with psychological and somatic health problems among Czech, Russian and U.S. adolescents.

Science.gov (United States)

Stickley, Andrew; Koyanagi, Ai; Koposov, Roman; Blatný, Marek; Hrdlička, Michal; Schwab-Stone, Mary; Ruchkin, Vladislav

2016-05-04

Loneliness is common in adolescence and has been linked to various negative outcomes. Until now, however, there has been little cross-country research on this phenomenon. The aim of the present study was to examine which factors are associated with adolescent loneliness in three countries that differ historically and culturally-the Czech Republic, Russia and the United States, and to determine whether adolescent loneliness is associated with poorer psychological and somatic health. Data from a school survey, the Social and Health Assessment (SAHA), were used to examine these relations among 2205 Czech, 1995 Russian, and 2050 U.S. male and female adolescents aged 13 to 15 years old. Logistic regression analysis was performed to examine if specific demographic, parenting, personal or school-based factors were linked to feeling lonely and whether lonely adolescents were more likely to report psychological (depression and anxiety) or somatic symptoms (e.g. headaches, pain). Inconsistent parenting, shyness, and peer victimisation were associated with higher odds for loneliness in at least 4 of the 6 country- and sex-wise subgroups (i.e. Czech, Russian, U.S. boys and girls). Parental warmth was a protective factor against feeling lonely among Czech and U.S. girls. Adolescents who were lonely had higher odds for reporting headaches, anxiety and depressive symptoms across all subgroups. Loneliness was associated with other somatic symptoms in at least half of the adolescent subgroups. Loneliness is associated with worse adolescent health across countries. The finding that variables from different domains are important for loneliness highlights the necessity of interventions in different settings in order to reduce loneliness and its detrimental effects on adolescent health.

Effect of Somatic Experiencing Resiliency-Based Trauma Treatment Training on Quality of Life and Psychological Health as Potential Markers of Resilience in Treating Professionals

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Neal E. Winblad

2018-02-01

Full Text Available Background: Individuals who treat trauma are at significant risk of vicarious traumatization and burnout. Somatic Experiencing® (SE® is a resiliency-focused trauma treatment modality designed to address autonomic nervous system (ANS dysregulation and its impacted physical health and mental health symptoms e.g., anxiety, depression, post-traumatic stress disorder, migraines, fibromyalgia, and chronic fatigue, etc. The SE® training supports the development of clinical skills to reduce physical health/mental health symptoms as well as increase clinician resilience. Individuals who display resilience often have increased experiences of well-being (quality of life and decreased levels of self-reported psychological symptoms. Greater resilience could mitigate the risks to providers and the clients they treat.Materials and Methods: This within-groups, longitudinal study assessed students (N = 18 over the course of a 3-year SE® practitioner training. This training focuses on increased ANS, physical, and emotional regulation skills. The convenience of a web-based survey allowed for: measures of a general quality of life (WHOQOL-BREF, psychological symptoms, somatic, anxiety, and depressive symptoms (PHQ-SADS, as well as a measure of early life exposure to adversity (CDC/Kaiser Permanente ACE Score Calculator Questionnaire. The clinician survey was conducted yearly for 3 years. Future studies would do well to also include laboratory-based objective measures of ANS functioning.Results: ANOVA with repeated measures showed that there were significant reductions in anxiety symptoms (GAD7, p < 0.001 and somatization symptoms (PHQ15, p < 0.001. Health-related quality of life (a measure of physical well-being and social quality of life (a measure of interpersonal well-being both increased significantly (Health QoL p = 0.028; Social QoL p = 0.046.Conclusions: Results suggest that professionals attending the 3-year SE® training course experience a significant

Negative Social Contextual Stressors and Somatic Symptoms Among Young Black Males: An Exploratory Study.

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Scott, Lionel D; McCoy, Henrika

This study examines whether negative social contextual stressors were associated with somatic symptoms among young Black males ( N = 74) after accounting for background and psychological characteristics. Using Cunningham and Spencer's Black Male Experiences Measure, negative social contextual stressors connoted those experiences connected to the personal attributes, devaluation, and negative imagery of young Black males, such as being followed when entering a store or police or security guards asking them what they are doing when hanging out (e.g., in the park or playground or on the street corner). Results showed that such stressors made a unique and significant contribution to the experience of somatic symptoms. Future research directions and implications for addressing the larger societal perceptions of young Black males are discussed.

Irritable bowel symptoms and the development of common mental disorders and functional somatic syndromes identified in secondary care – a long-term, population-based study

Directory of Open Access Journals (Sweden)

Poulsen CH

2017-07-01

Full Text Available Chalotte Heinsvig Poulsen,1,2 Lene Falgaard Eplov,2 Carsten Hjorthøj,2 Marie Eliasen,1 Sine Skovbjerg,1 Thomas Meinertz Dantoft,1 Andreas Schröder,3 Torben Jørgensen1,4,5 1Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup, 2Copenhagen University Hospital, Mental Health Centre Copenhagen, Hellerup, 3Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, 4Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 5The Faculty of Medicine, Aalborg University, Aalborg, Denmark Objective: Irritable bowel syndrome (IBS is associated with mental vulnerability, and half of patients report comorbid somatic and mental symptoms. We aimed to investigate the relationship between an IBS symptom continuum and the subsequent development of common mental disorders (CMDs and functional somatic syndromes (FSSs.Methods and study design: A longitudinal population-based study comprising two 5-year follow-up studies, Dan-MONICA 1 (1982–1987 and Inter99 (1999–2004, recruited from the western part of Copenhagen County. The total study population (n = 7,278 was divided into symptom groups according to the degree of IBS definition fulfillment at baseline and/or follow-up and was followed until December 2013 in Danish central registries. Cox regression was used for the analyses, adjusting for age, sex, length of education and cohort membership. In a subsequent analysis, we adjusted for mental vulnerability as a risk factor for both CMDs and FSSs, including IBS.Results: Over a 5-year period, 51% patients had no IBS symptoms, 17% patients had IBS symptoms without abdominal pain, 22% patients had IBS symptoms including abdominal pain and 10% patients fulfilled the IBS definition. IBS and IBS symptoms including abdominal pain were significantly associated with the development of CMDs and other FSSs identified in secondary care. When adjusting for mental

symptomatology and comorbidity of somatization disorder amongst

African Journals Online (AJOL)

underlying mental disorder, manifesting solely as somatic symptoms or with ... unsatisfactory visit and seemingly ineffective treatment plan. ... patients of all ages and both gender with various ..... identity and physical health: Interdisciplinary.

Health care utilization, somatic and mental health distress, and well-being among widowed and non-widowed female survivors of war

Science.gov (United States)

2012-01-01

Background The aim of the study was to assess levels of somatic and mental health distress, well-being, AS WELL AS utilization of primary and specialist health care services among war-related widowed and non-widowed female civilian survivors of war. Methods 100 war-related widowed lone mothers and 106 non-widowed mothers who had experienced the Kosovo war ten years previously participated in the study. Measures of somatic, depressive, post-traumatic stress, anxiety, and grief complaints, subjective well-being, and utilization of health care services during the previous three months were used. Results Compared to non-widowed mothers, widowed lone mothers reported significantly higher levels of somatic, depressive, post-traumatic stress, and anxiety complaints. Further, they reported significantly lower levels of subjective well-being as composed of positive and negative affect and satisfaction with life. More than half of both widowed and non-widowed mothers reported utilization of health care services during the last three months, without significant differences between the groups. However, only three percent of widowed lone mothers and four percent of non-bereaved mothers reported utilization of mental health services during the last three months, despite high levels of mental health distress especially among widowed lone mothers. Among widowed lone mothers, severity of prolonged grief symptoms significantly predicted number of contacts of specialist health care use over and above sociodemographic variables, number of war-related events, and other psychopathology. Conclusion War-related widowed lone mothers suffer from elevated somatic and mental distress even a decade after the war. The tiny proportion of widowed lone mothers in use of mental health services can be seen as a reflection of lack of previous and current mental health services to meet mental health needs of this population. PMID:22578096

Improving somatic health of outpatients with severe mental illness

NARCIS (Netherlands)

Van Hasselt, Fenneke M.; Oud, Marian J. T.; Krabbe, Paul F. M.; Postma, Maarten J.; Loonen, A.J.M.

2014-01-01

Background: Patients with severe mental illness (SMI) experience a 13-to 30-year reduction in life expectancy compared with the general population. The majority of these deaths can be attributed to somatic health problems. The risk on somatic health problems is partly increased due to a reduced

Somatic symptoms in social phobia : A treatment method based on rational emotive therapy and paradoxical interventions

NARCIS (Netherlands)

MERSCH, PPA; HILDEBRAND, M; LAVY, EH; WESSEL, Ineke; VANHOUT, WJPJ

Social phobia is often accompanied by somatic symptoms such as trembling, blushing, and sweating. In cases where these symptoms are predominant and, rather than the social situation, represent the feared stimulus, their unpredictable occurrence may reduce the effectiveness of an otherwise successful

Family disruption increases functional somatic symptoms in late adolescence: the TRAILS study.

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van Gils, Anne; Janssens, Karin A M; Rosmalen, Judith G M

2014-11-01

Functional somatic symptoms (FSSs) are physical symptoms that cannot be (fully) explained by organic pathology. FSSs are very common among children and adolescents, yet their etiology is largely unknown. We hypothesize that (a) the experience of family disruption due to parental divorce or parental death increases FSSs in adolescents; (b) symptoms of depression and anxiety contribute to the relationship between family disruption and FSSs; (c) girls are more vulnerable to these effects than boys. Data were obtained from the prospective population cohort of Dutch adolescents of the Tracking Adolescents' Individual Lives Survey (N = 2,230), aged 10 to 12 years at baseline. FSSs were assessed using the Somatic Complaints subscale of the Youth Self-Report. Parental divorce and parental death were assessed with self-reports. Both outcome and predictors were assessed during 3 assessment waves over the course of 5 years. Linear mixed models were used to investigate associations between both types of family disruption and FSSs. An interaction with age was found for parental divorce (B = 0.01, p = .02) and parental death (B = 0.03, p = .04), indicating that the influence of family disruption on FSSs increases during adolescence. This relationship seems to be partly explained by symptoms of depression and anxiety. No gender differences were found with regard to the effects of family disruption on FSSs. Family disruption is associated with an increased level of FSSs in late adolescence in both genders. This relationship is partly explained by symptoms of depression and/or anxiety. PsycINFO Database Record (c) 2014 APA, all rights reserved.

The Role of Acculturative Stress on Mental Health Symptoms for Immigrant Adolescents: A Longitudinal Investigation

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Sirin, Selcuk R.; Ryce, Patrice; Gupta, Taveeshi; Rogers-Sirin, Lauren

2013-01-01

Immigrant-origin adolescents represent the fastest growing segment of youth population in the United States, and in many urban schools they represent the majority of students. In this 3-wave longitudinal study, we explored trajectories of internalizing mental health symptoms (depression, anxiety, and somatic symptoms). The participants included…

Infant behaviors are predictive of functional somatic symptoms at ages 5-7 years

DEFF Research Database (Denmark)

Rask, Charlotte Ulrikka; Ørnbøl, Eva; Olsen, Else Marie

2013-01-01

OBJECTIVE: To investigate infancy predictors of impairing functional somatic symptoms (FSS) at child ages 5-7 years with a focus on problems with feeding, sleep, and tactile reactivity. STUDY DESIGN: This study is part of a longitudinal birth cohort study, Copenhagen Child Cohort CCC2000. Child h...

The Effect of Paroxetine on Depressive Symptom with Somatic Disease and Change of Platelet 5-HT Concentration

Institute of Scientific and Technical Information of China (English)

郑凯; 史庭慧; 刘晓晴

2003-01-01

To study the effect of paroxetine on depressive symptom accompanying somatic disease and the value of platelet 5-HT concentration in the diagnosis of depression, 30 patients with depressive symptom were treated with paroxetine. All patients were evaluated on Zung and HAMD scale and assayed of platelet 5-HT concentration before and after treatment. It was found that patients had a lower level of platelet 5-HT concentration than healthy people (P＜0. 01). After six weeks of treatment, depressive and somatic symptoms were both improved (P＜0. 01) and platelet 5-HT concentration was even lower (P＞0. 05). It was suggested that paroxetine was a good antidepressant and platelet 5-HT concentration was useful in the screening of depression.

Hypochondriasis and somatization.

Science.gov (United States)

Kellner, R

1987-11-20

Between 60% and 80% of healthy individuals experience somatic symptoms in any one week. About 10% to 20% of a random sample of people worry intermittently about illness. A substantial proportion of patients present physicians with somatic complaints for which no organic cause can be found. Patients who are hypochondriacal do not understand the benign nature of functional somatic symptoms and interpret these as evidence of disease. Hypochondriacal concerns range from common short-lived worries to persistent and distressing fears or convictions of having a disease. Hypochondriasis can be secondary to other psychiatric disorders (eg, melancholia or panic disorder), and hypochondriacal attitudes remit when the primary disorder is successfully treated. Patients with primary hypochondriasis are also anxious or depressed, but the fear of disease, or the false belief of having a disease, persists and is the most important feature of their psychopathology. There are substantial differences among hypochondriacal patients in their personalities and psychopathologies. Psychotherapy as well as psychotropic drugs are effective in the treatment of functional somatic symptoms. There are no adequate controlled studies on the value of psychotherapy in hypochondriasis; the recommended guidelines are based on uncontrolled studies of hypochondriasis and on controlled studies of the psychotherapy in similar disorders. The prognosis of functional somatic symptoms as well as that of hypochondriasis is good in a substantial proportion of patients.

Application of the Chinese Version of the Whiteley Index-7 for Detecting DSM-5 Somatic Symptom and Related Disorders.

Science.gov (United States)

Tu, Chao-Ying; Liao, Shih-Cheng; Liu, Chao-Yu; Chen, Tzu-Ting; Chen, I-Ming; Lin, Kuan-Fu; Huang, Wei-Lieh

2016-01-01

The Whiteley Index-7 (WI-7) is frequently used for evaluating patients with suspected hypochondriasis. However, information about its use on somatic symptom and related disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is still lacking. This study investigated the psychometric properties of the Mandarin Chinese version of the WI-7 and its application to evaluation of somatic symptom and related disorders. Participants completed the WI-7 and received diagnostic interview based on both Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and DSM-5 criteria. Exploratory factor analysis was performed, and the test-retest reliability and the internal consistency of the WI-7 were assessed. Receiver Operating Characteristic curves were established, and the area under the curve was calculated to determine the cutoff point to distinguish DSM-IV somatoform disorders and DSM-5 somatic symptom and related disorders, respectively. A total of 471 subjects were recruited for this study. The exploratory factor analysis of the WI-7 identified a single factor. The internal consistency and test-retest reliability of the WI-7 were 0.829 and 0.836, respectively. The area under Receiver Operating Characteristic curve using WI-7 to distinguish DSM-5 somatic symptom and related disorders is 0.660, higher than that when applying to distinguish DSM-IV somatoform disorders. The sensitivity and specificity at an optimal cutoff point of 0/1 are 0.645 and 0.675, respectively. The Mandarin Chinese version of the WI-7 is a potentially useful tool to detect individuals with DSM-5 somatic symptom and related disorders. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

A concept mapping study on perpetuating factors of functional somatic symptoms from clinicians' perspective

NARCIS (Netherlands)

Janssens, Karin A. M.; Houtveen, Jan H.; Tak, Lineke M.; Bonvanie, Irma J.; Scholtalbers, Anna; van Gils, Anne; Geenenc, Rinie; Rosmalen, Judith G. M.

2017-01-01

Objective: The aim of this concept mapping study was to identify the structure and alleged importance of perpetuating factors of functional somatic symptoms (FSS) from the perspective of professionals. Further, we examined to which extent these factors have been addressed in scientific literature.

[Psychosomatic symptoms in somatic diseases - open-angle glaucoma for example].

Science.gov (United States)

Emmerich, G M

2010-08-01

Psychological aspects exist in somatic diseases like tumours and even fractures, not only in the beginning but also in the management of disease. Somatic diseases give rise to signs of a special constellation of life and management of these diseases is important for the psychological constellation of the individual. Studies on open-angle glaucoma have shown that many patients suffering from this disease are anxious, hypochondric, perfectionist and emotional instable. Chronic diseases are demanding processes of flexibility and defense, and define how the individual can deal with the diseases and what place in life the disease will occupy in the future. In the holistic view of medicine even psychological conflicts should be treated. In many situations, these conflicts are not consciously experienced by the individual. Therapeutically, 2 different tools can be used: symbolic stories can bring forces to manage the conflict and to solve the conflict (2 examples in the text). The method of positive psychotherapy describes the reasons for psychosomatic diseases in three parts: psychosomatic in the traditional understanding, in further and comprehensive understanding. Especially the psychosomatic effects in comprehensive understanding are embedded in the individual's sociocultural environment and provide tips on reasons for the diseases in those parts of life. The "positive balance model" gives an example of life-management and conflict-therapy. In ophthalmology, fear is often more important for the patient than pain. To avoid this, the patients develop techniques to deny, to cover or to suppress the fear. In the article questions are presented like those the ophthalmologist should be able to ask patients in the office concerning open-angle glaucoma. Tips for the therapy and management for neurotic stress are offered and some special anamnestic questions for the ophthalmologist are presented. Unsolved conflicts and denied desires as neurotic symptoms can be focused in

Work participation and health-related characteristics of sickness absence beneficiaries with multiple somatic symptoms

DEFF Research Database (Denmark)

Momsen, A H; Nielsen, Claus Vinther; Nielsen, M B D

2016-01-01

unemployed was higher for this group than for those with a low score. Adjusting for general health reduced the association between symptoms and unemployment, whereas problems with social relations only affected it marginally. Conclusions: Sick-listed individuals reporting high levels of symptoms were more......Objectives: The primary aim was to study whether high levels of multiple symptoms influenced sick-listed individuals' employment status or desire to return to work (RTW) and whether this was associated with social relations at work. Study design: A cross-sectional study nested in a clinical trial......-listing, and use of health care were register-data. Multivariate logistic regression analyses with adjustments were performed. Results: Beneficiaries with high SCL-SOM score (n = 218, 33%) reported poorer health, job satisfaction, a lower desire to RTW and more problems with supervisors. The risk of being...

Somatic Complaints in Adolescence and Labour Market Participation in Young Adulthood.

Science.gov (United States)

Winding, Trine Nøhr; Andersen, Johan Hviid

2018-05-01

The primary aim was to investigate the association between somatic symptoms at ages 15 or 18 and reduced labour market participation at age 23, when socioeconomic, social, and mental health risk factors were taken into account. The study included 3223 participants from the West Jutland Cohort Study with questionnaire information on somatic symptoms at ages 15 or 18 and with register information on labour market participation at age 23, gathered from a national register on all public transfer benefits for a 52-week period. The analyses included additional information about socioeconomic background, number of negative life events, social climate in the family, social relations with friends, and depressive symptoms. Logistic regression analyses yielded odds ratios with 95% confidence intervals. Among the males, associations between reporting somatic symptoms at age 18 and low labour market participation was seen in both crude and adjusted analyses (odds ratio: 1.66; 95% confidence intervals: 1.01-2.75), whereas the association among the females disappeared after adjustments (odds ratio: 0.97; 95% confidence intervals: 0.63-1.52). The males that reported somatic symptoms in late adolescence appeared to be the most vulnerable to future reduced labour market participation.

The clinical inadequacy of the DSM-5 classification of somatic symptom and related disorders: an alternative trans-diagnostic model.

Science.gov (United States)

Cosci, Fiammetta; Fava, Giovanni A

2016-08-01

The Diagnostic and Statistical of Mental Disorders, Fifth Edition (DSM-5) somatic symptom and related disorders chapter has a limited clinical utility. In addition to the problems that the single diagnostic rubrics and the deletion of the diagnosis of hypochondriasis entail, there are 2 major ambiguities: (1) the use of the term "somatic symptoms" reflects an ill-defined concept of somatization and (2) abnormal illness behavior is included in all diagnostic rubrics, but it is never conceptually defined. In the present review of the literature, we will attempt to approach the clinical issue from a different angle, by introducing the trans-diagnostic viewpoint of illness behavior and propose an alternative clinimetric classification system, based on the Diagnostic Criteria for Psychosomatic Research.

[Somatization disorders of the urogenital tract].

Science.gov (United States)

Günthert, E A

2002-11-01

Diffuse symptoms in the urogenital region can frequently be explained by somatization disorders. Since they cannot be proven either by laboratory tests or with common technical diagnostic methods, somatization disorders should always be taken into consideration. Somatization disorders are to be considered functional disorders. Since somatization disorders due to muscular tension prevail in the urogenital region, the functional disturbance can be explained by the muscular tension. Subsequently, muscular tension causes the pathophysiological development of symptoms. As a rule they appear as myofascial pain or disorder. Muscular tension can have a psychic origin. The absence of urological findings is typical. Males and females between the ages of 16 and 75 can be affected by somatization disorders in the urogenital region. Somatization disorders due to muscular tension belong to the large group of symptoms due to tension. Diagnostic and therapeutic procedures as well as the pathophysiology of somatization disorders due to muscular tension are illustrated by two detailed case-reports.

Adolescents with Low Intelligence Are at Risk of Functional Somatic Symptoms : The TRAILS Study

NARCIS (Netherlands)

Kingma, Eva M.; Janssens, Karin A. M.; Venema, Manon; Ormel, Johan; de Jonge, Peter; Rosmalen, Judith G. M.

2011-01-01

Purpose: Low intelligence is a risk factor for functional somatic symptoms (FSSs) in adults, but it is unknown whether a similar association exists in adolescents. We hypothesized that low intelligence may lead to FSS, and that this association is mediated by low school performance. In addition, we

Validity of the Greek version of the PHQ 15-item Somatic Symptom Severity Scale in patients with chronic medical conditions and correlations with emergency department use and illness perceptions.

Science.gov (United States)

Hyphantis, Thomas; Kroenke, Kurt; Papatheodorou, Eugenia; Paika, Vassiliki; Theocharopoulos, Nicholaos; Ninou, Aggeliki; Tomenson, Barbara; Carvalho, Andre F; Guthrie, Elspeth

2014-11-01

The PHQ-15 is a brief measure assessing the severity of somatic symptoms and is widely used in different health care settings. We aimed to assess the psychometric properties of its Greek version in patients with chronic physical illnesses seeking urgent or unscheduled care in the Accident and Emergency Department (AED). The PHQ-15 was translated into Greek using back-translation, and it was administered to 303 patients with diabetes, COPD and rheumatic diseases visiting our AED during a one-year period. Patients were interviewed with the MINI. Depressive (PHQ-9) and somatization symptoms (SCL-12), illness perceptions (B-IPQ) and health-related quality of life (WHOQOL-BREF) were also assessed to test criterion and concurrent validity. The Greek version of the PHQ-15 showed acceptable internal consistency. Convergent validity was established by the strong associations observed between PHQ-15 scores and functional status, depressive symptom severity and AED visits during the previous year. PHQ-15 scores were also associated with the patients' concerns about personal and treatment illness's control and their beliefs regarding the number of bodily symptoms attributed to their illness (illness identity). The highly acceptable convergent and discriminant validity of the five individual bodily symptoms assessed by both the PHQ-15 and SCL-12 is a further construct validity indicator. The present findings support the applicability of the Greek version of PHQ-15 in assessing common somatic symptoms either medically explained or unexplained in patients seeking care in the AED, further confirming that it can be considered suitable for use in a broad range of populations in clinical research. Copyright © 2014 Elsevier Inc. All rights reserved.

Hypochondriasis and somatization: two distinct aspects of somatoform disorders?

Science.gov (United States)

Leibbrand, R; Hiller, W; Fichter, M M

2000-01-01

We investigated boundaries and overlap between somatization and hypochondriasis on different levels of psychopathology: (1) comorbidity between hypochondriasis and somatization on the level of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994): (2) comorbidity with other mental disorders; (3) differences in clinical characteristics: and (4) overlap on the level of psychometric measures. The sample consisted of 120 psycho somatic inpatients. Somatoform, hypochondriacal, and depressive symptomatology, cognitions about body and health, and further aspects of general symptomatology were investigated. Diagnoses of Axis I and II were based on DSM-IV Our results suggest a large overlap on the level of DSM-IV-diagnoses: only 3 of 31 hypochondriacal patients had no multiple somatoform symptoms, while 58 of 86 patients with multiple somatoform symptoms had no hypochondriasis. However, the overlap between hypochondriacal and somatization symptomatology on the level of psychometric measurement is only moderate, indicating that hypochondriasis is a markedly distinct aspect of somatoform disorders.

Gender similarities in somatic depression and in DSM depression secondary symptom profiles within the context of severity and bereavement.

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Thompson, Angus H; Bland, Roger C

2018-02-01

Most population studies report higher rates of depression among women than men, and some researchers have observed gender differences in depression symptoms overall, or in sub-groupings (e.g. somatic depression). However, gender symptom differences have been inconsistent, prompting this investigation of gender differences in secondary DSM symptom profiles in the context of bereavement status, age, and depression severity. Individuals with symptoms of core depression (flat affect or anhedonia) were selected from a large survey of adults in the Alberta, Canada workforce. Analyses involved the comparison of gender profiles across the seven DSM-IV secondary depressive symptoms plus a MANOVA of sex, bereavement, and age, with secondary symptoms comprising the dependent variable. Gender profiles were very similar, irrespective of depression severity or bereavement. Secondary symptoms were marginally more common among women and more frequent among bereaved young adults, but there was no evidence for a gender-related somatic factor. First, data were gathered only for persons in the workforce and thus may not be generalizable to, for example, stay-at-home parents or those with employment issues. Second, the focus here is restricted to DSM symptoms, leaving risk factors, social roles, and brain functioning for separate investigation. Third, inferences were drawn from associations between groups of persons, rather than between individuals, requiring caution when speculating about individual attributes. Gender differences in depression represent a difference in amount, not kind, suggesting that the range of depressive experiences is similar for men and women. There was no gender difference ascribable to somatic depression. Copyright © 2017 Elsevier B.V. All rights reserved.

Frequency of depression and somatic symptoms in patients on interferon alpha/ribavirin for chronic hepatitis C

International Nuclear Information System (INIS)

Shakoor, A.; Shafqat, F.; Mehmud, T.H.; Akram, M.; Riaz, S.; Iqbal, Z.; Khan, A.A.

2010-01-01

Large numbers of patients suffering from Chronic Hepatitis C (HCV) are seeking treatment with interferon alpha (IFN) because of significant advances in overall improvement in the course of HCV and its complications. Objectives were to estimate the frequency of depression and somatic symptoms in patients on interferon alpha/ribavirin treatment for chronic hepatitis C. Methods: It was an observational study conducted in the out-patient Department of Gastroenterology Shaikh Zayed Hospital, Lahore during a period of three months, i.e., from September to November 2008. One hundred consecutive patients undergoing interferon alpha/ ribavirin treatment for chronic HCV were included in the study. All patients, irrespective of age, sex or duration of treatment were administered with a check list of common physical complaints and DSM-IV symptoms for Major Depressive Episode. Results: Out of a total of 100 subjects 37 were male and 63 were female. In all, 39 (39%) patients fulfilled the diagnostic criteria of DSM-IV for Major Depressive Episode. Major Depression was more common in female 28 (44.4%) as compared to male 11 (28.7%) patients. Somatic symptoms were common in all the patients but they were reported more frequently by patients with Major Depression compared to those without Major Depression. Myalgias, headache, joint pain, nausea/vomiting, abdominal pain and palpitation were the most common physical symptoms. Conclusion: Major Depression and somatic complaints are a common consequence of interferon alpha/ribavirin treatment for chronic hepatitis C. All patients receiving this treatment should be periodically assessed for the detection of these side effects to promptly address relevant treatment options. (author)

Cross-cultural differences in somatic presentation in patients with generalized anxiety disorder.

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Hoge, Elizabeth A; Tamrakar, Sharad M; Christian, Kelly M; Mahara, Namrata; Nepal, Mahendra K; Pollack, Mark H; Simon, Naomi M

2006-12-01

Little is known about cultural differences in the expression of distress in anxiety disorders. Previous cross-cultural studies of depression have found a greater somatic focus in Asian populations. We examined anxiety symptoms in patients with generalized anxiety disorder (GAD) in urban mental health settings in Nepal (N = 30) and in the United States (N = 23). Participants completed the Beck Anxiety Inventory (BAI). The overall BAI score and somatic and psychological subscales were compared. While there was no difference in total BAI scores, the Nepali group scored higher on the somatic subscale (i.e. "dizziness" and "indigestion," t[df] = -2.63[50], p < 0.05), while the American group scored higher on the psychological subscale (i.e. "scared" and "nervous," t[df] = 3.27[50], p < 0.01). Nepali patients with GAD had higher levels of somatic symptoms and lower levels of psychological symptoms than American patients with GAD. Possible explanations include differences in cultural traditions of describing distress and the mind-body dichotomy.

Family therapy for adolescents with functional somatic symptoms: A systemic narrative approach on a biopsychosocial foundation

DEFF Research Database (Denmark)

Dehlholm-Lambertsen, Birgitte; Hulgaard, Ditte Roth

-established collaboration with the Pediatric department, University Hospital of Southern Denmark. The treatment is based on a biopsychosocial understanding combined with family therapy with elements of systemic and narrative theories. Objective: • Presentation of the family therapy approach used in the department of Child...... and Adolescent Psychiatry, University Hospital of Southern Denmark. • Discussion of different approaches to family therapy for adolescents with functional somatic symptoms • Discussion of challenges and advantages of a systemic narrative approach to families of adolescents with functional somatic symptoms....... evidence on the effect of psychological treatment. At the department of Child and Adolescent Psychiatry, University Hospital of Southern Denmark, a team of experienced therapists has developed an approach for the treatment of adolescents with FSS. This approach includes a formalized and well...

Depression, Anxiety and Somatic Complaints in Colombian Children Living in Rural Communities

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Ruby C. Castilla Puentes

2013-08-01

Full Text Available Introduction: In Colombia, children are frequently exposed to traumatic events; however, there are no data regarding the impact on depression, anxiety and somatic correlates of such exposure in children living in rural communities. Objective: To investigate the somatic complaints and symptoms of depression and anxiety among children exposed to traumatic events in a rural community of Colombia. Methods: Design: Cross-Sectional study. Participants: Two hundred and ninety-three Colombian children aged eight to 18 years. Main Outcome Measures: Standardized measures were administered to assess children's depression, anxiety, physical symptoms and exposure to traumatic events. Depression: CDI (Children's Depression Inventory; anxiety: SCARED (The Screen for Child Anxiety Related Emotional Disorders; somatic complaints: CBCL (Child Behavior Checklist, Somatic Complaints scale and reporting traumatic events during the K-SADS-PL (Diagnostic Interview for Children and Adolescents. Results: Ninety-one of the 293 children (31.1% reported somatic complaints. The most common somatic complaint was in the gastrointestinal category (35/91. One hundred and seventy eight children (60.5% had observed traumatic events, including homicides during the last month. Two hundred five (69.9% of the children showed depressive symptom profiles above established norms, and 239 (81.6% exhibited anxiety symptoms according to their own reports. The correlation between depression and traumatic events, anxiety and somatic complaints, and between anxiety and depression were statistically significant (p<0.005. Conclusions: As the first study of its kind in children living in rural communities in Colombia, it demonstrates a clear impact of traumatic events on mental health. Information that somatic complaints are commonly an expression of underlying depression and anxiety may facilitate the treatment and thereby help avoid unnecessary medical workups and sequelae from traumatized

Effect of Somatic Experiencing Resiliency-Based Trauma Treatment Training on Quality of Life and Psychological Health as Potential Markers of Resilience in Treating Professionals

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Winblad, Neal E.; Changaris, Michael; Stein, Phyllis K.

2018-01-01

Background: Individuals who treat trauma are at significant risk of vicarious traumatization and burnout. Somatic Experiencing® (SE®) is a resiliency-focused trauma treatment modality designed to address autonomic nervous system (ANS) dysregulation and its impacted physical health and mental health symptoms e.g., anxiety, depression, post-traumatic stress disorder, migraines, fibromyalgia, and chronic fatigue, etc. The SE® training supports the development of clinical skills to reduce physical health/mental health symptoms as well as increase clinician resilience. Individuals who display resilience often have increased experiences of well-being (quality of life) and decreased levels of self-reported psychological symptoms. Greater resilience could mitigate the risks to providers and the clients they treat. Materials and Methods: This within-groups, longitudinal study assessed students (N = 18) over the course of a 3-year SE® practitioner training. This training focuses on increased ANS, physical, and emotional regulation skills. The convenience of a web-based survey allowed for: measures of a general quality of life (WHOQOL-BREF), psychological symptoms, somatic, anxiety, and depressive symptoms (PHQ-SADS), as well as a measure of early life exposure to adversity (CDC/Kaiser Permanente ACE Score Calculator Questionnaire). The clinician survey was conducted yearly for 3 years. Future studies would do well to also include laboratory-based objective measures of ANS functioning. Results: ANOVA with repeated measures showed that there were significant reductions in anxiety symptoms (GAD7, p interpersonal well-being) both increased significantly (Health QoL p = 0.028; Social QoL p = 0.046). Conclusions: Results suggest that professionals attending the 3-year SE® training course experience a significant improvement in self-reported measures associated with resiliency including: quality of life (well-being) and psychological symptoms (anxiety and somatization). Our

MMPI screening scales for somatization disorder.

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Wetzel, R D; Brim, J; Guze, S B; Cloninger, C R; Martin, R L; Clayton, P J

1999-08-01

44 items on the MMPI were identified which appear to correspond to some of the symptoms in nine of the 10 groups on the Perley-Guze checklist for somatization disorder (hysteria). This list was organized into two scales, one reflecting the total number of symptoms endorsed and the other the number of organ systems with at least one endorsed symptom. Full MMPIs were then obtained from 29 women with primary affective disorder and 37 women with somatization disorder as part of a follow-up study of a consecutive series of 500 psychiatric clinic patients seen at Washington University. Women with the diagnosis of somatization disorder scored significantly higher on the somatization disorder scales created from the 44 items than did women with only major depression. These new scales appeared to be slightly more effective in identifying somatization disorder than the use of the standard MMPI scales for hypochondriasis and hysteria. Further development is needed.

Systematic review of measurement properties of questionnaires measuring somatization in primary care patients.

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Sitnikova, Kate; Dijkstra-Kersten, Sandra M A; Mokkink, Lidwine B; Terluin, Berend; van Marwijk, Harm W J; Leone, Stephanie S; van der Horst, Henriëtte E; van der Wouden, Johannes C

2017-12-01

The aim of this review is to critically appraise the evidence on measurement properties of self-report questionnaires measuring somatization in adult primary care patients and to provide recommendations about which questionnaires are most useful for this purpose. We assessed the methodological quality of included studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. To draw overall conclusions about the quality of the questionnaires, we conducted an evidence synthesis using predefined criteria for judging the measurement properties. We found 24 articles on 9 questionnaires. Studies on the Patient Health Questionnaire-15 (PHQ-15) and the Four-Dimensional Symptom Questionnaire (4DSQ) somatization subscale prevailed and covered the broadest range of measurement properties. These questionnaires had the best internal consistency, test-retest reliability, structural validity, and construct validity. The PHQ-15 also had good criterion validity, whereas the 4DSQ somatization subscale was validated in several languages. The Bodily Distress Syndrome (BDS) checklist had good internal consistency and structural validity. Some evidence was found for good construct validity and criterion validity of the Physical Symptom Checklist (PSC-51) and good construct validity of the Symptom Check-List (SCL-90-R) somatization subscale. However, these three questionnaires were only studied in a small number of primary care studies. Based on our findings, we recommend the use of either the PHQ-15 or 4DSQ somatization subscale for somatization in primary care. Other questionnaires, such as the BDS checklist, PSC-51 and the SCL-90-R somatization subscale show promising results but have not been studied extensively in primary care. Copyright © 2017 Elsevier Inc. All rights reserved.

Sexual Victimization and Somatic Complaints in Pregnancy: Examination of Depression as a Mediator.

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Littleton, Heather

2015-01-01

Research suggests that women with histories of sexual victimization are more likely to experience somatic complaints in pregnancy. However, prior studies have been limited by homogenous samples, have primarily only examined the relationship of childhood sexual abuse (CSA) to somatic complaints, and have not examined potential mechanisms explaining this association. Thus, the current study examined the relationship between lifetime sexual victimization history and somatic complaints in pregnancy in an ethnically diverse sample of pregnant women. Additionally, depressive symptoms were examined as a mediator of the sexual victimization-somatic complaints relationship. Women were recruited from the waiting room of a university-affiliated obstetrics-gynecology clinic to complete a study of psychological health and negative sexual experiences. The 407 currently pregnant participants who completed measures of their sexual victimization history, depressive symptoms, and somatic complaints were primarily African American (53.6%), low to middle income (75.4%), and reported an unplanned pregnancy (72%). A total of 27.7% of women had a history of CSA and/or adolescent/adult sexual assault. Mediation analyses using bootstrapping supported depression as a significant mediator of the relationship between sexual victimization and somatic complaints, with a medium-sized effect (κ(2) = .09). Having a history of sexual victimization is associated with risk for poor mental and physical health during pregnancy. There are likely multiple mechanisms explaining the association between sexual victimization and somatic complaints in pregnancy, which should be investigated in future research. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

The Self beyond Somatic Symptoms : A Narrative Approach to Self-Experience in Adolescent Chronic Fatigue Syndrome

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van Geelen, Stefan M.; Fuchs, Coralie E.; van Geel, Rolf; Luyten, Patrick; van de Putte, Elise M.

2015-01-01

BACKGROUND: The self and self-experience are often assumed to play an important role in adolescent patients presenting with severe somatic symptoms and bodily distress. Nonetheless, most empirical work on this subject is confined to studies of personality and patients' experience of negative

Adolescents with Functional Somatic Symptoms: The influence of family therapy on empowerment and illness beliefs

DEFF Research Database (Denmark)

Hulgaard, Ditte Roth; Rask, Charlotte; Dehlholm-Lambertsen, Birgitte

psychological treatment and the significance of illness beliefs and empowerment in children and adolescents with severe FSS is scarce. Aims: To conduct a qualitative study which aims to examine how specific illness beliefs and a sense of empowerment evolve and change during specialized family-based treatment......Background: Young patients with Functional Somatic Symptoms (FSS) are common and may present in all clinical settings. Psychological treatment targeting dysfunctional illness beliefs and poor sense of empowerment has been shown effective for FSS in adults. In comparison current knowledge about...... (IPA). Results: Preliminary data from a pilotstudy with 2 families, from interviews conducted prior to family therapy, indicate that illness beliefs and sense of empowerment may be diverging for children and their parents, and are influenced by many factors, such as health professionals, family history...

Psychological and interactional characteristics of patients with somatoform disorders: Validation of the Somatic Symptoms Experiences Questionnaire (SSEQ) in a clinical psychosomatic population.

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Herzog, Annabel; Voigt, Katharina; Meyer, Björn; Wollburg, Eileen; Weinmann, Nina; Langs, Gernot; Löwe, Bernd

2015-06-01

The new DSM-5 Somatic Symptom Disorder (SSD) emphasizes the importance of psychological processes related to somatic symptoms in patients with somatoform disorders. To address this, the Somatic Symptoms Experiences Questionnaire (SSEQ), the first self-report scale that assesses a broad range of psychological and interactional characteristics relevant to patients with a somatoform disorder or SSD, was developed. This prospective study was conducted to validate the SSEQ. The 15-item SSEQ was administered along with a battery of self-report questionnaires to psychosomatic inpatients. Patients were assessed with the Structured Clinical Interview for DSM-IV to confirm a somatoform, depressive, or anxiety disorder. Confirmatory factor analyses, tests of internal consistency and tests of validity were performed. Patients (n=262) with a mean age of 43.4 years, 60.3% women, were included in the analyses. The previously observed four-factor model was replicated and internal consistency was good (Cronbach's α=.90). Patients with a somatoform disorder had significantly higher scores on the SSEQ (t=4.24, pquality of life. Sensitivity to change was shown by significantly higher effect sizes of the SSEQ change scores for improved patients than for patients without improvement. The SSEQ appears to be a reliable, valid, and efficient instrument to assess a broad range of psychological and interactional features related to the experience of somatic symptoms. Copyright © 2015 Elsevier Inc. All rights reserved.

