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1
Hudiburg, Richard A. "Psychology of Computer Use: XVII. The Computer Technology Hassles Scale: Revision, Reliability, and Some Correlates." Psychological Reports 65, no. 3_suppl2 (December 1989): 1387–94. http://dx.doi.org/10.2466/pr0.1989.65.3f.1387.
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The reliability of the Computer Technology Hassles Scale, a measure of computer-related stress, and correlates of this measure were investigated. A questionnaire requested demographic data and exposure to computer information, the 69-item Computer Technology Hassles Scale, Perceived Stress Scale, a global measure of stress, the Computer Attitude Scale, and the somatic complaint items from the Hopkins Symptom Checklist. A total of 100 students responded to two administrations, given 2 months apart, of the questionnaire. Test-retest reliability was .64. Correlations of scores on the Computer Technology Hassles Scale with perceived stress were .26 (Time 1), .18 (Time 2) and with somatic complaints .15 (Time 2) and .36 (Time 2). Correlations of the scale with attitudes toward computers were –.08 (Time 1), .03 (Time 2) and with computer anxiety was –.11 (Time 2).
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Shanahan, L., N. Zucker, W. E. Copeland, C. L. Bondy, H. L. Egger, and E. J. Costello. "Childhood somatic complaints predict generalized anxiety and depressive disorders during young adulthood in a community sample." Psychological Medicine 45, no. 8 (December 18, 2014): 1721–30. http://dx.doi.org/10.1017/s0033291714002840.
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BackgroundChildren with somatic complaints are at increased risk for emotional disorders during childhood. Whether this elevated risk extends into young adulthood – and to which specific disorders – has rarely been tested with long-term prospective-longitudinal community samples. Here we test whether frequent and recurring stomach aches, headaches, and muscle aches during childhood predict emotional disorders in adulthood after accounting for childhood psychiatric and physical health status and psychosocial adversity.MethodThe Great Smoky Mountains Study is a community representative sample with 1420 participants. Children/adolescents were assessed 4–7 times between ages 9–16 years. They were assessed again up to three times between ages 19–26 years. Childhood somatic complaints were coded when subjects or their parents reported frequent and recurrent headaches, stomach aches, or muscular/joint aches at some point when children were aged 9–16 years. Psychiatric disorders were assessed with the Child and Adolescent Psychiatric Assessment and the Young Adult Psychiatric Assessment.ResultsFrequent and recurrent somatic complaints in childhood predicted adulthood emotional disorders. After controlling for potential confounders, predictions from childhood somatic complaints were specific to later depression and generalized anxiety disorder. Long-term predictions did not differ by sex. Somatic complaints that persisted across developmental periods were associated with the highest risk for young adult emotional distress disorders.ConclusionsChildren from the community with frequent and recurrent physical distress are at substantially increased risk for emotional distress disorders during young adulthood. Preventions and interventions for somatic complaints could help alleviate this risk.
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Fisch, Robert Z. "Masked Depression: Its Interrelations with Somatization, Hypochondriasis and Conversion." International Journal of Psychiatry in Medicine 17, no. 4 (December 1988): 367–79. http://dx.doi.org/10.2190/cr7j-wu5n-hc5x-2jq5.
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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.
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Zouini, Btissame, Anis Sfendla, Meftaha Senhaji, Maria Råstam, and Nóra Kerekes. "Somatic health and its association with negative psychosocial factors in a sample of Moroccan adolescents." SAGE Open Medicine 7 (January 2019): 205031211985252. http://dx.doi.org/10.1177/2050312119852527.
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Background: Adolescence is a distinct developmental phase characterized by multiple physical and psychological changes and by an increased vulnerability to somatic and mental health problems. These risk and vulnerability factors are part of a complex biopsychosocial matrix, encompassing multiple factors, such as inherited biological determinants and psychological, societal, and cultural influences, which affect an adolescent’s overall wellbeing. In Morocco, similar to other developing countries, adolescents (young people aged from 15 to 19 years) constitute a substantial proportion of the population (almost 9%). However, studies about adolescents’ health in developing countries are scarce. In this study, we describe adolescents’ somatic health in a sample of high school students from the city of Tetouan, Morocco, and investigate how negative psychosocial factors, such as parental alcohol use problems and/or the experience of abuse, may influence them. Methods: The study sample included 655 adolescents (315 boys and 340 girls, M = 16.64 years, range = 15–18 years) from conviniently selected classes of four high schools in the city of Tetouan in Morocco. The students responded to a survey that assessed the prevalence of somatic complaints/disorders. They also indicated whether they had ever experienced physical and/or psychological abuse and whether they had parents with alcohol use problems. Results: More than half of the adolescents suffered from headaches and one-third had substantial problems with diarrhea or constipation. Both problems were more common in female students. The third most frequent somatic problem, affecting one in four in both genders, was allergy. Almost one-third of Moroccan adolescents (significantly more boys than girls; p = 0.004) reported no somatic complaints. In adolescents who reported parental alcohol use problems and/or experience of physical and/or psychological abuse, the prevalence of several somatic complaints (epilepsy, migraine, headache, diarrhea/constipation, gluten intolerance, allergy, and skin or thyroid disease) increased highly significantly compared to the adolescents who reported no such psychosocial environmental factors. Conclusion: The results suggest that only 3 in 10 urban-living Moroccan adolescents are free of somatic complaints, while the majority suffer from some somatic problems, most often headaches and diarrhea/constipation. The association of certain negative psychosocial factors with adolescents’ somatic health suggests the need of a holistic approach to the treatment of affected adolescents.