The relations among body consciousness, somatic symptom report, and information processing speed in chronic fatigue syndrome.

NARCIS (Netherlands)

Werf, S.P. van der; Vree, B.P.W. de; Meer, J.W.M. van der; Bleijenberg, G.

2002-01-01

OBJECTIVE: The aim of this study was to assess the potential influence of body consciousness and levels of somatic symptom report upon information processing speed in patients with chronic fatigue syndrome (CFS). BACKGROUND: According to a model of a fixed information processing capacity, it was

Depression and hypochondriasis in family practice patients with somatization disorder.

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Oxman, T E; Barrett, J

1985-10-01

The relationships specified in DSM-III between somatization disorder and depression, and somatization disorder and hypochondriasis require further validation and easier methods of detection for use by primary care physicians. The authors investigated hypochondriacal and depressive symptoms in 13 family practice outpatients with somatization disorder. Pain complaints and depressive symptomatology were present in over 75% of this group, while hypochondriacal symptoms were present in 38%. The mean score on the somatization scale of the Hopkins Symptom Check List (HSCL-90) was greater than that reported for any other group. These findings support the separation of somatization disorder and hypochondriasis and suggest the need for better delineation of depressive subtypes in somatization disorder. The somatization scale of the HSCL-90 should be a useful screen for somatization disorder in future research.

Cognitive aspects of hypochondriasis and the somatization syndrome.

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Rief, W; Hiller, W; Margraf, J

1998-11-01

The aim of this study was to evaluate whether specific cognitive aspects are present in patients suffering from somatoform disorders. With a sample of 493 patients from a center for behavioral medicine, the authors evaluated a questionnaire assessing typical cognitions concerning body perception, illness behavior, and health. The authors further examined 225 participants, including patients with a somatization syndrome, patients with somatization syndrome and additional hypochondriasis, patients with hypochondriasis, patients with other mental disorders (clinical control group), and nonclinical controls. The results showed that not only patients with hypochondriasis but also patients with somatization syndrome had cognitive concerns and assumptions that were specific for the disorder. These patients had a self-concept of being weak and unable to tolerate stress. A catastrophizing interpretation of minor bodily complaints found in hypochondriacal patients in earlier studies was also found for patients with multiple somatization symptoms.

Health-related quality of life and symptom severity in Chinese patients with major depressive disorder.

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Cao, Yuping; Li, Wen; Shen, Jingjin; Malison, Robert T; Zhang, Yalin; Luo, Xingguang

2013-12-01

Patients suffering from major depressive disorder (MDD) have been reported to have substantial long-lasting limitations in multiple domains of health-related quality of life (HRQoL). The thoughtful assessment of HRQoL and the impact of treatment response on HRQoL are emerging as important issues in the care of patients with major depressive disorder. One hundred and three patients meeting Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for MDD took fluoxetine (20 mg/d) for 6 weeks and were assessed by the Short Form 36 Health Survey (SF-36), the 17-item Hamilton Depression Rating (HAMD-17) and the Clinical Global Impression (CGI) scales. Relationships between SF-36 scores and depressive symptom severity and early change of these symptoms were tested. SF-36 component scores at week 6 were higher than those at baseline (all P ≤ 0.0058). Scores for general health were significantly higher in responders than non-responders (P = 0.0009). The overall HAMD-17 and CGI scores at 2- and 6-week follow-up were significantly lower than those at baseline (P ≤ 0.0001). Higher scores for anxiety/somatization were significantly associated with poorer SF-36 scores at baseline (P = 0.0001); role-physical scores at week 6 were positively correlated with reduction rate of anxiety/somatization in 2-week follow-up (P = 0.0002). Depressive symptom severity was associated with HRQoL in patients with MDD. HRQoL may vary with severity of depression and/or anxiety-somatization at baseline. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Hypochondriacal concerns and somatization in panic disorder.

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Furer, P; Walker, J R; Chartier, M J; Stein, M B

1997-01-01

To clarify the relationship between panic disorder and the symptoms of hypochondriasis and somatization, we evaluated these symptoms and diagnoses in patients attending an Anxiety Disorders Clinic. Structured clinical interviews, self-report measures, and symptom diaries were used to assess 21 patients with panic disorder, 23 patients with social phobia, and 22 control subjects with no psychiatric disorders. Ten of the patients with panic disorder (48%) also met DSM-IV criteria for hypochondriasis, whereas only one of the patients with social phobia and none of the healthy control subjects met the criteria for this diagnosis. None of the participants met DSM-IV criteria for somatization disorder, even though both anxiety groups reported high levels of somatic symptoms. The panic disorder group reported higher levels of fear about illness and disease conviction and endorsed more somatic symptoms than did the other groups. A higher proportion of panic disorder patients reported previously diagnosed medical conditions (48%) as compared with patients with social phobia (17%) or healthy control subjects (14%). The panic disorder patients with DSM-IV hypochondriasis obtained higher scores on measures of hypochondriacal concerns, somatization, blood-injury phobia, and general anxiety and distress than did the panic disorder patients without hypochondriasis. The results suggest a strong association between panic disorder and hypochondriasis.

The predictive value of somatic and cognitive depressive symptoms for cytokine changes in patients with major depression

Directory of Open Access Journals (Sweden)

Dannehl K

2014-06-01

Full Text Available Katharina Dannehl,1 Winfried Rief,1 Markus J Schwarz,2 Annika Hennings,1 Sabine Riemer,1 Verena Selberdinger,3 Theresa Stapf,3 Frank Euteneuer11Division of Clinical Psychology and Psychotherapy, Philipps Universität Marburg, Marburg, Germany; 2Institute for Laboratory Medicine, Ludwig-Maximilian Universität, Munich, Germany; 3Department of Psychiatry, Ludwig-Maximilian Universität, Munich, GermanyContext: Elevated concentrations of proinflammatory cytokines have been hypothesized as an important factor in the pathophysiology of depression. Depression itself is considered to be a heterogeneous disorder. Current findings suggest that “cognitive” and “somatic” symptom dimensions are related to immune function in different ways. So far, little research has been done on the longitudinal aspects of inflammation in patients with major depression, especially with respect to different symptom dimensions of depression. Therefore, we investigated which aspects of depression may predict changes in tumor necrosis factor-alpha (TNF-alpha and interleukin (IL-6 over 4 weeks. Methods: Forty-one patients with major depression diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV, and 45 healthy controls were enrolled. Serum measurements of TNF-alpha and IL-6 were conducted at baseline and 4 weeks later. Psychometric measures included the assessment of cognitive-affective depressive symptoms and somatic symptoms during the last 7 days as well as somatic symptoms during the last 2 years. Results: Patients with depression showed increased levels of TNF-alpha (P<0.05 compared to healthy controls. Hierarchical regression analyses indicated that neither depressive nor somatic symptoms predict changes in proinflammatory cytokines in the whole sample of depressed patients. Moderation analyses and subsequent sex-stratified regression analyses indicated that higher somatoform symptoms during the last 2 years

Somatic health of 2500 women examined at a sexual assault center over 10 years

DEFF Research Database (Denmark)

Larsen, Mie-Louise; Hilden, Malene; Skovlund, Charlotte W

2016-01-01

Assault in Copenhagen, and 10004 women without a known assault experience (controls). Somatic diagnoses were retrieved from the National Health Registry and number of visits to general practitioners from the Danish Health Insurance Registry. Somatic data were assessed during the five-year period before......INTRODUCTION: Sexual assault is a public health issue with many potential short- and long-term consequences for the victims. We aimed to investigate somatic health of women before and after sexual assault. MATERIAL AND METHODS: We included 2501 women who attended the Centre for Victims of Sexual...

Negative Social Contextual Stressors and Somatic Symptoms Among Young Black Males: An Exploratory Study

OpenAIRE

Scott, Lionel D.; McCoy, Henrika

2015-01-01

This study examines whether negative social contextual stressors were associated with somatic symptoms among young Black males (N = 74) after accounting for background and psychological characteristics. Using Cunningham and Spencer’s Black Male Experiences Measure, negative social contextual stressors connoted those experiences connected to the personal attributes, devaluation, and negative imagery of young Black males, such as being followed when entering a store or police or security guards...

Somatic symptoms: an important index in predicting the outcome of depression at six-month and two-year follow-up points among outpatients with major depressive disorder.

Science.gov (United States)

Hung, Ching-I; Liu, Chia-Yih; Wang, Shuu-Jiun; Juang, Yeong-Yuh; Yang, Ching-Hui

2010-09-01

Few studies have simultaneously compared the ability of depression, anxiety, and somatic symptoms to predict the outcome of major depressive disorder (MDD). This study aimed to compare the MDD outcome predictive ability of depression, anxiety, and somatic severity at 6-month and 2-year follow-ups. One-hundred and thirty-five outpatients (men/women=34/101) with MDD were enrolled. Depression and anxiety were evaluated by the Hamilton Depression Rating Scale, Hospital Anxiety and Depression Scale, and depression subscale of the Depression and Somatic Symptoms Scale (DSSS). Somatic severity was evaluated by the somatic subscale of the DSSS. Subjects undergoing pharmacotherapy in the follow-up month were categorized into the treatment group; the others were categorized into the no-treatment group. Multiple linear regressions were used to identify the scales most powerful in predicting MDD outcome. Among the 135 subjects, 119 and 106 completed the 6-month and 2-year follow-ups, respectively. Somatic severity at baseline was correlated with the outcomes of the three scales at the two follow-ups. After controlling for demographic variables, somatic severity independently predicted most outcomes of the three scales at the two follow-ups in the no-treatment group and the cost of pharmacotherapy and DSSS score at the 6-month follow-up in the treatment group. Division of the subjects into treatment and no-treatment groups was not based on randomization and bias might have been introduced. Somatic severity was the most powerful index in predicting MDD outcome. Psychometric scales with appropriate somatic symptom items may be more accurate in predicting MDD outcome. 2010 Elsevier B.V. All rights reserved.

How useful is the concept of somatization in cross-cultural studies of maternal depression? A contribution from the Mothers in a New Country (MINC) study.

Science.gov (United States)

Small, R; Lumley, J; Yelland, J

2003-03-01

Somatization of depression symptoms has been assumed to characterize particular cultural groups, yet evidence for this has often been anecdotal. The Mothers in a New Country (MINC) study aimed to explore cultural assumptions about somatization in three groups of immigrant women who had recently given birth in Melbourne, Australia. Physical health (SF-36 physical health dimensions and a symptom list) and depression (EPDS, SF-36 mental health dimension and self assessment) data from personal interviews with Vietnamese (n = 104), Turkish (n = 107) and Filipino (n = 107) women, conducted in women's language of choice, six to nine months after childbirth were analyzed. Comparisons with data from a statewide postal survey of Victorian women are also made. Contrary to the study hypothesis that Turkish and Vietnamese women in particular would exhibit a high degree of somatization (leading to low depression scores on the standard measures and greater reporting of somatic symptoms), Turkish women were in fact most likely of the three groups to be assessed as depressed on the two psychological measures and by self-assessment, to report high levels of somatic symptoms, and Vietnamese and Filipino women had a low prevalence of depression on all measures and relatively lower levels of somatic symptom reporting. The MINC study findings thus call into question some common cultural assumptions about depression and demonstrate the importance of designing studies which can put hypothesized cultural differences to the test.

Assessing the prevalence of depression in Punjabi and English primary care attenders: the role of culture, physical illness and somatic symptoms.

Science.gov (United States)

Bhui, Kamaldeep; Bhugra, Dinesh; Goldberg, David; Sauer, Justin; Tylee, Andre

2004-09-01

Previous studies exploring the prevalence of depression among South Asians reported inconsistent findings. Research artefacts due to sampling bias, measurements errors and a failure to include ethnographic methods may all explain this. We estimated the prevalence of depression, and variations of prevalence with culture, cultural adaptation, somatic symptoms and physical disability in a cross-sectional primary care survey of Punjabi and English attendees. We included a culture specific screening instrument, culturally adapted the instruments and offered bilingual interviews. We found that, compared with their English counterparts, depressive diagnoses were more common among Punjabis, Punjabi women, Punjabis with physical complaints and, contrary to expectation, even Punjabis with low scores for somatic symptoms.

Ehlers-Danlos syndrome in a young woman with anorexia nervosa and complex somatic symptoms.

Science.gov (United States)

Lee, Michelle; Strand, Mattias

2018-03-01

The Ehler-Danlos syndromes (EDS) are a group of clinically heterogeneous connective tissue disorders characterized by joint hypermobility, hyperextensibility of the skin, and a general connective tissue fragility that can induce symptoms from multiple organ systems. We present a case of comorbid anorexia nervosa and EDS in a 23-year old woman with a multitude of somatic symptoms that were initially attributed to the eating disorder but that were likely caused by the underlying EDS. Various EDS symptoms, such as gastrointestinal complaints, smell and taste abnormalities, and altered somatosensory awareness may resemble or mask an underlying eating disorder, and vice versa. Because of the large clinical heterogeneity, correctly identifying symptoms of EDS presents a challenge for clinicians, who should be aware of this group of underdiagnosed and potentially serious syndromes. The Beighton Hypermobility Score is an easily applicable screening instrument in assessing potential EDS in patients with joint hypermobility. © 2017 Wiley Periodicals, Inc.

An inactive lifestyle and low physical fitness are associated with functional somatic symptoms in adolescents. The TRAILS study

NARCIS (Netherlands)

Janssens, Karin A. M.; Oldehinkel, Albertine J.; Bonvanie, Irma J.; Rosmalen, Judith G. M.

Objective: An inactive lifestyle has been associated with functional somatic symptoms (FSS), but findings are contradictory. Moreover, mediating factors in this relationship are unclear. We examined whether low physical activity was related to FSS in adolescents, and whether this association was

A randomized trial of treatments for high-utilizing somatizing patients.

Science.gov (United States)

Barsky, Arthur J; Ahern, David K; Bauer, Mark R; Nolido, Nyryan; Orav, E John

2013-11-01

Somatization and hypochondriacal health anxiety are common sources of distress, impairment, and costly medical utilization in primary care practice. A range of interventions is needed to improve the care of these patients. To determine the effectiveness of two cognitive behavioral interventions for high-utilizing, somatizing patients, using the resources found in a routine care setting. Patients were randomly assigned to a two-step cognitive behavioral treatment program accompanied by a training seminar for their primary care physicians, or to relaxation training. Providers routinely working in these patients' primary care practices delivered the cognitive behavior therapy and relaxation training. A follow-up assessment was completed immediately prior to treatment and 6 and 12 months later. Eighty-nine medical outpatients with elevated levels of somatization, hypochondriacal health anxiety, and medical care utilization. Somatization and hypochondriasis, overall psychiatric distress, and role impairment were assessed with well-validated, self-report questionnaires. Outpatient visits and medical care costs before and after the intervention were obtained from the encounter claims database. At 6 month and 12 month follow-up, both intervention groups showed significant improvements in somatization (p somatization, hypochondriacal symptoms, overall psychiatric distress, and role function. They also reduced the ambulatory visits and costs of these high utilizing outpatients.

Cognitive/affective and somatic/affective symptoms of depression in patients with heart disease and their association with cardiovascular prognosis : a meta-analysis

NARCIS (Netherlands)

Azevedo, R. de Miranda; Roest, A. M.; Hoen, P. W.; de Jonge, P.

2014-01-01

Background. Several prospective longitudinal studies have suggested that somatic/affective depressive symptoms, but not cognitive/affective depressive symptoms, are related to prognosis in patients with heart disease, but findings have been inconsistent. The aim of this study was to investigate the

Predictive factors for somatization in a trauma sample

DEFF Research Database (Denmark)

Elklit, Ask; Christiansen, Dorte M

2009-01-01

ABSTRACT: BACKGROUND: Unexplained somatic symptoms are common among trauma survivors. The relationship between trauma and somatization appears to be mediated by posttraumatic stress disorder (PTSD). However, only few studies have focused on what other psychological risk factors may predispose...... a trauma victim towards developing somatoform symptoms. METHODS: The present paper examines the predictive value of PTSD severity, dissociation, negative affectivity, depression, anxiety, and feeling incompetent on somatization in a Danish sample of 169 adult men and women who were affected by a series...... of incompetence significantly predicted somatization in the trauma sample whereas dissociation, depression, and anxiety were not associated with degree of somatization. PTSD as a risk factor was mediated by negative affectivity....

Anxiety, depression, and somatization in DSM-III hypochondriasis.

Science.gov (United States)

Kellner, R; Abbott, P; Winslow, W W; Pathak, D

1989-01-01

To assess the severity of distress and of somatization in hypochondriasis, the authors administered several validated self-rating scales of depression, anxiety, somatic symptoms, and anger/hostility to 21 psychiatric outpatients with the DSM-III diagnosis of hypochondriasis and to matched groups of other nonpsychotic psychiatric patients, family practice patients, and employees. Anxiety and somatic symptoms were highest in hypochondriacal patients; depression and anger/hostility did not differ from those of other psychiatric patients but were higher than in the other groups. The findings do not support the theory that hypochondriasis is a defense against anxiety or that it is a masked depression or depressive equivalent. The findings are consistent with the view that the interaction of severe anxiety and severe somatic symptoms is a common feature of the psychopathology of hypochondriasis.

Hearing loss in fibromyalgia? Somatic sensory and non-sensory symptoms in patients with fibromyalgia and other rheumatic disorders

NARCIS (Netherlands)

Wolfe, Frederick; Rasker, Johannes J.; Häuser, W.

2012-01-01

OBJECTIVES: It has been proposed that fibromyalgia can be understood as a disorder of central sensitisation and dysregulation (CD) and that characteristic somatic symptoms are the result of `central augmentation`. We examined this hypothesis by analysing sensory and non-sensory variables in the

DSM-5 somatic symptom disorder in patients with vertigo and dizziness symptoms.

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Limburg, Karina; Sattel, Heribert; Radziej, Katharina; Lahmann, Claas

2016-12-01

DSM-5 somatic symptom disorder (SSD) could potentially be a highly relevant diagnosis for patients with vertigo and dizziness. The criteria of SSD, particularly the B-criterion with its three components (cognitive, affective, behavioral), have however not yet been investigated in this patient group. We evaluated a large sample (n=399) of outpatients presenting in a neurological setting. Physical examinations and a psychometric assessment (SCID-I) were conducted; patients completed self-report questionnaires. The diagnosis of SSD was assigned retrospectively. The prevalence of SSD, its diagnostic criteria, and its overlap with former DSM-IV somatoform disorders were evaluated; comparisons were drawn between (1) patients fulfilling different components of the B-criterion and (2) patients with diagnoses after DSM-IV vs. DSM-5. SSD was almost twice as common as DSM-IV somatoform disorders. Patients with all three components of the B-criterion reported the highest impairment levels. Patients with both DSM-IV somatoform disorders and DSM-5 SSD were more impaired compared to groups with one of the diagnoses; patients with DSM-IV somatoform disorders only were more impaired than those with SSD only. Our findings demonstrate that SSD is highly prevalent in patients with vertigo and dizziness. The classification of severity based on the number of psychological symptoms appears valid and may assist in finding suitable treatment options according to clinical practice guidelines. Future studies should investigate the overlap of SSD and other psychiatric disorders, this may assist in better defining the diagnostic criteria of SSD. Copyright © 2016 Elsevier Inc. All rights reserved.

Somatic tinnitus prevalence and treatment with tinnitus retraining therapy.

Science.gov (United States)

Ostermann, K; Lurquin, P; Horoi, M; Cotton, P; Hervé, V; Thill, M P

2016-01-01

Somatic tinnitus originates from increased activity of the dorsal cochlear nucleus, a cross-point between the somatic and auditory systems. Its activity can be modified by auditory stimulation or somatic system manipulation. Thus, sound enrichment and white noise stimulation might decrease tinnitus and associated somatic symptoms. The present uncontrolled study sought to determine somatic tinnitus prevalence among tinnitus sufferers, and to investigate whether sound therapy with counselling (tinnitus retraining therapy; TRT) may decrease tinnitus-associated somatic symptoms. To determine somatic tinnitus prevalence, 70 patients following the TRT protocol completed the Jastreboff Structured Interview (JSI) with additional questions regarding the presence and type of somatic symptoms. Among 21 somatic tinnitus patients, we further investigated the effects of TRT on tinnitus-associated facial dysesthesia. Before and after three months of TRT, tinnitus severity was evaluated using the Tinnitus Handicap Inventory (THI), and facial dysesthesia was assessed with an extended JSI-based questionnaire. Among the evaluated tinnitus patients, 56% presented somatic tinnitus-including 51% with facial dysesthesia, 36% who could modulate tinnitus by head and neck movements, and 13% with both conditions. Self-evaluation indicated that TRT significantly improved tinnitus and facial dysesthesia in 76% of patients. Three months of TRT led to a 50% decrease in mean THI and JSI scores regarding facial dysesthesia. Somatic tinnitus is a frequent and underestimated condition. We suggest an extension of the JSI, including specific questions regarding somatic tinnitus. TRT significantly improved tinnitus and accompanying facial dysesthesia, and could be a useful somatic tinnitus treatment.

A European Research Agenda for Somatic Symptom Disorders, Bodily Distress Disorders, and Functional Disorders: Results of an Estimate-Talk-Estimate Delphi Expert Study

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Christina M. van der Feltz-Cornelis

2018-05-01

Full Text Available Background: Somatic Symptom Disorders (SSD, Bodily Distress Disorders (BDD and functional disorders (FD are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe.Aim: To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective.Methods: Delphi study conducted from July 2016 until October 2017 in 3 rounds with 3 workshop meetings and 3 online surveys, involving 75 experts and 21 European countries. EURONET-SOMA and the European Association of Psychosomatic Medicine (EAPM hosted the meetings.Results: Eight research priorities were identified: (1 Assessment of diagnostic profiles relevant to course and treatment outcome. (2 Development and evaluation of new, effective interventions. (3 Validation studies on questionnaires or semi-structured interviews that assess chronic medical conditions in this context. (4 Research into patients preferences for diagnosis and treatment. (5 Development of new methodologic designs to identify and explore mediators and moderators of clinical course and treatment outcomes (6. Translational research exploring how psychological and somatic symptoms develop from somatic conditions and biological and behavioral pathogenic factors. (7 Development of new, effective interventions to personalize treatment. (8 Implementation studies of treatment interventions in different settings, such as primary care, occupational care, general hospital and specialty mental health settings. The general public and policymakers will benefit from the development of new, effective, personalized interventions for SSD, BDD, and FD, that will be enhanced by translational research, as well as from the outcomes of research into patient involvement, GP

Bilateral Orchidopexy in a Hypochondriacal (Somatic Symptom Disorder) Patient and Determination of Fitness for Bilateral Orchidectomy.

Science.gov (United States)

Nwaopara, A U; Allagoa, Erefagha Leonardo P

2016-01-01

Introduction. DSM-5 identifies two disorders: somatic symptom disorder and illness anxiety disorder, to replace hypochondriasis in DSM-IV. Patients with both disorders are intensely anxious about the possibility of an undiagnosed illness or devote excessive time and energy to health concerns and are not easily reassured. Both disorders cause considerable distress and life disruption, even at moderate levels. However, hypochondriasis (DSM-IV) is an indication for neither orchidopexy nor orchidectomy. This is the rationale for this report which is the first of its kind to the best of available literature. This is an original case report of interest to a particular clinical specialty of mental health but it will have a broader clinical impact across medicine. Case Presentation. A 30-year-old black male presented to a primary care clinic with multiple internet searches on the topic of testicular pain and its differential diagnosis. He had a bilateral orchidopexy for a suspected torsion. He was referred to mental health unit, to determine fitness for further surgery. Conclusions. If hypochondriasis is suspected in a medical or surgical inpatient, a psychological medicine consultation should be performed, to elucidate the diagnosis, to avoid unnecessary procedures, and to optimize patient's care.

Fear of body symptoms and sensations in patients with panic disorders and patients with somatic diseases

Directory of Open Access Journals (Sweden)

Latas Milan

2009-01-01

Full Text Available Introduction. A cognitive model of aetiology of panic disorder assumes that people who experience frequent panic attacks have tendencies to catastrophically interpret normal and benign somatic sensations - as signs of serious illness. This arise the question: is this cognition specific for patients with panic disorder and in what intensity it is present in patients with serious somatic illness and in healthy subjects. Objective. The aim of the study was to ascertain the differences in the frequency and intensity of 'catastrophic' cognitions related to body sensations, and to ascertain the differences in the frequency and intensity of anxiety caused by different body sensations all related to three groups of subjects: a sample of patients with panic disorder, a sample of patients with history of myocardial infarction and a sample of healthy control subjects from general population. Methods. Three samples are observed in the study: A 53 patients with the diagnosis of panic disorder; B 25 patients with history of myocardial infarction; and C 47 healthy controls from general population. The catastrophic cognitions were assessed by the Agoraphobic Cognitions Questionnaire (ACQ and the Body Sensations Questionnaire (BSQ. These questionnaires assess the catastrophic thoughts associated with panic and agoraphobia (ACQ and the fear of body sensations (BSQ. All study subjects answered questionnaires items, and the scores of the answers were compared among the groups. Results. The results of the study suggest that: 1 There is no statistical difference in the tendency to catastrophically interpret body sensations and therefore to induce anxiety in the samples of healthy general population and patients with history of myocardial infarction; 2 The patients with panic disorder have a statistically significantly more intensive tendency to catastrophically interpret benign somatic symptoms and therefore to induce a high level of anxiety in comparison to the

Parental overprotection predicts the development of functional somatic symptoms in young adolescents.

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Janssens, Karin A M; Oldehinkel, Albertine J; Rosmalen, Judith G M

2009-06-01

To examine whether parental overprotection contributes to the development of functional somatic symptoms (FSS) in young adolescents. In addition, we aimed to study whether this potential effect of parental overprotection is mediated by parenting distress and/or moderated by the adolescent's sex. FSS were measured in 2230 adolescents (ages 10 to 12 years from the Tracking Adolescents' Individual Lives Survey) by the Somatic Complaints subscale of the Youth Self Report at baseline and at follow-up 2 1/2 years later. Parental overprotection as perceived by the child was assessed by means of the EMBU-C (Swedish acronym for my memories of upbringing-child version). Parents completed the Parenting Stress Index. Linear regression analyses were performed adjusted for FSS at baseline and sex. Parental overprotection was a predictor of the development of FSS in young adolescents (beta = 0.055, P overprotection was a predictor of the development of FSS in girls (beta = 0.085, P overprotection was a predictor of the development of FSS in boys (beta = 0.072, P overprotection and FSS was found. Parental overprotection may play a role in the development of FSS in young adolescents.

Prevalence of somatization and minor psychiatric morbidity in primary healthcare in Saudi Arabia: A preliminary study in Asir region

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Mohammed M Alqahtani

2008-01-01

Full Text Available Objective : To determine the prevalence of psychological disorders and somatization among primary care patients from a semi-urban area of the Kingdom of Saudi Arabia. Design : Screening of consecutive patients with the 12-item and 28-item versions of the General Health Questionnaires and assessments of physical symptoms associated with somatization, using the HSCL-12. Eight primary care health centres in Assir, Saudi Arabia. Results : About half of the sample had one or more psychological disorders. The prevalence of somatization detected by the GHQ-28 was 16%. The prevalence of somatization indicated by GPs′ identification of medically unexplained symptoms was 14%. Women displayed higher levels of somatization than men. Conclusion : This study reported prevalence of psychological disorders that was as high as found in the more modern areas of Saudi Arabia such as Riyadh. The view that individuals in less open areas are protected from psychological disorders associated with stress and lifestyle pressure seems to be unsubstantiated. The results highlight the potential value of screening for psychological disorders using such simple instruments as the GHQ

Prevalence of somatization and minor psychiatric morbidity in primary healthcare in saudi arabia: a preliminary study in asir region.

Science.gov (United States)

Alqahtani, Mohammed M; Salmon, Peter

2008-01-01

To determine the prevalence of psychological disorders and somatization among primary care patients from a semi-urban area of the Kingdom of Saudi Arabia. Screening of consecutive patients with the 12-item and 28-item versions of the General Health Questionnaires and assessments of physical symptoms associated with somatization, using the HSCL-12. Eight primary care health centres in Assir, Saudi Arabia. About half of the sample had one or more psychological disorders. The prevalence of somatization detected by the GHQ-28 was 16%. The prevalence of somatization indicated by GPs' identification of medically unexplained symptoms was 14%. Women displayed higher levels of somatization than men. This study reported prevalence of psychological disorders that was as high as found in the more modern areas of Saudi Arabia such as Riyadh. The view that individuals in less open areas are protected from psychological disorders associated with stress and lifestyle pressure seems to be unsubstantiated. The results highlight the potential value of screening for psychological disorders using such simple instruments as the GHQ.

Are Cardiac Autonomic Nervous System Activity and Perceived Stress Related to Functional Somatic Symptoms in Adolescents? The TRAILS Study

NARCIS (Netherlands)

K.A.M. Janssens (Karin); H. Riese (Harriëtte); A.M.M. van Roon (Arie); J.A.M. Hunfeld (Joke); Groot, P.F.C. (Paul F. C.); A.J. Oldehinkel (Albertine); J.G.M. Rosmalen (Judith)

2016-01-01

textabstractObjective Stressors have been related to medically insufficiently explained or functional somatic symptoms (FSS). However, the underlying mechanism of this association is largely unclear. In the current study, we examined whether FSS are associated with different perceived stress and

Are Cardiac Autonomic Nervous System Activity and Perceived Stress Related to Functional Somatic Symptoms in Adolescents? The TRAILS Study

NARCIS (Netherlands)

Janssens, Karin A. M.; Riese, Harriëtte; van Roon, Arie M.; Hunfeld, Joke A. M.; Groot, Paul F. C.; Oldehinkel, Albertine J.; Rosmalen, Judith G. M.

2016-01-01

Stressors have been related to medically insufficiently explained or functional somatic symptoms (FSS). However, the underlying mechanism of this association is largely unclear. In the current study, we examined whether FSS are associated with different perceived stress and cardiac autonomic nervous

Are Cardiac Autonomic Nervous System Activity and Perceived Stress Related to Functional Somatic Symptoms in Adolescents? The TRAILS Study

NARCIS (Netherlands)

Janssens, Karin A. M.; Riese, Harriette; Van Roon, Arie M.; Hunfeld, Joke A. M.; Groot, Paul F. C.; Oldehinkel, Albertine J.; Rosmalen, Judith G. M.

2016-01-01

Objective Stressors have been related to medically insufficiently explained or functional somatic symptoms (FSS). However, the underlying mechanism of this association is largely unclear. In the current study, we examined whether FSS are associated with different perceived stress and cardiac

Health Anxiety in Panic Disorder, Somatization Disorder and Hypochondriasis

Directory of Open Access Journals (Sweden)

Özgün Karaer KARAPIÇAK

2012-04-01

Results: Results of this study support that health anxiety is a significant major component of hypochondriasis. On the other hand, health anxiety seems to be common in panic disorder and somatization disorder. Health anxiety also may be a part of depression or present in healthy people. Conclusion: Further studies are needed in order to search how to manage health anxiety appropriately and which psychotherapeutic interventions are more effective. [JCBPR 2012; 1(1.000: 43-51

Measuring somatic symptoms with the CES-D to assess depression in cancer patients after treatment : Comparison among patients with oral/oropharyngeal, gynecological, colorectal, and breast cancer

NARCIS (Netherlands)

van Wilgen, C.P.; Dijkstra, P.U.; Stewart, R.E.; Ranchor, A.V.; Roodenburg, J.L.N.

2006-01-01

There is a high prevalence of depression after cancer treatment. In the literature, several authors have raised questions about assessing somatic symptoms to explore depression after cancer treatment. These somatic sequelae are a consequence of cancer treatment and should cause higher depression

Dysfunction of the hypothalamic-pituitary-adrenal axis and functional somatic symptoms : A longitudinal cohort study in the general population

NARCIS (Netherlands)

Tak, Lineke M.; Bakker, Stephan J. L.; Rosmalen, Judith G. M.

In persons with functional somatic symptoms (FSS), no conventionally defined organic pathology is apparent. It has been suggested that complex interactions of psychological, physiological, and social factors are involved in the etiology of FSS. One of the physiological mechanisms that may contribute

Enduring somatic threat perceptions and post-traumatic stress disorder symptoms in survivors of cardiac events.

Science.gov (United States)

Meli, Laura; Alcántara, Carmela; Sumner, Jennifer A; Swan, Brendan; Chang, Bernard P; Edmondson, Donald

2017-04-01

Post-traumatic stress disorder due to acute cardiovascular events may be uniquely defined by enduring perceptions of somatic threat. We tested whether post-traumatic stress disorder at 1 month post-acute coronary syndrome indeed required both high peritraumatic threat during the acute coronary syndrome and ongoing cardiac threat perceptions. We assessed peritraumatic threat during emergency department enrollment of 284 patients with a provisional acute coronary syndrome diagnosis and cardiac threat perceptions and post-traumatic stress disorder symptoms 1 month post-discharge. In a multiple regression model with adjustment for important covariates, emergency department threat perceptions were associated with higher 1 month post-traumatic stress disorder symptoms only among those with high levels of ongoing cardiac threat.

Dysfunctional illness perception and illness behaviour associated with high somatic symptom severity and low quality of life in general hospital outpatients in China.

Science.gov (United States)

Zhang, Yaoyin; Fritzsche, Kurt; Leonhart, Rainer; Zhao, Xudong; Zhang, Lan; Wei, Jing; Yang, Jianzhong; Wirsching, Michael; Nater-Mewes, Ricarda; Larisch, Astrid; Schaefert, Rainer

2014-09-01

In primary care populations in Western countries, high somatic symptom severity (SSS) and low quality of life (QoL) are associated with adverse psychobehavioural characteristics. This study assessed the relationship between SSS, QoL and psychobehavioural characteristics in Chinese general hospital outpatients. This multicentre cross-sectional study enrolled 404 patients from 10 outpatient departments, including Neurology, Gastroenterology, Traditional Chinese Medicine [TCM] and Psychosomatic Medicine departments, in Beijing, Shanghai, Chengdu and Kunming. A structured interview was used to assess the cognitive, affective and behavioural features associated with somatic complaints, independent of their origin. Several standard instruments were used to assess SSS, emotional distress and health-related QoL. Patients who reported low SSS (PHQ-15Western countries, high SSS was associated with negative illness and self-perception, low physical QoL with avoidance behaviour, and low mental QoL with reassurance seeking in Chinese general hospital outpatients. Copyright © 2014 Elsevier Inc. All rights reserved.

Big Five personality traits and medically unexplained symptoms in later life.

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van Dijk, S D M; Hanssen, D; Naarding, P; Lucassen, P; Comijs, H; Oude Voshaar, R

2016-10-01

Personality dysfunction has been postulated as the most clinically salient problem of persons suffering from medically unexplained symptoms (MUS) but empirical studies are scarce. This study aims to compare the personality profile of older patients suffering from MUS with two comparison groups and a control group. Ninety-six older patients with MUS were compared with 153 frequent attenders in primary care suffering from medically explained symptoms (MES), 255 patients with a past-month depressive disorder (DSM-IV-TR), and a control group of 125 older persons. The Big Five personality domains (NEO-Five-Factor Inventory) were compared between groups by multiple ANCOVAs adjusted for age, sex, education, partner status and cognitive functioning. Linear regression analyses were applied to examine the association between health anxiety (Whitley Index) and somatization (Brief Symptom Inventory). The four groups differed with respect to neuroticism (Ppersonality profile. Health anxiety and somatization were associated with a higher level of neuroticism and a lower level of extraversion and conscientiousness, irrespective whether the physical symptom was explained or not. Older patients with MUS have a specific personality profile, comparable to MES patients. Health anxiety and somatization may be better indicators of psychopathology than whether a physical symptom is medically explained or not. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment.

Science.gov (United States)

Löwe, Bernd; Spitzer, Robert L; Williams, Janet B W; Mussell, Monika; Schellberg, Dieter; Kroenke, Kurt

2008-01-01

To determine diagnostic overlap of depression, anxiety and somatization as well as their unique and overlapping contribution to functional impairment. Two thousand ninety-one consecutive primary care clinic patients participated in a multicenter cross-sectional survey in 15 primary care clinics in the United States (participation rate, 92%). Depression, anxiety, somatization and functional impairment were assessed using validated scales from the Patient Health Questionnaire (PHQ) (PHQ-8, eight-item depression module; GAD-7, seven-item Generalized Anxiety Disorder Scale; and PHQ-15, 15-item somatic symptom scale) and the Short-Form General Health Survey (SF-20). Multiple linear regression analyses were used to investigate unique and overlapping associations of depression, anxiety and somatization with functional impairment. In over 50% of cases, comorbidities existed between depression, anxiety and somatization. The contribution of the commonalities of depression, anxiety and somatization to functional impairment substantially exceeded the contribution of their independent parts. Nevertheless, depression, anxiety and somatization did have important and individual effects (i.e., separate from their overlap effect) on certain areas of functional impairment. Given the large syndrome overlap, a potential consideration for future diagnostic classification would be to describe basic diagnostic criteria for a single overarching disorder and to optionally code additional diagnostic features that allow a more detailed classification into specific depressive, anxiety and somatoform subtypes.

Prevalence, Co-Occurrence and Associations with Self-Perceived Health and Limitations Due To Physical Health - A Danish Population-Based Study

DEFF Research Database (Denmark)

Eliasen, Marie; Kreiner, Svend; Ebstrup, Jeanette F

2016-01-01

) the associations between the symptoms, and 3) the associations between the somatic symptoms, self-perceived health and limitations due to physical health accounting for the co-occurrence of symptoms. Information on 19 somatic symptoms, self-perceived health and limitations due to physical health was achieved from...... a population-based questionnaire survey of 36,163 randomly selected adults in the Capital Region of Denmark in 2006/07. Chain graph models were used to transparently identify and describe the associations between symptoms, self-perceived health and limitations due to physical health. In total, 94...... all strongly directly associated with both of the outcomes (γ>0.30). Chest pain was strongly associated with self-perceived health, and other musculoskeletal symptoms and urinary retention were strongly associated with limitations due to physical health. Other symptoms were either moderate...

Bilateral Orchidopexy in a Hypochondriacal (Somatic Symptom Disorder Patient and Determination of Fitness for Bilateral Orchidectomy

Directory of Open Access Journals (Sweden)

A. U. Nwaopara

2016-01-01

Full Text Available Introduction. DSM-5 identifies two disorders: somatic symptom disorder and illness anxiety disorder, to replace hypochondriasis in DSM-IV. Patients with both disorders are intensely anxious about the possibility of an undiagnosed illness or devote excessive time and energy to health concerns and are not easily reassured. Both disorders cause considerable distress and life disruption, even at moderate levels. However, hypochondriasis (DSM-IV is an indication for neither orchidopexy nor orchidectomy. This is the rationale for this report which is the first of its kind to the best of available literature. This is an original case report of interest to a particular clinical specialty of mental health but it will have a broader clinical impact across medicine. Case Presentation. A 30-year-old black male presented to a primary care clinic with multiple internet searches on the topic of testicular pain and its differential diagnosis. He had a bilateral orchidopexy for a suspected torsion. He was referred to mental health unit, to determine fitness for further surgery. Conclusions. If hypochondriasis is suspected in a medical or surgical inpatient, a psychological medicine consultation should be performed, to elucidate the diagnosis, to avoid unnecessary procedures, and to optimize patient’s care.

Do early changes in the HAM-D-17 anxiety/somatization factor items affect the treatment outcome among depressed outpatients? Comparison of two controlled trials of St John's wort (Hypericum perforatum) versus a SSRI.

Science.gov (United States)

Bitran, Stella; Farabaugh, Amy H; Ameral, Victoria E; LaRocca, Rachel A; Clain, Alisabet J; Fava, Maurizio; Mischoulon, David

2011-07-01

To assess whether early changes in Hamilton Depression Rating Scale-17 anxiety/somatization items predict remission in two controlled studies of Hypericum perforatum (St John's wort) versus selective serotonin reuptake inhibitors for major depressive disorder. The Hypericum Depression Trial Study Group (National Institute of Mental Health) randomized 340 patients to Hypericum, sertraline, or placebo for 8 weeks, whereas the Massachusetts General Hospital study randomized 135 patients to Hypericum, fluoxetine, or placebo for 12 weeks. The investigators examined whether remission was associated with early changes in anxiety/somatization symptoms. In the National Institute of Mental Health study, significant associations were observed between remission and early improvement in the anxiety (psychic) item (sertraline arm), somatic (gastrointestinal item; Hypericum arm), and somatic (general) symptoms (placebo arm). None of the three treatment arms of the Massachusetts General Hospital study showed significant associations between anxiety/somatization symptoms and remission. When both study samples were pooled, we found associations for anxiety (psychic; selective serotonin reuptake inhibitors arm), somatic (gastrointestinal), and hypochondriasis (Hypericum arm), and anxiety (psychic) and somatic (general) symptoms (placebo arm). In the entire sample, remission was associated with the improvement in the anxiety (psychic), somatic (gastrointestinal), and somatic (general) items. The number and the type of anxiety/somatization items associated with remission varied depending on the intervention. Early scrutiny of the Hamilton Depression Rating Scale-17 anxiety/somatization items may help to predict remission of major depressive disorder.

High utilizers of medical care: a crucial subgroup among somatizing patients.

Science.gov (United States)

Hiller, Wolfgang; Fichter, Manfred M

2004-04-01

Patients with somatoform disorders (SFD) are likely to overutilize healthcare services. This study investigates (a) whether extraordinarily high medical costs can be predicted from patient characteristics or psychopathology, and (b) whether high-utilizing patients respond differently to cognitive-behavioral treatment. We compared 42 SFD high utilizers with 53 SFD average utilizers and 29 patients suffering from other than SFD mental disorders. High utilization was defined by healthcare expenditures of > or = 2500 euros during the past 2 years. Costs were computed from medical and billing records of health insurance companies. Somatization distress, hypochondriasis, depression, dysfunctional cognitions related to bodily symptoms, general psychopathology, personality profiles, and psychosocial disabilities were assessed before treatment. High utilizers had higher levels of self- and observer-rated illness behavior, self-perceived bodily weakness, and psychosocial disabilities. Although they did not report more somatization symptoms, their subjective symptom distress was higher. There were no differences between high and average utilizers concerning general psychopathology, DSM-IV comorbidity, and personality profiles. Treatment improvements were similar. High- and average-utilizing somatizers represent distinguishable subgroups. The results emphasize the importance of mechanisms specifically related to SFD and may enhance the early detection of patients who are likely to develop overutilization. Copyright 2004 Elsevier Inc.

Effects of Response Styles on the Report of Psychological and Somatic Distress.

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Linden, Wolfgang; And Others

1986-01-01

Assessed the impact of two major response style dimensions (self-deception and impression management) on the report of psychological and somatic symptoms. Results confirmed that response styles were more predictive of psychological than somatic symptoms. Both anxiety and depression were associated with a high rate of physical symptoms,…

Somatization in Parkinson's Disease

DEFF Research Database (Denmark)

Carrozzino, Danilo; Bech, Per; Patierno, Chiara

2017-01-01

The current systematic review study is aimed at critically analyzing from a clinimetric viewpoint the clinical consequence of somatization in Parkinson's Disease (PD). By focusing on the International Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we...... consequence of such psychiatric symptom should be further evaluated by replacing the clinically inadequate diagnostic label of psychogenic parkinsonism with the psychosomatic concept of persistent somatization as conceived by the Diagnostic Criteria for Psychosomatic Research (DCPR)....

Perceived social support and life satisfaction in persons with somatization disorder

Directory of Open Access Journals (Sweden)

Arif Ali

2010-01-01

Full Text Available Background: Life satisfaction and perceived social support been shown to improve the well-being of a person and also affect the outcome of treatment in somatization disorder. The phenomenon of somatization was explored in relation to the perceived social support and life satisfaction. Aim: This study aimed at investigating perceived social support and life satisfaction in people with somatization disorder. Materials and Methods: The study was conducted on persons having somatization disorder attending the outpatient unit of LGB Regional Institute of Mental Health, Tezpur, Assam. Satisfaction with life scale and multidimensional scale of perceived social support were used to assess life satisfaction and perceived social support respectively. Results: Women reported more somatic symptoms than men. Family perceived social support was high in the patient in comparison to significant others′ perceived social support and friends′ perceived social support. Perceived social support showed that a significant positive correlation was found with life satisfaction. Conclusion: Poor social support and low life satisfaction might be a stress response with regard to increased distress severity and psychosocial stressors rather than a cultural response to express psychological problems in somatic terms.

Psychiatric and somatic health in relation to experience of parental divorce in childhood.

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Angarne-Lindberg, Teresia; Wadsby, Marie

2012-01-01

The outcome of studies about the experience of parental divorce and its effects on mental and physical health differs, a result possibly caused by the use of different questionnaires and instruments, varying length of time since the divorce and divergent drop-out of participants. To study the presence of psychiatric records and number of diagnosed somatic and mental healthcare visits in a group of young adults with childhood experience of parental divorce in comparison to a group without this experience. The presence of records at public psychiatric clinics and 10 years of administrative healthcare data (somatic and mental) were checked for both groups. Significantly more persons from the divorce group appeared in child and adolescent psychiatric care; this was most pronounced in females. However, there were no significant differences between the groups in the number of persons seeking adult psychiatry or in the number of psychiatric consultations. Experience of parental divorce was not found to be an indicator of larger somatic health problems. Experience of parental divorce in childhood is not an indicator of adult psychiatric or somatic need of care.

Somatic syndromes, insomnia, anxiety, and stress among sleep disordered breathing patients.

Science.gov (United States)

Amdo, Tshering; Hasaneen, Nadia; Gold, Morris S; Gold, Avram R

2016-05-01

We tested the hypothesis that the prevalence of somatic syndromes, anxiety, and insomnia among sleep disordered breathing (SDB) patients is correlated with their levels of somatic arousal, the symptoms of increased sympathetic nervous system tone under conditions of stress. We administered the Body Sensation Questionnaire (BSQ; a 17-item questionnaire with increasing levels of somatic arousal scored 17-85) to 152 consecutive upper airway resistance syndrome (UARS) patients and 150 consecutive obstructive sleep apnea/hypopnea (OSA/H) patients. From medical records, we characterized each patient in terms of the presence of syndromes and symptoms into three categories: somatic syndromes (six syndromes), anxiety (anxiety disorders, nightmares, use of benzodiazepines), and insomnia (sleep onset, sleep maintenance, and use of hypnotics). For the pooled sample of SDB patients, we modeled the correlation of the BSQ score with the presence of each syndrome/symptom parameter within each of the three categories, with adjustment for male vs. female. Mean BSQ scores in females were significantly higher than those in males (32.5 ± 11.1 vs. 26.9 ± 8.2; mean ± SD). Increasing BSQ scores significantly correlated with increasing prevalence rates of somatic syndromes (p insomnia (p ≤ 0.0001). In general, females had higher prevalence rates of somatic syndromes and symptoms of anxiety than males at any BSQ score while rates of insomnia were similar. In patients with SDB, there is a strong association between the level of somatic arousal and the presence of stress-related disorders like somatic syndromes, anxiety, and insomnia.

Operationalization of diagnostic criteria of DSM-5 somatic symptom disorders.

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Xiong, Nana; Zhang, Yaoyin; Wei, Jing; Leonhart, Rainer; Fritzsche, Kurt; Mewes, Ricarda; Hong, Xia; Cao, Jinya; Li, Tao; Jiang, Jing; Zhao, Xudong; Zhang, Lan; Schaefert, Rainer

2017-11-07

The aim of this study was to test the operationalization of DSM-5 somatic symptom disorder (SSD) psychological criteria among Chinese general hospital outpatients. This multicenter, cross-sectional study enrolled 491 patients from 10 general hospital outpatient departments. The structured clinical "interview about cognitive, affective, and behavioral features associated with somatic complaints" was used to operationalize the SSD criteria B. For comparison, DSM-IV somatoform disorders were assessed with the Mini International Neuropsychiatric Interview plus. Cohen's к scores were given to illustrate the agreement of the diagnoses. A three-structure model of the interview, within which items were classified as respectively assessing the cognitive (B1), affective (B2), and behavioral (B3) features, was examined. According to percentages of screening-positive persons and the receiver operator characteristic (ROC) analysis, a cut-off point of 2 was recommended for each subscale of the interview. With the operationalization, the frequency of DSM-5 SSD was estimated as 36.5% in our sample, and that of DSM-IV somatoform disorders was 8.2%. The agreement between them was small (Cohen's к = 0.152). Comparisons of sociodemographic features of SSD patients with different severity levels (mild, moderate, severe) showed that mild SSD patients were better-off in terms of financial and employment status, and that the severity subtypes were congruent with the level of depression, anxiety, quality of life impairment, and the frequency of doctor visits. The operationalization of the diagnosis and severity specifications of SSD was valid, but the diagnostic agreement between DSM-5 SSD and DSM-IV somatoform disorders was small. The interpretation the SSD criteria should be made cautiously, so that the diagnosis would not became over-inclusive.

Loneliness and its association with psychological and somatic health problems among Czech, Russian and US adolescents

Czech Academy of Sciences Publication Activity Database

Stickley, A.; Koyanagi, A.; Koposov, R.; Blatný, Marek; Hrdlička, M.; Schwab-Stone, M.; Ruchkin, V.

2016-01-01

Roč. 16, MAY (2016), s. 1-11, č. článku 128. ISSN 1471-244X Institutional support: RVO:68081740 Keywords : Adolescent * Correlates * Loneliness * Somatic symptoms Subject RIV: AN - Psychology Impact factor: 2.613, year: 2016

The impact of economic recession on the association between youth unemployment and functional somatic symptoms in adulthood: a difference-in-difference analysis from Sweden.

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Brydsten, Anna; Hammarström, Anne; San Sebastian, Miguel

2016-03-05

The impact of macroeconomic conditions on health has been extensively explored, as well as the relationship between individual unemployment and health. There are, however, few studies taking both aspects into account and even fewer studies looking at the relationship in a life course perspective. In this study the aim was to assess the role of macroeconomic conditions, such as national unemployment level, for the long-term relationship between individual unemployment and functional somatic symptoms (FSS), by analysing data from two longitudinal cohorts representing different periods of unemployment level in Sweden. A difference-in-difference (DiD) analysis was applied, looking at the difference over time between recession and pre-recession periods for unemployed youths (age 21 to 25) on FSS in adulthood. FSS was constructed as an index of ten self-reported items of somatic ill-health. Covariates for socioeconomics, previous health status and social environment were included. An association was found in the difference of adult FSS between unemployed and employed youths in the pre-recession and recession periods, remaining in the adjusted model for the pre-recession period. The DiD analysis between unemployed youths showed that men had significantly lower adult FSS during the recession compared to men in the pre-recession time. Adulthood FSS showed to be significantly lower among unemployed youths, in particular among men, during recession compared to pre-recession times. Since this is a fairly unexplored research field, more research is needed to explore the role of macroeconomic conditions for various health outcomes, long-term implications and gender differences.

Employment status and perceived health in the Hordaland Health Study (HUSK

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Aarø Leif

2006-08-01

Full Text Available Abstract Background Most western countries have disability benefit schemes ostensibly based upon requiring (1 a work inhibiting functional limitation that (2 can be attributed to a diagnosable condition, injury or disease. The present paper examines to what extent current practice matches the core premises of this model by examining how much poorer the perceived health of disability benefit recipients is, compared to the employed and the unemployed, and further to examine to what extent any poorer perceived health among benefit recipients can be attributed to mental or somatic illness and symptoms. Methods Information on disability benefit recipiency was obtained from Norwegian registry data, and merged with health information from the Hordaland Health Study (HUSK in Western Norway, 1997–99. Participants (N = 14 946 aged 40–47 were assessed for perceived physical and mental health (Short Form-12, somatic symptoms, mental health, and self reported somatic conditions and diseases treated with medication. Differences associated with employment status were tested in chi-square and t-tests, as well as multivariate and univariate regression models to adjust for potential confounders. Results Recipients of disability benefits (n = 1 351 had poorer perceived physical and mental health than employees (n = 13 156; group differences were 1.86 and 0.74 pooled standard deviations respectively. Self reported somatic diagnoses, mental health and symptoms accounted for very little of this difference in perceived health. The unemployed (n = 439 were comparable to the employed rather than the recipients of disability benefits. Conclusion Recipients of disability benefits have poor perceived health compared to both the employed and the unemployed. Surprisingly little of this difference can be ascribed to respondents' descriptions of their illnesses and symptoms. Even allowing for potential underascertainment of condition severity, this finding supports the

Employment status and perceived health in the Hordaland Health Study (HUSK)

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Overland, Simon; Glozier, Nicholas; Mæland, John Gunnar; Aarø, Leif Edvard; Mykletun, Arnstein

2006-01-01

Background Most western countries have disability benefit schemes ostensibly based upon requiring (1) a work inhibiting functional limitation that (2) can be attributed to a diagnosable condition, injury or disease. The present paper examines to what extent current practice matches the core premises of this model by examining how much poorer the perceived health of disability benefit recipients is, compared to the employed and the unemployed, and further to examine to what extent any poorer perceived health among benefit recipients can be attributed to mental or somatic illness and symptoms. Methods Information on disability benefit recipiency was obtained from Norwegian registry data, and merged with health information from the Hordaland Health Study (HUSK) in Western Norway, 1997–99. Participants (N = 14 946) aged 40–47 were assessed for perceived physical and mental health (Short Form-12), somatic symptoms, mental health, and self reported somatic conditions and diseases treated with medication. Differences associated with employment status were tested in chi-square and t-tests, as well as multivariate and univariate regression models to adjust for potential confounders. Results Recipients of disability benefits (n = 1 351) had poorer perceived physical and mental health than employees (n = 13 156); group differences were 1.86 and 0.74 pooled standard deviations respectively. Self reported somatic diagnoses, mental health and symptoms accounted for very little of this difference in perceived health. The unemployed (n = 439) were comparable to the employed rather than the recipients of disability benefits. Conclusion Recipients of disability benefits have poor perceived health compared to both the employed and the unemployed. Surprisingly little of this difference can be ascribed to respondents' descriptions of their illnesses and symptoms. Even allowing for potential underascertainment of condition severity, this finding supports the increasing focus on non

Somatic perception, cultural differences and immigration: results from administration of the Modified Somatic Perception Questionnaire (MSPQ to a sample of immigrants

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Bragazzi NL

2014-06-01

Full Text Available Nicola Luigi Bragazzi, Giovanni Del Puente, Werner Maria NattaDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, ItalyAbstract: The number of immigrants in Italy has doubled every 10 years from 1972 and Genoa hosts two large communities of immigrants from South America and Africa. We investigated differences in the somatic perception between immigrants and Italians and between South Americans and Africans living in the city of Genoa. During a 7 month period, an anonymous questionnaire asking for sociodemographic information and the Modified Somatic Perception Questionnaire (MSPQ were administered to all immigrants accessing an outpatient clinic or the general practitioners offices. MSPQ mean scores were significantly higher in immigrant patients than in Italian patients, after adjusting for sex and age differences. We found no differences between South Americans and Africans in MSPQ score. The tendency to express discomfort through physical symptoms appears to be related to being a foreigner who arrived in Italy through a migratory trip and also to being a person who comes from a cultural context that is very different from the one of developed countries.Keywords: immigrants, Modified Somatic Perception Questionnaire (MSPQ, somatization, transcultural psychiatry

Association of Neglect-Like Symptoms with Anxiety, Somatization, and Depersonalization in Complex Regional Pain Syndrome.

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Michal, Matthias; Adler, Julia; Reiner, Iris; Wermke, Andreas; Ackermann, Tatiana; Schlereth, Tanja; Birklein, Frank

2017-04-01

Many patients with complex regional pain syndrome (CRPS) report some foreignness of the affected limb, which is referred to as "neglect-like symptoms" (NLS). Despite similarities of the NLS reports to symptoms of body image disturbances in mental disorders, no study has been conducted to examine such associations. We investigated 50 patients with CRPS and 45 pain control patients (N = 27, chronic limb pain; N = 18, migraine headache). NLS, anxiety, depression, depersonalization, and somatization were assessed using validated questionnaires. Seventy-two percent of the CRPS patients reported at least one NLS vs 29.6% and 33.3% in the two patient control groups. In limb pain controls, NLS correlated with pain intensity. In CRPS patients, NLS correlated with anxiety (rho = 0.658, P  psychological studies. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

[Interdependance between somatic symptoms, sleep and dreams].

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Todorov, Assya

2014-03-19

Even in an established illness, somatic complains can hide other emotional inquiries. The therapist, always with a kind attitude, can ask more about patient's sexual life. This can be use of having a better idea of patient's life and problems. Talking about dreams can also be useful: it gives new and surprising elements about patient's personality and helps to progress on healing's way.

Effect of mindfulness-based stress reduction on somatic symptoms, distress, mindfulness and spiritual wellbeing in women with breast cancer

DEFF Research Database (Denmark)

Würtzen, Hanne; Dalton, Susanne Oksbjerg; Christensen, Jane

2015-01-01

Background. Women with breast cancer experience different symptoms related to surgical or adjuvant therapy. Previous findings and theoretical models of mind-body interactions suggest that psychological wellbeing, i.e. levels of distress, influence the subjective evaluation of symptoms, which...... influences or determines functioning. The eight-week mindfulness-based stress reduction (MBSR) program significantly reduced anxiety and depression in breast cancer patients in a randomized controlled trial (NCT00990977). In this study we tested the effect of MBSR on the burden of breast cancer related...... somatic symptoms, distress, mindfulness and spiritual wellbeing and evaluated possible effect modification by adjuvant therapy and baseline levels of, distress, mindfulness and spiritual wellbeing. Material and methods. A population-based sample of 336 women Danish women operated for breast cancer stages...

Symptom Presentation and Symptom Meaning among Traumatized Cambodian Refugees: Relevance to a Somatically Focused Cognitive-Behavior Therapy

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Hinton, Devon E.; Otto, Michael W.

2006-01-01

Among psychologically distressed Cambodian refugees, somatic complaints are particularly prominent. Cambodians interpret anxiety-related somatic sensations in terms of "Wind" ("khyal"), an ethnophysiology that gives rise to multiple catastrophic interpretations; and they have prominent trauma-memory associations to anxiety-related somatic…

Stress and Arousal Symptoms in Individuals and Groups - Persian Gulf War Symptoms as a Paradigm.

Science.gov (United States)

1999-09-01

Symptoms." Psychological Medicine, 1991:21: 1029-1045, quotation from pp. 1040-1041. 18Kellner R., "Functional Somatic Symptoms and Hypochondriasis ...quasi-specific for future patterns of research into the somatic and other consequences of combat stress, deployment stress and other stresses of...psychiatric folklore. Much of the earlier research into the somatic consequences of stress and indeed into medicine as a whole, was correlational in

Neurocognitive dysfunctioning and the impact of comorbid depression and anxiety in patients with somatic symptom and related disorders : A cross-sectional clinical study

NARCIS (Netherlands)

De Vroege, L.; Timmermans, Anique; Kop, W.J.; van der Feltz-Cornelis, C.M.

2018-01-01

The prevalence and severity of neurocognitive dysfunctioning of patients with somatic symptom and related disorders (SSRD) is unknown. Furthermore, the influence of comorbid depression and anxiety has not been evaluated. This study examines neurocognitive dysfunctioning of patients with SSRD and

Linking Anger Trait with Somatization in Low-Grade College Students: Moderating Roles of Family Cohesion and Adaptability.

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Liu, Liang; Liu, Cuilian; Zhao, Xudong

2017-02-25

Between 22% and 58% of patients in primary care settings complain of somatic symptoms. Previous research has found that somatization was associated with anger traits and family functions. However, studies that specifically assess the moderating effect of family function in how anger traits become somatic complaints are lacking. This study was designed to examine whether the variances in family cohesion and family adaptability moderated the strength of the relationship between anger traits and somatization. A cross-section design was conducted and 2008 college students were recruited from a comprehensive university in Shanghai. All participants finished questionnaires including Symptom Check List- 90 (SCL-90), State-Trait Anger Expression Inventory 2 (STAXI-2, Chinese version) and Family Adaptability and Cohesion Scale, second edition (FACES II, Chinese Version) to assess their degree of current somatization, anger trait and family function. Hierarchical linear regression analysis (Enter) was conducted respectively for men and women to examine the moderation effect of family cohesion and family adaptability in the association between anger and somatization. Somatic symptoms were significantly linked in the expected directions with depression and anger trait for both genders. Family cohesion and family adaptability were negatively associated with somatic symptoms. For female college students family cohesion was found to moderate the link between anger trait and somatization, but for male college students the moderation effect of family cohesion was marginally significant. The moderating role of family adaptability was significant for neither male nor female after current depressive symptoms were accounted for. Proneness to anger is an independent predictor of somatization. For women, a high level of family cohesion was a protective factor which could reduce the influence of anger trait on somatic symptoms. Without comorbidity of current depression, family

Body image and self-esteem in somatizing patients.

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Sertoz, Ozen O; Doganavsargil, Ozge; Elbi, Hayriye

2009-08-01

The aim of the present study was to determine dissatisfaction with body appearance and bodily functions and to assess self-esteem in somatizing patients. Body image and self-esteem were investigated in 128 women; 34 of those had diagnosed somatoform disorders, 50 were breast cancer patients with total mastectomy surgery alone, and 44 were healthy subjects. Body image and self-esteem were assessed using the Body Cathexis Scale and Rosenberg Self-Esteem Scale. The two clinical groups did not differ from one another (z = -1.832, P = 0.067), but differed from healthy controls in terms of body image (somatizing patients vs healthy controls, z = -3.628, P self-esteem (z = -0.936, P = 0.349) when depressive symptoms were controlled. No statistically significant difference was observed between total mastectomy patients and healthy controls in terms of self-esteem (z = -1.727, P = 0.084). The lower levels of self-esteem in somatizing patients were largely mediated by depressive symptoms. Depressed and non-depressed somatizing patients differed significantly from healthy controls with respect to their self-esteem and body image. Somatizing patients who were dissatisfied with their bodily functions and appearance had lower levels of self-esteem and high comorbidity of depression. In clinical practice it is suggested that clinicians should take into account psychiatric comorbidity, self-esteem, and body image in somatizing patients when planning treatment approaches.

Changes in illness perceptions mediated the effect of cognitive behavioural therapy in severe functional somatic syndromes

DEFF Research Database (Denmark)

Christensen, Sara Sletten; Frostholm, Lisbeth; Ørnbøl, Eva

2014-01-01

Objective Although there is substantial evidence that cognitive behavioural therapy alleviates symptoms in functional somatic syndromes, the mechanisms of change are less investigated. This study examined whether changes in illness perceptions mediated the effect of cognitive behavioural therapy....... Methods We analysed additional data from a randomised controlled trial comparing completers of cognitive behavioural group therapy (46 patients) to an enhanced usual care group (66 patients). Proposed mediators (illness perceptions) and primary (physical health) and secondary (somatic symptoms and illness...... worry) outcomes were assessed by means of questionnaires at referral, baseline, end of treatment, and 10 and 16 months after randomisation. Multiple mediation analysis determined whether (1) changes in specific illness perceptions during treatment mediated the effect of cognitive behavioural therapy...

Children and adolescents with functional somatic symptoms

DEFF Research Database (Denmark)

Hulgaard, Ditte Roth; Rask, Charlotte; Risør, Mette Bech

aims to examine how specific illness beliefs and a sense of empowerment evolve and change during specialized family-based treatment delivered in a child and adolescent mental health services (CAMHS) setting. Further, how these affect symptom experiences and coping strategies. Methods: Data collection...... illness beliefs and poor sense of empowerment has been shown effective for FSS in adults. In comparison current knowledge about psychological treatment and the significance of illness beliefs and empowerment in children and adolescents with severe FSS is scarce. Aims: To conduct a qualitative study which......: Preliminary data from interviews conducted prior to family therapy, indicate that illness beliefs and sense of empowerment may be diverging for children and their parents, and are influenced by many factors, such as health professionals, family history, media and personal experiences. Conclusions: Increased...

The Four-Dimensional Symptom Questionnaire (4DSQ): a validation study of a multidimensional self-report questionnaire to assess distress, depression, anxiety and somatization

NARCIS (Netherlands)

Terluin, B.; van Marwijk, H.W.J.; Ader, H.J.; de Vet, H.C.W.; Penninx, B.W.J.H.; Hermens, M.L.M.; van Boeijen, C.A.; van Balkom, A.J.L.M.; van der Klink, J.J.L.; Stalman, W.A.B.

2006-01-01

Background: The Four-Dimensional Symptom Questionnaire (4DSQ) is a self-report questionnaire that has been developed in primary care to distinguish non-specific general distress from depression, anxiety and somatization. The purpose of this paper is to evaluate its criterion and construct validity.

Osteoporosis and Somatization of Anxiety

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Maria Papanikou

2013-12-01

Full Text Available Chronic stress can now be physiologically traced as a significant player in the creation of osteoporotic bones. The present pilot study involved 100 women (N = 42 have been diagnosed with osteopenia, N = 21 have been diagnosed with osteoporosis, N = 37 had a non-osteoporotic condition who participated in the Hellenic Society of Osteoporosis Association Support. Correlations between somatic symptoms of anxiety and osteoporosis, and among medications and somatization in women were explored. Assessments were based on a self-report demographic questionnaire and on the Short Anxiety Screening Test (SAST administered for detection of anxiety disorder and somatization. Statistical analysis detected non-significant differences regarding the correlation between anxiety symptomatology or somatization due to osteoporosis and osteopenia diagnosis. The same pattern is observed among women’s age group, the occupational and marital status. Hypothesis that the osteoporosis and osteopenia group would manifest significant relationships with the age group and medicines was confirmed, as well as between somatization and medicines that women with osteoporosis and osteopenia undertake. The results suggest that women are not prone to manifest anxiety or somatization in relation to the osteoporosis condition. However, the majority of women with osteoporosis and osteopenia consume more than two medicines other than those for osteoporosis. This quantity and combination they undertake appear to contribute and deteriorate their anxiety/somatization symptomatology. Further research based on a larger sample would give more definite results.

Symptoms, the Nature of Fibromyalgia, and Diagnostic and Statistical Manual 5 (DSM-5) Defined Mental Illness in Patients with Rheumatoid Arthritis and Fibromyalgia

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Wolfe, Frederick; Walitt, Brian T.; Katz, Robert S.; Häuser, Winfried

2014-01-01

Purpose To describe and evaluate somatic symptoms in patients with rheumatoid arthritis (RA) and fibromyalgia, determine the relation between somatization syndromes and fibromyalgia, and evaluate symptom data in light of the Diagnostic and Statistical Manual-5 (DSM-5) criteria for somatic symptom disorder. Methods We administered the Patient Health Questionnaire-15 (PHQ-15), a measure of somatic symptom severity to 6,233 persons with fibromyalgia, RA, and osteoarthritis. PHQ-15 scores of 5, 10, and 15 represent low, medium, and high somatic symptom severity cut-points. A likely somatization syndrome was diagnosed when PHQ-15 score was ≥10. The intensity of fibromyalgia diagnostic symptoms was measured by the polysymptomatic distress (PSD) scale. Results 26.4% of RA patients and 88.9% with fibromyalgia had PHQ-15 scores ≥10 compared with 9.3% in the general population. With each step-wise increase in PHQ-15 category, more abnormal mental and physical health status scores were observed. RA patients satisfying fibromyalgia criteria increased from 1.2% in the PHQ-15 low category to 88.9% in the high category. The sensitivity and specificity of PHQ-15≥10 for fibromyalgia diagnosis was 80.9% and 80.0% (correctly classified = 80.3%) compared with 84.3% and 93.7% (correctly classified = 91.7%) for the PSD scale. 51.4% of fibromyalgia patients and 14.8% with RA had fatigue, sleep or cognitive problems that were severe, continuous, and life-disturbing; and almost all fibromyalgia patients had severe impairments of function and quality of life. Conclusions All patients with fibromyalgia will satisfy the DSM-5 “A” criterion for distressing somatic symptoms, and most would seem to satisfy DSM-5 “B” criterion because symptom impact is life-disturbing or associated with substantial impairment of function and quality of life. But the “B” designation requires special knowledge that symptoms are “disproportionate” or “excessive,” something that is

Symptoms, the nature of fibromyalgia, and diagnostic and statistical manual 5 (DSM-5 defined mental illness in patients with rheumatoid arthritis and fibromyalgia.

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Frederick Wolfe

Full Text Available PURPOSE: To describe and evaluate somatic symptoms in patients with rheumatoid arthritis (RA and fibromyalgia, determine the relation between somatization syndromes and fibromyalgia, and evaluate symptom data in light of the Diagnostic and Statistical Manual-5 (DSM-5 criteria for somatic symptom disorder. METHODS: We administered the Patient Health Questionnaire-15 (PHQ-15, a measure of somatic symptom severity to 6,233 persons with fibromyalgia, RA, and osteoarthritis. PHQ-15 scores of 5, 10, and 15 represent low, medium, and high somatic symptom severity cut-points. A likely somatization syndrome was diagnosed when PHQ-15 score was ≥10. The intensity of fibromyalgia diagnostic symptoms was measured by the polysymptomatic distress (PSD scale. RESULTS: 26.4% of RA patients and 88.9% with fibromyalgia had PHQ-15 scores ≥10 compared with 9.3% in the general population. With each step-wise increase in PHQ-15 category, more abnormal mental and physical health status scores were observed. RA patients satisfying fibromyalgia criteria increased from 1.2% in the PHQ-15 low category to 88.9% in the high category. The sensitivity and specificity of PHQ-15≥10 for fibromyalgia diagnosis was 80.9% and 80.0% (correctly classified = 80.3% compared with 84.3% and 93.7% (correctly classified = 91.7% for the PSD scale. 51.4% of fibromyalgia patients and 14.8% with RA had fatigue, sleep or cognitive problems that were severe, continuous, and life-disturbing; and almost all fibromyalgia patients had severe impairments of function and quality of life. CONCLUSIONS: All patients with fibromyalgia will satisfy the DSM-5 "A" criterion for distressing somatic symptoms, and most would seem to satisfy DSM-5 "B" criterion because symptom impact is life-disturbing or associated with substantial impairment of function and quality of life. But the "B" designation requires special knowledge that symptoms are "disproportionate" or "excessive," something that is

Symptoms, the nature of fibromyalgia, and diagnostic and statistical manual 5 (DSM-5) defined mental illness in patients with rheumatoid arthritis and fibromyalgia.

Science.gov (United States)

Wolfe, Frederick; Walitt, Brian T; Katz, Robert S; Häuser, Winfried

2014-01-01

To describe and evaluate somatic symptoms in patients with rheumatoid arthritis (RA) and fibromyalgia, determine the relation between somatization syndromes and fibromyalgia, and evaluate symptom data in light of the Diagnostic and Statistical Manual-5 (DSM-5) criteria for somatic symptom disorder. We administered the Patient Health Questionnaire-15 (PHQ-15), a measure of somatic symptom severity to 6,233 persons with fibromyalgia, RA, and osteoarthritis. PHQ-15 scores of 5, 10, and 15 represent low, medium, and high somatic symptom severity cut-points. A likely somatization syndrome was diagnosed when PHQ-15 score was ≥10. The intensity of fibromyalgia diagnostic symptoms was measured by the polysymptomatic distress (PSD) scale. 26.4% of RA patients and 88.9% with fibromyalgia had PHQ-15 scores ≥10 compared with 9.3% in the general population. With each step-wise increase in PHQ-15 category, more abnormal mental and physical health status scores were observed. RA patients satisfying fibromyalgia criteria increased from 1.2% in the PHQ-15 low category to 88.9% in the high category. The sensitivity and specificity of PHQ-15≥10 for fibromyalgia diagnosis was 80.9% and 80.0% (correctly classified = 80.3%) compared with 84.3% and 93.7% (correctly classified = 91.7%) for the PSD scale. 51.4% of fibromyalgia patients and 14.8% with RA had fatigue, sleep or cognitive problems that were severe, continuous, and life-disturbing; and almost all fibromyalgia patients had severe impairments of function and quality of life. All patients with fibromyalgia will satisfy the DSM-5 "A" criterion for distressing somatic symptoms, and most would seem to satisfy DSM-5 "B" criterion because symptom impact is life-disturbing or associated with substantial impairment of function and quality of life. But the "B" designation requires special knowledge that symptoms are "disproportionate" or "excessive," something that is uncertain and controversial. The reliability and validity

Non-specific symptoms as clues to changes in emotional well-being

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Blumberg Gari

2011-07-01

Full Text Available Abstract Background - Somatic symptoms are a common reason for visits to the family physician. The aim of this study was to examine the relation between non-specific symptoms and changes in emotional well-being and the degree to which the physician considers the possibility of mental distress when faced with such patients. Methods - Patients who complained of two or more symptoms including headache, dizziness, fatigue or weakness, palpitations and sleep disorders over one year were identified from the medical records of a random sample of 45 primary care physicians. A control group matched for gender and age was selected from the same population. Emotional well-being was assessed using the MOS-SF 36 in both groups. Results - The study group and the control group each contained 110 patients. Completed MOS questionnaires were obtained from 92 patients, 48 patients with somatic symptoms and 44 controls. Sixty percent of the patients with somatic symptoms experienced decreased emotional well being compared to 25% in the control group (p = 0.00005. Symptoms of dizziness, fatigue and sleep disturbances were significantly linked with mental health impairments. Primary care physicians identified only 6 of 29 patients (21% whose responses revealed functional limitations due to emotional problems as suffering from an emotional disorder and only 6 of 23 patients (26% with a lack of emotional well being were diagnosed with an emotional disorder. Conclusions - Non-specific somatic symptoms may be clues to changes in emotional well-being. Improved recognition and recording of mental distress among patients who complain of these symptoms may enable better follow up and treatment.

Shift, Interrupted: Strategies for Managing Difficult Patients Including Those with Personality Disorders and Somatic Symptoms in the Emergency Department.

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Moukaddam, Nidal; AufderHeide, Erin; Flores, Araceli; Tucci, Veronica

2015-11-01

Difficult patients are often those who present with a mix of physical and psychiatric symptoms, and seem refractory to usual treatments or reassurance. such patients can include those with personality disorders, those with somatization symptoms; they can come across as entitled, drug-seeking, manipulative, or simply draining to the provider. Such patients are often frequent visitors to Emergency Departments. Other reasons for difficult encounters could be rooted in provider bias or countertransference, rather than sole patient factors. Emergency providers need to have high awareness of these possibilities, and be prepared to manage such situations, otherwise workup can be sub-standard and dangerous medical mistakes can be made. Copyright © 2015 Elsevier Inc. All rights reserved.

Health Anxiety in Preadolescence

DEFF Research Database (Denmark)

Rask, Charlotte Ulrikka; Munkholm, Anja; Clemmensen, Lars

2016-01-01

Epidemiological data on the distribution, persistence, and clinical correlates of health anxiety (HA) in childhood are scarce. We investigated continuity of HA symptoms and associated health problems and medical costs in primary health services in a general population birth cohort. HA symptoms were...... assessed in 1886 Danish 11-12 year old children (48 % boys) from the Copenhagen Child Cohort using the Childhood Illness Attitude Scales (CIAS) together with information on socio-demographics and the child's somatic and mental status and healthcare expenditure. Non-parametric statistics and regression......; they showed continuity from early childhood and association with emotional disorders, unspecific somatic complaints, and increased healthcare expenditure. Further research in the clinical significance of childhood HA is required....

Cultural identity and mental health: differing trajectories among Asian and Latino youth.

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Rogers-Sirin, Lauren; Gupta, Taveeshi

2012-10-01

Asians and Latinos are the 2 fastest growing immigrant populations in the United States. In this 3-year longitudinal study, we explored trajectories of mental health symptoms (withdrawn/depressed and somatic symptoms) among 163 first- and second-generation Asian (n = 76) and Latino (n = 97) adolescents. The focus of the study was to examine how ethnic identity and U.S. identity, as 2 separate processes of identity development, affect mental health symptoms, and whether these relationships are moderated by ethnic group, Asian or Latino. Participants were recruited when they entered 10th grade, and 2 additional waves of data were gathered at 12-month intervals. Results revealed that somatic and depressed symptoms decreased over time for both groups. Similarly, for both groups, U.S. identity and ethnic identity increased over time. Ethnic identity was associated with lower levels of withdrawn/depressed symptoms for both Latino and Asian youth. Ethnic identity was associated with lower levels of somatic symptoms for Asian youth, but not for Latino youth. U.S. identity was not associated with reduced levels of somatic or withdrawn/depressed symptoms for either group. Implications for clinicians are discussed. (c) 2012 APA, all rights reserved.

Access to primary and specialized somatic health care for persons with severe mental illness: a qualitative study of perceived barriers and facilitators in Swedish health care.

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Björk Brämberg, Elisabeth; Torgerson, Jarl; Norman Kjellström, Anna; Welin, Peder; Rusner, Marie

2018-01-09

Persons with severe mental illness (e.g. schizophrenia, bipolar disorder) have a high prevalence of somatic conditions compared to the general population. Mortality data in the Nordic countries reveal that these persons die 15-20 years earlier than the general population. Some factors explaining this high prevalence may be related to the individuals in question; others arise from the health care system's difficulty in offering somatic health care to these patient groups. The aim of the present study was therefore to explore the experiences and views of patients, relatives and clinicians regarding individual and organizational factors which facilitate or hinder access to somatic health care for persons with severe mental illness. Flexible qualitative design. Data was collected by means of semi-structured individual interviews with patients with severe mental illness, relatives and clinicians representing primary and specialized health care. In all, 50 participants participated. The main barrier to accessing somatic care is the gap between the organization of the health care system and the patients' individual health care needs. This is observed at both individual and organizational level. The health care system seems unable to support patients with severe mental illness and their psychiatric-somatic comorbidity. The main facilitators are the links between severe mental illness patients and medical departments. These links take the form of functions (i.e. systems which ensure that patients receive regular reminders), or persons (i.e. professional contacts who facilitate patients' access the health care). Health care services for patients with severe mental illness need reorganization. Organizational structures and systems that facilitate cooperation between different departments must be put in place, along with training for health care professionals about somatic disease among psychiatric patients. The links between individual and organizational levels could be

Genetic aspects of somatic cell count and udder health in the Italian Valle del Belice dairy sheep

NARCIS (Netherlands)

Riggio, V.

2012-01-01

Mastitis is an inflammation of the udder, which leads to economic loss, mainly consisting of discarded milk, reduced milk production and quality, and increased health costs. Somatic cell count (SCC), and therefore somatic cell score (SCS), is widely used as indicator of mastitis. In this thesis,

Effort-reward imbalance in the school setting: associations with somatic pain and self-rated health.