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Giurgi-Oncu, C., C. Bredicean, F. Giurgi-Oncu, R. Romosan, and M. Ienciu. "Depression, somatic complaints and medical help-seeking in a Romanian sample." European Psychiatry 33, S1 (March 2016): S389. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1401.
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IntroductionDepression as a disorder, with all its intensities and clinical forms, requires to be projected on the backdrop of human suffering. In evaluating a depressive episode of a somatically ill person, it is important to assess personality and social context as a whole.ObjectivesTo establish the degree of somatic comorbidity/somatization in depressive patients and the correlation with their social support network.AimsTo recommend cost-effective psycho-social interventions to offer relief and support.MethodWe evaluated 60 patients with depression of various etiologies (Recurrent depressive disorder, Paranoid-depressive disorder, Anxious-depressive disorder). Self-report and observer rating scales were used (SCL-90, Beck, Hamilton) along with a suplimentary consult (where required) by different specialists. Direct observations were made regarding the social support network, in terms of evaluating their scale and efficiency.ResultsThe majority of patients included showed an obvious inconsistency in terms of objective and subjective symptoms, correlated with the lack of an adequate social support network. This resulted in more medical help-seeking, a polymorphic array of somatic symptoms, oscillations of somatic complaints, some showing lack of adherence and only mild improvement with psychotropic therapy. Most of the somatized complaints were gastro-intestinal, respiratory, pain-related and pseudo-neurological, with an increased overall evidence-based cardio-vascular comorbidity.ConclusionsWe suggest that in order to help support patients and ensure fluidization of medical services, mental health care could also be delivered effectively in primary care settings, through community-based programmes and task shifting approaches that engage and support skilled non-specialist health professionals, lay workers, affected individuals, and caregivers (Kakuma, 2011).Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Goldman, Susan L., Joan Hargrave, Robert E. Hillman, Eva Holmberg, and Carla Gress. "Stress, Anxiety, Somatic Complaints, and Voice Use in Women With Vocal Nodules." American Journal of Speech-Language Pathology 5, no. 1 (February 1996): 44–54. http://dx.doi.org/10.1044/1058-0360.0501.44.
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Psychosocial factors long have been associated with the development of hyperfunctional voice disorders such as vocal nodules. However, experimental evidence concerning the role of these factors in the etiology of vocal nodules specifically is sparse. The present study represents a preliminary examination of some psychosocial factors for 3 groups of adult female subjects: 27 with vocal nodules, 17 with hyperfunctionally related voice disorders other than nodules (pathological control), and 33 with no history of voice disorders (normal control). Four psychosocial factors were studied: stress (measured by the Social Readjustment Rating Questionnaire), anxiety (measured by the State-Trait Anxiety Inventory), voice use, and somatic complaints (both measured by our own instruments). Relative to the normal control group, the patients with nodules showed significantly increased scores on all factors except stress. The pathological control group showed significantly increased scores on all factors except voice use. No significant differences were found between the group with nodules and the pathological control group on any factor. The results are discussed in terms of their implications for clinical practice and future research.
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Huda, Nazmul, Md Nure Alam Siddiqui, Md Zahirul Haque, Md Azizul Hoque, MMR Khan, MK Rahman, Md Rafiqul Islam, Abdullah Al Mamun Hussain, and Jawadul Haque. "Feeling of fever is a feature of psychiatric illness in our patients." TAJ: Journal of Teachers Association 27, no. 1 (November 28, 2018): 1–3. http://dx.doi.org/10.3329/taj.v27i1.37600.