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Låftman, Sara Brolin; Modin, Bitte; Östberg, Viveca; Hoven, Hanno; Plenty, Stephanie

2015-03-01

According to the workplace theory of effort-reward imbalance (ERI), individuals who perceive a lack of reciprocity between their effort spent at work and the rewards received in turn are at an increased risk of stress-related ill-health. It is also assumed that being overcommitted to work is linked to an increased risk of stress-related ill-health. This study applies the effort-reward imbalance model to the school setting. It aims to analyse the associations that effort-reward imbalance and overcommitment share with somatic pain and self-rated health among adolescents. Data are from the School Stress and Support Study (TriSSS), involving students in grades 8 and 9 (ages 14-16 years) in two schools in Stockholm, Sweden, during 2010 (n=403). Information on effort-reward imbalance and health outcomes was gathered from self-report questionnaires. An adjusted short version of ERI was used. Factor analysis showed that extrinsic effort, reward and overcommitment constitute three distinct dimensions. The designed measures demonstrated sound psychometric properties both for the full sample and for subgroups. Ordered logistic regressions were conducted. The analyses showed that low reward and higher overcommitment were associated with greater somatic pain and poorer self-rated health. Furthermore, effort-reward imbalance was linked with an elevated risk of somatic pain and poorer self-rated health. Students are more likely to experience stress-related ill-health when they perceive an imbalance between their effort and rewards. In addition, high overcommitment is associated with an increased risk of ill-health among students. © 2014 the Nordic Societies of Public Health.

Internet-based cognitive behavioral therapy versus psychoeducation control for illness anxiety disorder and somatic symptom disorder: A randomized controlled trial.

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Newby, Jill M; Smith, Jessica; Uppal, Shivani; Mason, Elizabeth; Mahoney, Alison E J; Andrews, Gavin

2018-01-01

To examine the efficacy of an Internet-delivered cognitive-behavioral therapy (iCBT) program for health anxiety compared to an active psychoeducation control group. Individuals (N = 86, mean age: 30 years, 87% female) with a Diagnostic and Statistical Manual of Mental Disorders (5th ed.) diagnosis of illness anxiety disorder or somatic symptom disorder with health anxiety were randomized to either a 6-lesson clinician-guided iCBT program for health anxiety (n = 45) or an active control group who received anxiety psychoeducation, clinical support, and monitoring (control, n = 41) over a 12-week period. Both groups experienced significant improvements between baseline and posttreatment on self-report measures of health anxiety, depression, general anxiety, and functional impairment. Intention-to-treat analyses indicated that the iCBT group experienced greater improvements in health anxiety on the Short Health Anxiety Inventory (SHAI) compared to controls (between-groups effect size = 1.39, 95% confidence interval [0.87, 1.93]), and a greater proportion of the iCBT group showed clinically reliable change on the SHAI (84% vs. 34% in the control group). Similarly, the iCBT group outperformed the control group on secondary measures of depression, generalized anxiety, functional impairment, maladaptive cognitions, body hypervigilance, safety behaviors and avoidance, and intolerance of uncertainty. Gains were maintained at 3-month follow-up in the iCBT group. iCBT for health anxiety is more effective than psychoeducation, clinical support, and monitoring, and presents an efficacious and accessible treatment option for people with health anxiety. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care.

Science.gov (United States)

Oud, Marian J T; Meyboom-de Jong, Betty

2009-05-09

Schizophrenia patients frequently develop somatic co-morbidity. Core tasks for GPs are the prevention and diagnosis of somatic diseases and the provision of care for patients with chronic diseases. Schizophrenia patients experience difficulties in recognizing and coping with their physical problems; however GPs have neither specific management policies nor guidelines for the diagnosis and treatment of somatic co-morbidity in schizophrenia patients. This paper systematically reviews the prevalence and treatment of somatic co-morbidity in schizophrenia patients in general practice. The MEDLINE, EMBASE, PsycINFO data-bases and the Cochrane Library were searched and original research articles on somatic diseases of schizophrenia patients and their treatment in the primary care setting were selected. The results of this search show that the incidence of a wide range of diseases, such as diabetes mellitus, the metabolic syndrome, coronary heart diseases, and COPD is significantly higher in schizophrenia patients than in the normal population. The health of schizophrenic patients is less than optimal in several areas, partly due to their inadequate help-seeking behaviour. Current GP management of such patients appears not to take this fact into account. However, when schizophrenic patients seek the GP's help, they value the care provided. Schizophrenia patients are at risk of undetected somatic co-morbidity. They present physical complaints at a late, more serious stage. GPs should take this into account by adopting proactive behaviour. The development of a set of guidelines with a clear description of the GP's responsibilities would facilitate the desired changes in the management of somatic diseases in these patients.

Masked depression: its interrelations with somatization, hypochondriasis and conversion.

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Fisch, R Z

1987-01-01

Masked depression appears to be a common clinical phenomenon. Most depressions present with some somatic complaints in addition to affective and cognitive ones. About one half of all depressions seen by primary care physicians initially present predominantly or exclusively with somatic symptoms. Many of these depressions are not recognized or are misdiagnosed and mistreated. The possible reasons for this are discussed here. The phenomenon of somatization in depressions and other conditions is reviewed and the interface with other related clinical problems like hypochondriasis and conversion is delineated. It is hypothesized that the proportion of depressions that are masked is positively correlated to the patients' tendency to somatize and negatively correlated to the doctors' ability to recognize depressions that hide behind somatic complaints. Suggestions for the diagnosis and treatment of masked depressions are given.

Somatization: a perspective from self psychology.

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Rodin, G M

1991-01-01

Somatization is a complex phenomenon that occurs in many forms and diverse settings. It is not necessarily pathological and may be found in a variety of psychiatric disorders. Much of the psychiatric literature has focused on patients with conversion disorders and hypochondriasis. Psychoanalytic theories regarding such conditions were largely based upon concepts of drive, conflict, and defense. The perspective from self psychology, with its emphasis on subjective experience and the sense of self, may further enhance the psychoanalytic understanding of somatization. Individuals with disturbances in the stability and organization of the self may present with somatic symptoms and disturbances in emotional awareness. Somatization in such cases may be the experiential manifestation of a disturbance in the cohesion of the self and/or may result from defensive operations to ward off affect. The latter may be prominent when affective arousal triggers the psychological threat of fragmentation. Somatization may diminish in such individuals when a self-object relationship is formed that bolsters and consolidates the sense of self. The integration of affect into ongoing subjective experience may also be an important aspect of psychoanalytic treatment in such patients.

Integrative Relationship Between Retirement Syndromes Components With General Health Symptoms Among Retired Adults

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Mohsen Golparvar

2011-07-01

Full Text Available Objectives: This research was administered with the aim of studying the relationship between retirement syndrome components with general health symptoms in retired adults in Esfahan city. Methods & Materials: This research carried out in descriptive and correlational method. Research statistical population was the retired adults in Esfahan city, among them, 461 persons for participating to research were selected using stratified random sampling, and then retirement syndrome questionnaire (helplessness and failure, older and idleness, trying and new direction and conflict and confusion and general health questionnaire (somatization, anxiety and insomnia, social dysfunction, and depression administered to them. Results: 1 Three components have predictive power for prediction of somatization, consisted of: helplessness and failure, older and idleness, trying and new directions, 2 for prediction of anxiety and insomnia, helplessness and failure, trying and new direction, older and idleness have significant predictive power, 3 For prediction of social dysfunction, helplessness and failure, and trying and new directions have significant predictive power, 4 For prediction of depression also, helplessness and failure and trying and new directions have significant predictive power. Conclusion: The finding of this research revealed that, helplessness and failure along with trying and new direction are the two components which must be considered in retired adults. Therefore, it is essential for this two dimensions established counseling centers related to retirement centers for helping retired adults.

Depressive and anxious symptoms and 20-year mortality: Evidence from the Stirling County study.

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Colman, Ian; Kingsbury, Mila; Sucha, Ewa; Horton, Nicholas J; Murphy, Jane M; Gilman, Stephen E

2018-05-02

Depression and anxiety disorders are highly comorbid, and share significant symptom overlap. Whereas depression has been consistently associated with excess mortality, the association between anxiety and mortality is less clear. Our aim was to identify constellations of anxious and depressive symptoms and examine their associations with mortality. This study considers respondents from the 1970 (n = 1203) and 1992 (n = 1402) cohorts of the Stirling County study. Symptoms of depression and anxiety were assessed using structured at-home interviews. Vital status of participants through 2011 was determined using probabilistic linkages to the Canadian Mortality Database. Exploratory factor analysis yielded three correlated factors in each cohort. Items loading on each factor varied slightly between cohorts, but roughly corresponded to (1) depressive symptoms, (2) anxious symptoms, and (3) somatic symptoms. The depressive factor was associated with increased risk of mortality in both the 1970 (HR: 1.35, 95% CI: 1.12, 1.62) and 1992 (HR: 1.25, 95% CI: 1.05, 1.48) cohorts. Anxious symptoms were associated with a reduced risk of mortality in the 1992 sample (HR: 0.72; 95% CI: 0.53, 0.90). Somatic symptoms were associated with a reduced risk of mortality in the 1970 sample (HR: 0.83, 95% CI: 0.69, 0.99), but an elevated risk of mortality in the 1992 sample (HR: 1.29; 95% CI: 1.11, 1.51). This study provides evidence that symptoms of depression and anxiety may have differential associations with early mortality. Somatic symptoms such as upset stomach and loss of appetite may be protective against mortality, perhaps through increased use of health care services. Conversely, symptoms such as weakness and cold sweats may be indicative of failing health. © 2018 Wiley Periodicals, Inc.

Psychosomatic symptoms in medical outpatients: an investigation of self-handicapping theory.

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Organista, P B; Miranda, J

1991-01-01

Investigated self-handicapping theory as it relates to somatization in medical patients. We predicted that medical outpatients (N = 113) would report psychosomatic symptoms in response to events that threaten their self-esteem. As predicted, results of hierarchical multiple regression indicated that high-perfectionism patients reported somatic symptoms positively related to the number of events that jeopardize their sense of accomplishment, whereas low-perfectionism patients' somatic symptoms were not related to these events (p = .005). Contrary to prediction, high-dependency patients did not differ significantly from low-dependency patients in the relationship of somatic symptoms and events that threatened their interpersonal relationships (p = .115). Implications of these findings and the utility of self-handicapping theory for predicting somatization in medical patients are discussed.

Alexithymia and illness behaviour among female Indian outpatients with multiple somatic symptoms

OpenAIRE

Sarkar, Jaydip; Chandra, Prabha

2003-01-01

Sixty Indian muslim women outpatients with multiple somatic complaints of nonorganic origin were assessed for alexithymia and abnormal illness behavior using the Toronto Alexithymia Scale (TAS) and the Illness Behaviour Assessment Schedule (IBAS). Alexithymia represented by TAS scores correlated best with the IBAS variables of communication of affect, somatic illness causal beliefs and denial. Correlation with other IBAS variables was modest to poor.There was no correlation of IBAS variables ...

Irritable bowel symptoms and the development of common mental disorders and functional somatic syndromes identified in secondary care - a long-term, population-based study

DEFF Research Database (Denmark)

Poulsen, Chalotte Heinsvig; Eplov, Lene Falgaard; Hjorthøj, Carsten

2017-01-01

) and functional somatic syndromes (FSSs). Methods and study design: A longitudinal population-based study comprising two 5-year follow-up studies, Dan-MONICA 1 (1982-1987) and Inter99 (1999-2004), recruited from the western part of Copenhagen County. The total study population (n = 7,278) was divided into symptom...... for mental vulnerability as a risk factor for both CMDs and FSSs, including IBS. Results: Over a 5-year period, 51% patients had no IBS symptoms, 17% patients had IBS symptoms without abdominal pain, 22% patients had IBS symptoms including abdominal pain and 10% patients fulfilled the IBS definition. IBS...... and IBS symptoms including abdominal pain were significantly associated with the development of CMDs and other FSSs identified in secondary care. When adjusting for mental vulnerability, IBS and IBS symptoms including abdominal pain were no longer associated with CMDs, but the significant relationship...

Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care

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Meyboom-de Jong Betty

2009-05-01

Full Text Available Abstract Background Schizophrenia patients frequently develop somatic co-morbidity. Core tasks for GPs are the prevention and diagnosis of somatic diseases and the provision of care for patients with chronic diseases. Schizophrenia patients experience difficulties in recognizing and coping with their physical problems; however GPs have neither specific management policies nor guidelines for the diagnosis and treatment of somatic co-morbidity in schizophrenia patients. This paper systematically reviews the prevalence and treatment of somatic co-morbidity in schizophrenia patients in general practice. Methods The MEDLINE, EMBASE, PsycINFO data-bases and the Cochrane Library were searched and original research articles on somatic diseases of schizophrenia patients and their treatment in the primary care setting were selected. Results The results of this search show that the incidence of a wide range of diseases, such as diabetes mellitus, the metabolic syndrome, coronary heart diseases, and COPD is significantly higher in schizophrenia patients than in the normal population. The health of schizophrenic patients is less than optimal in several areas, partly due to their inadequate help-seeking behaviour. Current GP management of such patients appears not to take this fact into account. However, when schizophrenic patients seek the GP's help, they value the care provided. Conclusion Schizophrenia patients are at risk of undetected somatic co-morbidity. They present physical complaints at a late, more serious stage. GPs should take this into account by adopting proactive behaviour. The development of a set of guidelines with a clear description of the GP's responsibilities would facilitate the desired changes in the management of somatic diseases in these patients.

Depressive symptoms and health problems among Chinese immigrant elders in the US and Chinese elders in China.

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Wu, Bei; Chi, Iris; Plassman, Brenda L; Guo, Man

2010-08-01

Researchers speculate that depression tends to be more prevalent among immigrant elders due to their lack of resources, acculturation stress, language problems, and social isolation. However, other characteristics of elderly immigrants, such as the healthy immigrant effect, may counteract these potential risk factors. This study examined whether depressive symptoms differed between Chinese immigrant elders and their counterparts in China and whether health conditions were similarly associated with depressive symptoms in these two samples. Depression and health information was collected from 177 Chinese immigrant elders in Boston, the US in 2000 and from 428 education and gender-matched elders in Shanghai, China in 2003. Chinese immigrants had a significantly lower score on the modified Center for Epidemiologic Studies Depression Scale (CES-D) and its subscales: somatic symptoms and depressive affect. The association remained for the subscale depressive affect in multivariate analyses. Arthritis and back or neck problems were associated with a higher level of depressive symptoms among Chinese immigrants, while problems in walking were associated with depression among their counterparts in China. Pain was an underlying contributor to the association between depression and these health problems in both the groups. This study suggests that Chinese immigrant elders might be more resilient than their counterparts despite many challenges they face after moving abroad. With the growing number of older Chinese immigrants in the US, a better understanding of depressive symptoms is essential to provide culturally competent services to better serve this population.

Neuroticism and maladaptive coping in patients with functional somatic syndromes

DEFF Research Database (Denmark)

Pedersen, Heidi Frølund; Frostholm, Lisbeth; Jensen, Jens Søndergaard

2016-01-01

Objectives. The cognitive-behavioural model of functional somatic syndromes (FSS) proposes a multifactorial aetiology consisting of predisposing, precipitating and perpetuating factors. In this study, we sought to investigate three questions that can be drawn from this model: (1) Do patients...... with FSS show high levels of neuroticism? (2) Does neuroticism affect physical health and social functioning, either directly or indirectly through maladaptive coping? (3) Does more adaptive coping mediate the effect of cognitive-behavioural therapy (CBT) on outcome? Design. Secondary analysis....... Reduction in symptom catastrophizing during group CBT partially mediated its long-term effect. Conclusions. The results give support to a generic cognitive-behavioural model of FSS. Targeting symptom catastrophizing may be an essential component in CBT for patients with FSS, regardless of their specific...

Subtypes of depressive symptoms and inflammatory biomarkers: An exploratory study on a sample of HIV-positive patients.

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Norcini Pala, A; Steca, P; Bagrodia, R; Helpman, L; Colangeli, V; Viale, P; Wainberg, M L

2016-08-01

Depressive symptoms cause major impairment and may accelerate HIV progression despite the use of antiretroviral medication. The somatic symptoms criteria for HIV infection and depression partially overlap, which can make differential diagnosis challenging. Because of chronic inflammation caused by HIV infection, HIV-positive patients may develop somatic and affective-cognitive symptoms of depression. Inflammation-related depression is primarily characterized with severe somatic symptoms such as fatigue and sleep disturbance. This study sought to explore the patterns of somatic and cognitive-affective depressive symptoms that characterize HIV-positive patients. Our specific aims were (1) to identify subtypes of depressive symptoms in a sample of HIV-positive patients; and (2) to test the subtypes' difference on inflammatory and HIV disease progression biomarkers. HIV-positive men and women (N=102) with and without depressive symptoms were randomly selected from an Italian HIV clinic. Depressive symptoms (PHQ-9), viral load (VL), CD4+, Il-6, TNF-α, and monocytes were assessed. The three subtypes formed using Latent Class Analysis (LCA) identified patients with (1) severe cognitive-affective and somatic depressive symptoms; (2) severe/moderate somatic symptoms; and (3) absent or low depressive symptoms. The subtype with severe/moderate somatic symptoms was characterized with elevated levels of Il-6 and monocytes. No difference on HIV progression biomarkers was found. The subtypes of depressive symptoms might help differentiating depressive symptoms from HIV- and inflammatory-related somatic symptoms. When present, cognitive-affective and/or somatic symptoms cause significant impairment to patients' lives and thus warrant further assessment and treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

The Potential Impact of Internet and Mobile Use on Headache and Other Somatic Symptoms in Adolescence. A Population-Based Cross-Sectional Study.

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Cerutti, Rita; Presaghi, Fabio; Spensieri, Valentina; Valastro, Carmela; Guidetti, Vincenzo

2016-07-01

(tension type headache was the 39% in no addiction group, the 40% in mobile addiction group, the 32% in internet addiction group, and the 31% in mobile and internet addiction group, P = .71). Daily internet users reported higher median scores for somatic symptoms than the occasional internet users in the no-headache group (Kruskal-Wallis χ(2) (1) = 5.44, P = .02) and in the migraine group (Kruskal-Wallis χ(2) (1) = 6.54, P = .01). Results highlighted the potential impact of excessive internet and mobile use, which ranges from different types of headache to other somatic symptoms. Further studies are needed to confirm these findings and to determine if there is a need for promoting preventive health interventions, especially in school setting. © 2016 American Headache Society.

Depressive symptoms are associated with allostatic load among community-dwelling older adults.

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Kobrosly, Roni W; van Wijngaarden, Edwin; Seplaki, Christopher L; Cory-Slechta, Deborah A; Moynihan, Jan

2014-01-17

The allostatic load model has been used to quantify the physiological costs of the body's response to repeated stressful demands and may provide a useful, integrative perspective on the various correlates of late-life depressive symptoms. We interviewed 125 Rochester, NY adults, ranging in age from 67 to 94 years. We employed an allostatic load score as a measure of multisystem dysfunction in hypothalamic–pituitary–adrenal axis function, immune function, anabolic activity, and cardiovascular activity. Overall, affective, and somatic depressive symptom scores were computed using the 20-item Center for Epidemiologic Studies Depression Scale. Multiple linear regression models were used to estimate associations between allostatic load scores and affective, somatic, and overall depressive symptoms. Among our sample of mean age 76.1 years, the one-week prevalence of clinically significant depressive symptoms was 12.8%. In models adjusting for demographic, socioeconomic, and health-related factors, higher allostatic load scores were associated with elevated scores for overall, affective, and somatic depressive symptoms: beta = 1.21 (95% CI = 0.38, 2.05); beta = 0.14 (95% CI = 0.040, 0.24); beta = 0.60 (95% CI = 0.23, 0.97), respectively. Our results suggest that allostatic load measure is associated with late-life depressive symptoms. This association appears to be of clinical significance, as the magnitude of the effect size was comparable (but opposite in direction) to that of antidepressant use. Future research should examine the inter-relationships of allostatic load, psychological stress, and late-life depressive symptoms.

Health care utilization, somatic and mental health distress, and well-being among widowed and non-widowed female survivors of war

NARCIS (Netherlands)

Morina, N.; Emmelkamp, P.M.G.

2012-01-01

Background The aim of the study was to assess levels of somatic and mental health distress, well-being, AS WELL AS utilization of primary and specialist health care services among war-related widowed and non-widowed female civilian survivors of war. Methods 100 war-related widowed lone mothers and

"SAFE" LEVEL OF SOMATIC HEALTH IN INDICATORS REGULATION OF CARDIORESPIRATORY SYSTEM AT YOUNG MEN

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Alexander P Romanchuk

2015-12-01

2Lviv State University Physical Culture The aim of this study was to determine the functional state cardiorespiratory system in males younger with "safe" level of somatic health (LSH. Were examined 104 males aged 20,6 ± 0,9 years, engaged in various sports, and had no existing acute and chronic diseases. The survey was conducted using spiroarteriocardiorhythmography (SACR. It is shown that in all studied systems of regulation, regulation except SBP probably marked differences between persons with "safe" and "low" LSH. At the same time, the comparison of "safe" and "medium" LSH differences relate only to the predominance of sympathetic influences on heart rate, decrease suprasegmental effects on DBP, reducing regulatory influences on spontaneous breath and their high-frequency components, reducing of baroreflex sensitivity and cardiac output. Key words: "safe" level of somatic health, regulation of the cardiorespiratory system.

Perceived discrimination and its associations with mental health and substance use among Asian American and Pacific Islander undergraduate and graduate students.

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Chen, Angela Chia-Chen; Szalacha, Laura A; Menon, Usha

2014-01-01

Racial discrimination experiences can negatively affect health. This study examined perceived discrimination and its relationship with mental health and substance use among Asian American and Pacific Islander (API) undergraduate and graduate students. A total of 113 API students aged 18-35 completed the study during February-June, 2011. The authors conducted a cross-sectional, anonymous survey online. Dependent variables included mental health (depressive, anxiety, and somatic symptoms) and substance use (alcohol problems, use of tobacco, marijuana or hashish, and other illegal drugs). Students' perceived discrimination were significantly, positively associated with depressive, anxiety, and somatic symptoms, but not with substance use. Ethnic identity moderated the relationship between perceived discrimination and somatic symptoms, but not depressive or anxiety symptoms. These findings suggested the negative effect of racial discrimination on API students' mental health. The buffering effect of ethnic identity may increase resilience in these students when they face racial discrimination.

Pathological spirit possession as a cultural interpretation of trauma-related symptoms.

Science.gov (United States)

Hecker, Tobias; Barnewitz, Eva; Stenmark, Hakon; Iversen, Valentina

2016-07-01

Spirit possession is a phenomenon frequently occurring in war-torn countries. It has been shown to be an idiom of distress entailing dissociative symptoms. However, its association with trauma exposure and trauma-related disorders remains unclear. This study aimed to explore subjective disease models and the relationship between pathological spirit possession and trauma-related disorders in the Eastern Democratic Republic of the Congo. Seventy-three (formerly) possessed persons (74% female, mean age = 34 years), referred by traditional and spiritual healers, were interviewed about their experiences of pathological spirit possession, trauma exposure, posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, shame and guilt, psychotic symptoms, somatic complaints, and the impairment of psychosocial functioning. The most common disease model for pathological spirit possession was another person having sent the spirit, mostly a family member or a neighbor, out of jealousy or conflict over resources. Significant correlations were found between spirit possession over lifetime and PTSD symptom severity, feelings of shame and guilt, depressive symptoms, somatic complaints, and psychotic symptoms. Spirit possession during the preceding 4 weeks was associated with PTSD symptom severity, impairment of psychosocial functioning, and psychotic symptom severity. The results of this study indicate that pathological spirit possession is a broad explanatory framework for various subjectively unexplainable mental and physical health problems, including but not limited to trauma-related disorders. Understanding pathological spirit possession as a subjective disease model for various mental and physical health problems may help researchers and clinicians to develop culturally sensitive treatment approaches for affected individuals. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Somatic Experiencing Treatment with Social Service Workers Following Hurricanes Katrina and Rita

Science.gov (United States)

Leitch, M. Laurie; Vanslyke, Jan; Allen, Marisa

2009-01-01

In a disaster, social service workers are often survivors themselves. This study examines whether somatic intervention using a brief (one to two session) stabilization model now called the Trauma Resiliency Model[TM] (TRM), which uses the skills of Somatic Experiencing[R] (SE), can reduce the postdisaster symptoms of social service workers…

Self-Report of Depressive Symptoms in Low Back Pain Patients.

Science.gov (United States)

Crisson, James; And Others

1986-01-01

Presents two studies designed to examine the self-report of depressive symptoms in low back pain patients (N=134). Both studies found that patients were more likely to report somatic than cognitive symptoms of depression. Patients with multiple physical findings were not more likely to report somatic symptoms than patients with few physical…

Number of bodily symptoms predicts outcome more accurately than health anxiety in patients attending neurology, cardiology, and gastroenterology clinics.

Science.gov (United States)

Jackson, Judy; Fiddler, Maggie; Kapur, Navneet; Wells, Adrian; Tomenson, Barbara; Creed, Francis

2006-04-01

In consecutive new outpatients, we aimed to assess whether somatization and health anxiety predicted health care use and quality of life 6 months later in all patients or in those without demonstrable abnormalities. On the first clinic visit, participants completed the Illness Perception Questionnaire (IPQ), the Health Anxiety Questionnaire (HAQ), and the Hospital Anxiety and Depression Scale (HADS). Outcome was assessed as: (a) the number of medical consultations over the subsequent 6 months, extracted from medical records, and (b) Short-Form Health Survey 36 (SF36) physical component score 6 months after index clinic visit. A total of 295 patients were recruited (77% response rate), and medical consultation data were available for 275. The number of bodily symptoms was associated with both outcomes in linear fashion (Psomatization and hypochondriasis.

The impact of anticipated stigma on psychological and physical health problems in the unemployed group

Directory of Open Access Journals (Sweden)

Aisling T. O'Donnell

2015-08-01

Full Text Available Previous research has demonstrated that the unemployed suffer increased psychological and physical health problems compared to their employed counterparts. Further, unemployment leads to an unwanted new social identity that is stigmatizing, and stigma is known to be a stressor causing psychological and physical health problems. However, it is not yet known whether being stigmatized as an unemployed group member is associated with psychological and physical health in this group. The current study tested the impact of anticipated stigma on psychological distress and physical health problems, operationalized as somatic symptoms, in a volunteer sample of unemployed people. Results revealed that anticipated stigma had a direct effect on both psychological distress and somatic symptoms, such that greater anticipated stigma significantly predicted higher levels of both. Moreover, the direct effect on somatic symptoms became non-significant when psychological distress was taken into account. Thus, to the extent that unemployed participants anticipated experiencing greater stigma, they also reported increased psychological distress, and this psychological distress predicted increased somatic symptoms. Our findings complement and extend the existing literature on the relationships between stigmatized identities, psychological distress and physical health problems, particularly in relation to the unemployed group. This group is important to consider both theoretically, given the unwanted and transient nature of the identity compared to other stigmatized identities, but also practically, as the findings indicate a need to orient to the perceived valence of the unemployed identity and its effects on psychological and physical health.

Bullying and victimisation are common in four-year-old children and are associated with somatic symptoms and conduct and peer problems.

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Ilola, Anna-Marja; Lempinen, Lotta; Huttunen, Jukka; Ristkari, Terja; Sourander, Andre

2016-05-01

There are few population-based studies on bullying behaviour among preschool children. The aims of the study were to investigate the prevalence of bullying behaviour among four-year-old children, as reported by their parents, the prevalence of types of bullying behaviour and the associations between bullying behaviour and psychosocial factors. This study was based on a population-based study sample of 931 children who attended their check-up at a child health clinic at four years of age. Parents completed the questionnaire about their child's bullying behaviour and risk factors during the check-up. Bullying behaviour, especially being both a bully and a victim, was a common phenomenon among four-year-old children. Being a bully or both a bully and victim were most strongly associated with conduct problems, while being a victim was associated with somatic symptoms and peer problems. Bullying behaviour was frequently found in preschool children and associated with a wide range of other problems, which indicate that routine checking of bullying behaviour should be included in child health clinic check-ups. Bullying prevention programmes are usually targeted at school-aged children, but this study highlights the importance of focusing already on preschool children. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Monitoring Milk Somatic Cell Counts

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Gheorghe Şteţca

2014-11-01

Full Text Available The presence of somatic cells in milk is a widely disputed issue in milk production sector. The somatic cell counts in raw milk are a marker for the specific cow diseases such as mastitis or swollen udder. The high level of somatic cells causes physical and chemical changes to milk composition and nutritional value, and as well to milk products. Also, the mastitic milk is not proper for human consumption due to its contribution to spreading of certain diseases and food poisoning. According to these effects, EU Regulations established the maximum threshold of admitted somatic cells in raw milk to 400000 cells / mL starting with 2014. The purpose of this study was carried out in order to examine the raw milk samples provided from small farms, industrial type farms and milk processing units. There are several ways to count somatic cells in milk but the reference accepted method is the microscopic method described by the SR EN ISO 13366-1/2008. Generally samples registered values in accordance with the admissible limit. By periodical monitoring of the somatic cell count, certain technological process issues are being avoided and consumer’s health ensured.

Somatoform symptoms and treatment nonadherence in depressed family medicine outpatients.

Science.gov (United States)

Keeley, R; Smith, M; Miller, J

2000-01-01

To examine whether somatoform symptoms, specifically symptoms of conversion, somatization, and hypochondriasis, are associated with side-effect reporting and treatment nonadherence in depressed family medicine outpatients, and to measure whether symptoms improve with pharmacotherapy. Inception cohort study with 14-week follow-up. Inner-city family medicine residency clinic. Thirty-nine consecutive adults with major depressive disorder were asked to participate, and 30 consented. Antidepressants for 14 weeks. The Personality Assessment Inventory (PAI) was administered before treatment. The PAI is a self-reported inventory compatible with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, designed to measure a broad range of personality characteristics. After 14 weeks, the side-effect incidence and treatment nonadherence rates were determined, and 12 patients were readministered the PAI. Depressed family medicine patients demonstrated trends toward elevated Somatic Complaints scale and conversion subscale scores and a lower Suicidal Ideation scale score relative to those of a standardized depressed psychiatric patient profile. Conversion and hypochondriacal symptoms were associated with side-effect reporting and treatment nonadherence. Somatization and hypochondriacal symptoms improved clinically and statistically during treatment for depression. Somatoform distress is a complex, common, and understudied phenomenon in primary care that can adversely affect the treatment of depression. Somatoform symptoms of conversion and hypochondriasis, but not somatization, were found to be risk factors for treatment nonadherence. Somatization and hypochondriacal symptoms may represent personality states that improve with pharmacotherapy, and conversion symptoms may be a personality trait resistant to medical treatment for depression.

Psychiatric and somatic health in relation to expereince of parental divorce in childhood

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Ängarne-Lindberg, Teresia; Wadsby, Marie

2012-01-01

Background: The outcome of studies about experience of parental divorce and effects on mental and physical health differs in result possibly caused by the use of different questionnaires and instruments, varying length of time since the divorce and divergent drop-off of participants. Aims: To study the presence of psychiatric records and number of diagnosed somatic and mental health care visits in a group of young adults with childhood experience of parental divorce in comparison to a group ...

Dimensions of somatization and hypochondriasis.

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Ford, C V

1995-05-01

A significantly large group of patients who communicate their psychosocial distress in the form of physical symptoms are called somatizers. They tend to overuse medical services. The syndromes with which they present have indistinct boundaries, and there tends to be some fluidity of their symptomatic presentations. Underlying psychiatric disorders such as mood disorders, anxiety disorders (including obsessive compulsive disorder), and personality disorders are frequently present.

Upper gastrointestinal symptoms, psychosocial co-morbidity and health care seeking in general practice: population based case control study

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Schellevis François G

2009-09-01

Full Text Available Abstract Background The pathophysiology of upper gastrointestinal (GI symptoms is still poorly understood. Psychological symptoms were found to be more common in patients with functional gastrointestinal complaints, but it is debated whether they are primarily linked to GI symptoms or rather represent motivations for health-care seeking. Purpose of our study was to compare co-morbidity, in particular psychological and social problems, between patients with and without upper GI symptoms. In addition, we investigated whether the prevalence of psychological and social problems is part of a broader pattern of illness related health care use. Methods Population based case control study based on the second Dutch National Survey of general practice (conducted in 2001. Cases (adults visiting their primary care physician (PCP with upper GI symptoms and controls (individuals not having any of these complaints, matched for gender, age, PCP-practice and ethnicity were compared. Main outcome measures were contact frequency, prevalence of somatic as well as psychosocial diagnoses, prescription rate of (psychopharmacological agents, and referral rates. Data were analyzed using odds ratios, the Chi square test as well as multivariable logistic regression analysis. Results Data from 13,389 patients with upper GI symptoms and 13,389 control patients were analyzed. Patients with upper GI symptoms visited their PCP twice as frequently as controls (8.6 vs 4.4 times/year. Patients with upper GI symptoms presented not only more psychological and social problems, but also more other health problems to their PCP (odds ratios (ORs ranging from 1.37 to 3.45. Patients with upper GI symptoms more frequently used drugs of any ATC-class (ORs ranging from 1.39 to 2.90, including psychotropic agents. The observed differences were less pronounced when we adjusted for non-attending control patients. In multivariate regression analysis, contact frequency and not psychological or

Italian university students' self-perceived health and satisfaction of life.

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de Waure, Chiara; Soffiani, Valentina; Virdis, Andrea; Poscia, Andrea; Di Pietro, Maria Luisa

2015-01-01

Health is defined as a state of complete physical, social and mental well-being, therefore, it should not be considered as simply the absence of disease. In this light, the assessment of self-perceived health and life satisfaction plays an important role as it allows addressing the subjective perception of physical health, as well as mental health and social functioning. This study analyzed data from 8516 university students enrolled in the "Sportello Salute Giovani" project ("Youth Health Information Desk"). In particular, it addressed self-perceived health and life satisfaction, reported somatic and psychological symptoms and ability to cope with daily problems of university students from 18 to 30 years old. Overall, 77.1% of students declared to have a good or very good health and the mean score of life satisfaction was 7.46. In respect to somatic and psychological symptoms, 25.8% of students reported to suffer almost daily of at least one among headache, stomach pain, back pain, tiredness, nervousness, dizziness and troubles falling asleep. Results varied on the basis of sex, with women showing lower self-perceived health compared to men and reporting more symptoms. Furthermore, self-perceived health was shown better in younger students and in those belonging to higher socio-economic level. The survey showed that concern exists with respect to university students' self-perceived health, which is different from that arising from other evidence. Female students had a significant lower self-perceived health and reported somatic and psychological symptoms more commonly than men. On the other hand, results about life satisfaction seem to be aligned with the literature. One of the most important implications of the study is the need to address self-perceived health and reported symptoms in university students in order to monitor them and initiate interventions aimed at improving well-being and controlling inequalities.

The critical role of psychosomatics in promoting a new perspective upon health and disease.

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Dragoş, Dorin; Tănăsescu, Maria Daniela

2009-01-01

In an evolutionary model, health and disease are regarded as successful and respectively failed adaptation to the demands of the environment. The social factors are critical for a successful adaptation, while emotions are means of both signaling the organism's state and of adapting the physiological responses to environmental challenges. Hence the importance of a biopsychosocial model of health and disease. Psychoemotional distress generates and/or amplifies somatic symptoms. Somatization may be viewed as an altered cognitive process, inclining the individual to an augmented perception of bodily sensations and to an increased degree of complexity in reporting negative experiences (hence the greater cognitive effort allocated thereto). Somatosensory amplification and alexithymia are key elements in this process. The brain's right hemisphere is more involved in the generation of emotionally conditioned somatization symptoms. Somatic symptoms have various psychological and social functions and are strongly influenced by the particular belief system of the individual. Inappropriately perceiving the environment as an aggressor and excessively responding to it (by activating the cytokine system in correlation with the arousal of the psychic, nervous, and endocrine systems) may be a key element in the altered cognition conducive to ill health.

Three forms of somatization in primary care: prevalence, co-occurrence, and sociodemographic characteristics.

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Kirmayer, L J; Robbins, J M

1991-11-01

Three definitions of somatization were operationalized: (a) high levels of functional somatic distress, measured by the Somatic Symptom Index (SSI) of the Diagnostic Interview Schedule; (b) hypochondriasis measured by high scores on a measure of illness worry in the absence of evidence for serious illness; and (c) exclusively somatic clinical presentations among patients with current major depression or anxiety. Of 685 patients attending two family medicine clinics, 26.3% met criteria for one or more forms of somatization. While DSM-III somatization disorder had a prevalence of only 1% in this population, 16.6% of the patients met abridged criteria for subsyndromal somatization disorder (SSI 4,6). Hypochondriacal worry had a prevalence of 7.7% in the clinic sample. Somatized presentations of current major depression or anxiety disorder had a prevalence of 8%. The three forms of somatization were associated with different sociodemographic and illness behavior characteristics. A majority of patients met criteria for only one type of somatization, suggesting that distinct pathogenic processes may be involved in each of the three types.

Acceptance and commitment group therapy for health anxiety--results from a pilot study.

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Eilenberg, T; Kronstrand, L; Fink, P; Frostholm, L

2013-06-01

Health anxiety (or hypochondriasis) is prevalent, may be persistent and disabling for the sufferers and associated with high societal costs. Acceptance and Commitment Therapy (ACT) is a new third-wave behavioral cognitive therapy that has not yet been tested in health anxiety. 34 consecutive Danish patients with severe health anxiety were referred from general practitioners or hospital departments and received a ten-session ACT group therapy. Patients were followed up by questionnaires for 6 months. There were significant reductions in health anxiety, somatic symptoms and emotional distress at 6 months compared to baseline: a 49% reduction in health anxiety (Whiteley-7 Index), a 47% decrease in emotional distress (SCL-8), and a 40% decrease in somatic symptoms (SCL-90R Somatization Subscale). The patients' emotional representations and perception of the consequences of their illness (IPQ) improved significantly, and 87% of the patients were very or extremely satisfied with the treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

Mental health of newly arrived Burmese refugees in Australia: contributions of pre-migration and post-migration experience.

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Schweitzer, Robert D; Brough, Mark; Vromans, Lyn; Asic-Kobe, Mary

2011-04-01

This study documents the mental health status of people from Burmese refugee backgrounds recently arrived in Australia, then examines the contributions of gender, pre-migration and post-migration factors in predicting mental health. Structured interviews, including a demographic questionnaire, the Harvard Trauma Questionnaire, the Post-migration Living Difficulties Checklist and Hopkins Symptom Checklist assessed pre-migration trauma, post-migration living difficulties, depression, anxiety, somatization and traumatization symptoms in a sample of 70 adults across five Burmese ethnic groups. Substantial proportions of participants reported psychological distress in symptomatic ranges including: post-traumatic stress disorder (9%), anxiety (20%) and depression (36%), as well as significant symptoms of somatization (37%). Participants reported multiple and severe pre-migration traumas. Post-migration living difficulties of greatest concern included communication problems and worry about family not in Australia. Gender did not predict mental health. Level of exposure to traumatic events and post-migration living difficulties each made unique and relatively equal contributions to traumatization symptoms. Post-migration living difficulties made unique contributions to depression, anxiety and somatization symptoms. While exposure to traumatic events impacted on participants' mental well-being, post-migration living difficulties had greater salience in predicting mental health outcomes of people from Burmese refugee backgrounds. Reported rates of post-traumatic stress disorder symptoms were consistent with a large review of adults across seven western countries. High levels of somatization point to a nuanced expression of distress. Findings have implications for service provision in terms of implementing appropriate interventions to effectively meet the needs of this newly arrived group in Australia.

Increasing the treatment motivation of patients with somatic symptom disorder: applying the URICA-S scale.

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Mander, Johannes; Schaller, Georg; Bents, Hinrich; Dinger, Ulrike; Zipfel, Stephan; Junne, Florian

2017-07-03

Therapeutic intervention programs for somatic symptom disorder (SSD) show only small-to-moderate effect sizes. These effects are partly explained by the motivational problems of SSD patients. Hence, fostering treatment motivation could increase treatment success. One central aspect in SSD patients might be damage to motivation because of symptomatic relapses. Consequently, the aim of the present study was to investigate associations between motivational relapse struggle and therapeutic outcome in SSD patients. We assessed 84 inpatients diagnosed with SSD in the early, middle and late stages of their inpatient treatment. The maintenance subscale of the University of Rhode Island Change Assessment-Short (URICA-S) was applied as a measure to assess motivational relapse struggle. Additionally, patients completed measures of treatment outcome that focus on clinical symptoms, stress levels and interpersonal functioning. The results from multiple regression analyses indicate that higher URICA-S maintenance scores assessed in early stages of inpatient treatment were related to more negative treatment outcomes in SSD patients. SSD patients with ambivalent treatment motivation may fail in their struggle against relapse over the course of therapy. The URICA-S maintenance score assessed at therapy admission facilitated early identification of SSD patients who are at greater risk of relapse. Future studies should incorporate randomized controlled trials to investigate whether this subgroup could benefit from motivational interventions that address relapse.

The Relationship Between Job Stress, Job Satisfaction, and the Symptom Checklist-90-Revision (SCL-90-R in Marine Officers on Board

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Jae Hee Kim

2016-11-01

Full Text Available Objectives This study was conducted to investigate the relationships among job stress, job satisfaction, and mental health in marine officers. Methods The researchers gathered data on marine officers working at a harbor in Chungcheong Province, South Korea, using a self-reported questionnaire. Mental health was measured by the Symptom Checklist-90-Revision (SCL-90-R, and general characteristics including socioeconomic factors, job stress, and job satisfaction were measured by structured questionnaires. Multiple regression analysis was performed to investigate the relationships among job stress, job satisfaction, and mental health status according to the symptom dimensions of the SCL-90-R. Results Among the marine officers, obsessive-compulsive behavior, depression, and somatization were the most problematic symptoms. Those who reported poor health, low job satisfaction, and high job stress had a higher prevalence of psychoticism, somatization, depression, anxiety, and phobic anxiety. Conclusions An occupational health system should be introduced that would regularly check the mental health of marine officers in charge of ships and sailors, in order to help reduce their stress levels, enhance their job satisfaction, and thereby improve their mental health.

Exposure-based cognitive-behavioural therapy via the internet and as bibliotherapy for somatic symptom disorder and illness anxiety disorder: randomised controlled trial.

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Hedman, Erik; Axelsson, Erland; Andersson, Erik; Lekander, Mats; Ljótsson, Brjánn

2016-11-01

In DSM-5 two new diagnoses, somatic symptom disorder (SSD) and illness anxiety disorder (IAD), have replaced DSM-IV hypochondriasis. There are no previous treatment studies for these disorders. Cognitive-behavioural therapy (CBT) delivered as therapist-guided or unguided internet treatment or as unguided bibliotherapy could be used to increase treatment accessibility. To investigate the effect of CBT delivered as guided internet treatment (ICBT), unguided internet treatment (U-ICBT) and as unguided bibliotherapy. A randomised controlled trial (RCT) where participants (n = 132) with a diagnosis of SSD or IAD were randomised to ICBT, U-ICBT, bibliotherapy or to a control condition on a waiting list (trial registration: Clinicaltrials.gov identifier NCT01966705). Compared with the control condition, all three treatment groups made large and significant improvements on the primary outcome Health Anxiety Inventory (between-group d at post-treatment was 0.80-1.27). ICBT, U-ICBT and bibliotherapy can be highly effective in the treatment of SSD and IAD. This is the first study showing that these new DSM-5 disorders can be effectively treated. © The Royal College of Psychiatrists 2016.

Subtypes of depressive symptoms and inflammatory biomarkers: An exploratory study on a sample of HIV-positive patients

OpenAIRE

Pala, A. Norcini; Steca, P.; Bagrodia, R.; Helpman, L.; Colangeli, V.; Viale, P.; Wainberg, M.L.

2016-01-01

Depressive symptoms cause major impairment and may accelerate HIV progression despite the use of antiretroviral medication. The somatic symptoms criteria for HIV infection and depression partially overlap, which can make differential diagnosis challenging. Because of chronic inflammation caused by HIV infection, HIV-positive patients may develop somatic and affective-cognitive symptoms of depression. Inflammation-related depression is primarily characterized with severe somatic symptoms such ...

Symptom Dimensions of Anxiety Following Myocardial Infarction : Associations With Depressive Symptoms and Prognosis

NARCIS (Netherlands)

Roest, Annelieke M.; Heideveld, Anne; Martens, Elisabeth J.; de Jonge, Peter; Denollet, Johan

2014-01-01

Objective: Differential associations of symptom dimensions with prognosis in myocardial infarction (MI) patients have been shown for depression, but no studies have focused on anxiety dimensions. The aim of this study was to assess the association between somatic and psychological symptoms of

The relationship between early changes in the HAMD-17 anxiety/somatization factor items and treatment outcome among depressed outpatients.

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Farabaugh, Amy; Mischoulon, David; Fava, Maurizio; Wu, Shirley L; Mascarini, Alessandra; Tossani, Eliana; Alpert, Jonathan E

2005-03-01

The 17-item Hamilton Rating Scale for Depression (HAMD-17) Anxiety/Somatization factor includes six items: Anxiety (psychic), Anxiety (somatic), Somatic Symptoms (gastrointestinal), Somatic Symptoms (general), Hypochondriasis and Insight. This study examines the relationship between early changes (defined as those observed between baseline and week 1) in these HAMD-17 Anxiety/Somatization Factor items and treatment outcome among major depressive disorder (MDD) patients who participated in a study comparing the antidepressant efficacy of a standardized extract of hypericum with both placebo and fluoxetine. Following a 1-week, single-blind washout, patients with MDD diagnosed by the Structured Clinical Interview for DSM-IV (SCID) were randomized to 12 weeks of double-blind treatment with hypericum extract (900 mg/day), fluoxetine (20 mg/day) or placebo. The relationship between early changes in HAMD-17 anxiety/somatization factor items and treatment outcome was assessed separately for patients who received study treatment (hypericum or fluoxetine) versus placebo with a logistic regression method. One hundred and thirty-five patients (female 57%, mean age=37.3+/-11.0 years; mean baseline HAMD-17=19.7+/-3.2 years) were randomized to double-blind treatment and were included in the intent-to-treat (ITT) analyses. After adjusting for baseline HAMD-17 scores and for multiple comparisons with the Bonferroni correction, patients who remitted (HAMD-17 score Somatic Symptoms (General) scores than non-remitters. No other significant differences in early changes were noted for the remaining items between remitters versus non-remitters who received active treatment. For patients treated with placebo, early change was not predictive of remission for any of the items after Bonferroni correction. In conclusion, the presence of early improvement on the HAMD-17 item concerning fatigue and general somatic symptoms is significantly predictive of achieving remission at endpoint with

Health status and productive performance of somatic cell cloned cattle and their offspring produced in Japan.

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Watanabe, Shinya; Nagai, Takashi

2008-02-01

Since the first somatic cell cloned calves were born in Japan in 1998, more than 500 cloned cattle have been produced by somatic cell nuclear transfer and many studies concerning cloned cattle and their offspring have been conducted in this country. However, most of the results have been published in Japanese; thus, the data produced in this country is not well utilized by researchers throughout the world. This article reviews the 65 reports produced by Japanese researchers (62 written in Japanese and 3 written in English), which employed 171 clones and 32 offspring, and categorizes them according to the following 7 categories: (1) genetic similarities and muzzle prints, (2) hematology and clinical chemistry findings, (3) pathology, (4) growth performance, (5) reproductive performance, (6) meat production performance and (7) milk production performance. No remarkable differences in health status or reproductive performance were found among conventionally bred cattle, somatic cell cloned cattle surviving to adulthood and offspring of somatic cell cloned cattle. Similarities in growth performance and meat quality were observed between nuclear donor cattle and their clones. The growth curves of the offspring resembled those of their full siblings.

Psychological distress longitudinally mediates the effect of vertigo symptoms on vertigo-related handicap.

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Probst, Thomas; Dinkel, Andreas; Schmid-Mühlbauer, Gabriele; Radziej, Katharina; Limburg, Karina; Pieh, Christoph; Lahmann, Claas

2017-02-01

Vertigo symptoms can lead to more or less vertigo-related handicap. This longitudinal study investigated whether depression, anxiety, and/or somatization mediate the relationship between vertigo symptoms and vertigo-related handicap. N=111 patients with vertigo/dizziness provided complete data on the following measures: Vertigo symptoms at baseline, depression at 6-month follow-up, anxiety at 6-month follow-up, somatization at 6-month follow-up, and vertigo handicap at 12-month follow-up. Mediation analyses with bootstrapping were performed to investigate the mediating role of anxiety, depression, and somatization in the relationship between vertigo symptoms and vertigo-related handicap. When the mediating role of anxiety, depression, and somatization was evaluated separately from each other in single mediation models, the effect vertigo symptoms at baseline exerted on vertigo-related handicap at 12-month follow-up was significantly mediated by depression at 6-month follow-up (pvertigo symptoms at baseline on vertigo-related handicap at 12-month follow-up (pvertigo symptoms lead to vertigo-related handicap. Copyright © 2016 Elsevier Inc. All rights reserved.

DSM-IV-TR "pain disorder associated with psychological factors" as a nonhysterical form of somatization.

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Aragona, Massimiliano; Tarsitani, Lorenzo; De Nitto, Serena; Inghilleri, Maurizio

2008-01-01

Elevated Minnesota Multiphasic Personality Inventory (MMPI) scores on the hysteria (Hy) scale are reported in several forms of pain. Previous results were possibly biased by diagnostic heterogeneity (psychogenic, somatic and mixed pain syndromes included in the same index sample) or Hy heterogeneity (failure to differentiate Hy scores into clinically meaningful subscales, such as admission of symptoms [Ad] and denial of symptoms [Dn]). To overcome this drawback, 48 patients diagnosed as having a Diagnostic and Statistical Manual of Mental Disorders, 4th edn, Text Revision (DSM-IV-TR) diagnosis of "pain disorder associated with psychological factors" were compared with 48 patients experiencing somatic pain excluding psychological factors, and 42 somatic controls without pain. MMPI Hy and hypochondriasis (Hs) scores were significantly higher in the pain disorder group than in control groups, who scored similarly. MMPI correction (K) scores and Dn scores were similar in the three groups, whereas Ad was significantly higher in the pain disorder group and lower and similar in the two control groups, respectively. In the pain disorder group, Ad and Dn were negatively correlated, whereas in control groups they were unrelated. These findings suggest that whereas a pattern of high Hs and Hy scores together with a normal K score might characterize patients with a pain disorder associated with psychological factors, elevated Hy scores per se do not indicate hysterical traits. In the pain disorder group, elevated Hy scores reflected the Ad subscale alone, indicating a strikingly high frequency of distressing somatic symptoms. They tend not to repress or deny the emotional malaise linked to symptoms, as the hysterical construct expects. The pain disorder designation should be considered a nonhysterical form of somatization.

Symptom profile of depression in elderly: Is assessment with geriatric depression rating scale enough?

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Aseem Mehra

2017-01-01

Full Text Available Aim of the Study: This study aimed to evaluate the symptom profile, including somatic symptoms among elderly patients with first episode depression using the Geriatric depression scale (GDS-30 and Patient Health Questionnaire-15 (PHQ-15 items version scale. Additional aims were to carry out the factor analysis of symptoms reported on GDS-30 and PHQ-15 among elderly. Methodology: Seventy-nine elderly patients (age ≥60 years were evaluated on GDS-30 item Hindi version and Hindi version of the PHQ-15. Results: As per GDS-30, the most common symptom noted among elderly was “dropped many of your activities and interests” (91.1%, mind not as clear as it used (88.6%, feeling that life is empty (86.1%, bothered by thoughts you cannot get out of your head (86.1% and hard to get started on new projects (86.1%, prefer to avoid social gatherings (86.1%. All patients reported at least one somatic complaint as per PHQ-15. The most common somatic symptoms were trouble sleeping (97.5%, feeling tired or having little energy (96.2%, feeling that the heart is racing (52.9%, constipation, loose bowels, or diarrhea (49.6%, shortness of breath (46.8%, nausea, gas or indigestion (45.6%, pain in the arms, legs, or joints (43.3%, and back pain (41.8%. The prevalence of somatic symptoms was not influenced to a large extent by the demographic variables, clinical variables and presence or absence of physical comorbidity. However, the severity of somatic symptoms correlated positively with GDS-30 score. Factor analysis of Hindi version of GDS-30 yielded a four-factor solution, which was similar to many studies across the world. The addition of items of PHQ-15 items of factor analysis still yielded a four-factor solution. Factor 1 of combined GDS-30 and PHQ-15 items included items only from GDS-30 and Factor 3 and 4 included items only from PHQ-15. There was some overlap of items on Factor 2. Conclusion: The present study suggests that GDS-30 does not tap all the

Hypochondriasis and somatization related to personality and attitudes toward self.

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Hollifield, M; Tuttle, L; Paine, S; Kellner, R

1999-01-01

Better definition of the boundary between hypochondriasis and somatization was determined by measuring attitudes to self and personality dimensions associated with these syndromes. In this study, the primary care patients with hypochondriacal responses (HR) on the Illness Attitudes Scales or high somatic concern (HSC) on the Symptom Questionnaire had more negative attitudes to self and more psychological distress than the matched group of primary care control subjects. The HR subjects were different from the non-HR subjects on two of five personality domains on the NEO Personality Inventory (NEO)-Five-Factor Inventory, and the HSC subjects were different from the non-HSC subjects on four of five NEO domains. Analysis of variance demonstrated that somatization explained most of the variance in attitudes, personality, and psychological distress, but hypochondriasis uniquely contributed only to thanatophobia. The authors discuss the boundary between hypochondriasis and somatization and offer a descriptive model of this relationship.

Mental health and alcohol problems among Estonian cleanup workers 24 years after the Chernobyl accident.

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Laidra, Kaia; Rahu, Kaja; Tekkel, Mare; Aluoja, Anu; Leinsalu, Mall

2015-11-01

To study the long-term mental health consequences of the 1986 Chernobyl nuclear accident among cleanup workers from Estonia. In 2010, 614 Estonian Chernobyl cleanup workers and 706 geographically and age-matched population-based controls completed a mail survey that included self-rated health, the Posttraumatic Stress Disorder Checklist (PCL), alcohol symptoms (AUDIT), and scales measuring depressive, anxiety, agoraphobia, fatigue, insomnia, and somatization symptoms. Respondents were dichotomized into high (top quartile) and low symptom groups on each measure. Logistic regression analysis detected significant differences between cleanup workers and controls on all measures even after adjustment for ethnicity, education, marital status, and employment status. The strongest difference was found for somatization, with cleanup workers being three times more likely than controls to score in the top quartile (OR = 3.28, 95% CI 2.39-4.52), whereas for alcohol problems the difference was half as large (OR = 1.52, 95% CI 1.16-1.99). Among cleanup workers, arrival at Chernobyl in 1986 (vs. later) was associated with sleep problems, somatization, and symptoms of agoraphobia. The toll of cleanup work was evident 24 years after the Chernobyl accident among Estonian cleanup workers indicating the need for focused mental health interventions.

Health Anxiety in Young Indonesian Adults: A Preliminary Study

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Venie Viktoria Rondang Maulina

2018-05-01

Full Text Available In young adulthood most people begin to realize the meaning of health. The amount of costs to be incurred for the treatment of a person when they are suffering from a disease also affects a person's health concern. According to Taylor and Asmundson (2004, most people feel anxious about their health. Anxiety about health can differ from one person to another. Through this study a general overview of health anxiety for young adults in Indonesia, especially in Jakarta, can be seen. Participants in this study consisted of 263 people, aged 20-40 years (M = 27.23 , SD = 5.50. Sociodemographic variables include ages, gender, and marital status, level of education, employment status, and ethnicity. Researcher used Short Health Anxiety Inventory (SHAI; Salkovskis, Rimes, & Warwick, 2002, Patient Health Questionnaire Somatic Symptom Severity Scale (PHQ-15; Kroenke, Spitzer, & William, 2002. For data analysis, researcher used The Pearson Product Moment Correlation. The results showed significant correlation between health anxiety and somatic symptoms.

Do early changes in the HAM-D-17 anxiety/somatization factor items affect treatment outcome among depressed outpatients? Comparison of two controlled trials of St John’s Wort (Hypericum Perforatum) versus an SSRI

Science.gov (United States)

Bitran, Stella; Farabaugh, Amy H; Ameral, Victoria E; LaRocca, Rachel A; Clain, Alisabet J; Fava, Maurizio; Mischoulon, David

2011-01-01

Objective To assess whether early changes in HAM-D-17 anxiety/somatization items predict remission in two controlled studies of hypericum perforatum (St. John’s wort) versus an SSRI for major depressive disorder (MDD). Methods The Hypericum Depression Trial Study Group (NIMH) study randomized 340 subjects to hypericum, sertraline, or placebo for 8 weeks. The MGH study randomized 135 subjects to hypericum, fluoxetine, or placebo for 12 weeks. We examined whether remission was associated with early changes in anxiety/somatization symptoms. Results In the NIMH study, significant associations were observed between remission and early improvement in the anxiety-psychic item (sertraline arm), somatic-gastrointestinal item (hypericum arm), and somatic symptoms-general (placebo arm). None of the three treatment arms of the MGH study showed significant associations between anxiety/somatization symptoms and remission. When both study samples were pooled, we found associations for anxiety-psychic (SSRI arm), somatic-gastrointestinal and hypochondriasis (hypericum arm), and anxiety-psychic and somatic symptoms-general (placebo arm). In the entire sample, remission was associated with improvement in the anxiety-psychic, somatic-gastrointestinal, and somatic symptoms-general items. Conclusions The number and type of anxiety/somatization items associated with remission varied depending on the intervention. Early scrutiny of the HAM-D-17 anxiety/somatization items may help predict remission of MDD. PMID:21278577

Italian university students' self-perceived health and satisfaction of life

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Chiara de Waure

Full Text Available INTRODUCTION: Health is defined as a state of complete physical, social and mental wellbeing, therefore, it should not be considered as simply the absence of disease. In this light, the assessment of self-perceived health and life satisfaction plays an important role as it allows addressing the subjective perception of physical health, as well as mental health and social functioning. MATERIAL AND METHODS: This study analyzed data from 8516 university students enrolled in the "Sportello Salute Giovani" project ("Youth Health Information Desk". In particular, it addressed self-perceived health and life satisfaction, reported somatic and psychological symptoms and ability to cope with daily problems of university students from 18 to 30 years old. RESULTS: Overall, 77.1% of students declared to have a good or very good health and the mean score of life satisfaction was 7.46. In respect to somatic and psychological symptoms, 25.8% of students reported to suffer almost daily of at least one among headache, stomach pain, back pain, tiredness, nervousness, dizziness and troubles falling asleep. Results varied on the basis of sex, with women showing lower self-perceived health compared to men and reporting more symptoms. Furthermore, self-perceived health was shown better in younger students and in those belonging to higher socio-economic level. DISCUSSION: The survey showed that concern exists with respect to university students' self-perceived health, which is different from that arising from other evidence. Female students had a significant lower self-perceived health and reported somatic and psychological symptoms more commonly than men. On the other hand, results about life satisfaction seem to be aligned with the literature. CONCLUSION: One of the most important implications of the study is the need to address self-perceived health and reported symptoms in university students in order to monitor them and initiate interventions aimed at improving

Activated neuro-oxidative and neuro-nitrosative pathways at the end of term are associated with inflammation and physio-somatic and depression symptoms, while predicting outcome characteristics in mother and baby.

Science.gov (United States)

Roomruangwong, Chutima; Barbosa, Decio Sabbatini; Matsumoto, Andressa Keiko; Nogueira, André de Souza; Kanchanatawan, Buranee; Sirivichayakul, Sunee; Carvalho, André F; Duleu, Sebastien; Geffard, Michel; Moreira, Estefania Gastaldello; Maes, Michael

2017-12-01

To examine oxidative & nitrosative stress (O&NS) biomarkers at the end of term in relation to perinatal affective symptoms, neuro-immune biomarkers and pregnancy-related outcome variables. We measured plasma advanced oxidation protein products (AOPP), nitric oxide metabolites (NOx), total radical trapping antioxidant parameter (TRAP), -sulfhydryl (-SH), peroxides (LOOH) and paraoxonase (PON)1 activity in pregnant women with and without prenatal depression and non-pregnant controls. Pregnancy is accompanied by significantly increased AOPP and NOx, and lowered TRAP, -SH and LOOH. Increased O&NS and lowered LOOH and -SH levels are associated with prenatal depressive and physio-somatic symptoms (fatigue, pain, dyspepsia, gastro-intestinal symptoms). Increased AOPP and NOx are significantly associated with lowered -SH, TRAP and zinc, and with increased haptoglobin and C-reactive protein levels. Increased O&NS and lowered TRAP and PON 1 activity, at the end of term predict mother (e.g. hyperpigmentation, labor duration, caesarian section, cord length, breast milk flow) and baby (e.g. sleep and feeding problems) outcome characteristics. Pregnancy is accompanied by interrelated signs of O&NS, lowered antioxidant defenses and activated neuro-immune pathways. Increased O&NS at the end of term is associated with perinatal depressive and physio-somatic symptoms and may predict obstetric and behavioral complications in mother and baby. Copyright © 2017 Elsevier B.V. All rights reserved.

Neuropsychiatric symptoms and celiac disease.

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Urban-Kowalczyk, Małgorzata; OEmigielski, Janusz; Gmitrowicz, Agnieszka

2014-01-01

Neuropsychiatric symptoms may represent an atypical manifestation of celiac disease that occur before a gastroenterological diagnosis is made. Some studies suggest that a gluten-free diet is effective in treating the depression, anxiety, and neurological complications associated with celiac disease. The article describes the case of a patient suffering from chronic, treatment-resistant symptoms of depression and anxiety. The diagnosis of celiac disease and introduction of an elimination diet caused a significant improvement in mental state and everyday functioning in the presenting patient. The presence of persistent anxiety and depressive symptoms, with a poor reaction to pharmacological treatment, indicates a need to identify somatic reasons for the underlying condition. It is important to remember that celiac disease can occur at any age, not only in childhood. The presence of this somatic cause of persistent depressive and anxiety symptoms should be considered in the diagnostic process in adults.

Symptoms, Quality of Life and level of functioning of traumatized refugees at Psychiatric Trauma Clinic in Copenhagen

DEFF Research Database (Denmark)

Buhman, Cæcilie; Mortensen, Erik Lykke; Lundstrøm, Stine

2014-01-01

with mental health were explored using linear and logistic regression and Pearson's correlation coefficients. RESULTS: Among the patients, the prevalence of depression, somatic disease, pain, psychotic symptoms co-existing with PTSD and very low level of functioning was high. Persecution, being an ex...

Interoceptive Dysfunction: Toward An Integrated Framework for Understanding Somatic and Affective Disturbance in Depression

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Harshaw, Christopher

2014-01-01

Depression is characterized by disturbed sleep and eating, a variety of other, nonspecific somatic symptoms, and significant somatic comorbidities. Why there is such close association between cognitive and somatic dysfunction in depression is nonetheless poorly understood. An explosion of research in the area of interoception—the perception and interpretation of bodily signals—over the last decade nonetheless holds promise for illuminating what have until now been obscure links between the social, cognitive-affective, and somatic features of depression. This paper reviews rapidly accumulating evidence that both somatic signaling and interoception are frequently altered in depression. This includes comparative studies showing vagus-mediated effects on depression-like behaviors in rodent models as well as studies in humans indicating both dysfunction in the neural substrates for interoception (e.g., vagus, insula, anterior cingulate cortex) and reduced sensitivity to bodily stimuli in depression. An integrative framework for organizing and interpreting this evidence is put forward which incorporates (a) multiple potential pathways to interoceptive dysfunction; (b) interaction with individual, gender, and cultural differences in interoception; and (c) a developmental psychobiological systems perspective, emphasizing likely differential susceptibility to somatic and interoceptive dysfunction across the lifespan. Combined with current theory and evidence, it is suggested that core symptoms of depression (e.g., anhedonia, social deficits) may be products of disturbed interoceptive-exteroceptive integration. More research is nonetheless needed to fully elucidate the relationship between mind, body, and social context in depression. PMID:25365763

Mental and somatic health in a non-clinical sample 10 years after a diagnosis of encopresis.

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Hultén, Ib; Jonsson, Jakob; Jonsson, Carl-Otto

2005-12-01

The aim of this study was to assess the relation between the diagnosis of encopresis at 8 and 10 years of age, and mental and somatic health 10 years later. The importance of type of encopresis (primary or secondary) at 8 years was also studied. Subjects were a non-clinical encopretic sample (N=73) and control subjects (N=75) [2]. Seven assessment variables from conscription surveys provided information about mental and somatic health status at 18 years of age. Former encopretics (n=66) did not differ significantly from the controls (n=67) at 18 years of age, although there were consistent, small negative differences. The boys who at 10 years of age had still been encopretic did not differ significantly at 18 years of age from the boys who at 10 years had recovered from encopresis, and the signs indicating the small differences varied. For former primary and secondary encopretic boys, there were two significant differences, the men in the secondary group being more often exempted from conscription than the primary group and the control cases. The results indicate that boys with non-clinical encopresis show only small, if any, mental and somatic disturbances at the beginning of adulthood. Comprehensive investigations of encopretic patients are recommended as important clinical problems, in addition to encopresis, might be present.

Mental health among older refugees: the role of trauma, discrimination, and religiousness.

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Mölsä, Mulki; Kuittinen, Saija; Tiilikainen, Marja; Honkasalo, Marja-Liisa; Punamäki, Raija-Leena

2017-08-01

The aim of this study was to examine, first, how past traumatic stress and present acculturation indices, and discrimination are associated with mental health; and, second, whether religiousness can buffer the mental health from negative impacts of war trauma. Participants were 128 older (50-80 years) Somali refugees living in Finland. They reported experiences of war trauma and childhood adversities, and filled-in questionnaires of perceived ethnic discrimination, religiousness (beliefs, attendance, and observance of Islamic faith), and symptoms of posttraumatic stress disorder (PTSD), depressive (BDI-21), psychological distress (GHQ-12), and somatization (SCL-90). Symptom-specific regression models showed that newly arrived refugees with non-permanent legal status and severe exposures to war trauma, childhood adversity, and discrimination endorsed greater PTSD symptoms, while only war trauma and discrimination were associated with depressive symptoms. Results confirmed that high religiousness could play a buffering role among older Somalis, as exposure to severe war trauma was not associated with high levels of PTSD or somatization symptoms among highly religious refugees. Health care should consider both unique past and present vulnerabilities and resources when treating refugees, and everyday discrimination and racism should be regarded as health risks.

Somatic experiencing treatment with social service workers following Hurricanes Katrina and Rita.

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Leitch, M Laurie; Vanslyke, Jan; Allen, Marisa

2009-01-01

In a disaster, social service workers are often survivors themselves.This study examines whether somatic intervention using a brief (one to two session) stabilization model now called the Trauma Resiliency Model (TRM), which uses the skills of Somatic Experiencing (SE), can reduce the postdisaster symptoms of social service workers involved in postdisaster service delivery.The study was implemented with a nonrandom sample of 142 social service workers who were survivors of Hurricanes Katrina and Rita in New Orleans and Baton Rouge, Louisiana, two to three months after the disasters. Ninety-one participants received SE/TRM and were compared with a matched comparison group of 51 participants through the use of propensity score matching. All participants first received group psychoeducation. Results support the benefits of the brief intervention inspired by SE. The treatment group showed statistically significant gains in resiliency indicators and decreases in posttraumatic stress disorder symptoms. Although psychological symptoms increased in both groups at the three to four month follow-up, the treatment group's psychological symptoms were statistically lower than those of the comparison group.

[Long-term effects of traumatic experiences on somatic and psychic complaints of German World War Two refugees].

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Fischer, C J; Struwe, J; Lemke, M R

2006-01-01

The effects of expulsion from German territories following World War Two have not been studied systematically, and little is known about long-term effects of this potentially traumatic experience. Via mail, 600 refugees from former German territories due to World War Two were asked to complete questionnaires about biographic data, somatic and psychic health (SCL-90-R questionnaire), and specific aspects related to traumatic experiences (post-traumatic stress disorder questionnaire). Of those contacted, 25% participated in the investigation. Of them, 9.8% fulfilled diagnostic criteria of post-traumatic stress disorder according to DSM IV. Only 1.8% of an age-matched control group met these criteria. Analysis of the SCL-90-R questionnaire showed higher scores for former refugees in somatic and psychic complaints than the control group. We show that expulsion following war may lead to symptoms of post-traumatic stress disorder and somatic and psychic complaints after more than 50 years. Our investigation supports the necessity of adequate care for subjects expelled from their home countries and the psychologically traumatised.

The role played by depression associated with somatic symptomatology in accounting for the gender difference in the prevalence of depression.

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Silverstein, B; Edwards, T; Gamma, A; Ajdacic-Gross, V; Rossler, W; Angst, J

2013-02-01

A variety of studies suggest the existence of a distinct phenotype of somatic depression, i.e., depression accompanied by significant somatic symptomatology. Previous research suggests that the gender difference in the prevalence of depression is primarily due to a difference in somatic depression. The aim of this study was to compare the gender difference in the prevalence of somatic depression and of depression not accompanied by significant somatic symptomatology (labelled "pure" depression) in two representative samples, the National Comorbidity Survey-Replication (NCS-R) and the Zurich Study. The gender difference in lifetime somatic depression was compared to that of pure depression based on analyses weighted back to the general population in two representative samples. The NCS-R analyses involved a narrow definition of somatic depression with items from the DSM criteria for depression--appetite, sleep, and fatigue. The analysis of the Zurich study added headaches, body image issues, and breathing difficulties to the criteria and comparison to atypical depression. In both samples, the gender difference in depressive prevalence was due to a large difference in somatic depression with other phenotypes showing little or no gender difference. The gender differences were found to be due to the somatic symptoms rather than the number of symptoms and were much larger for somatic than for atypical depression. The gender difference in the prevalence of depression results from the higher prevalence among women of a specific phenotype, somatic depression.

A population-based study of associations between current posttraumatic stress symptoms and current fatigue.

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Lerdal, Anners; Lee, Kathryn A; Rokne, Berit; Knudsen, Øistein; Wahl, Astrid K; Dahl, Alv A

2010-10-01

This study explores current experience with posttraumatic stress disorder (PTSD) symptoms and other variables (sociodemographic, mental distress, somatic morbidity, self-rated health, and quality of life [QoL]) in relation to fatigue. A representative sample of the Norwegian population (N = 3,944) was invited to participate in a mailed survey, and 1,857 (47%) returned valid responses on the questionnaire that included the Fatigue Severity Scale and the Posttraumatic Symptom Scale-10. Posttraumatic stress disorder symptoms showed a strong association with fatigue in univariate (β = .41) and multivariate analyses (β = .33). Associations between psychosocial health variables, QoL, and fatigue were confirmed. However, PTSD symptoms showed the strongest association with fatigue in the analyses. Findings need to be replicated in other population samples and in clinical samples with PTSD and fatigue.

Hypochondriasis and somatization in college women: a personal projects analysis.

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Karoly, P; Lecci, L

1993-03-01

Although the descriptive features of hypochondriasis and somatization have been widely studied, the motivational correlates (goal representations) of individuals manifesting abnormal illness patterns have not been considered. The Personal Projects Analysis method (Little, 1983) was used to contrast the health and nonhealth goals of female undergraduates. Subjects selected 10 goals for evaluation along a series of dimensions. When health pursuits alone were examined, hypochondriasis on the Minnesota Multiphasic Personality Inventory was found to correlate directly with goal appraisal dimensions subsumed by an anxiety-absorption factor and inversely with dimensions characterizing rewardingness, thus suggesting a negativity of health goal construal. Somatizers also pursued more health-related projects than did nonsomatizers; nonhealth goal cognition did not relate as strongly to hypochondriasis. Finally, using discriminant function analysis, goal representations were shown to significantly and substantially differentiate somatizers from nonsomatizers.

Psychosocial health mediates the gratitude-physical health link.

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O'Connell, Brenda H; Killeen-Byrt, Mary

2018-04-29

There is now a growing body of research demonstrating the physical health benefits of being grateful. However, research has only just began to explore the mechanisms accounting for this gratitude-health relationship. This study examines the relationship between dispositional gratitude and self-reported physical health symptoms, and explores whether this relationship is explained through reduced levels of perceived loneliness and stress. This study employed a cross-sectional design with a sample of 607 healthy adults. Serial mediation analysis revealed that the positive effect of gratitude on physical health was significantly mediated by lower reported levels of perceived loneliness and stress. These findings are important given evidence that gratitude can be cultivated, and may serve to buffer against stress and loneliness and improve somatic health symptoms in the general population.

DSM-IV-TR “pain disorder associated with psychological factors” as a nonhysterical form of somatization

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Aragona, Massimiliano; Tarsitani, Lorenzo; De Nitto, Serena; Inghilleri, Maurizio

2008-01-01

BACKGROUND: Elevated Minnesota Multiphasic Personality Inventory (MMPI) scores on the hysteria (Hy) scale are reported in several forms of pain. Previous results were possibly biased by diagnostic heterogeneity (psychogenic, somatic and mixed pain syndromes included in the same index sample) or Hy heterogeneity (failure to differentiate Hy scores into clinically meaningful sub-scales, such as admission of symptoms [Ad] and denial of symptoms [Dn]). METHODS: To overcome this drawback, 48 patients diagnosed as having a Diagnostic and Statistical Manual of Mental Disorders, 4th edn, Text Revision (DSM-IV-TR) diagnosis of “pain disorder associated with psychological factors” were compared with 48 patients experiencing somatic pain excluding psychological factors, and 42 somatic controls without pain. RESULTS: MMPI Hy and hypochondriasis (Hs) scores were significantly higher in the pain disorder group than in control groups, who scored similarly. MMPI correction (K) scores and Dn scores were similar in the three groups, whereas Ad was significantly higher in the pain disorder group and lower and similar in the two control groups, respectively. In the pain disorder group, Ad and Dn were negatively correlated, whereas in control groups they were unrelated. CONCLUSIONS: These findings suggest that whereas a pattern of high Hs and Hy scores together with a normal K score might characterize patients with a pain disorder associated with psychological factors, elevated Hy scores per se do not indicate hysterical traits. In the pain disorder group, elevated Hy scores reflected the Ad subscale alone, indicating a strikingly high frequency of distressing somatic symptoms. They tend not to repress or deny the emotional malaise linked to symptoms, as the hysterical construct expects. The pain disorder designation should be considered a nonhysterical form of somatization. PMID:18301811

The impact of abuse and mood on bowel symptoms and health-related quality of life in irritable bowel syndrome (IBS).

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Kanuri, N; Cassell, B; Bruce, S E; White, K S; Gott, B M; Gyawali, C P; Sayuk, G S

2016-10-01

Irritable bowel syndrome (IBS) is a common abdominal pain disorder without an organic explanation. Abuse histories (physical, sexual, emotional) are prevalent in IBS. While abuse relates to mood disorders (depression and anxiety) also common in IBS, the influence of abuse on gastrointestinal (GI) symptoms and health-related quality of life (HRQOL) and its independence from psychological symptom comorbidity has not been studied. Consecutive GI outpatients completed the ROME III Research Diagnostic Questionnaire and questionnaires on trauma (Life-Stress Questionnaire), mood (Beck Depression/Anxiety Inventories), somatic symptoms (PHQ-12), and HRQOL (SF-36). Current GI symptom severity and bother were assessed using 10-cm Visual Analog Scales. 272 ROME-defined IBS (47.6 ± 0.9 years, 81% female) and 246 non-FGID (51.6 ± 1.0 years, 65% female) subjects participated. IBS patients reported greater rates of physical, sexual, and emotional abuse (p IBS with abuse. Abuse effects were additive, with greater IBS symptom severity and poorer HRQOL noted in cases with multiple forms of abuse. Mediation analyses suggested that abuse effects on GI symptoms and HRQOL were partially mediated by mood. Abuse experiences common among IBS sufferers are associated with reports of greater GI symptoms and poorer HRQOL, particularly in those with multiple forms of abuse; this relationship may be partially mediated by concomitant mood disturbances. © 2016 John Wiley & Sons Ltd.

Depressive symptoms and symptoms of post-traumatic stress disorder in women after childbirth.

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Zaers, Stefanie; Waschke, Melanie; Ehlert, Ulrike

2008-03-01

This study examined the course of psychological problems in women from late pregnancy to six months postpartum, the rates of psychiatric, especially depressive and post-traumatic stress symptoms and possible related antecedent variables. During late pregnancy, one to three days postpartum, six weeks and six months postpartum, 47 of the 60 participating women completed a battery of questionnaires including the General Health Questionnaire, the State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, and the PTSD Symptom Scale. In general, most women recovered from psychiatric and somatic problems over the period of investigation. However, depressive and post-traumatic stress symptoms in particular were not found to decline significantly. Six weeks postpartum, 22% of the women had depressive symptoms, with this figure remaining at 21.3% six months postpartum. In addition, 6% of the women studied reported clinically significant PTSD symptoms at six weeks postpartum with 14.9% reporting such symptoms at six months postpartum. The most important predictor for depressive and post-traumatic stress symptoms was the block variable "anxiety in late pregnancy". Other predictors were the variables "psychiatric symptoms in late pregnancy", "critical life events" and the "experience of delivery". The results of our study show a high prevalence rate of psychiatric symptoms in women after childbirth and suggest, besides the experience of the delivery itself, a vulnerability or predisposing history that makes the development of psychiatric symptoms after childbirth more probable.

An experiential mind-body approach to the management of medically unexplained symptoms.

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Bakal, D; Steiert, M; Coll, P; Schaefer, J

2006-01-01

This article outlines an experiential mind-body framework for understanding and treating patients with medically unexplained symptoms. The model relies on somatic awareness, a normal part of consciousness, to resolve the mind-body dualism inherent in conventional multidisciplinary approaches. Somatic awareness represents a guiding healing heuristic which allows for a linear treatment application of the biopsychosocial model. The heuristic acknowledges the validity of the patient's physical symptoms and identifies psychological and social factors needed for the healing process. Somatic awareness is used to direct changes in coping styles, illness beliefs, medication dependence and personal dynamics that are necessary to achieve symptom control. The mind-body concept is consistent with and supported by neurobiological models which draw on central nervous system mechanisms to explain medically unexplained symptoms. The concept is also supported by a recent hypothesis concerning the role peripheral connective tissue may play in influencing illness and well-being. Finally, somatic awareness is described as having potential to enhance understanding and conscious use of inner healing mechanisms at the basis of the placebo effect.

Menopause characteristics and subjective symptoms in women with and without spinal cord injury.