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The patients present to their physician with their somatic symptoms which are attributable to some medical illness. This is not always true. Sometimes a few patients present with the complaints of prolonged fever for months to year duration. As fever is an important vital sign it gains attention of the physician to work up and reveal the cause. In this study apparently healthy patients who complained of prolonged fever were clinically assessed, routine investigations were done and found normal. Then they were provided with a temperature chart to note down body temperature with a thermometer for one week from first visit. Afebrile such fifty patients complaining of fever were referred to psychiatrist for evaluation. All patients showed some sort of psychiatric illness. 20 (40%) were of generalized anxiety disorder, 10 (20%) depression, 5 (10%) mixed anxiety and depression, 5 (10%) obsessive compulsive disorder, 10 (20%) somatoform disorder. The practicing physician may encounter many patients of prolonged fever which are not febrile at all so they need psychiatric assessment and treatment to relieve their distress.TAJ 2014; 27(1): 1-3
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Yemelyanova, N. Yu. "CLINICAL INDICES OF DENTAL STATUS OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASES." Ukrainian Dental Almanac, no. 3 (September 4, 2018): 5–10. http://dx.doi.org/10.31718/2409-0255.3.2018.01.
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The article deals with the main dental manifestations in COPD comorbid with CHD on the background of received basic therapy. Chronic obstructive pulmonary disease (COPD), and often coronary heart disease (CHD) associated with it are some of the somatic diseases that have dental manifestations. COPD manifests itself as a persistent restriction of airway patency and is associated with increased chronic inflammatory response of respiratory tract to the action of harmful particles or gases. COPD is often complicated by CHD which combination occurs in more than 55% of cases. It is known that the drugs that are used to treat these diseases have a side effect on the oral cavity.
The aim of the study was to research complaints and the clinical status of the oral cavity in patients with cardiorespiratory pathology.
Material and methods of the study: 130 patients with a verified diagnosis of COPD and CHD taking baseline therapy have been questioned and examined according to the domestic and international protocols for diagnosis and treatment. All patients were divided into three groups depending on the duration of therapy for the underlying disease: 1A group (49 patients with duration of treatment not more than 3 years), 1B group (40 patients with duration of therapy from 3 to 5 years) and 1C group (41 patients with duration of treatment more than 5 years). The questionnaire included the presence and nature of complaints and questions about individual oral hygiene. The definition of dental status has been carried out according to the standard scheme. Statistical processing has been carried out with the calculation of the median, interquartile range, the Mann-Whitney and c-square test.
Results of the study. The main stomatologic complaints of all patients are dryness in the oral cavity, taste distortion, halitosis and hyperesthesia. The most common complaint of the vast majority of all patients was dryness in the oral cavity, which, in the respondents' opinion, was associated with the basic therapy of somatic disease. It is typical that frequency of these complaints occurrence was significantly higher in the group that takes long-term medications for COPD and СHD. The sensation of saliva lack was eliminated by mouth rinsing with water, however, despite the fact that relief was immediate, its duration was no more than two hours. The increased sensitivity of the teeth is associated with a violation of mineral metabolism due to a decrease of remineralizing properties of saliva and release of mineral components from the hard tissue of the teeth under the drugs. Patients form each of the groups noted distortion of taste sensations, which were associated with the beginning drugs intake. The main clinical changes were found in the mucous membrane of the lips, cheeks and papillary apparatus of the tongue, the severity and prevalence of these changes increased with duration of the disease. Almost all patients have got various clinical and morphological pathological changes in periodontal tissues. However, if the ratio of inflammatory changes to atrophic in 1A group is 1: 4.5, then in the 1C group this ratio is 1: 2.
Conclusions: The frequency and intensity of dental complaints and clinical manifestations increase with the duration of COPD and CHD. All changes have been caused by the influence both of somatic pathology itself and side effects of medications. Thus, the study of the long-term side effect of drug therapy on the oral cavity of patients with somatic pathology seems relevant, and the variety of manifestations requires the development of adequate comprehensive diagnostic and prophylactic methods.
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Shvailikova, I. E., and E. I. Belikova. "Evaluation of the condition of the eye surface in patients with burdened general somatic history. Early diagnosis, treatment and prevention methods." Fyodorov journal of ophthalmic surgery, no. 4 (December 29, 2020): 56–62. http://dx.doi.org/10.25276/0235-4160-2020-4-56-62.