Science.gov (United States)

Kalpakjian, Claire Z; Quint, Elisabeth H; Bushnik, Tamara; Rodriguez, Gianna M; Terrill, Melissa Sendroy

2010-04-01

To examine menopause transition characteristics and symptom bother in women with spinal cord injury (SCI). Prospective cohort (4 data collection periods across 4 years). Community. Women (n=62) with SCI (injury levels C6-T12, nonambulatory, >36mo postinjury; 86.1% retention) and women without SCI (n=66; 92.9% retention) with intact ovaries, not using hormone therapy, and between the ages of 45 and 60 years volunteered. A total of 505 observations were collected and analyzed. None. Age at final menstrual period (FMP), transitions through menopause status classifications, and menopause symptom bother (vasomotor, somatic, psychologic symptoms). The number of women transitioning through a menopause status classification over the course of the study did not significantly vary by group (P=.263), nor did age at FMP (P=.643). Women with SCI experienced greater bother of somatic symptoms (a subscale, P<.001), bladder infections (P<.001), and diminished sexual arousal (P=.012). Women without SCI had significantly greater bother of vasomotor symptoms (P=.020). There were no significant group by menopause status interactions; main effects for menopause status were significant only for vasomotor symptoms and vaginal dryness. Results suggested that women with SCI experience greater symptom bother in certain areas, but that patterns of symptom bother across menopause, transition through menopause, and age at FMP are similar to those of their peers. Larger studies are needed to examine menopause outcomes with respect to level of injury and completeness of injury. These findings provide a framework that women with SCI and their health care providers can use to address the menopause transition and highlight the importance of multidisciplinary involvement to maximize health and well being during this transition. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Relación entre la depresión, la ansiedad y los síntomas psicosomáticos en una muestra de estudiantes universitarios del norte de México The relationship among depression, anxiety, and somatic symptoms in a sample of university students in northern Mexico

Directory of Open Access Journals (Sweden)

Mónica Teresa González Ramírez

2009-02-01

northern Mexico. METHODS: An exploratory study was conducted through self-administered questionnaires applied to a convenience sample of 506 psychology students at two universities in Monterrey, in the state of Nuevo León, Mexico. To evaluate somatic symptoms, the Patient Health Questionnaire was used; for depression, the Beck Depression Inventory; and for anxiety, the Social Anxiety Scale for Adolescents. Spearman's correlation was used to determine to what extent the associations among the variables were significant. The Kruskal-Wallis test was used to compare anxiety and depression levels between groups of students organized by severity of somatic symptoms. RESULTS: Of the participants, 129 (25.5% presented somatic symptoms that were of medium intensity or severe; just 4 (0.8% had severe depression; and only 2 (0.4% students presented anxiety levels over 75% of the scale maximum. The severity of somatic symptoms increased in step with anxiety and depression levels. The somatic symptoms occurring most frequently and of greatest concern among the study sample were: headache, menstrual pain, and backache, as well as feeling tired and having difficulty sleeping. CONCLUSIONS: The direct association between the severity of somatic symptoms and depression and anxiety was confirmed. It is recommended that all treatment and/or prevention programs addressing one of these conditions, include the other two as well. Programs specifically aimed at university youth should be implemented.

Separate and joint effects of physical and mental health on participation of people with somatic chronic illness.

NARCIS (Netherlands)

Jansen, D.L.; Rijken, M.

2011-01-01

Aim: To examine the extent to which people with a somatic chronic illness participate in paid jobs, volunteer work, informal care and social activities, and to investigate the separate and joint effects of physical and mental health on participation. Background. Compared with healthy people, people

Fecal Incontinence in Adolescents Is Associated With Child Abuse, Somatization, and Poor Health-related Quality of Life

NARCIS (Netherlands)

Rajindrajith, Shaman; Devanarayana, Niranga Manjuri; Benninga, Marc Alexander

2016-01-01

The aim of this study was to evaluate the association between fecal incontinence (FI), child abuse, somatization, and health-related quality of life (HRQoL) in adolescents. Adolescents (ages 13-18 years) were selected from 4 semi-urban schools in the Gampaha district, Sri Lanka. A validated,

Physical "phantasies" and family functions: overcoming the mind/body dualism in somatization.

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Redekop, F; Stuart, S; Mertens, C

1999-01-01

In this article, we examine some of the ways in which family therapists have conceptualized the experience of illness of unexplained physical origin. We argue that opinions about the etiology of somatic symptoms should not be the primary focus of therapeutic work with people who share the prototypical characteristics of what has been defined as "somatization disorder." We suggest that current research in neurobiology can expand the linguistic resources of clinicians and help them avoid perpetuating unhelpful dichotomies between the mind and the body.

A-MUPS score to differentiate patients with somatic symptom disorder from those with medical disease for complaints of non-acute pain

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Suzuki S

2017-06-01

Full Text Available Shingo Suzuki, Yoshiyuki Ohira, Kazutaka Noda, Masatomi Ikusaka Department of General Medicine, Chiba University Hospital, Chiba, Japan Purpose: To develop a clinical score to discriminate patients with somatic symptom disorder (SSD from those with medical disease (MD for complaints of non-acute pain.Methods: We retrospectively examined the clinical records of consecutive patients with pain for a duration of ≥1 month in our department from April 2003 to March 2015. We divided the subjects according to the diagnoses of definite SSD (as diagnosed and tracked by psychiatrists in our hospital, probable SSD (without evaluation by psychiatrists in our hospital, matched MD (randomly matched two patients by age, sex, and pain location for each definite SSD patient, unmatched MD, other mental disease, or functional somatic syndrome (FSS. We investigated eight clinical factors for definite SSD and matched MD, and developed a diagnostic score to ­identify SSD. We subsequently validated the model with cases of probable SSD and unmatched MD.Results: The number of patients with definite SSD, probable SSD, matched MD, unmatched MD, other mental disease, and FSS was 104 (3.5%, 214 (7.3%, 197 (6.7%, 742 (25%, 708 (24%, and 978 (33%, respectively. In a conditional logistic regression analysis, the following five factors were included as independent predictors of SSD: Analgesics ineffective, Mental disorder history, Unclear provocative/palliative factors, Persistence without cessation, and Stress feelings/episodes (A-MUPS. The area under the receiver operating characteristic curve (AUC of the model was 0.900 (95% CI: 0.864–0.937, p<0.001, and the McFadden’s pseudo-R-squared was 0.709. For internal validation, the AUC between probable SSD and unmatched MD was 0.930 (95% CI: 0.910–0.950, p<0.001. The prevalence and the likelihood ratio of SSD increased as the score increased.Conclusion: The A-MUPS score was useful for discriminating patients with SSD from

Psychosocial employment characteristics and postpartum maternal mental health symptoms.

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Schwab-Reese, Laura M; Ramirez, Marizen; Ashida, Sato; Peek-Asa, Corinne

2017-01-01

For new mothers returning to work, the role of the workplace psychosocial environment on maternal mental health has not been fully described. The purpose of this study was to identify the relationship between psychosocial employment characteristics and mothers' postpartum depression, anxiety, and stress symptoms. Ninety-seven women answered survey questions regarding employment, job demand, control, and support, and postpartum depression, anxiety, and stress symptoms soon after live birth and 6 months later. Working and nonworking mothers reported similar mental health symptoms. Psychological characteristics of employment were not associated with increased odds of mental health symptoms. Increased social support provided by coworkers, supervisors, and the organization was associated with reduced odds of anxiety symptoms. Our findings identified lack of workplace social support as a modifiable risk factor for postpartum anxiety. Future evaluations of workplace social support interventions may be explored to improve postpartum mental health symptoms. Am. J. Ind. Med. 60:109-120, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Cost-utility of a specific collaborative group intervention for patients with functional somatic syndromes.

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Konnopka, Alexander; König, Hans-Helmut; Kaufmann, Claudia; Egger, Nina; Wild, Beate; Szecsenyi, Joachim; Herzog, Wolfgang; Schellberg, Dieter; Schaefert, Rainer

2016-11-01

Collaborative group intervention (CGI) in patients with functional somatic syndromes (FSS) has been shown to improve mental quality of life. To analyse incremental cost-utility of CGI compared to enhanced medical care in patients with FSS. An economic evaluation alongside a cluster-randomised controlled trial was performed. 35 general practitioners (GPs) recruited 300 FSS patients. Patients in the CGI arm were offered 10 group sessions within 3months and 2 booster sessions 6 and 12months after baseline. Costs were assessed via questionnaire. Quality adjusted life years (QALYs) were calculated using the SF-6D index, derived from the 36-item short-form health survey (SF-36). We calculated patients' net-monetary-benefit (NMB), estimated the treatment effect via regression, and generated cost-effectiveness acceptability curves. Using intention-to-treat analysis, total costs during the 12-month study period were 5777EUR in the intervention, and 6858EUR in the control group. Controlling for possible confounders, we found a small, but significant positive intervention effect on QALYs (+0.017; p=0.019) and an insignificant cost saving resulting from a cost-increase in the control group (-10.5%; p=0.278). NMB regression showed that the probability of CGI to be cost-effective was 69% for a willingness to pay (WTP) of 0EUR/QALY, increased to 92% for a WTP of 50,000EUR/QALY and reached the level of 95% at a WTP of 70,375EUR/QALY. Subgroup analyses yielded that CGI was only cost-effective in severe somatic symptom severity (PHQ-15≥15). CGI has a high probability to be a cost-effective treatment for FSS, in particular for patients with severe somatic symptom severity. Copyright © 2016 Elsevier Inc. All rights reserved.

What characterizes individuals developing chronic whiplash?: The Nord-Trøndelag Health Study (HUNT).

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Myrtveit, Solbjørg Makalani; Wilhelmsen, Ingvard; Petrie, Keith J; Skogen, Jens Christoffer; Sivertsen, Børge

2013-05-01

Most individuals experiencing whiplash accidents recover rapidly. A considerable proportion, however, develop chronic symptoms. Psychological factors may slow recovery, possibly by increasing the likelihood of other symptoms being misattributed to, and amplified by the whiplash injury. We aimed to investigate how pre-injury mental and somatic symptoms, self-rated health, use of health-services and medications, health-behavior and socio-demographics predict the development of chronic whiplash. Data from two waves of a large, population based study (HUNT2 (baseline) and HUNT3) were used. Individuals reporting no whiplash at baseline were identified in HUNT3. Characteristics reported at baseline were compared between those who had developed chronic whiplash in HUNT3 (n=199) and those who had not (n=20,600), using Pearson's chi-squared tests, independent sample t-tests and logistic regression analyses. Individuals developing chronic whiplash reported worse baseline health than those reporting no chronic whiplash. Poor self-rated health was a strong risk factor for subsequent chronic whiplash (OR=2.26, 95%CI: 1.68-3.04). Musculoskeletal pain also increased the risk (OR=1.21, 95%CI: 1.15-1.26), as did diffuse somatic symptoms (OR=2.09, 95%CI: 1.47-2.96), use of different health services (OR=1.31, 95%CI: 1.19-1.45), high use of medications (OR=1.28, 95%CI: 1.14-1.43) and symptoms of anxiety (OR=1.93, 95%CI: 1.39-2.68). Physical activity was protective (OR=0.67, 95%CI: 0.49-0.91). Most socio-demographic variables were not significantly associated with chronic whiplash. Poor somatic and mental pre-injury health increased the risk of subsequent chronic whiplash. This suggests that chronic whiplash is not merely an organic disorder, and highlights the importance of individual expectations, symptom reattribution and amplification in development of chronic whiplash. Copyright © 2013 Elsevier Inc. All rights reserved.

Mental Wellbeing and Self-reported Symptoms of Reproductive Tract Infections among Girls

Directory of Open Access Journals (Sweden)

Sushama A. Khopkar

2017-12-01

Full Text Available This study examined the self-reported mental wellbeing among slum-dwelling adolescents in Western India and asked whether adolescent postmenarcheal girls’ mental wellbeing and self-reported symptoms suggestive of reproductive tract infections (RTIs were associated. A sub-section of a cross-sectional personal interview survey among unmarried 10–18-year-old adolescents (n= 85 in a slum in the city of Nashik was analyzed. Logistic regression models were used to assess the associations between sociodemographic variables, physical health indicators, and adolescent postmenarcheal girls’ mental wellbeing. Nearly every other postmenarcheal girl reported having experienced symptoms suggestive of RTIs during the last twelve months. Adolescent postmenarcheal girls’ mental health and some aspects of somatic health appear to be closely interrelated. Understanding the relationship between adolescent mental wellbeing and reproductive health in low-income countries requires further investigation. Health service development in growing informal urban agglomerations in India and beyond should provide combined mental and reproductive health services for adolescents.  

Introducing a psychological agenda for understanding somatic symptoms--an area of conflict for clinicians in relation to patients in a multicultural community.

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Bäärnhielm, Sofie; Ekblad, Solvig

2008-09-01

Culturally capable care requires that clinicians possess insights into patients' reasoning about illness. It is universally common for emotional distress to be expressed in terms of somatic symptoms. Converting meanings of illness from a somatic to a psychological agenda for understanding distress may be complicated for patients. Objectives of this study were to explore (a) professionals' experiences of encountering patients who use a bodily idiom for emotional distress in a multicultural milieu and their ascriptions of meaning and (b) how professionals impart their agenda of illness meaning to patients. Data were collected by seven focus-group interviews with professionals working in a multicultural suburban area of Stockholm, Sweden, and analyzed in two steps. The first step was content analysis. The second step was an inductive analysis with a revised grounded theory approach. Results showed that the caregivers stressed the importance of constructing a working alliance with the patient. With few exceptions, this did not include a patient-centered approach by the staff for exploring patients' perspectives and understandings of illness. Current knowledge about the importance of gaining insights into patients' perspectives was not implemented. Results of this study point to the importance of implementing new knowledge and according priority to research on the outcomes of that implementation.

Returning to the "homeland": work-related ethnic discrimination and the health of Japanese Brazilians in Japan.

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Asakura, Takashi; Gee, Gilbert C; Nakayama, Kazuhiro; Niwa, Sayuri

2008-04-01

We investigated whether self-reported ethnic discrimination in the workplace was associated with well-being among Japanese Brazilians who had returned to Japan. Further, we examined interactions between discrimination and education on well-being. We obtained data from a cross-sectional survey of Japanese Brazilian workers (n = 313) conducted in 2000 and 2001. Outcomes were self-rated health, psychological symptoms as measured by the 12-item General Health Questionnaire (GHQ-12) score, and a checklist of somatic symptoms. Reports of ethnic discrimination were associated with increased risk of poor self-rated health and psychological symptoms (GHQ-12 score), after we controlled for self-assessed workload, supportive relations at work, physically dangerous working conditions, workplace environmental hazards, shift work, number of working hours, age, gender, marital status, income, education, Japanese lineage, length of residence, and Japanese language proficiency. Further, the relationship between discrimination and self-rated health and somatic symptoms was most robust for those with the least education. Ethnic discrimination appears to be a correlate of morbidity among Japanese Brazilian migrants. Future research should investigate how educational and workplace interventions may reduce discrimination and possibly improve health.

Are Cardiac Autonomic Nervous System Activity and Perceived Stress Related to Functional Somatic Symptoms in Adolescents? The TRAILS Study.

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Karin A M Janssens

Full Text Available Stressors have been related to medically insufficiently explained or functional somatic symptoms (FSS. However, the underlying mechanism of this association is largely unclear. In the current study, we examined whether FSS are associated with different perceived stress and cardiac autonomic nervous system (ANS levels during a standardized stressful situation, and whether these associations are symptom-specific.We examined 715 adolescents (16.1 years, 51.3% girls from the Dutch cohort study Tracking Adolescents' Individual Lives Sample during the Groningen Social Stress Test (GSST. FSS were assessed by the Youth Self-Report, and clustered into a cluster of overtiredness, dizziness and musculoskeletal pain and a cluster of headache and gastrointestinal symptoms. Perceived stress levels (i.e. unpleasantness and arousal were assessed by the Self-Assessment Manikin, and cardiac ANS activity by assessing heart rate variability (HRV-HF and pre-ejection period (PEP. Perceived stress and cardiac ANS levels before, during, and after the GSST were studied as well as cardiac ANS reactivity. Linear regression analyses were used to examine the associations.Perceived arousal levels during (beta = 0.09, p = 0.04 and after (beta = 0.07, p = 0.047 the GSST, and perceived unpleasantness levels before (beta = 0.07, p = 0.048 and during (beta = 0.12, p = 0.001 the GSST were related to FSS during the past couple of months. The association between perceived stress and FSS was stronger for the FSS cluster of overtiredness, dizziness and musculoskeletal pain than for the cluster of headache and gastrointestinal symptoms. Neither ANS activity levels before, during, and after the GSST, nor maximal HF-HRV and PEP reactivity were related to FSS.This study suggests that perceived stress levels during social stress are related to FSS, whereas cardiac ANS activity and reactivity are not related to FSS.

The association between herpes virus infections and functional somatic symptoms in a general population of adolescents. The TRAILS study.

Directory of Open Access Journals (Sweden)

Iris Jonker

Full Text Available FSS have been suggested to follow activation of the immune system, triggered by herpes virus infections. The aim of this study was to find out whether herpes virus infections were associated with the experience of FSS in adolescents, and whether this association was mediated by hsCRP, as a general marker of immune activation.This study was performed in TRAILS, a large prospective population cohort of 2230 adolescents (mean age: 16.1 years, SD = .66, 53.4% girls. FSS were assessed using the somatic complaints subscale of the Youth Self-Report. FSS were analyzed as total scores and divided in two group clusters based on previous studies in this cohort. Levels of hsCRP and antibody levels to the herpes viruses HSV1, HSV2, CMV, EBV and HHV6 were assessed in blood samples at age 16. Also a value for pathogen burden was created adding the number of viruses the adolescents were seropositive for. Multiple regression analysis with bootstrapping was used to analyze the association between viral antibodies and pathogen burden, hsCRP and FSS scores.Antibody levels and pathogen burden were not associated with FSS total scores or FSS scores in both symptom groups. hsCRP was associated with the total FSS score (B = .02, 95% CI: .004 to .028, p = .01 and FSS score in the symptom group of headache and gastrointestinal complaints (B = .02, 95% CI: .001 to .039, p = .04.Our study showed no association between herpes virus infections and FSS in general or specific FSS symptom clusters. A role for inflammatory processes in FSS development was supported by the significant association we found between hsCRP levels and FSS, especially in the symptom group of headache and gastrointestinal complaints.

The association between herpes virus infections and functional somatic symptoms in a general population of adolescents. The TRAILS study.

Science.gov (United States)

Jonker, Iris; Schoevers, Robert; Klein, Hans; Rosmalen, Judith

2017-01-01

FSS have been suggested to follow activation of the immune system, triggered by herpes virus infections. The aim of this study was to find out whether herpes virus infections were associated with the experience of FSS in adolescents, and whether this association was mediated by hsCRP, as a general marker of immune activation. This study was performed in TRAILS, a large prospective population cohort of 2230 adolescents (mean age: 16.1 years, SD = .66, 53.4% girls). FSS were assessed using the somatic complaints subscale of the Youth Self-Report. FSS were analyzed as total scores and divided in two group clusters based on previous studies in this cohort. Levels of hsCRP and antibody levels to the herpes viruses HSV1, HSV2, CMV, EBV and HHV6 were assessed in blood samples at age 16. Also a value for pathogen burden was created adding the number of viruses the adolescents were seropositive for. Multiple regression analysis with bootstrapping was used to analyze the association between viral antibodies and pathogen burden, hsCRP and FSS scores. Antibody levels and pathogen burden were not associated with FSS total scores or FSS scores in both symptom groups. hsCRP was associated with the total FSS score (B = .02, 95% CI: .004 to .028, p = .01) and FSS score in the symptom group of headache and gastrointestinal complaints (B = .02, 95% CI: .001 to .039, p = .04). Our study showed no association between herpes virus infections and FSS in general or specific FSS symptom clusters. A role for inflammatory processes in FSS development was supported by the significant association we found between hsCRP levels and FSS, especially in the symptom group of headache and gastrointestinal complaints.

Symptom dimensions of affective disorders in migraine patients.

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Louter, M A; Pijpers, J A; Wardenaar, K J; van Zwet, E W; van Hemert, A M; Zitman, F G; Ferrari, M D; Penninx, B W; Terwindt, G M

2015-11-01

A strong association has been established between migraine and depression. However, this is the first study to differentiate in a large sample of migraine patients for symptom dimensions of the affective disorder spectrum. Migraine patients (n=3174) from the LUMINA (Leiden University Medical Centre Migraine Neuro-analysis Program) study and patients with current psychopathology (n=1129), past psychopathology (n=477), and healthy controls (n=561) from the NESDA (Netherlands Study of Depression and Anxiety) study, were compared for three symptom dimensions of depression and anxiety. The dimensions -lack of positive affect (depression specific); negative affect (nonspecific); and somatic arousal (anxiety specific)- were assessed by a shortened adaptation of the Mood and Anxiety Symptom Questionnaire (MASQ-D30). Within the migraine group, the association with migraine specific determinants was established. Multivariate regression analyses were conducted. Migraine patients differed significantly (pmigraine patients were predominantly similar to the past psychopathology group. For the somatic arousal dimension, migraine patients scores were more comparable with the current psychopathology group. Migraine specific determinants for high scores on all dimensions were high frequency of attacks and cutaneous allodynia during attacks. This study shows that affective symptoms in migraine patients are especially associated with the somatic arousal component. Copyright © 2015 Elsevier Inc. All rights reserved.

Do Exercisers With Musculoskeletal Injuries Report Symptoms of Depression and Stress?

DEFF Research Database (Denmark)

Lichtenstein, Mia Beck; Gudex, Claire; Andersen, Kjeld

2018-01-01

on somatic symptoms. OBJECTIVE: The primary aim of this study was to estimate the prevalence of depression and emotional stress, and measure self-rated health in regular exercisers presenting to a sports medicine clinic with musculoskeletal injury. The secondary aim was to identify psychosocial factors...... associated with depression in injured exercisers and the potential need for psychological counselling. DESIGN: A cross-sectional survey study. SETTING: A sports medicine clinic for injuries of the foot, knee, or shoulder. PARTICIPANTS: Regular exercisers with present injuries (n=694) and exercisers without...... completed the Major Depression Inventory (MDI), Perceived Stress Scale (PSS), health-related quality of life (EQ-5D-5L), and questions on sociodemographics, exercise habits, and injury history. RESULTS: Symptoms of depression were reported by 12% of injured exercisers and 5% of non-injured controls (p

Asthma Symptoms in Early Childhood: A public health perspective

NARCIS (Netherlands)

E.H.D. Hafkamp-De Groen (Esther)

2014-01-01

markdownabstract__Abstract__ This thesis focuses on asthma symptoms in early childhood. From a public health perspective, we aim to improve health and health-related quality of life through the prevention of asthma symptoms and by signaling, counselling or management of children who are at a high

Role of the body self and self-esteem in experiencing the intensity of menopausal symptoms.

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Włodarczyk, Małgorzata; Dolińska-Zygmunt, Grażyna

2017-10-29

The aim of the study was to test differences in self-esteem and strength of the body self, body image, comfort with closeness with others and body protection among women reporting high and low intensity of psychological, vasomotor and somatic symptoms of menopause. The sample included 201 women aged 45-55 years. The Menopause Symptom List was used to test the intensity of menopausal symptoms, the Body Self Questionnaire was used to diagnose the body self, and the Rosenberg Self-Esteem Scale was used to examine participants'levels of self-esteem. Differences between women experiencing high and low intensity of symptoms were analyzed using Student's t-test for independent samples. Women experiencing high-intensity psychological, vasomotor and somatic symptoms of menopause showed significantly lower self-esteem and poorer body-self functioning in all its dimensions except for body protection. Women experiencing high-intensity psychological, vasomotor and somatic symptoms of menopause demonstrated poorer functioning of the body self and lower self-esteem.

'I'm more sick than my doctors think': ethical issues in managing somatization in developing countries.

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Chandra, Prabha S; Satyanarayana, Veena A

2013-02-01

Several ethical issues confront the healthcare professional who is managing somatization in developing countries where cost constraints, low literacy, poverty, poor nutrition and infections and inadequate access to healthcare are common. The paper discusses these in the context of the ethical principles of autonomy, beneficence, non-maleficence and justice. Some of the ethical issues in managing somatization include being influenced by patient distress rather than rational medical decision-making, inadequate attention to the cultural meaning of symptoms, psychologizing versus medicalizing, the ethics of nomenclature and labels, communicating ethically with patients, and managing them adequately given lack of evidence and training. An ethical approach to managing somatization in this context would include using an integrated and simultaneous medical and psychiatric approach. To ensure patient beneficence, the medical, psychological and social assessment should be undertaken side-by-side as much as possible and should be cost effective. Respecting patient autonomy by using adequate communication methods and the patient's cultural model of the illness as part of management is also integral to ethical practice. In the developing world, issues of equity are also an important ethical concern. When more serious illnesses are the health priority, functional syndromes may not get equal importance or resources.

Morningness-eveningness and depressive symptoms: Test on the components level with CES-D in Polish students.

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Jankowski, Konrad S

2016-05-15

The study aimed to elucidate previously observed associations between morningness-eveningness and depressive symptomatology in university students. Relations between components of depressive symptomatology and morningness-eveningness were analysed. Nine hundred and seventy-four university students completed Polish versions of the Centre for Epidemiological Studies - Depression scale (CES-D; Polish translation appended to this paper) and the Composite Scale of Morningness. Principal component analysis (PCA) was used to test the structure of depressive symptoms. Pearson and partial correlations (with age and sex controlled), along with regression analyses with morning affect (MA) and circadian preference as predictors, were used. PCA revealed three components of depressive symptoms: depressed/somatic affect, positive affect, interpersonal relations. Greater MA was related to less depressive symptoms in three components. Morning circadian preference was related to less depressive symptoms in depressed/somatic and positive affects and unrelated to interpersonal relations. Both morningness-eveningness components exhibited stronger links with depressed/somatic and positive affects than with interpersonal relations. Three CES-D components exhibited stronger links with MA than with circadian preference. In regression analyses only MA was statistically significant for positive affect and better interpersonal relations, whereas more depressed/somatic affect was predicted by lower MA and morning circadian preference (relationship reversed compared to correlations). Self-report assessment. There are three groups of depressive symptoms in Polish university students. Associations of MA with depressed/somatic and positive affects are primarily responsible for the observed links between morningness-eveningness and depressive symptoms in university students. People with evening circadian preference whose MA is not lowered have less depressed/somatic affect. Copyright © 2016

Is chronic pain associated with somatization/hypochondriasis? An evidence-based structured review.

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Fishbain, David A; Lewis, John E; Gao, Jinrun; Cole, Brandly; Steele Rosomoff, R

2009-01-01

This is an evidence-based structured review. The objectives of this review were to answer the following questions: (1) Are somatization/hypochondriasis associated with chronic pain? (2) Is the degree of somatization/hypochondriasis related to pain levels? (3) Does pain treatment improve somatization/hypochondriasis? (4) Are some pain diagnoses differentially associated with somatization/hypochondriasis? Fifty-seven studies which fulfilled inclusion criteria and had high quality scores were sorted by the above-mentioned objectives. Agency for health care policy and research guidelines were utilized to type and characterize the strength/consistency of the study evidence within each objective. Somatization and hypochondriasis were both consistently associated with chronic pain (consistency ratings B and A, respectively). Study evidence indicated a correlation between pain intensity and presence of somatization and hypochondriasis (consistency rating A and B, respectively). Pain treatment improved somatization and hypochondriasis (consistency rating B and A, respectively). Some chronic pain diagnostic groups somatized more (consistency rating B). Somatization is commonly associated with chronic pain and may relate to pain levels.

Computer use, sleep duration and health symptoms

DEFF Research Database (Denmark)

Nuutinen, Teija; Roos, Eva; Ray, Carola

2014-01-01

OBJECTIVES: This study investigated whether computer use is associated with health symptoms through sleep duration among 15-year olds in Finland, France and Denmark. METHODS: We used data from the WHO cross-national Health Behaviour in School-aged Children study collected in Finland, France...... and Denmark in 2010, including data on 5,402 adolescents (mean age 15.61 (SD 0.37), girls 53 %). Symptoms assessed included feeling low, irritability/bad temper, nervousness, headache, stomachache, backache, and feeling dizzy. We used structural equation modeling to explore the mediating effect of sleep...... duration on the association between computer use and symptom load. RESULTS: Adolescents slept approximately 8 h a night and computer use was approximately 2 h a day. Computer use was associated with shorter sleep duration and higher symptom load. Sleep duration partly mediated the association between...

[Menopause-related symptoms in middle-aged women residing in the Zaragoza Province].

Science.gov (United States)

Pérez-Roncero, Gonzalo Ramón; Martínez-Dearth, Rebeca; López-Baena, María Teresa; Ornat-Clemente, Lía

2013-01-01

The aim of this study was to assess menopausal symptoms and related sociodemographic conditions in middle-aged women from the Spanish province of Zaragoza. This was a cross-sectional study in which 241 women (40-59 years old) from the Zaragoza province completed the Menopause Rating Scale (MRS) and a sociodemographic questionnaire containing personal and partner data to assess symptoms associated with the menopause. The most prevalent symptoms were musculoskeletal, followed by hot flushes and perspiration. Somatic, psychological and urogenital symptoms were more severe in post-menopausal women. Somatic and urogenital symptoms worsen with age, body mass index, age at menopause, and partner age. Multiple linear regression analysis (MA) for somatic symptoms was related with the menopausal status, psychiatric treatment, problems with sexual relationships, and history of gender violence. The MA for psychological symptoms was associated with menopausal status, psychiatric treatment and a history of gender violence. The MA for urogenital symptoms was associated with menopausal status, problems with sexual relationships, urinary incontinence and partner alcohol abuse. A history of gender violence was reported by 11.6% of the women. In this sample of middle-aged women, menopausal symptoms were related to menopausal status, and other factors associated with their partner factors, including gender violence. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Work-Recreation Balance, Health-Promoting Lifestyles and Suboptimal Health Status in Southern China: A Cross-Sectional Study

OpenAIRE

Wu, Shengwei; Xuan, Zhengzheng; Li, Fei; Xiao, Wei; Fu, Xiuqiong; Jiang, Pingping; Chen, Jieyu; Xiang, Lei; Liu, Yanyan; Nie, Xiaoli; Luo, Ren; Sun, Xiaomin; Kwan, Hiuyee; Zhao, Xiaoshan

2016-01-01

Suboptimal health status (SHS)—an intermediate state between health and illness—refers to functional somatic symptoms that are medically undiagnosed. Although SHS has become a great challenge for global public health, very little about its etiology and mechanisms are known. Work-recreation balance is a part of work−life balance, and is related to stress which greatly influences health status. We therefore carried out a cross-sectional investigation between 2012 and 2013 within a clustered sam...

Prevalence of psychological symptoms in Saudi Secondary School girls in Abha, Saudi Arabia

International Nuclear Information System (INIS)

AlGelban, Khalid S.

2009-01-01

Adolescence is characterized by rapid physiological, social and cognititive changes. Aim of the present work is to study mental health of Saudi adolescent secondary school girls in Abha city, Aseer region, Saudi Arabia. A cross-sectional study was conducted in 10 secondary schools for girls using the Arabic version of the symptom-revised checklist 90 (SCL 90-R), a mental health questionnaire that was administered to the girls by fourth-year female medical students. The most prevalent mental symptoms in the 545 female students were phobic anxiety (16.4%), psycchoticism (14.8%), anxiety (14.3%), and somatization (14.2%). The prevalence of depression, paranoid ideation and interpersonal sensitivity amounted to 13.9%, 13.8% and 13.8%, respectively. The least prevalent mental symptoms were hostility (12.8%) and obsessive-compulsive behavior (12.3%). Overall, psychological symptoms (in terms of a positive global severity index) were found in 16.3% of the girls. In a multivariate logistic regression analysis, no significant relationship was found with sociodemographic factors. Psychological symptoms and disorders are prevalent in secondary school girls and health professionals need to be able to recognize, manage and follow-up mental health problems in young people. Further research is needed to explore the magnitude of the problem at the national level. (author)

Perceptions of health and somatic sensations in women reporting premenstrual syndrome and premenstrual dysphoric disorder.

Science.gov (United States)

Craner, Julia; Sigmon, Sandra; Martinson, Amber; McGillicuddy, Morgan

2013-09-01

Focus on bodily sensations may be involved in the etiology of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). This study investigated the relationship between two types of somatic self-focus (i.e., health anxiety and anxiety sensitivity) and health-related quality of life (QOL) in women with provision diagnoses of PMS and PMDD. On the basis of responses to a screening measure, 731 college women were divided into three groups: PMDD, Moderate/Severe PMS, and Mild/No PMS. Measures included health-related QOL, health anxiety, anxiety sensitivity, and trait anxiety. Women with provisional diagnoses of PMDD and moderate/severe PMS reported higher levels of health anxiety and anxiety sensitivity. These relationships were not accounted for by trait anxiety. Furthermore, women in the PMDD and Moderate/Severe PMS groups reported lower health-related QOL. There is a significant health-related QOL burden for college women with PMDD and PMS. Health anxiety and anxiety sensitivity may contribute to the etiology of premenstrual disorders.

SOMATIC EMBRYOGENESIS AND MORPHOANATOMY OF Ocotea porosa SOMATIC EMBRYOS

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Luciana Luiza Pelegrini

2013-01-01

Full Text Available Ocotea porosa seeds have strong tegument dormancy, recalcitrant behavior, low and irregular germination and that makes its natural propagation difficult. The aim of this study was to establish a protocol of regeneration of Ocotea porosa from somatic embryogenesis. Immature embryonic axes were inoculated on WPM culture medium supplemented with 2.4-D (200 μM combined or not with hydrolyzed casein or glutamine (0.5 or 1 g l-1, during 90 days. The repetitive embryogenesis was induced on medium with 2.4-D (22.62 μM combined with 2-iP (2.46 μM followed by transfer to culture medium with hydrolyzed casein or glutamine (1 g l-1 during 90 days. The maturation of somatic embryos was tested in culture medium containing NAA (0.5 μM and 2-iP (5; 10 and 20 μM. The highest percentage of somatic embryos induction (8.3% was observed in WPM culture medium containing 200 μM 2.4-D and 1 g L-1 hydrolyzed casein and the development of somatic embryos occurred indirectly. Repetitive somatic embryogenesis was promoted in WPM medium containing hydrolyzed casein or glutamine. However, the culture medium containing hydrolyzed casein promoted the maintenance of embryogenic capacity for more than two years. During the maturity phase, there was a low progression of globular embryos to cordiform and torpedo stages. The different ontogenetic stages of somatic embryos of Ocotea porosa were characterized by histological studies.

SOMATIC EMBRYOGENESIS AND MORPHOANATOMY OF Ocotea porosa SOMATIC EMBRYOS

Directory of Open Access Journals (Sweden)

Luciana Luiza Pelegrini

2013-12-01

Full Text Available http://dx.doi.org/10.5902/1980509812343Ocotea porosa seeds have strong tegument dormancy, recalcitrant behavior, low and irregular germinationand that makes its natural propagation difficult. The aim of this study was to establish a protocol ofregeneration of Ocotea porosa from somatic embryogenesis. Immature embryonic axes were inoculatedon WPM culture medium supplemented with 2.4-D (200 μM combined or not with hydrolyzed casein orglutamine (0.5 or 1 g l-1, during 90 days. The repetitive embryogenesis was induced on medium with 2.4-D(22.62 μM combined with 2-iP (2.46 μM followed by transfer to culture medium with hydrolyzed caseinor glutamine (1 g l-1 during 90 days. The maturation of somatic embryos was tested in culture mediumcontaining NAA (0.5 μM and 2-iP (5; 10 and 20 μM. The highest percentage of somatic embryos induction(8.3% was observed in WPM culture medium containing 200 μM 2.4-D and 1 g L-1 hydrolyzed casein andthe development of somatic embryos occurred indirectly. Repetitive somatic embryogenesis was promotedin WPM medium containing hydrolyzed casein or glutamine. However, the culture medium containinghydrolyzed casein promoted the maintenance of embryogenic capacity for more than two years. Duringthe maturity phase, there was a low progression of globular embryos to cordiform and torpedo stages.The different ontogenetic stages of somatic embryos of Ocotea porosa were characterized by histologicalstudies.

Insomnia symptoms and behavioural health symptoms in veterans 1 year after traumatic brain injury.

Science.gov (United States)

Farrell-Carnahan, Leah; Barnett, Scott; Lamberty, Gregory; Hammond, Flora M; Kretzmer, Tracy S; Franke, Laura M; Geiss, Meghan; Howe, Laura; Nakase-Richardson, Risa

2015-01-01

Insomnia and behavioural health symptoms 1 year after traumatic brain injury (TBI) were examined in a clinical sample representative of veterans who received inpatient treatment for TBI-related issues within the Veterans Health Administration. This was a cross-sectional sub-study (n = 112) of the Polytrauma Rehabilitation Centres' traumatic brain injury model system programme. Prevalence estimates of insomnia, depression, general anxiety, nightmares, headache and substance use, stratified by injury severity, were derived. Univariate logistic regression was used to examine unadjusted effects for each behavioural health problem and insomnia by injury severity. Participants were primarily male, insomnia; those with mild TBI were significantly more likely to meet criteria (43%) than those with moderate/severe TBI (22%), χ(2)(1, n = 112) = 5.088, p ≤ 0.05. Univariable logistic regression analyses revealed depressive symptoms and general anxiety were significantly associated with insomnia symptoms after TBI of any severity. Headache and binge drinking were significantly inversely related to insomnia symptoms after moderate/severe TBI, but not MTBI. Veterans with history of TBI, of any severity, and current insomnia symptoms may be at increased risk for depression and anxiety 1 year after TBI.

Multiple physical healthcare needs among outpatients with schizophrenia: findings from a health examination study.

Science.gov (United States)

Eskelinen, Saana; Sailas, Eila; Joutsenniemi, Kaisla; Holi, Matti; Koskela, Tuomas H; Suvisaari, Jaana

2017-08-01

Despite the abundant literature on physical comorbidity, the full range of the concurrent somatic healthcare needs among individuals with schizophrenia has rarely been studied. This observational study aimed to assess the distressing somatic symptoms and needs for physical health interventions in outpatients with schizophrenia, and factors predicting those needs. A structured, comprehensive health examination was carried out, including a visit to a nurse and a general practitioner on 275 outpatients with schizophrenia. The required interventions were classified by type of disease. Logistic regression was used to assess the influence of sociodemographic factors, lifestyle, functional limitations, factors related to psychiatric disorder, and healthcare use on the need for interventions. In total, 44.9% of the patients (mean age 44.9 years) reported somatic symptoms affecting daily life; 87.6% needed specific interventions for a disease or condition, most commonly for cardiovascular, dermatological, dental, ophthalmological, and gastrointestinal conditions, and for altered glucose homeostasis. Smoking and obesity predicted significantly a need of any intervention, but the predictors varied in each disease category. Strikingly, use of general practitioner services during the previous year did not reduce the need for interventions. Health examinations for outpatients with schizophrenia revealed numerous physical healthcare needs. The health examinations for patients with schizophrenia should contain a medical history taking and a physical examination, in addition to basic measurements and laboratory tests. Prevention and treatment of obesity and smoking should be given priority in order to diminish somatic comorbidities in schizophrenia.

Association of the Interaction Between Smoking and Depressive Symptom Clusters With Coronary Artery Calcification: The CARDIA Study.

Science.gov (United States)

Carroll, Allison J; Auer, Reto; Colangelo, Laura A; Carnethon, Mercedes R; Jacobs, David R; Stewart, Jesse C; Widome, Rachel; Carr, John Jeffrey; Liu, Kiang; Hitsman, Brian

2017-01-01

Depressive symptom clusters are differentially associated with prognosis among patients with cardiovascular disease (CVD). Few studies have prospectively evaluated the association between depressive symptom clusters and risk of CVD. Previously, we observed that smoking and global depressive symptoms were synergistically associated with coronary artery calcification (CAC). The purpose of this study was to determine whether the smoking by depressive symptoms interaction, measured cumulatively over 25 years, differed by depressive symptom cluster (negative affect, anhedonia, and somatic symptoms) in association with CAC. Participants (N = 3,189: 54.5% female; 51.5% Black; average age = 50.1 years) were followed from 1985-1986 through 2010-2011 in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Smoking exposure was measured by cumulative cigarette pack-years (cigarette packs smoked per day × number of years smoking; year 0 through year 25). Depressive symptoms were measured using a 14-item, 3-factor (negative affect, anhedonia, somatic symptoms) model of the Center for Epidemiologic Studies Depression (CES-D) Scale (years 5, 10, 15, 20, and 25). CAC was assessed at year 25. Logistic regression models were used to evaluate the association between the smoking by depressive symptom clusters interactions with CAC ( = 0 vs. > 0), adjusted for CVD-related sociodemographic, behavioral, and clinical covariates. 907 participants (28% of the sample) had CAC > 0 at year 25. The depressive symptom clusters did not differ significantly between the two groups. Only the cumulative somatic symptom cluster by cumulative smoking exposure interaction was significantly associated with CAC > 0 at year 25 (p = .028). Specifically, adults with elevated somatic symptoms (score 9 out of 18) who had 10, 20, or 30 pack-years of smoking exposure had respective odds ratios (95% confidence intervals) of 2.06 [1.08, 3.93], 3.71 [1.81, 7.57], and 6.68 [2.87, 15.53], ps Negative

Workplace bullying and subsequent health problems.

Science.gov (United States)

Nielsen, Morten Birkeland; Magerøy, Nils; Gjerstad, Johannes; Einarsen, Ståle

2014-07-01

Cross-sectional studies demonstrate that exposure to bullying in the workplace is positively correlated with self-reported health problems. However, these studies do not provide a basis to draw conclusions on the extent to which bullying leads to increased health problems or whether health problems increase the risk of being bullied. To provide better indications of a causal relationship, knowledge from prospective studies on the association between bullying in the workplace and health outcomes is therefore summarised. We conducted a systematic literature review of original articles from central literature databases on longitudinal associations between bullying in the workplace and health. Average associations between bullying and health outcomes are calculated using meta-analysis. A consistent finding across the studies is that exposure to bullying is significantly positively related to mental health problems (OR =1.68; 95% KI 1.35-2.09) and somatic symptoms (OR = 1.77; 95% KI 1.41-2.22) over time. Mental health problems are also associated with subsequent exposure to bullying (OR = 1.74; 95% KI 1.44-2.12). Bullying is positively related to mental health problems and somatic symptoms. The association between mental health problems and subsequent bullying indicates a self-reinforcing process between mental health and bullying. The methodological quality of the studies that were conducted is relatively sound. However, based on the existing knowledge base there are no grounds for conclusions regarding an unambiguous causal relationship between bullying and health.

Nicotine Dependence in Adolescence and Physical Health Symptoms in Early Adulthood.

Science.gov (United States)

Griesler, Pamela C; Hu, Mei-Chen; Kandel, Denise B

2016-05-01

To examine the prospective associations of Diagnostic and Statistical Manual of Mental Disorders nicotine dependence (ND) and other individual and parental factors in adolescence on self-reported health symptoms in early adulthood. Multiethnic prospective longitudinal cohort of adolescents from grades 6-10 and a parent (N = 908) from the Chicago Public Schools. Adolescents were interviewed five times at 6-month intervals (Waves 1-5) and once 4.5 years later (Wave 6). Parents were interviewed annually three times (W1, W3, W5). Multivariate regressions estimated prospective associations of Diagnostic and Statistical Manual of Mental Disorders ND, other individual and familial risk factors in adolescence (mean age 16.6) on physical health symptoms in early adulthood (mean age 21.3), controlling for health symptoms in adolescence. Levels of health symptoms declined from adolescence to early adulthood, except among dependent smokers. Nicotine dependent adolescents reported more health symptoms as young adults than nonsmokers and nondependent smokers, especially if depressed. ND and health symptoms in adolescence were the strongest predictors of health in early adulthood. These two adolescent factors, depression, and the familial factors of parental ND, depression and health conditions, each independently predicted health symptoms in young adulthood. Females reported more symptoms than males. There is continuity of health status over time. ND, depression, and parental factors in adolescence contribute to poor health in early adulthood. The findings highlight not only the role of adolescent behavior, but the importance of the family in the development of young adult health. Reducing smoking, particularly ND, and depression among adolescents and parents will decrease physical health burden. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Functional Somatic Syndromes: Emerging Biomedical Models and Traditional Chinese Medicine

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Steven Tan

2004-01-01

Full Text Available The so-called functional somatic syndromes comprise a group of disorders that are primarily symptom-based, multisystemic in presentation and probably involve alterations in mind-brain-body interactions. The emerging neurobiological models of allostasis/allostatic load and of the emotional motor system show striking similarities with concepts used by Traditional Chinese Medicine (TCM to understand the functional somatic disorders and their underlying pathogenesis. These models incorporate a macroscopic perspective, accounting for the toll of acute and chronic traumas, physical and emotional stressors and the complex interactions between the mind, brain and body. The convergence of these biomedical models with the ancient paradigm of TCM may provide a new insight into scientifically verifiable diagnostic and therapeutic approaches for these common disorders.

Factors related to non-recovery from whiplash. The Nord-Trøndelag Health Study (HUNT).

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Myrtveit, Solbjørg Makalani; Skogen, Jens Christoffer; Petrie, Keith J; Wilhelmsen, Ingvard; Wenzel, Hanne Gro; Sivertsen, Børge

2014-06-01

Whiplash injuries show a variable prognosis which is difficult to predict. Most individuals experiencing whiplash injuries rapidly recover but a significant proportion develop chronic symptoms and ongoing disability. By employing longitudinal data, we investigated how psychological and physical symptoms, self-rated health, use of health services and medications, health behavior and demographic factors predict recovery from whiplash. Data from two waves of a large, Norwegian, population-based study (The Nord-Trøndelag Health Study: HUNT2 and HUNT3) were used. Individuals reporting whiplash in HUNT2 (baseline) were identified in HUNT3 11 years later. The characteristics of individuals still suffering from whiplash in HUNT3 were compared with the characteristics of individuals who had recovered using Pearson's chi-squared test, independent sample t-tests and logistic regression. At follow-up, 31.6 % of those reporting whiplash at baseline had not recovered. These individuals (n = 199) reported worse health at baseline than recovered individuals (n = 431); they reported poorer self-rated health (odds ratio [OR] = 3.12; 95 % confidence interval [CI], 2.20-4.43), more symptoms of anxiety (OR = 1.70; 95 % CI, 1.15-2.50), more diffuse somatic symptoms (OR = 2.38; 95 % CI, 1.61-3.51) and more musculoskeletal symptoms (OR = 1.21; 95 % CI, 1.13-1.29). Individuals still suffering from whiplash also visited more health practitioners at baseline (OR = 1.18; 95 % CI, 1.06-1.32) and used more medications (OR = 1.24; 95 % CI, 1.09-1.40). Poor self-rated health seems to be a strong risk factor for whiplash injuries becoming chronic. Diffuse somatic symptoms, musculoskeletal symptoms and symptoms of anxiety at baseline are important prognostic risk factors. Knowledge of these maintaining risk factors enables identification of individuals at risk of non-recovery, facilitating adequate treatment for this vulnerable group.

Investigation of Mental Health in Patients with Medically ‎Unexplained Physical Symptoms‎

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Frough Riahi

2016-02-01

Full Text Available Objective: Medically unexplained symptoms are physical symptoms, which cannot be explained by organic ‎causes. This study aimed to investigate mental health in patients with medically unexplained ‎physical symptoms. ‎Method: One hundred outpatients who were admitted to the Electro Diagnosis Clinic of Imam Khomeini ‎hospital, Ahvaz/Iran, participated in this study. Data were collected using physical examination, ‎paraclinical examinations, and SCL-90-R, and analyzed through multivariate analysis of variance ‎‎ (MANOVA, Chi-square test and Fisher’s exact test. ‎Results: The findings revealed significant differences between clients with medically explained and ‎unexplained symptoms in obsessive compulsive and somatization (p<0.05. Differences in ‎depression, anxiety, phobia, psychosis, aggression and paranoia were not significant (p>0.05.‎Conclusion: The present study suggested an association between some psychological problems and somatic ‎symptoms. Therefore, screening for psychological impairments can improve clinical outcomes.

Symptom-specific course trajectories and their determinants in primary care patients with Major Depressive Disorder: Evidence for two etiologically distinct prototypes.

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Wardenaar, K J; Monden, R; Conradi, H J; de Jonge, P

2015-07-01

The course-heterogeneity of Major Depressive Disorder (MDD) hampers development of better prognostic models. Although latent class growth analyses (LCGA) have been used to explain course-heterogeneity, such analyses have failed to also account for symptom-heterogeneity of depressive symptoms. Therefore, the aim was to identify more specific data-driven subgroups based on patterns of course-trajectories on different depressive symptom domains. In primary care MDD patients (n=205), the presence of the MDD criterion symptoms was determined for each week during a year. Weekly 'mood/cognition' (MC) and 'somatic' (SOM) scores were computed and parallel processes-LCGA (PP-LCGA) was used to identify subgroups based on the course on these domains. The classes׳ associations with baseline predictors and 2-/3-year outcomes were investigated. PP-LCGA identified four classes: quick recovery, persisting SOM, persisting MC, and persisting SOM+MC (chronic). Persisting SOM was specifically predicted by higher baseline somatic symptomatology and somatization, and was associated with more somatic depressive symptomatology at long-term follow-up. Persisting MC was specifically predicted by higher depressive severity, thinking insufficiencies, neuroticism, loneliness and lower self-esteem, and was associated with lower mental health related quality of life and more mood/cognitive depressive symptomatology at follow-up. The sample was small and contained only primary care MDD patients. The weekly depression assessments were collected retrospectively at 3-month intervals. The results indicate that there are two specific prototypes of depression, characterized by either persisting MC or persisting SOM, which have different sets of associated prognostic factors and long-term outcomes, and could have different etiological mechanisms. Copyright © 2015 Elsevier B.V. All rights reserved.

Avoidant personality problems--their association with somatic and mental health, lifestyle, and social network. A community-based study.

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Olssøn, Ingrid; Dahl, Alv A

2012-08-01

The aim of the study was to explore the associations between the presence of avoidant personality problems (APPs) and 5 areas of impairment: demography, somatic issues, mental health, lifestyle, and social issues. Avoidant personality problem was defined by confirmation of the 2 avoidant personality disorder items of the Iowa Personality Disorder Screen and and the Social Phobia Inventory (SPIN) short version (MINI-SPIN) screening assessment for generalized social anxiety disorder sum score of 6 or more. The questionnaires were administered in a Norwegian population survey (the Oslo Health Study-HUBRO). Cases consisted of 280 individuals with APP and 5 randomly selected controls without APP (n = 1400). The APP group more frequently reported living alone, lower level of education, and lower income than controls. Poor self-rated health, presence of somatic disease, muscular pain, frequent use of analgesics, and visits at a general practitioner were significantly more common in the APP group than among controls. The APP group had significantly higher proportion of caseness of mental distress, low general self-efficacy, and insomnia, and this result held up in multivariate analyses. The APP group showed statistically significant higher proportions of physical inactivity, obesity, daily smoking, and alcohol problems compared with controls. As for social impairment, a significantly higher proportion of the APP group reported "not having enough good friends," "high powerlessness," and low community activism, and the 2 former variables held up in multivariate analyses. In this population-based study, we found that high levels of APP, defined closely to avoidant personality disorder, were significantly associated with demographic, somatic, and mental impairment; low general self-efficacy; and insomnia affecting work ability. In addition, APP showed associations with negative lifestyle, alcohol problems, and social impairment reporting lack of good friends and lack of

A randomized controlled trial of brief Somatic Experiencing for chronic low back pain and comorbid post-traumatic stress disorder symptoms

DEFF Research Database (Denmark)

Andersen, Tonny Elmose; Lahav, Yael; Ellegaard, Hanne

2017-01-01

Background: It is well documented that comorbid post-traumatic stress disorder (PTSD) in chronic pain is associated with a more severe symptom profile with respect to pain, disability and psychological distress. However, very few intervention studies exist targeting both PTSD and pain. The current...... study is the first randomized controlled trial evaluating the effect of the body-oriented trauma approach of Somatic Experiencing (SE) for comorbid PTSD and low back pain. Although the method is well recognized by clinicians and widely used, SE still needs to be tested in a randomized clinical trial...... in comparison with an active control group. Objective: The aim of the current study was to compare the effect of an SE intervention in addition to treatment-as-usual (TAU) for patients with chronic low back pain and comorbid PTSD compared to TAU alone. Method: The study was a two-group randomized controlled...

Residual symptoms and functioning in depression, does the type of residual symptom matter? A post-hoc analysis

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Romera Irene

2013-02-01

Full Text Available Abstract Background The degrees to which residual symptoms in major depressive disorder (MDD adversely affect patient functioning is not known. This post-hoc analysis explored the association between different residual symptoms and patient functioning. Methods Patients with MDD who responded (≥50% on the 17-item Hamilton Rating Scale for Depression; HAMD-17 after 3 months of treatment (624/930 were included. Residual core mood-symptoms (HAMD-17 core symptom subscale ≥1, residual insomnia-symptoms (HAMD-17 sleep subscale ≥1, residual anxiety-symptoms (HAMD-17-anxiety subscale ≥1, residual somatic-symptoms (HAMD-17 Item 13 ≥1, pain (Visual Analogue Scale ≥30, and functioning were assessed after 3 months treatment. A stepwise logistic regression model with normal functioning (Social and Occupational Functioning Assessment Scale ≥80 as the dependent variable was used. Results After 3 months, 59.5% of patients (371/624 achieved normal functioning and 66.0% (412/624 were in remission. Residual symptom prevalence was: core mood symptoms 72%; insomnia 63%; anxiety 78%; and somatic symptoms 41%. Pain reported in 18%. Factors associated with normal functioning were absence of core mood symptoms (odds ratio [OR] 8.7; 95% confidence interval [CI], 4.6–16.7, absence of insomnia symptoms (OR 1.8; 95% CI, 1.2–2.7, episode length (4–24 weeks vs. ≥24 weeks [OR 2.0; 95% CI, 1.1–3.6] and better baseline functioning (OR 1.0; 95% CI, 1.0–1.1. A significant interaction between residual anxiety symptoms and pain was found (p = 0.0080. Conclusions Different residual symptoms are associated to different degrees with patient functioning. To achieve normal functioning, specific residual symptoms domains might be targeted for treatment.

Negative Effects on Psychological Health and Quality of Life of Genuine Irritable Bowel Syndrome-type Symptoms in Patients With Inflammatory Bowel Disease.

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Gracie, David J; Williams, Christopher J M; Sood, Ruchit; Mumtaz, Saqib; Bholah, M Hassan; Hamlin, P John; Ford, Alexander C

2017-03-01

Symptoms compatible with irritable bowel syndrome (IBS) are common in patients with inflammatory bowel disease (IBD), but it is unclear whether this relates to occult IBD activity. We attempted to resolve this issue in a secondary care population by using a cross-sectional study design. We analyzed Rome III IBS symptoms, disease activity indices, and psychological, somatization, and quality of life data from 378 consecutive, unselected adult patients with IBD seen in clinics at St James's University Hospital in Leeds, United Kingdom from November 2012 through June 2015. Participants provided a stool sample for fecal calprotectin (FC) analysis; levels ≥250 μg/g were used to define mucosal inflammation. By using symptom data and FC levels we identified 4 distinct groups of patients: those with true IBS-type symptoms (IBS-type symptoms with FC levels life levels were also significantly reduced compared with patients with quiescent disease or occult inflammation and were similar to those of patients with active IBD. By using FC levels ≥100 μg/g to define mucosal inflammation, we found a similar effect of IBS-type symptoms on psychological health and quality of life. In a cross-sectional study, we identified a distinct group of patients with IBD and genuine IBS-type symptoms in the absence of mucosal inflammation. These symptoms had negative effects on psychological well-being and quality of life to the same degree as active IBD. New management strategies are required for this patient group. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Medically Unexplained Physical Symptoms in Military Health (Symptomes physiques medicalement inexpliques dans la sante militaire)

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2017-12-01

REPORT TR-HFM-175 Medically Unexplained Physical Symptoms in Military Health (Symptômes physiques médicalement inexpliqués dans la santé militaire...STO TECHNICAL REPORT TR-HFM-175 Medically Unexplained Physical Symptoms in Military Health (Symptômes physiques médicalement inexpliqués dans...The General Internist 10-7 10.5.1 The Health Psychologist 10-8 10.5.2 Medical Specialists 10-8 10.5.3 The Physiatrist 10-9 10.5.4 The Physical

Religiosity dimensions and subjective health status in Greek students.

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Kioulos, K T; Bergiannaki, J D; Glaros, A; Vassiliadou, M; Alexandri, Z; Papadimitriou, G

2015-01-01

The quest for existential meaning constitutes a universal phenomenon traditionally manifested in official religions (religiosity) or personal modes of transcendence (spirituality). Religiosity and spirituality have been found to be associated with a variety of mental health and illness parameters. In the last decades there is an increasing number of publications with interesting results on the relationship between religiosity and mental health, both on a theoretical and a clinical level. Recent research suggests the presence of clinically important interactions between religious beliefs and mental health, although the exact nature of the associations remains unclear. The aim of the present study is to investigate subjective health status in relation to specific dimensions of religiosity and spirituality in Greek students; 202 students of the faculty of Theology of the University of Athens were interviewed using the Brief Multidimensional Measurement of Religiousness/Spirituality (BMMRS), which assesses the dimensions of "daily spiritual experiences", "meaning", "values/beliefs", "forgiveness", "private religious practices", "religious/spiritual coping", "religious support", "religious/ spiritual history", "commitment", "organizational religiousness", and "religious preferences". Subjective health status was measured by the General Health Questionnaire (GHQ-28) which examines four areas of health in the following sub-scales: (a) somatic symptoms, (b) anxiety and insomnia, (c) social dysfunction and (d) severe depression. Pearson correlations coefficients and linear regression analyses were used to estimate the associations of GHQ-28 subscales with religiosity dimensions. High scores in each dimension of BMMRS corresponded to a low level of religiosity. The dimension of "daily spiritual experiences" was positively correlated with the subscales of anxiety/ insomnia, social dysfunction and severe depression, while the dimension of "values/beliefs" with social

What do bodily symptoms in African psychiatric patients mean ...

African Journals Online (AJOL)

Objective: To review the various bodily symptoms presented by African psychiatric patients and attempt to understand them. Method: The literature on bodily (somatic) symptoms is surveyed with special reference to Africans and examples are drawn from a focused group discussion in one African rural community.

Effect of the inoculation density in Coffea arabica L. cv. `Caturra rojo' somatic embryos germination in RITA® Temporary Immersion System

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Raúl Barbon

2014-04-01

Full Text Available The development of somatic embryogenesis of coffee (Coffea spp. in liquid culture medium is a viable alternative for the propagation of these species. The use of liquid culture medium and temporary immersion systems could increase the germination of somatic embryos and improve the quality of plants. The objective of this work was to determine the effect of inoculation density on germination of somatic embryos of Coffea arabica L. cv. `Caturra rojo' in temporary immersion systems RITA®. It were used as inoculum densities 40, 50, 60, 70 and 80 somatic embryos per RITA®. After 90 days of culture the number of somatic embryos germinated, hyperhydricity symptoms, number of true leaves, length and root development was quantified. With inoculum density of 70 somatic embryos per RITA®, it was obtained a highest germination percentage (60% with good leaf development and length of the plants. Key words: hyperhydricity, liquid culture medium, partial germination, total germination, somatic embryogenesis

Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis.

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Shaheen E Lakhan

Full Text Available BACKGROUND: Mindfulness-based therapy (MBT has been used effectively to treat a variety of physical and psychological disorders, including depression, anxiety, and chronic pain. Recently, several lines of research have explored the potential for mindfulness-therapy in treating somatization disorders, including fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome. METHODS: Thirteen studies were identified as fulfilling the present criteria of employing randomized controlled trials to determine the efficacy of any form of MBT in treating somatization disorders. A meta-analysis of the effects of mindfulness-based therapy on pain, symptom severity, quality of life, depression, and anxiety was performed to determine the potential of this form of treatment. FINDINGS: While limited in power, the meta-analysis indicated a small to moderate positive effect of MBT (compared to wait-list or support group controls in reducing pain (SMD = -0.21, 95% CI: -0.37, -0.03; p<0.05, symptom severity (SMD = -0.40, 95% CI: -0.54, -0.26; p<0.001, depression (SMD = -0.23, 95% CI: -0.40, -0.07, p<0.01, and anxiety (SMD = -0.20, 95% CI: -0.42, 0.02, p = 0.07 associated with somatization disorders, and improving quality of life (SMD = 0.39, 95% CI: 0.19, 0.59; p<0.001 in patients with this disorder. Subgroup analyses indicated that the efficacy of MBT was most consistent for irritable bowel syndrome (p<0.001 for pain, symptom severity, and quality of life, and that mindfulness-based stress reduction (MBSR and mindfulness-based cognitive therapy (MCBT were more effective than eclectic/unspecified MBT. CONCLUSIONS: Preliminary evidence suggests that MBT may be effective in treating at least some aspects of somatization disorders. Further research is warranted.

Prevalence of psychological symptoms in Saudi Secondary School girls in Abha, Saudi Arabia

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Al Gelban, Khalid S.

2009-01-01

BACKGROUND AND OBJECTIVES: Adolescence is characterized by rapid physiological, social and cognititive changes. Aim of the present work is to study mental health of Saudi adolescent secondary school girls in Abha city, Aseer region, Saudi Arabia. METHODS: A cross-sectional study was conducted in 10 secondary schools for girls using the Arabic version of the symptom-revised checklist 90 (SCL 90-R), a mental health questionnaire that was administered to the girls by fourth-year female medical students. RESULTS: The most prevalent mental symptoms in the 545 female students were phobic anxiety (16.4%), psychoticism (14.8%), anxiety (14.3%), and somatization (14.2%). The prevalence of depression, paranoid ideation and interpersonal sensitivity amounted to 13.9%, 13.8% and 13.8%, respectively. The least prevalent mental symptoms were hostility (12.8%) and obsessive-compulsive behavior (12.3%). Overall, psychological symptoms (in terms of a positive global severity index) were found in 16.3% of the girls. In a multivariate logistic regression analysis, no significant relationship was found with sociodemographic factors. CONCLUSION: Psychological symptoms and disorders are prevalent in secondary school girls and health professionals need to be able to recognize, manage and follow-up mental health problems in young people. Further research is needed to explore the magnitude of the problem at the national level. PMID:19584586

Physical activity, symptoms, esteem, and life satisfaction during menopause.

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Elavsky, Steriani; McAuley, Edward

2005-01-01

The present study examined the relationships among physical activity (PA), symptom reporting, self-esteem, and satisfaction with life (SWL) in 133 women (M age=51.12, S.D.=4.10) of varying menopausal status. Multivariate analyses of co-variance (MANCOVA) revealed that independent of menopausal status, women who were more physically active reported significantly less severe vaso-somatic and general somatic symptoms, and higher levels of physical self-worth (PSW). Subsequent hierarchical regression analyses indicated that expended MET-h/week, reported symptoms (frequency and severity, respectively), and PSW accounted for significant variance in SWL (R2 model=0.32, for symptom frequency, and 0.33, for symptom severity). Physical activity was significantly related to SWL through the mediation of PSW. However, both reported symptom frequency and severity retained significant association with SWL after controlling for PSW, although the original associations were significantly reduced. Finally, both symptoms and MET-h/week were independent contributors to the variance in PSW (R2 model=0.33 and 0.34). The results suggest that being physically active may reduce perceived severity of menopausal symptoms and enhance psychological well-being, and that the relationship between physical activity and QOL in mid-life women may be mediated by factors such as physical self-perceptions and menopausal symptoms.

Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life.

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Böhn, Lena; Störsrud, Stine; Törnblom, Hans; Bengtsson, Ulf; Simrén, Magnus

2013-05-01

Despite the fact that food and diet are central issues, that concern patients with irritable bowel syndrome (IBS), the current understanding about the association between the intake of certain foods/food groups and the gastrointestinal (GI) symptom pattern, psychological symptoms, and quality of life is poor. The aim of this study was to determine which food groups and specific food items IBS patients report causing GI symptoms, and to investigate the association with GI and psychological symptoms and quality of life. We included 197 IBS patients (mean age 35 (18-72) years; 142 female subjects) who completed a food questionnaire in which they specified symptoms from 56 different food items or food groups relevant to food intolerance/allergy. The patients also completed questionnaires to assess depression and general anxiety (Hospital Anxiety and Depression), GI-specific anxiety (Visceral Sensitivity Index), IBS symptoms (IBS-Severity Scoring System), somatic symptoms (Patient Health Questionnaire-15), and quality of life (Irritable Bowel Syndrome Quality of Life Questionnaire). In all, 84% of the studied population reported symptoms related to at least one of the food items surveyed. Symptoms related to intake of food items with incompletely absorbed carbohydrates were noted in 138 (70%) patients; the most common were dairy products (49%), beans/lentils (36%), apple (28%), flour (24%), and plum (23%). Of these, 58% experienced GI symptoms from foods rich in biogenic amines, such as wine/beer (31%), salami (22%), and cheese (20%). Histamine-releasing foods, such as milk (43%), wine/beer (31%), and pork (21%), were also considered causes of symptoms in IBS patients. GI symptoms were also frequently reported after intake of fried and fatty foods (52%). With increasing IBS symptom severity, patients reported more food items responsible for their GI symptoms (P=0.004), and this was also found in patients with more severe somatic symptoms (Psleep (r=-0.25; P=0

Cellular Mechanisms of Somatic Stem Cell Aging

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Jung, Yunjoon

2014-01-01

Tissue homeostasis and regenerative capacity rely on rare populations of somatic stem cells endowed with the potential to self-renew and differentiate. During aging, many tissues show a decline in regenerative potential coupled with a loss of stem cell function. Cells including somatic stem cells have evolved a series of checks and balances to sense and repair cellular damage to maximize tissue function. However, during aging the mechanisms that protect normal cell function begin to fail. In this review, we will discuss how common cellular mechanisms that maintain tissue fidelity and organismal lifespan impact somatic stem cell function. We will highlight context-dependent changes and commonalities that define aging, by focusing on three age-sensitive stem cell compartments: blood, neural, and muscle. Understanding the interaction between extrinsic regulators and intrinsic effectors that operate within different stem cell compartments is likely to have important implications for identifying strategies to improve health span and treat age-related degenerative diseases. PMID:24439814

Somatic expressions of grief and psychosomatic illness in the works of William Shakespeare and his coevals.

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Heaton, Kenneth W

2012-10-01

To find out if Shakespeare, famed for his insights into human nature, is exceptional in how much his characters express grief through somatic symptoms and signs, and by physical illness. The texts of all large-scale works currently attributed to Shakespeare (39 plays, 3 long narrative poems) were systematically searched for bodily changes and for evidence of grief as dominating the character's emotional state at the time. The findings were compared with those from a search of 46 works, similar in genre, by 15 prominent playwrights active at the same time as Shakespeare. In Shakespeare 31 different grief-associated symptoms or signs were found, in 140 instances. They are present in all but two of his plays and long poems and involve most systems of the body. With non-Shakespearean writers there were 26 kinds, 132 instances. Twenty-two changes are common to both groups, including fainting, death (sudden or after a decline), and wrinkled face, and symptoms such as malaise, fatigue, awareness of the heart-beat, and anorexia. Ten somatic expressions of grief were found only in Shakespeare, including hyperventilation, hair turning white and premature childbirth. Four were found only in his contemporaries but were trivial or unconvincing. Deaths and non-fatal illnesses are prevalent in Shakespeare. Grieving Shakespearean characters exhibit many somatic symptoms and signs and a wide range of psychosomatic illnesses. This panoply of psychosomatic phenomena may be an artistic artefact but it also confirms that Shakespeare's empathy with grieving humanity was unrivalled. Copyright © 2012 Elsevier Inc. All rights reserved.

Acculturation, self-construal, mental and physical health: an explorative study of East Asian students in Germany.

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Shim, Gayoung; Freund, Henning; Stopsack, Malte; Kämmerer, Annette; Barnow, Sven

2014-08-01

The present study explores acculturation and its associated aspects of two East Asian student groups with different levels of exposure to German culture (100 international students from East Asian countries [IS]; 61 second generation students of East Asian descent [SGS]). First, we investigated the relationships between acculturation, self-construal, depressive and somatic symptoms, and differences between the student groups in these variables. Second, the four acculturation types (integration, assimilation, separation and marginalization) were examined regarding their relationship to self-construal and health outcomes. The results showed that the acculturation dimensions (mainstream, heritage) were relevant to the level of depressive symptoms for IS which was not the case for SGS. Furthermore, IS reported more somatic symptoms whereas there was no difference between the two groups in the level of depressive symptoms. In the analysis of acculturation types, assimilated and integrated students were characterized by high independent self-construal, while separated and integrated students showed high interdependent self-construal. Assimilated students displayed the least depressive symptoms of all acculturation groups. This study highlights different characteristics of East Asian students in acculturation, self-construal and health outcomes, and discusses the complexity of the relationships between acculturation types and health. © 2013 International Union of Psychological Science.

[Correlation between specific and nonspecific posttraumatic stress disorder symptoms with healthcare consumption among 340 French soldiers].

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Holterbach, L; Baumann, C; Andreani, B; Desré, D; Auxéméry, Y

2015-10-01

The psychotraumatic disorders are often difficult to diagnose because the specific symptoms of posttraumatic stress disorder (revival, hyperarousal, avoidance) are rarely a direct demand for health care: for reasons determined by the psychopathological structure of trauma, its symptomatology and course, the psychotraumatised subjects seek a care system for nonspecific psychological or somatoform symptoms: depressive episode, cognitive disorders, other anxiety disorders, histrionic and obsessive symptoms, changes in personality, pain disorders and somatization. Somatic pain may also result from a war injury and psychosomatic complications, addictive or consequences of risk behaviours during the evolution of posttraumatic stress disorder. To establish a correlation between the PCLS and the evaluation of the healthcare consumption in a military population. We conducted a multicenter epidemiological study analyzing the PCLS and a questionnaire assessing health care consumption. The PCLS has been studied in various forms: quantitative (17 to 85), in qualitative classes (disorders, could be developed a score of health care consumption which would include the number of days of sick leave and unavailability, the number and quality of medical consultations, the number and quality of drug and laboratory requirements, the number of hospitalisations. To the identification of posttraumatic stress disorder, the PCLS score as well as the consumer healthcare score are valuable tools but do not replace the subjectivity of the clinical relationship: return to this shared subjectivity with the practitioner remains a diagnostic dimension, but also therapeutic, fundamental. Copyright © 2015 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Mental health symptoms following war and repression in eastern Afghanistan.

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Scholte, Willem F; Olff, Miranda; Ventevogel, Peter; de Vries, Giel-Jan; Jansveld, Eveline; Cardozo, Barbara Lopes; Crawford, Carol A Gotway

2004-08-04

Decades of armed conflict, suppression, and displacement resulted in a high prevalence of mental health symptoms throughout Afghanistan. Its Eastern province of Nangarhar is part of the region that originated the Taliban movement. This may have had a distinct impact on the living circumstances and mental health condition of the province's population. To determine the rate of exposure to traumatic events; estimate prevalence rates of symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety; identify resources used for emotional support and risk factors for mental health symptoms; and assess the present coverage of basic needs in Nangarhar province, Afghanistan. A cross-sectional multicluster sample survey of 1011 respondents aged 15 years or older, conducted in Nangarhar province during January and March 2003; 362 households were represented with a mean of 2.8 respondents per household (72% participation rate). Posttraumatic stress disorder symptoms and traumatic events using the Harvard Trauma Questionnaire; depression and general anxiety symptoms using the Hopkins Symptom Checklist; and resources for emotional support through a locally informed questionnaire. During the past 10 years, 432 respondents (43.7%) experienced between 8 and 10 traumatic events; 141 respondents (14.1%) experienced 11 or more. High rates of symptoms of depression were reported by 391 respondents (38.5%); anxiety, 524 (51.8%); and PTSD, 207 (20.4%). Symptoms were more prevalent in women than in men (depression: odds ratio [OR], 7.3 [95% confidence interval [CI], 5.4-9.8]; anxiety: OR, 12.8 [95% CI, 9.0-18.1]; PTSD: OR, 5.8 [95% CI, 3.8-8.9]). Higher rates of symptoms were associated with higher numbers of traumas experienced. The main resources for emotional support were religion and family. Medical care was reported to be insufficient by 228 respondents (22.6%). In this survey of inhabitants of Nangarhar province, Afghanistan, prevalence rates of having experienced

Persecution-induced reduction in earning capacity of Holocaust victims: influence of psychiatric and somatic aspects.

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Müller, Helge; Seifert, Frank; Asemann, Rita; Schütz, Patricia; Maler, Juan-Manuel; Sperling, Wolfgang

2011-01-01

The incidence of mental and somatic sequelae is very high in the group of persons damaged by the Holocaust. Based on the sociomedical criteria prevailing in Germany, the assessment of persecution-induced reduction in earning capacity of Holocaust victims (vMdE) is mainly orientated towards direct Holocaust-induced somatic and mental sequelae but must also take into account the interaction of direct Holocaust-induced damage with subsequently acquired physical, mental, and psychosocial factors. The current medical evaluation is focused on the question whether persecution-induced symptoms are exacerbated by endogenous factors like mental or somatic diseases and/or exogenous factors like life events. In that case the grade of vMdE could be increased. Based on the synopsis of 56 Holocaust victims, we ascertained in this study that newly acquired somatic diseases and psychic morbidities contribute to an increase in persecution-induced mental complaints. Copyright © 2011 S. Karger AG, Basel.

[A description of children and adolescents with somatic unexplained physical symptoms in a Dutch mental health care institution].

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Kouijzer, M E J; Loman, F; van der Feltz-Cornelis, C M

2013-01-01

Medically unexplained symptoms (MUS) occur frequently in children and adolescents. Treatment of MUS in children and adolescents takes place mainly in mental health care (MHC) institutions, as does the treatment of adults with MUS. However, there is hardly any literature about the prevalence of MUS in children and adolescents in MHC. To study the prevalence of MUS in children and adolescents in Dutch MHC. Comparisons were drawn between children and adolescents with MUS and those without MUS who had been referred to a Dutch MHC institution. Children and adolescents with MUS had more anxiety and depression and more introvert personality characteristics than children and adolescents without MUS. However, the quality of life of children and adolescents with MUS was similar to that of children and adolescents without MUS. One in five children and adolescents in Dutch MHC had MUS. These children and adolescents had introverted personality characteristics and showed anxious and depressed behavior, withdrawn-depressed behavior, and thought problems. The quality of life of children and adolescents with MUS and those without MUS was below average.

Self-reported versus informant-reported depressive symptoms in adults with mild intellectual disability.

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Mileviciute, I; Hartley, S L

2015-02-01

Virtually nothing is known about potential differences in the types of depression symptoms reported by adults with mild intellectual disability (ID) on self-reported questionnaires as compared with the types of symptoms reported by caregivers on informant questionnaires. Moreover, little is known about how the presentation of depression among adults with mild ID varies based on socio-demographic characteristics. We compared findings from two self-reported questionnaires, the Self-Reported Depression Questionnaire (SRDQ) and the Glasgow Depression Scale for People with a Learning Disability (GDS), to that of an informant questionnaire of depressive symptoms, the Glasgow Depression Scale--Caregiver Supplement (CGDS), in 80 adults with mild ID. We also examined the association between age, sex, IQ and the presence of a co-occurring psychiatric disorder and frequency of affective, cognitive and somatic depressive symptoms in our sample of adults with mild ID. Adults with mild ID self-reported a higher frequency of affective and cognitive depressive symptoms than staff reported on the informant measure. Staff reported a higher frequency of somatic symptoms than adults with mild ID on one of the self-reported questionnaires (GDS) and a similar frequency on the other self-reported questionnaire (SRDQ). Important differences were found in the types of depressive symptoms based on their IQ, age and presence of a co-occurring psychiatric disorder. Informant questionnaires offer valuable information, but assessment should include self-reported questionnaires as these questionnaires add unique information about internalised experiences (affective and cognitive symptoms) of adults with mild ID that may not be apparent to caregivers. Health care providers should be made aware of the important differences in the presentation of depressive based on their IQ, age and presence of a co-occurring psychiatric disorder. © 2013 John Wiley & Sons Ltd, MENCAP & IASSID.

THE CONNECTION OF LEARNED HELPLESSNESS, WILL-POWER DEVELOPMENT AND SOMATIC HEALTH OF PRE-SCHOOLERS: THE CORE AND WAYS OF PROBLEM SOLVING

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Olesya Vladimirovna Volkova

2013-09-01

Full Text Available The article concerns the detailed theoretically-methodological analysis of the modern psychological researches devoted to studying of a “helplessness” phenomenon. The question of studying the relevance of “learned helplessness” phenomenon interrelation with somatic health of the person in the course of his human development is raised. The problem of interrelation of will-power development level with specifics of formation the phenomenon of "learned helplessness" is raised. The special role in this research is given to the pre-school age (the object of the study as one of the most important periods in the process of human development. The presented integrative approach includes both inter and intra personal factors determining children’s development in the pre-school age, in particular specific features of the age, somatic health, specific child’s health and disease perception, special type of parental attitude to the child’s state of health, special type of parental attitude to the child determining the learned helplessness formation. Expediency of mechanisms specifics of formation the "learned helplessness" from the position of psychosomatic approaches, also taking into account basic provisions of the modern cultural and historical concept is proved.Purpose of the research is to study the connection between the phenomena of “learned helplessness” and the level of will-power development in the pre-school age combined with the weakened somatic health, also developing the special program aimed to prevent the formation of learned helplessness in the pre-school age.Methodology. The theoretical and methodological basis of the research is presented with culturally historical approach in Psychology, principle of system and psycho-somatic approach, ideas of L.S. Vygotsky about the social situation of development and the zone of nearest development as the most important circumstances of child’s personality formation, conceptual theory

Primary care consultations about medically unexplained symptoms: how do patients indicate what they want?

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Salmon, Peter; Ring, Adele; Humphris, Gerry M; Davies, John C; Dowrick, Christopher F

2009-04-01

Patients with medically unexplained physical symptoms (MUS) are often thought to deny psychological needs when they consult general practitioners (GPs) and to request somatic intervention instead. We tested predictions from the contrasting theory that they are transparent in communicating their psychological and other needs. To test predictions that what patients tell GPs when they consult about MUS is related transparently to their desire for (1) emotional support, (2) symptom explanation and (3) somatic intervention. Prospective naturalistic study. Before consultation, patients indicated what they wanted from it using a self-report questionnaire measuring patients' desire for: emotional support, explanation and reassurance, and physical investigation and treatment. Their speech during consultation was audio-recorded, transcribed and coded utterance-by-utterance. Multilevel regression analysis tested relationships between what patients sought and what they said. Patients (N = 326) consulting 33 GPs about symptoms that the GPs designated as MUS. Patients who wanted emotional support spoke more about psychosocial problems, including psychosocial causes of symptoms and their need for psychosocial help. Patients who wanted explanation and reassurance suggested more physical explanations, including diseases, but did not overtly request explanation. Patients' wish for somatic intervention was associated only with their talk about details of such interventions and not with their requests for them. In general, patients with medically unexplained symptoms provide many cues to their desire for emotional support. They are more indirect or guarded in communicating their desire for explanation and somatic intervention.

Cyberbullying a modern form of bullying: let's talk about this health and social problem.

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Ferrara, Pietro; Ianniello, Francesca; Villani, Alberto; Corsello, Giovanni

2018-01-17

Cyberbullying or electronic aggression has already been designated as a serious public health threat. Cyberbullying should also be considered as a cause for new onset psychological symptoms, somatic symptoms of unclear etiology or a drop in academic performance. Pediatricians should be trained to play a major role in caring for and supporting the social and developmental well-being of children.

Genetic Moderators of the Impact of Physical Activity on Depressive Symptoms.