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Introduction. Modern computerisation, frequent use of contact correction, surgical interventions on the visual organ and long-term drug installations often lead to the formation and further progression of dry eye syndrome (DES) with subsequent increased sensitivity and inflammatory symptoms on the conjunctiva and cornea. Purpose. Evaluation of the condition of the eye surface in patients with a burdened general somatic history. Development of measures for prevention, diagnosis and comprehensive treatment of this condition. Material and methods. A retrospective analysis of disease histories and medical records of 108 patients (108 eyes) with phacoemulsification of uncomplicated cataract with IOL implantation was carried out. Patients were divided into three main groups based on the presence of burdening factors of somatic status and the course of the postoperative period: I group included patients with unburdened somatic status and no complications during the course of the postoperative period; II group included patients with burdened general somatic history with complications during the course of the postoperative period; 3rd group included patients with burdened general somatic history with complications during the course of the postoperative period. 3rd group of patients used a special scheme to prevent and treat inflammatory reactions from the eye surface. Results. 1st group patients were less likely to complain and had no clinical manifestations of conjunctival and corneal inflammatory responses. Accordingly, this group of patients did not require additional treatment, which is indicative of the low incidence of complications in this category of patients. II group patients who had been identified as predisposing factors for conjunctival and corneal inflammatory reactions and did not receive additional treatment were more likely to experience complaints and the frequency of clinical manifestations was 20% higher than III group patients. Patients in III group required additional treatment in the postoperative period. Conclusion. Prolonged prescription of high doses of drugs of different groups with different preservative and auxiliary substances content in patients after surgical intervention in some cases leads to damage to the conjunctival and corneal epithelium, which in turn causes an aggravation of symptoms of SSG with the development of inflammatory reaction of the conjunctiva and cornea. The application of preventive measures before and after the surgery leads to a significant reduction in the objective manifestations of the eye surface complications and, as a result, a reduction in the number of complaints from patients about discomfort in the postoperative period. Key words: ocular surface, dry eye syndrome, cataract, allergies, tear film stability.
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Sonmark, Kristina, and Bitte Modin. "Psychosocial work environment in school and students’ somatic health complaints: An analysis of buffering resources." Scandinavian Journal of Public Health 45, no. 1 (November 24, 2016): 64–72. http://dx.doi.org/10.1177/1403494816677116.
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Aim: This study explores the association between the psychosocial work environment in school and students’ somatic health complaints. With its point of departure from the Demand–Control–Support (DCS) model, the aim was to examine how aspects of decision control and social support can moderate stress-related health implications of high psychological demands. Methods: Data come from two cross-sectional waves of the Swedish version of Health Behaviour in School-aged Children (HBSC 2005/2006 and 2009/2010), which consists of a total of 9427 11-, 13- and 15-year-old students. A two-level random intercept model was applied, with school class as the level 2 unit. Results: Findings showed significant associations between school demands and somatic health complaints for all studied age groups, with a slight increase in strength with age. Decision control as well as social support from teachers, parents and peers consistently predicted a favorable association with health. An age pattern emerged in the analyses of stress-moderating resources. For 11 year olds parental support was the only resource that displayed a significant interaction with demands in relation to somatic health complaints, whereas for 13 year olds, decision control and support from teachers and parents all demonstrated moderating effects on student health. For 15 year olds, however, it was peer support that acted as a buffering resource in the studied relationship. Conclusions: The psychosocial work environment is an important predictor of students’ health complaints. Overall, social support was a better stress-moderating resource than decision control, but some “buffers” were more important at certain ages than others.
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Makhubela, Malose S. "Measurement invariance of the Beck Depression Inventory-Second Edition across race with South African university students." South African Journal of Psychology 46, no. 4 (August 2, 2016): 449–61. http://dx.doi.org/10.1177/0081246316645045.
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Measurement invariance of the Beck Depression Inventory-Second Edition across race (Blacks and Whites) was examined in a sample of university students, from two universities from diverse geographical areas of South Africa ( N = 870). Multigroup confirmatory factor analysis (i.e., means and covariance structures) was used to test the factorial invariance of the hierarchical four-factor structure, composed of three first-order factors (i.e., Negative Attitude, Performance Difficulty, and Somatic Complaints) and one second-order general factor (Depression) found with South African students. Evidence of measurement invariance was established at the level of configural, metric, and scalar invariance. However, there were some evidence of differential additive response style across race—with two non-invariant intercepts (Item 5 and 14) being identified. Results also revealed significant latent mean differences favoring Black students on the Performance Difficulty and Somatic Complaints factors but not on the Negative Attitude factor. Findings suggest that the Beck Depression Inventory-Second Edition provides an assessment of the severity of depressive symptoms that is equivalent across race in university students.
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Foo, SC, WO Phoon, and J. Lee. "Neurobehavioural Symptoms Among Workers Occupationally Exposed to Toluene." Asia Pacific Journal of Public Health 2, no. 3 (July 1988): 192–97. http://dx.doi.org/10.1177/101053958800200310.
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Symptoms of memory loss, unstable mood and some somatic complaints were experienced more frequently among women workers in an electronic factory exposed to toluene than in unexposed female assembly workers in the same factory. Personal exposure levels of toluene ranged from 49 ppm to 140 ppm. Neurobehavioural symptoms were significantly more in the group exposed to higher levels as compared to the control group or group exposed to lower levels.
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Kvaal, Steven A., and Shobhana Patodia. "Relations among Positive Affect, Negative Affect, and Somatic Symptoms in a Medically Ill Patient Sample." Psychological Reports 87, no. 1 (August 2000): 227–33. http://dx.doi.org/10.2466/pr0.2000.87.1.227.
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The Positive and Negative Affect Scale (PANAS), a brief measure of Positive and Negative Affect, may be useful in assessing mood of medical patients because it does not include somatic items frequently confounded with medical conditions. In previous research Positive and Negative Affect have been independent and uncorrelated, and Negative Affect but not Positive Affect has been positively correlated with somatic symptoms. However, relationships between variables may vary in different populations, and there is relatively little information on Positive and Negative Affect in medical patients. In the current study, the PANAS was used to assess the relationships among Positive Affect, Negative Affect, and somatic symptoms and pain in a medically ill hospital population. Positive and Negative Affect scores were positively correlated and for patients reporting pain, Positive Affect scores were positively correlated with pain intensity. Results from this and other studies indicate that Positive and Negative Affect are independent but in some populations may be correlated; positive affects such as hopefulness may co-occur with both somatic complaints and psychological distress.
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Kinyanda, Eugene, Helen A. Weiss, Margaret Mungherera, Patrick Onyango-Mangen, Emmanuel Ngabirano, Rehema Kajungu, Johnson Kagugube, Winston Muhwezi, Julius Muron, and Vikram Patel. "Prevalence and Risk Factors of Attempted Suicide in Adult War-Affected Population of Eastern Uganda." Crisis 34, no. 5 (September 1, 2013): 314–23. http://dx.doi.org/10.1027/0227-5910/a000196.
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Background: There is conflicting evidence on the relationship between war trauma and suicidal behavior. Some studies point to an increased risk of suicidal behavior while others do not, with a paucity of such data from sub-Saharan Africa. Aims: To investigate the prevalence and risk factors of attempted suicide in war-affected Eastern Uganda. Method: A cross-sectional survey was carried out in two districts of Eastern Uganda where 1,560 respondents (15 years and older) were interviewed. Multivariable logistic regression was used to assess risk factors of attempted suicide in this population. Results: Lifetime attempted suicide was 9.2% (n = 142; 95% CI, 7.8%–10.8%), and 12-month attempted suicide was 2.6% (n = 41; 95% CI, 1.9–3.5%). Lifetime attempted suicide was significantly higher among females 101 (11.1%) than among males 43 (6.5%; OR = 1.80, 95% CI 1.21–2.65). Factors independently associated with lifetime rate of attempted suicide among females were subcounty, being a victim of intimate partner violence, having reproductive health complaints, and having major depressive disorder. Among males these were belonging to a war-vulnerable group, having a surgical complaint, and having a major depressive disorder. Conclusions: In both sexes, the lifetime rate of attempted suicide was not independently directly related to experiences of war trauma. It was, however, indirectly related to war trauma through its association with psychological, somatic, and psychosocial sequelae of war.
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Atti, A. R., A. Marengoni, D. De Ronchi, K. Palmer, C. Forlani, E. Dalmonte, and L. Fratiglioni. "Cognitive complaints are associated to multi-morbidity in an old population with good cognitive functioning." European Psychiatry 26, S2 (March 2011): 827. http://dx.doi.org/10.1016/s0924-9338(11)72532-9.