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Dotson, V M; Hsu, F C; Langaee, T Y; McDonough, C W; King, A C; Cohen, R A; Newman, A B; Kritchevsky, S B; Myers, V; Manini, T M; Pahor, M

2016-01-01

Converging evidence suggests that physical activity is an effective intervention for both clinical depression and sub-threshold depressive symptoms; however, findings are not always consistent. These mixed results might reflect heterogeneity in response to physical activity, with some subgroups of individuals responding positively, but not others. 1) To examine the impact of genetic variation and sex on changes in depressive symptoms in older adults after a physical activity (PA) intervention, and 2) to determine if PA differentially improves particular symptom dimensions of depression. Randomized controlled trial. Four field centers (Cooper Institute, Stanford University, University of Pittsburgh, and Wake Forest University). 396 community-dwelling adults aged 70-89 years who participated in the Lifestyle Interventions and Independence for Elders Pilot Study (LIFE-P). 12-month PA intervention compared to an education control. Polymorphisms in the serotonin transporter (5-HTT), brain-derived neurotrophic factor (BDNF), and apolipoprotein E (APOE) genes; 12-month change in the Center for Epidemiologic Studies Depression Scale total score, as well as scores on the depressed affect, somatic symptoms, and lack of positive affect subscales. Men randomized to the PA arm showed the greatest decreases in somatic symptoms, with a preferential benefit in male carriers of the BDNF Met allele. Symptoms of lack of positive affect decreased more in men compared to women, particularly in those possessing the 5-HTT L allele, but the effect did not differ by intervention arm. APOE status did not affect change in depressive symptoms. Results of this study suggest that the impact of PA on depressive symptoms varies by genotype and sex, and that PA may mitigate somatic symptoms of depression more than other symptoms. The results suggest that a targeted approach to recommending PA therapy for treatment of depression is viable.

A pilot study of Trabajadora de salud, a lay health worker intervention for Latinas/os with traumatic brain injuries and their caregivers.

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Linton, Kristen F; Kim, Bum Jung

2018-01-01

Latinas/os with traumatic brain injuries (TBIs) and their caregivers experience worse outcomes than others. The study aimed to assess the acceptability and promise of Trabajadora de Salud on the functional abilities, hospital readmission, rehabilitation, employment, depression, somatic symptoms, and caregiver burden among Latinas/os with TBIs and their caregivers. A pre-posttest experimental pilot study was conducted. A total of eight Latina/o adult patients (50% female) with mild or moderate TBI and six of their caregivers (66.7% female) were randomized to receive Trabajadora de Salud or a telephone only control group. Trabajadora de Salud, a three-month, in-home intervention administered by bilingual lay health workers, focused on: 1) providing empathy and validation of TBI symptoms, 2) addressing basic needs, 3) goal setting, and 4) improving communication with healthcare providers. Trabajadora de Salud was widely accepted by patients, caregivers, and health professionals. The functional, depression, and somatic symptoms of the patients as well as the somatic symptoms and caregiver burden of the caregivers improved more for participants in the intervention group than the control group. Trabajadora de Salud demonstrated promise in improving outcomes of Latinas/os with TBIs and their caregivers and should be further studied. Copyright © 2017 Elsevier Inc. All rights reserved.

A Symptom Profile Analysis of Depression in a Sample of Iranian Patients

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Shekoofeh Seifsafari

2013-03-01

Full Text Available Background: In some cultures, including ours, direct explanation of inner psychic world is inhibited and stigmatized, therefore finding alternative modes of expression. The aim of this cross-sectional study was to assess the frequency of somatization in the depressed patients.Methods: The present study comprised 500 patients referred to the outpatient clinic of Shiraz University of Medical Sciences, and diagnosed with major depressive disorders based on DSM-IV-TR. The presenting complaints of these patients were assessed through psychiatric interview. The presenting symptoms were divided into three main categories including mental symptoms, pain, and physical symptoms without pain. Statistical analysis (chi-square and logistic regression were performed to determine the relationship between presenting symptoms and some demographic variables such as age, gender, marital status, educational level and cultural background (urban or rural.Results: Physical symptoms other than pain, mental symptoms, and pain were found in 193 (38.6%, 186 (37.2%, and in 121 (24.2% patients respectively. Pain and physical complaints were more common in patients with rural cultural background, lower education, women and the married individuals. Headache (15.2%, irritability (10.6% and pain in different parts of the body (10.4% were the most frequent chief complaints of the patients. Hypochondriasis, suicidal idea, crying, irritability and insomnia were significant symptoms associated with the complaint of somatization.Conclusion: Somatic symptoms, especially pain, have a significant weight in the chief complaints of depressed patients. Physicians need to pay particular attention to this important issue in order to better understand these patients.

A Symptom Profile Analysis of Depression in a Sample of Iranian Patients

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Seifsafari, Shekoofeh; Firoozabadi, Ali; Ghanizadeh, Ahmad; Salehi, Alireza

2013-01-01

Background: In some cultures, including ours, direct explanation of inner psychic world is inhibited and stigmatized, therefore finding alternative modes of expression. The aim of this cross-sectional study was to assess the frequency of somatization in the depressed patients. Methods: The present study comprised 500 patients referred to the outpatient clinic of Shiraz University of Medical Sciences, and diagnosed with major depressive disorders based on DSM-IV-TR. The presenting complaints of these patients were assessed through psychiatric interview. The presenting symptoms were divided into three main categories including mental symptoms, pain, and physical symptoms without pain. Statistical analysis (chi-square and logistic regression) were performed to determine the relationship between presenting symptoms and some demographic variables such as age, gender, marital status, educational level and cultural background (urban or rural). Results: Physical symptoms other than pain, mental symptoms, and pain were found in 193 (38.6%), 186 (37.2%), and in 121 (24.2%) patients respectively. Pain and physical complaints were more common in patients with rural cultural background, lower education, women and the married individuals. Headache (15.2%), irritability (10.6%) and pain in different parts of the body (10.4%) were the most frequent chief complaints of the patients. Hypochondriasis, suicidal idea, crying, irritability and insomnia were significant symptoms associated with the complaint of somatization. Conclusion: Somatic symptoms, especially pain, have a significant weight in the chief complaints of depressed patients. Physicians need to pay particular attention to this important issue in order to better understand these patients. PMID:23645954

DSM-IV-TR “Pain Disorder Associated with Psychological Factors” as a Nonhysterical Form of Somatization

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Massimiliano Aragona

2008-01-01

Full Text Available BACKGROUND: Elevated Minnesota Multiphasic Personality Inventory (MMPI scores on the hysteria (Hy scale are reported in several forms of pain. Previous results were possibly biased by diagnostic heterogeneity (psychogenic, somatic and mixed pain syndromes included in the same index sample or Hy heterogeneity (failure to differentiate Hy scores into clinically meaningful sub-scales, such as admission of symptoms [Ad] and denial of symptoms [Dn].

Post-traumatic stress disorder symptoms may explain poor mental health in patients with fibromyalgia.

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Toussaint, Loren L; Whipple, Mary O; Vincent, Ann

2017-05-01

Symptoms of post-traumatic stress disorder are common in fibromyalgia patients. This study compared post-traumatic stress disorder symptoms in fibromyalgia patients and healthy controls and determined whether patient-control differences in post-traumatic stress disorder symptoms mediated differences in mental health. In all, 30 patients and 30 healthy controls completed questionnaires assessing symptoms of post-traumatic stress disorder and mental health. Fibromyalgia patients had greater symptoms of post-traumatic stress disorder and mental health than controls. Patient-control differences in mental health symptoms were fully or partially mediated by differences in post-traumatic stress disorder symptoms. Healthcare providers should understand the role of trauma as management of trauma symptoms may be one strategy for improving mental health.

Perceived Discrimination and Mental Health Symptoms among Black Men with HIV

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Bogart, Laura M.; Wagner, Glenn J.; Galvan, Frank H.; Landrine, Hope; Klein, David J.; Sticklor, Laurel A.

2011-01-01

Objective People living with HIV (PLWH) exhibit more severe mental health symptoms than do members of the general public (including depression and post-traumatic stress disorder/PTSD symptoms). We examined whether perceived discrimination, which has been associated with poor mental health in prior research, contributes to greater depression and PTSD symptoms among HIV-positive Black men who have sex with men (MSM), who are at high risk for discrimination from multiple stigmatized characteristics (HIV-serostatus, race/ethnicity, sexual orientation). Method A total of 181 Black MSM living with HIV completed audio computer-assisted self-interviews (ACASI) that included measures of mental health symptoms (depression, PTSD) and scales assessing perceived discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation. Results In bivariate tests, all three perceived discrimination scales were significantly associated with greater symptoms of depression and PTSD (i.e., re-experiencing, avoidance, and arousal subscales) (all p-values discrimination types (p discrimination was negatively associated with depression symptoms when considered in isolation from other forms of discrimination, but positively associated when all three types of discrimination were present. In multivariate tests, only perceived HIV-related discrimination was associated with PTSD symptoms (p discrimination contribute to poor mental health among PLWH. Researchers need to take into account intersecting stigmas when developing interventions to improve mental health among PLWH. PMID:21787061

Psychological Distress, Physical Symptoms, and the Role of Attachment Style in Acupuncture.

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Sochos, Antigonos; Bennett, Ashley

2016-03-01

Context • Attachment research has contributed significantly to the understanding of the origins as well as the treatment of psychological and somatic distress; however, no study so far has explored the role of attachment in acupuncture. The effects on endogenous opioids of both acupuncture and intimate interpersonal bonding as well as clients' reliance on a practitioner's care may suggest that individual differences in attachment style could be linked to individual differences in responses to acupuncture. Objective • The study intended to investigate the role of attachment style in determining outcomes in acupuncture. Design • A pre- and postintervention, single group, quasiexperimental design was used. Setting • Treatment and data collection took place in an acupuncture clinic in London, England, United Kingdom. Eighty-two acupuncture clients with a mean age of 46 ± 14.53 took part in the study. Participants suffered from a variety of somatic and psychological complaints. Intervention • Traditional Chinese acupuncture was administered to all participants in weekly sessions, with the mean number of sessions that participants received being 5 ± 3.5. Outcome Measures • Psychological distress and somatic symptoms were measured using the General Heath Questionnaire (GHQ-12) and the Bradford Somatic Inventory (BSI), respectively. The Relationship Questionnaire (RQ) was used to assess attachment style, with the 4 styles being secure, dismissing, preoccupied, and fearful. Results • After treatment, both somatic and nonsomatic distress were reduced (P attachment insecurity and symptom severity ceased to exist. The strength rather than the quality of the attachment style moderated the reduction in somatic distress, whereas the preoccupied style of attachment moderated the effects of medically unexplained symptoms on distress. Conclusions • Attachment style may have an impact on acupuncture outcomes by predisposing individuals to different patterns of

Temporal Dynamics of Health and Well-Being: A Crowdsourcing Approach to Momentary Assessments and Automated Generation of Personalized Feedback.

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van der Krieke, Lian; Blaauw, Frank J; Emerencia, Ando C; Schenk, Hendrika M; Slaets, Joris P J; Bos, Elisabeth H; de Jonge, Peter; Jeronimus, Bertus F

Recent developments in research and mobile health enable a quantitative idiographic approach in health research. The present study investigates the potential of an electronic diary crowdsourcing study in the Netherlands for (1) large-scale automated self-assessment for individual-based health promotion and (2) enabling research at both the between-persons and within-persons level. To illustrate the latter, we examined between-persons and within-persons associations between somatic symptoms and quality of life. A website provided the general Dutch population access to a 30-day (3 times a day) diary study assessing 43 items related to health and well-being, which gave participants personalized feedback. Associations between somatic symptoms and quality of life were examined with a linear mixed model. A total of 629 participants completed 28,430 assessments, with a mean (SD) of 45 (32) assessments per participant. Most participants (n = 517 [82%]) were women and 531 (84%) had high education. Almost 40% of the participants (n = 247) completed enough assessments (t = 68) to generate personalized feedback including temporal dynamics between well-being, health behavior, and emotions. Substantial between-person variability was found in the within-person association between somatic symptoms and quality of life. We successfully built an application for automated diary assessments and personalized feedback. The application was used by a sample of mainly highly educated women, which suggests that the potential of our intensive diary assessment method for large-scale health promotion is limited. However, a rich data set was collected that allows for group-level and idiographic analyses that can shed light on etiological processes and may contribute to the development of empirical-based health promotion solutions.

Burgeoning menopausal symptoms: An urgent public health concern

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Praveen Kulkarni

2016-01-01

Conclusion: There is a high burden of postmenopausal symptoms which have shown an increasing trend with advancement of age. This calls for establishment of specific health interventions for postmenopausal women in the health-care settings.

[Product safety analysis of somatic cell cloned bovine].

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Hua, Song; Lan, Jie; Song, Yongli; Lu, Chenglong; Zhang, Yong

2010-05-01

Somatic cell cloning (nuclear transfer) is a technique through which the nucleus (DNA) of a somatic cell is transferred into an enucleated oocyte for the generation of a new individual, genetically identical to the somatic cell donor. It could be applied for the enhancement of reproduction rate and the improvement of food products involving quality, yield and nutrition. In recent years, the United States, Japan and Europe as well as other countries announced that meat and milk products made from cloned cattle are safe for human consumption. Yet, cloned animals are faced with a wide range of health problems, with a high death rate and a high incidence of disease. The precise causal mechanisms for the low efficiency of cloning remain unclear. Is it safe that any products from cloned animals were allowed into the food supply? This review focuses on the security of meat, milk and products from cloned cattle based on the available data.

DSM-IV-TR “pain disorder associated with psychological factors” as a nonhysterical form of somatization

OpenAIRE

Aragona, Massimiliano; Tarsitani, Lorenzo; De Nitto, Serena; Inghilleri, Maurizio

2008-01-01

BACKGROUND: Elevated Minnesota Multiphasic Personality Inventory (MMPI) scores on the hysteria (Hy) scale are reported in several forms of pain. Previous results were possibly biased by diagnostic heterogeneity (psychogenic, somatic and mixed pain syndromes included in the same index sample) or Hy heterogeneity (failure to differentiate Hy scores into clinically meaningful sub-scales, such as admission of symptoms [Ad] and denial of symptoms [Dn]).METHODS: To overcome this drawback, 48 patien...

Nausea in Children With Functional Abdominal Pain Predicts Poor Health Outcomes in Young Adulthood.

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Russell, Alexandra C; Stone, Amanda L; Walker, Lynn S

2017-05-01

Nausea is common among children with functional abdominal pain (FAP). We evaluated the relation of nausea to short- and long-term morbidity in pediatric patients with FAP. We performed a prospective study of 871 children with FAP (age, 8-17 y) seen in a pediatric gastroenterology practice; follow-up data were collected from 392 of the patients at 8.7 ± 3.3 years later. Participants were defined as having significant nausea if they reported nausea "a lot" or "a whole lot" within the past 2 weeks. Validated questionnaires assessed abdominal pain, gastrointestinal and somatic symptoms, and depression. Baseline measures, anxiety, and the Rome III criteria were assessed in the follow-up evaluation. At baseline, 44.8% of the patients reported significant nausea. Those with nausea reported worse abdominal pain, gastrointestinal symptoms, somatic symptoms, and depression than those without nausea (P abdominal pain severity. Pediatric patients with FAP and nausea have more severe short- and long-term gastrointestinal and somatic symptoms than patients with FAP without nausea, as well as reductions in mental health and daily function. Pediatric patients with FAP and nausea therefore need intensive treatment and follow-up evaluation. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Attribution-Based Nocebo Effects. Perceived Effects of a Placebo Pill and a Sham Magnetic Field on Cognitive Performance and Somatic Symptoms.

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Szemerszky, Renáta; Dömötör, Zsuzsanna; Berkes, Tímea; Köteles, Ferenc

2016-04-01

Negative non-specific (nocebo-like) effects of medications and electromagnetic fields are often described as results of mistaken attribution. The current study aimed to find empirical evidence supporting this theory. Participants completed questionnaires assessing modern health worries, health anxiety, and somatosensory amplification, were assigned to one of three conditions (placebo pill with sedative information, sham magnetic field, or control), and completed a 14-min vigilance task. Changes in physiological arousal (heart rate, heart rate variability, and skin conductance) and reported symptoms were also measured. Finally, causal attributions concerning cognitive performance and reported symptoms were assessed. No increase in symptom reports and physiological arousal was measured in the two intervention groups. A perceived negative effect on cognitive performance was attributed to both sham conditions, and attributions were connected to modern health worries. A proportion of reported symptoms was ascribed to the placebo pill but not to the sham magnetic field. Symptom attributions were not related to any assessed psychological variables. An aroused physiological state is not necessary for the automatic causal attribution process. Negative effects attributed to medication and environmental factors can be regarded as unavoidable side effects of human cognitive-emotional functioning; they might be alleviated, but cannot be completely eradicated.

High somatic distress with high long-term stability in selected patients with chronic depression: a 3-year follow-up of ratings with Karolinska Scales of Personality (KSP).

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Gardner, Ann; Hällström, Tore

2004-01-01

The main aim of the present study was to investigate mean levels and long-term stability of three scales from the Karolinska Scales of Personality (KSP), assessing somatic components of anxiety proneness in selected patients with chronic depressive symptoms. The KSP was filled in by 84 patients (26 men and 58 women) with a history of or ongoing major depression and audiological, or other comorbid somatic, symptoms. Mean scores for the Somatic Anxiety, Muscular Tension and Psychasthenia scales were above two standard deviations compared to a normative group sampled from the population. The KSP was filled in at follow-up by 65 patients. The mean interval between the ratings was 3.5 years. Comparisons between the ratings of the three scales revealed no significant mean score differences, and quite high individual stability. The mean scores were significantly increased in comparisons with depressed patients in primary care suggesting that these patients with chronic depression may comprise a depressive sub-type characterized by high "somatic distress". A putative origin for the high and stable scores in the presented sub-group of depressed patients, and the concept of "personality trait" in use even for pronounced symptoms, are discussed.

The association of depression and anxiety with medical symptom burden in patients with chronic medical illness.

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Katon, Wayne; Lin, Elizabeth H B; Kroenke, Kurt

2007-01-01

Primary care patients with anxiety and depression often describe multiple physical symptoms, but no systematic review has studied the effect of anxiety and depressive comorbidity in patients with chronic medical illnesses. MEDLINE databases were searched from 1966 through 2006 using the combined search terms diabetes, coronary artery disease (CAD), congestive heart failure (CHF), asthma, COPD, osteoarthritis (OA), rheumatoid arthritis (RA), with depression, anxiety and symptoms. Cross-sectional and longitudinal studies with >100 patients were included as were all randomized controlled trials that measure the impact of improving anxiety and depressive symptoms on medical symptom outcomes. Thirty-one studies involving 16,922 patients met our inclusion criteria. Patients with chronic medical illness and comorbid depression or anxiety compared to those with chronic medical illness alone reported significantly higher numbers of medical symptoms when controlling for severity of medical disorder. Across the four categories of common medical disorders examined (diabetes, pulmonary disease, heart disease, arthritis), somatic symptoms were at least as strongly associated with depression and anxiety as were objective physiologic measures. Two treatment studies also showed that improvement in depression outcome was associated with decreased somatic symptoms without improvement in physiologic measures. Accurate diagnosis of comorbid depressive and anxiety disorders in patients with chronic medical illness is essential in understanding the cause and in optimizing the management of somatic symptom burden.

Primary care, depression, and anxiety: exploring somatic and emotional predictors of mental health status in adolescents.

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Dumont, Ian P; Olson, Ardis L

2012-01-01

A growing body of research points to regular, comprehensive mental health screening in primary care practices as an effective tool, but a thorough and efficient approach is not yet widely used. The purpose of this report is to describe the pattern of mental health-related concerns, protective and social risk factors reported by adolescents during routine well-child visits in primary care settings, and their occurrence among teens that screen positive for either depression or anxiety with brief validated measures. A personal digital assistant-based questionnaire was administered as part of clinical care to adolescents 11 to 18 years old (N = 2184) attending preventive well-child visits in 13 pediatric and family medicine primary care practices in a northern New England practice-based research network over 18 months (2008 to 2009). Depressive and anxiety-related symptoms were assessed using the 2-question versions of the Patient Health Questionnaire and Generalized Anxiety Disorder scale, respectively. Analyses determined the role that the protective and social risk factors played in determining who screens positive for depression and anxiety. In the fully adjusted model, risk factors that were significant (P stress (AOR, 3.59); anger (AOR, 1.94); and worries about family alcohol and drug use (AOR, 2.69). Among protective factors, that is, those that reduce the risk of depression, age (AOR, 0.87 for younger patients); having parents who listen (AOR, 0.34); and having more assets (AOR, 0.65) were significant. Significant predictors of screening positive for anxiety included substance use (AOR, 1.97); stress (AOR, 6.10); anger (AOR, 2.31); trouble sleeping (AOR, 1.75), and the sex of the adolescent (AOR, 1.87 for girls). Although having parents who listen was still a significant protective factor for anxiety (AOR, 2.26), other assets were not significant. Comprehensive primary care mental health screening that considers both anxiety and depression while including

Intimate partner violence and mental health symptoms in African American female ED patients.

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Houry, Debra; Kemball, Robin; Rhodes, Karin V; Kaslow, Nadine J

2006-07-01

Intimate partner violence (IPV) victims often seek care in the ED, whether for an injury from abuse or other sequelae such as mental health symptoms. The objective of the study was to assess whether depressive symptoms, posttraumatic stress disorder (PTSD), and suicidality were associated with physical, sexual, or emotional IPV in African American female ED patients and to determine if experiencing multiple types of abuse was associated with increased mental health symptoms. All eligible African American female patients were approached in the ED waiting room during study periods. Patients participated in the screening process via a computer kiosk. Questions regarding IPV and mental health symptoms were asked using validated tools. In this prospective cohort, 569 participated and 36% of those in a relationship in the past year (n=461) disclosed that there were victims of IPV in the past year. In the past year, 22% experienced recent physical abuse, 9% recent sexual abuse, and 32% recent emotional abuse. A Pearson correlation was conducted and showed that all mental health symptoms were positively correlated with each type of IPV and each type of mental health symptom category. Mental health symptoms increased significantly with amount of abuse: depression (odds ratio [OR], 5.9 for 3 types of abuse), PTSD (OR, 9.4 for 3), and suicidality (OR, 17.5 for 3). Emotional, sexual, and physical IPV were significantly associated with mental health symptoms. Each type of abuse was independently associated with depression, suicidality, and PTSD. Experiencing more than 1 type of abuse was also correlated with increased mental health symptoms.

Acceptance and commitment group therapy for health anxiety

DEFF Research Database (Denmark)

Eilenberg, Trine

2013-01-01

Health anxiety (or hypochondriasis) is prevalent, may be persistent and disabling for the sufferers and associated with high societal costs. Acceptance and Commitment Therapy (ACT) is a new third-wave behavioral cognitive therapy that has not yet been tested in health anxiety. 34 consecutive Danish...... patients with severe health anxiety were referred from general practitioners or hospital departments and received a ten session ACT group therapy. Patients were followed-up by questionnaires for 6 months. There were significant reductions in health anxiety, somatic symptoms and emotional distress at 6...

Predictors of Mental Health Symptoms, Automatic Thoughts, and Self-Esteem Among University Students.

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Hiçdurmaz, Duygu; İnci, Figen; Karahan, Sevilay

2017-01-01

University youth is a risk group regarding mental health, and many mental health problems are frequent in this group. Sociodemographic factors such as level of income and familial factors such as relationship with father are reported to be associated with mental health symptoms, automatic thoughts, and self-esteem. Also, there are interrelations between mental health problems, automatic thoughts, and self-esteem. The extent of predictive effect of each of these variables on automatic thoughts, self-esteem, and mental health symptoms is not known. We aimed to determine the predictive factors of mental health symptoms, automatic thoughts, and self-esteem in university students. Participants were 530 students enrolled at a university in Turkey, during 2014-2015 academic year. Data were collected using the student information form, the Brief Symptom Inventory, the Automatic Thoughts Questionnaire, and the Rosenberg Self-Esteem Scale. Mental health symptoms, self-esteem, perception of the relationship with the father, and level of income as a student significantly predicted automatic thoughts. Automatic thoughts, mental health symptoms, participation in family decisions, and age had significant predictive effects on self-esteem. Finally, automatic thoughts, self-esteem, age, and perception of the relationship with the father had significant predictive effects on mental health symptoms. The predictive factors revealed in our study provide important information to practitioners and researchers by showing the elements that need to be screened for mental health of university students and issues that need to be included in counseling activities.

THE OUTCOME OF INITIAL PRE SELF HYPNOSIS ON SOM ATIC AND PSYCHOBIOLOGIC SYMPTOMS

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Avnish

2015-10-01

Full Text Available Study was carried out in 30 stressed male subjects in the age group of 18 - 70 years at Samatvam Institute, Baroda. The mean age of the subject was 42 years. Parameters selected were somatic and psychological symptoms (sleeplessne ss, emotional disturbance, self - esteem, helple ssness, sexual problems. The subjects underwent hypnotic sessions and the symptoms were assessed before and after on the scale of 1 to 10. The result obtained shows improvement in both somatic and psychological symptoms post hypnotic sessions. Somatic pre sentation improved from 4.3 to 5.5, Sleep disturbance improved from 4.2 to 6.06, Emotional disturbance were brought und er control 3.2 to 5.6, low self - esteem was corrected from 6.2 to 7.1, Helplessness & Sexual problems showed positive change from 6.4 to 7 .03 and from 6.5 to 7.1 respectively. The results were analysed by paired t Test with the help of SPSS 17 package. Most of the results were significant while some showed negative significance

Web Use for Symptom Appraisal of Physical Health Conditions: A Systematic Review.

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Mueller, Julia; Jay, Caroline; Harper, Simon; Davies, Alan; Vega, Julio; Todd, Chris

2017-06-13

The Web has become an important information source for appraising symptoms. We need to understand the role it currently plays in help seeking and symptom evaluation to leverage its potential to support health care delivery. The aim was to systematically review the literature currently available on Web use for symptom appraisal. We searched PubMed, EMBASE, PsycINFO, ACM Digital Library, SCOPUS, and Web of Science for any empirical studies that addressed the use of the Web by lay people to evaluate symptoms for physical conditions. Articles were excluded if they did not meet minimum quality criteria. Study findings were synthesized using a thematic approach. A total of 32 studies were included. Study designs included cross-sectional surveys, qualitative studies, experimental studies, and studies involving website/search engine usage data. Approximately 35% of adults engage in Web use for symptom appraisal, but this proportion varies between 23% and 75% depending on sociodemographic and disease-related factors. Most searches were symptom-based rather than condition-based. Users viewed only the top search results and interacted more with results that mentioned serious conditions. Web use for symptom appraisal appears to impact on the decision to present to health services, communication with health professionals, and anxiety. Web use for symptom appraisal has the potential to influence the timing of help seeking for symptoms and the communication between patients and health care professionals during consultations. However, studies lack suitable comparison groups as well as follow-up of participants over time to determine whether Web use results in health care utilization and diagnosis. Future research should involve longitudinal follow-up so that we can weigh the benefits of Web use for symptom appraisal (eg, reductions in delays to diagnosis) against the disadvantages (eg, unnecessary anxiety and health care use) and relate these to health care costs. ©Julia Mueller

Association between psychiatric symptoms and erectile dysfunction.

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Corona, Giovanni; Ricca, Valdo; Bandini, Elisa; Mannucci, Edoardo; Petrone, Luisa; Fisher, Alessandra D; Lotti, Francesco; Balercia, Giancarlo; Faravelli, Carlo; Forti, Gianni; Maggi, Mario

2008-02-01

Erectile dysfunction (ED) is often associated with a wide array of psychiatric symptoms, although few studies systematically address their specific association with ED determinants. The aim of this study is to explore the relationship between ED (as assessed by SIEDY Structured Interview, a 13-item tool which identifies and quantifies the contribution of organic, relational, and intrapsychic domains of ED) and different psychopathological symptoms (as assessed by the Middlesex Hospital Questionnaire, a self-reported test for the screening of mental disorders in a nonpsychiatric setting). A consecutive series of 1,388 (mean age 51 +/- 13 years) male patients with ED was studied. Several hormonal and biochemical parameters were investigated, along with SIEDY Interview and the Middlesex Hospital Questionnaire. Psychiatric symptoms resulted differentially associated with SIEDY domains. Depressive and phobic-anxiety symptoms were associated with the relational domain, somatization with the organic one, while free-floating anxiety, obsessive-compulsive, and phobic symptoms were significantly related with higher intrapsychic SIEDY scores. In addition, relevant depressive symptomatology was associated with hypogonadism, the presence of low frequency of intercourse, hypoactive sexual desire (HSD), and conflictual relationships within the couple and the family. Patients with high free-floating anxiety symptoms were younger, and complained of an unsatisfactory work and a conflictual relationship within family. Conversely, subjects with higher phobic anxious symptoms displayed a more robust relational functioning. Similar results were observed in subjects with obsessive-compulsive symptoms, who also reported a lower prevalence of HSD. Finally, subjects with somatization symptoms showed the worst erectile function. The main value of this study is that it alters various clinicians' belief that many psychiatric symptoms can be found among ED patients. Systematic testing of

Human Figure Test in the research of psychopathological state of refugees and somatically traumatized

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Opalić Petar

2005-01-01

Full Text Available Machover Human Figure Test was used to investigate eight clinical features in five diagnostic categories (neurosis, depression, schizophrenia, paranoid feature and aggressiveness and one symptom (motor deficiency through graphical features of human figure drawing. The test involved 201 subjects, out of whom 109 were refugees from refugee camp in Krnjača, 31 somatically traumatized patients from the Orthopedic Clinic, Clinical Center of Serbia, Belgrade, and 61 subjects from Belgrade denying any traumatic experience whatsoever. The following was determined in three tested subgroups: - Out of general psychopathological features, "thickened line of the drawing", "unclear medium line of the drawing" and "absence of an arm or a leg" were significantly most frequent in the group of somatically traumatized subjects, thus supporting the hypothesis that Machover Test examined projective aspects of disorder of the body scheme experience. - Out of eight diagnostic categories, only "motor deficiency" was significantly different - of course, in the group of somatically traumatized subjects, while "aggressiveness" was different in the group of refugees.

Less screen time and more frequent vigorous physical activity is associated with lower risk of reporting negative mental health symptoms among Icelandic adolescents.

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Soffia M Hrafnkelsdottir

Full Text Available Few studies have explored the potential interrelated associations of screen time and physical activity with mental health in youth, particularly using objective methods. We examined cross-sectional associations of these variables among Icelandic adolescents, using objective and subjective measurements of physical activity.Data were collected in the spring of 2015 from 315 tenth grade students (mean age 15.8 years in six elementary schools in metropolitan Reykjavík, Iceland. Participants reported, via questionnaire, on demographics, weekly frequency of vigorous physical activity, daily hours of screen time and mental health status (symptoms of depression, anxiety and somatic complaints, self-esteem and life satisfaction. Total physical activity was measured over one week with wrist-worn accelerometers. Body composition was determined by DXA-scanning. Poisson regression analysis was used to explore independent and interactive associations of screen time and physical activity with mental health variables, adjusting for gender, body fat percentage and maternal education.Less screen time (below the group median of 5.3 h/day and more frequent vigorous physical activity (≥4x/week were each associated with reporting fewer symptoms of depression, anxiety, low self-esteem, and life dissatisfaction. No significant associations were observed between objectively measured physical activity and mental health outcomes. Interactive regression analysis showed that the group reporting both less screen time and more frequent vigorous physical activity had the lowest risk of reporting symptoms of depression, anxiety, low self-esteem, and life dissatisfaction.Reports of less screen time and more frequent vigorous physical activity were associated with lower risk of reporting mental health problems among Icelandic adolescents. Those who reported a combination of engaging in less screen time and more frequent vigorous physical activity had the lowest risk

Posttraumatic Stress Disorder and Physical Health Symptoms Among Women Seeking Help for Relationship Aggression

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Taft, Casey T.; Vogt, Dawne S.; Mechanic, Mindy B.; Resick, Patricia A.

2010-01-01

This study examined associations between intimate partner aggression and physical health symptoms among a sample of help-seeking women experiencing relationship aggression (N = 388). Using a structural equation modeling framework, the authors found posttraumatic stress disorder (PTSD) symptoms to fully mediate the associations of both physical and psychological aggression with physical health symptoms. The influence of PTSD symptoms on physical health symptoms was partially mediated by anger/irritability. Results were consistent with studies from other trauma groups suggesting that PTSD is pivotal with respect to explaining the effects of trauma on health. PMID:17874920

Mental health of Chinese primary care patients with lower urinary tract symptoms.

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Choi, Edmond P H; Lam, Cindy L K; Chin, Weng Yee

2016-01-01

The aim of this study was to evaluate the mental health of Chinese primary care patients with lower urinary tract symptoms (LUTS). This was a cross-sectional observational study. Five hundred and nineteen subjects with LUTS completed a structured questionnaire containing the Depression, Anxiety, and Stress Scale-Short Form, the International Prostate Symptom Score, the adapted International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and questions about socio-demographics. Overall, 17.7% of subjects reported depressive symptoms, 24.3% anxiety symptoms and 9.6% stress symptoms. In males, demographic factors associated with poorer mental health included being not married; clinical factors included higher LUTS severity, weak stream, straining and mixed urinary incontinence. In females, demographic factors associated with poorer mental health included being younger, not married and lower household income; clinical factors included higher LUTS severity, incomplete bladder emptying, urgency and weak stream. Chinese primary care patients with LUTS appear to be an at-risk group for poorer mental health with increased prevalence of anxiety and depressive symptoms and may require routine screening to identify those who may require more tailored interventions to address both their urinary symptoms and psychological distress.

Symptoms and Syndromes of Bodily Distress: An Exploratory Study of 978 Internal Medical, Neurological, and Primary Care Patients

DEFF Research Database (Denmark)

Fink, Per; Toft, Tomas; Hansen, Morten Steen

2007-01-01

OBJECTIVE: Physical complaints not attributable to verifiable, conventionally defined diseases, i.e., medically unexplained or functional somatic symptoms, are prevalent in all medical settings, but their classification is contested as numerous overlapping diagnoses and syndrome labels have been...... using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) diagnostic instrument. RESULTS: Patients complained of a median of five functional somatic symptoms; women of six, men of four (p ... component factor analysis identified a cardiopulmonary including autonomic (CP), a musculoskeletal (MS), and a gastrointestinal (GI) symptom group explaining 36.9% of the variance. Latent class analysis showed that the symptom groups are likely to materialize in the same patients, suggesting...

The relationship between ataque de nervios and unexplained neurological symptoms: a preliminary analysis.

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Interian, Alejandro; Guarnaccia, Peter J; Vega, William A; Gara, Michael A; Like, Robert C; Escobar, Javier I; Díaz-Martínez, Angélica M

2005-01-01

Within somatization, unexplained neurological symptoms (UNSs) have been shown to mark a distinct subgroup with greater clinical severity. However, some UNSs resemble ataque de nervios somatic symptoms. This raises questions about cultural factors related to Hispanics with somatization characterized by UNSs. To examine cultural factors, preliminary analyses examined the relationship between Hispanic ethnicity, UNSs, and ataque de nervios. Data were obtained from 127 primary care patients (95 Hispanic, 32 European American) with somatization. The Composite International Diagnostic Interview provided somatization data, whereas the Primary Care Evaluation of Mental Disorders was used for data on Axis I disorders. Ataque de nervios was assessed via a proxy measure. Within each ethnic group, cross-tabs examined the relationship between ataque de nervios and multiple UNSs, and ataque de nervios and selected Axis I disorders. Only among Hispanics, a significant overlap was found between ataque de nervios and having four or more UNSs (p nervios and a diagnosis of panic disorder (p = .05). Although equal percentages of European Americans and Hispanics experience multiple UNSs, these results show that the presentation of UNSs among some Hispanics may be qualitatively different, because it may involve features related to ataque de nervios. A diagnosis of panic disorder also appears to interact with cultural factors.

The psychosomatic symptom and the self: a sirens' song.

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Kradin, R L

1997-07-01

This paper examines the symbolic nature of the psychosomatic symptom. It is suggested that the psychosomatic symptom is an informationally rich symbolic derivative of the Self that serves to focus attention on developmental disturbances in the archetypal processes of constructing body image and interpreting dysphoric somatic sensations. Clinical examples are offered to illustrate the changing nature of the psychomatic symptom in society. The therapeutic importance of monitoring affectual transactions in the transference-countertransference field is stressed.

Health symptoms in residents living near shale gas activity: A retrospective record review from the Environmental Health Project

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Beth Weinberger

2017-12-01

Full Text Available Increasing evidence demonstrates an association between health symptoms and exposure to unconventional natural gas development (UNGD. The purpose of this study is to describe the health of adults in communities with intense UNGD who presented for evaluation of symptoms. Records of 135 structured health assessments conducted between February 2012 and October 2015 were reviewed retrospectively. Publicly available data were used to determine proximity to gas wells. Analysis was restricted to records of adults who lived within 1km of a well in Pennsylvania and denied employment in the gas industry (n=51. Symptoms in each record were reviewed by a physician. Symptoms that could be explained by pre-existing or concurrent conditions or social history and those that began or worsened prior to exposure were excluded. Exposure was calculated using date of well drilling within 1km. The number of symptoms/participant ranged from 0 to 19 (mean=6.2; SD=5.1. Symptoms most commonly reported were: sleep disruption, headache, throat irritation, stress or anxiety, cough, shortness of breath, sinus problems, fatigue, nausea, and wheezing. These results are consistent with findings of prior studies using self-report without physician review. In comparison, our results are strengthened by the collection of health data by a health care provider, critical review of symptoms for possible alternative causes, and confirmation of timing of exposure to unconventional natural gas well relative to symptom onset or exacerbation. Our findings confirm earlier studies and add to the growing body of evidence of the association between symptoms and exposure to UNGD. Keywords: Hydraulic fracturing, Health, Fracking, Shale gas, Unconventional gas

A-MUPS score to differentiate patients with somatic symptom disorder from those with medical disease for complaints of non-acute pain.

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Suzuki, Shingo; Ohira, Yoshiyuki; Noda, Kazutaka; Ikusaka, Masatomi

2017-01-01

To develop a clinical score to discriminate patients with somatic symptom disorder (SSD) from those with medical disease (MD) for complaints of non-acute pain. We retrospectively examined the clinical records of consecutive patients with pain for a duration of ≥1 month in our department from April 2003 to March 2015. We divided the subjects according to the diagnoses of definite SSD (as diagnosed and tracked by psychiatrists in our hospital), probable SSD (without evaluation by psychiatrists in our hospital), matched MD (randomly matched two patients by age, sex, and pain location for each definite SSD patient), unmatched MD, other mental disease, or functional somatic syndrome (FSS). We investigated eight clinical factors for definite SSD and matched MD, and developed a diagnostic score to identify SSD. We subsequently validated the model with cases of probable SSD and unmatched MD. The number of patients with definite SSD, probable SSD, matched MD, unmatched MD, other mental disease, and FSS was 104 (3.5%), 214 (7.3%), 197 (6.7%), 742 (25%), 708 (24%), and 978 (33%), respectively. In a conditional logistic regression analysis, the following five factors were included as independent predictors of SSD: Analgesics ineffective, Mental disorder history, Unclear provocative/palliative factors, Persistence without cessation, and Stress feelings/episodes (A-MUPS). The area under the receiver operating characteristic curve (AUC) of the model was 0.900 (95% CI: 0.864-0.937, p <0.001), and the McFadden's pseudo- R -squared was 0.709. For internal validation, the AUC between probable SSD and unmatched MD was 0.930 (95% CI: 0.910-0.950, p <0.001). The prevalence and the likelihood ratio of SSD increased as the score increased. The A-MUPS score was useful for discriminating patients with SSD from those with MD for complaints of non-acute pain, although external validation and refinement should be needed.

Work overload, burnout, and psychological ill-health symptoms: a three-wave mediation model of the employee health impairment process.