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IntroductionThe role of cognitive complaints has recently received increasing attention in dementia research.AimTo investigate whether the subjective perception of cognitive deficits is related to multi-morbidity in an old Italian cohort.MethodsThe study population(N = 6,825) included persons who did not receive a diagnosis of dementia(DSM-IIIR criteria), were not cognitively impaired and scored < 4 at the Global Deterioration Scale(GDS). On GDS stage one, Individuals with GDS score equal to one do not report memory problems and no deficits are detected during the interview. In subjects with GDS score = 2, a very mild cognitive decline is appreciable. On GDS score = 3,deficiencies begin to be noted. The examining physicians diagnosed the somatic disorders according to the International Classification Disease version 10 (ICD-10). Mental health was clinically assessed by the examining physicians with semi-structured questions. A multimorbidity index was created based on the number of co-occurring chronic disorders. Binary logistic regression analyses were used to estimate multiadjusted Odds ratio (aOR) and 95% Confidence Intervals (CI).ResultsAccording to GDS, 28.4% (N = 1,940) of participants reported some degree of perceived cognitive decline. Cognitive complaints were associated with increasing age, low education, and multimorbidity. Stroke (aOR,95%CI 1.6;1.3–1.9),diabetes(aOR,95%CI 1.4;1.1–1.7),depressive(aOR,95%CI 2.2;1.8–2.7) and anxiety symptoms(aOR, 95%CI 1.5;1.3–1.8) were significantly associated with perceived cognitive decline. When performances at MMSE were taken into account, cardiovascular(aOR,95%CI 2.3;1.3–4.1) and respiratory diseases(aOR,95%CI 1.9;1.0–3.6) were associated with self-perceived cognitive decline in absence of observable cognitive deficits.ConclusionsCognitive complaints have many somatic correlates and some of them may account for the discrepancy between perceived cognitive decline and cognitive assessment.
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Porter, Ian. "Is routine physical examination of psychiatric in-patients really necessary?" Psychiatric Bulletin 20, no. 4 (April 1996): 218–20. http://dx.doi.org/10.1192/pb.20.4.218.
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Although there are some well recognised physical disorders such as intracranial lesions that can present with mental illness, many psychiatric conditions do not appear to be associated with underlying somatic complaints. However, a number of recent studies have shown that there are often high rates of concurrent medical conditions among acute psychiatric in-patients that were previously undiagnosed or unsuspected. The author illustrates this point by presenting two case studies in which a significant medical condition was only identified after physical examination on a psychiatric unit.
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Patel, Vikram, and Athula Sumathipala. "Psychological approaches to somatisation in developing countries." Advances in Psychiatric Treatment 12, no. 1 (January 2006): 54–62. http://dx.doi.org/10.1192/apt.12.1.54.
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Medically unexplained somatic complaints are among the most common clinical presentations in primary care in developing countries and they are a considerable burden for patients and the healthcare system. They are assumed to be the result of psychosocial factors, and the process by which symptoms are experienced is termed somatisation. Common mental disorders, somatoform disorders and socio-economic adversities are the major risk factors for these complaints. There is evidence suggesting that cognitive–behavioural therapy, which has proven efficacy for somatoform disorders in the developed world, can be used in developing countries with some adaptations (e.g. by simplifying the content so that it can be applied in primary care by non-specialist health practitioners; using culturally appropriate analogies; and delivering the intervention over fewer and shorter sessions). The main components of such an intervention are presented in this article.
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Hutschemaekers, Giel J. M., and Harry Oosterhuis. "Psychotherapy in The Netherlands after the Second World War." Medical History 48, no. 4 (October 1, 2004): 429–48. http://dx.doi.org/10.1017/s002572730000795x.
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The early history of psychotherapy in the Netherlands hardly differs from that of the surrounding countries. Somewhat later than in France and Germany, psychotherapy appeared during the last decades of the nineteenth century, with general practitioners who started to treat their patients (mainly for all kinds of somatic complaints) by psychological means. In the early decades of the twentieth century, psychotherapy was narrowed down to mainly psychoanalytic treatment. The patient population consisted of a small élite group of people who belonged to the upper social classes. The practice of psychotherapy was restricted to some “enlightened” psychoanalysts.
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Pérez Morenilla, A. L., A. Salazar, I. Failde, and J. A. Mico. "Somatic Symptoms As Measured By Ssi-26 (somatic Symptom Inventory) Correlate With Social And Physical Functioning (sf36) In Depressed Patients. The Relative Contribution Of Anhedonia." European Psychiatry 33, S1 (March 2016): S420—S421. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1518.
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According to the DSM5, Somatic Symptom Disorder (SSD) is characterized by somatic symptoms that are either very distressing or result in significant disruption of functioning. These criteria are significantly different compared with previous editions of DSM. For example, the DSM-IV diagnosis of somatization disorder required a specific number of complaints from among four symptom groups, however the SSD criteria no longer have such a requirement. Nevertheless somatic symptoms must be significantly distressing or disruptive to daily life. Very few studies have focussed on the influence of suffering anhedonia on the perception of somatic symptoms and how this impact on Health Related Quality of Life (HRQoL), particularly physical functioning. We studied the relative impact of somatic symptoms on the social and physical functioning in depressed patients. Moreover we have explored the influence of anhedonia as measured by the Snaith-Hamilton Anhedonia Pleasure Scale (SHAPS). We analysed the correlations between the scores of the 8 dimensions of the SF-36, the SSI-26 and the SHAPS questionnaires. The results show a significant correlation between SSI-26 score and physical functioning (r = –0.565; P < 0.001), role physical (r = –0.551; P < 0.001), bodily pain (r = –0.659; P < 0.001), general health (r = –0.534; P < 0.001), vitality (r = –0.481; P = 0.001), social functioning (r = –0.302; P = 0.044) and mental health (r = –0.461; P = 0.001). Additionally, SHAPS score correlates with vitality (r = –0.371; P = 0.012), social functioning (r = –0.574; P < 0.001) and mental health (r = –0.445; P = 0.002). The results demonstrated that both somatic symptoms and level of anhedonia negatively correlate with HRQoL, suggesting a potential relationship between level of anhedonia and some somatic symptoms. This could impact on the diagnosis and treatment of depressed patients with somatic symptoms and anhedonia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Kapfhammer, H. P. "CS03-04 - Concept of somatoform disorder." European Psychiatry 26, S2 (March 2011): 1777. http://dx.doi.org/10.1016/s0924-9338(11)73481-2.
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Patients presenting with bodily symptoms and complaints that are not sufficiently explained by organic pathology or well known pathophysiological mechanisms present a major challenge to any health delivery system. From a perspective of psychiatric classification these medically unexplained somatic symptoms may be diagnosed as primary psychiatric disorders such as depressive and anxiety disorders on the one hand, as somatoform disorders on the other. Among medical specialties a separate diagnostic approach is taken to conceptualize functional somatic syndromes. Unfortunately, both diagnostic systems do not conform to each other very well.The concept of somatoform disorders as outlined in DSM-III to DSM-IV-TR and in ICD-10 refers to a group of heterogeneous disorders with prominent somatic symptoms or special body-focussed anxieties, or convictions of illness. These disorders seem to indicate medical conditions that cannot, however, fully be explained either in terms of medical diagnostics or of other primary psychiatric disorders. There is one major conceptual assumption that postulates a decisive impact of psychosocial stress on the origin, onset and/or course of these somatic symptoms and complaints. And there is one major path of diagnostic steps to be taken, i.e. just to count the number of medically unexplained somatic symptoms, to determine their reference to any main organ system, to prove that they are not self-induced, to put special stress on prevailing pain symptoms and to separately assess dominant health anxieties or illness convictions.Since introduction of the diagnostic concept of somatoform disorders there have been arising many critical issues regarding the soundness of this diagnostic category. These issues, among other things, refer to a problematic mind-body dichotomy overemphasizing psychosocial and psychological factors and neglecting major neurobiological processes, to the impracticable criterion of “medically unexplained”, to the demand of conceptual clarity and coherence of this diagnostic category, to the rather trivial diagnostic procedure of just counting the number of medically unexplained somatic symptoms whereas not assessing typical dimensions of illness behaviour in a corresponding way, to the major overlap between subgroups of somatoform disorders on the one hand and factitious disorders, anxiety disorders and depressive disorders on the other, to a principal focus on the epidemiologically rare condition of somatisation disorder as core disorder thereby undervaluing much more prevalent subthreshold conditions, to the difficult communication of the whole diagnostic group to medical colleagues dealing with the same problems by using a different conceptual approach, however.These critical issues surrounding the concept of somatoform disorder will be reflected in respect of some major revisions projected in future diagnostic classification systems of DSM-V and ICD-11.
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Alam, Elie S., Dominique L. Musselman, Darius Chyou, Ghaith Shukri, Corinna G. Levine, Saurin Sanghvi, Hang Zhang, and Roy R. Casiano. "Somatization, Depression, and Anxiety Disorders in a Rhinology Practice." American Journal of Rhinology & Allergy 33, no. 5 (April 5, 2019): 470–77. http://dx.doi.org/10.1177/1945892419841317.
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Background Patients present to rhinology clinics with various complaints. Symptoms may be attributable to objective findings, some remain unexplained. The objective is to investigate the incidence of psychological disorders in a rhinologic practice and evaluate a correlation of these psychiatric diseases with rhinologic symptoms. Methods Patients presenting to a rhinology clinic were administered the Generalized Anxiety Disorder 7 (GAD 7), Patient Health Questionnaire 9 (PHQ 9), and PHQ 15, psychometric instruments that can screen for generalized anxiety, major depression, and somatization disorder, respectively. Patients’ symptoms, endoscopic findings, medication, and psychiatric history were recorded. Multivariable analysis was performed for patients showed moderate-to-severe anxiety, depression, and somatic symptoms via 3 logistic regressions where the outcome was a GAD 7, PHQ 9, or PHQ 15 above 10. Results One hundred ninety-six patients were included for this study. There were 109 females and 87 males with a mean age of 49 years. Overall, 9%, 14%, and 21% exhibited moderate-to-severe anxiety, depressive, and somatization symptoms, respectively. Nasal obstruction was the only statistically significant variable that increased the odds of having moderate-to-severe anxiety symptoms. Similarly, headache, nasal obstruction, and anosmia/hyposmia were associated with increased odds of having depressive symptoms, and female gender, headache, and nasal discharge increased the odds of somatic symptom disorder. Edema was the only objective endoscopic finding, which was associated with depression only. Conclusions Patients should be counseled about the pathophysiology and psychiatric comorbidities affecting their primary rhinologic complaints. The provider needs to set realistic treatment expectations in order to achieve the desired clinical outcomes.
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Bloch, Yuval H., Adi Leiba, Nurit Veaacnin, Yohanan Paizer, Dagan Schwartz, Ahuva Kraskas, Gali Weiss, Avishay Goldberg, and Yaron Bar-Dayan. "Managing Mild Casualties in Mass-Casualty Incidents: Lessons Learned from an Aborted Terrorist Attack." Prehospital and Disaster Medicine 22, no. 3 (June 2007): 181–85. http://dx.doi.org/10.1017/s1049023x00004623.
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AbstractIntroduction:Mildly injured and “worried well” patients can have profound effects on the management of a mass-casualty incident. The objective of this study is to describe the characteristics and lessons learned from an event that occurred on 28 August 2005 near the central bus station in Beer-Sheva, Israel. The unique profile of injuries allows for the examination of the medical and operational aspects of the management of mild casualties.Methods:Data were collected during and after the event, using patient records and formal debriefings.They were processed focusing on the characteristics of patient complaints, medical response, and the dynamics of admission.Results:A total of 64 patients presented to the local emergency department, including two critical casualties. The remaining 62 patients were mildly injured or suffered from stress. Patient presentation to the emergency department was bi-phasic; during the first two hours following the attack (i.e., early phase), the rate of arrival was high (one patient every three minutes), and anxiety was the most frequent chief complaint.During the second phase, the rate of arrival was lower (one patient every 27 minutes), and the typical chief complaint was somatic. Additionally, tinnitus and complaints related to minor trauma also were recorded frequently.Psychiatric consultation was obtained for 58 (91%) of the patients. Social services were involved in the care of 47 of the patients (73%).Otolaryngology and surgery consultations were obtained for 45% and 44%, respectively. The need for some medical specialties (e.g., surgery and orthopedics) mainly was during the first phase, whereas others, mainly psychiatry and otolaryngology, were needed during both phases. Only 13 patients (20%) needed a consultation from internal medicine.Conclusions:Following a terrorist attack, a large number of mildly injured victims and those experiencing stress are to be expected, without a direct relation to the effectiveness of the attack. Mildly injured patients tend to appear in two phases. In the first phase, the rate of admission is expected to be higher. Due to the high incidence of anxiety and other stress-related phenomena, many mildly injured patients will require psychiatric evaluation. In the case of a bombing attack, many of the victims must be evaluated by an otolaryngologist.
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Escobar, Javier I., Angelica Dìaz-Martínez, and Michael Gara. "Idiopathic Physical Symptoms: A Common Manifestation of Psychiatric Disorders in Primary Care." CNS Spectrums 11, no. 3 (March 2006): 201–10. http://dx.doi.org/10.1017/s1092852900014371.
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ABSTRACTWorldwide, patients with common mental disorders, such as depression and anxiety, have a tendency to present first to primary care exhibiting idiopathic physical symptoms. Typically, these symptoms consist of pain and other physical complaints that remain medically unexplained. While in the past, traditional psychopathology emphasized the relevance of somatic presentations for disorders, such as depression, in the last few decades, the “somatic component” has been neglected in the assessment and treatment of psychiatric patients. Medical specialties have come up with a variety of “fashionable” labels to characterize these patients and the new psychiatric nomenclatures, such as the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, attempt to classify these patients into a separate “somatoform disorders” category. These efforts fall short, and revisionists are asking altogether for the elimination of “somatoform disorders” from future nomenclatures.This review emphasizes the importance of idiopathic physical symptoms to the clinical phenomenology of many psychiatric disorders, offers suggestions to the diagnostic conundrum, and provides some hints for the proper assessment and management of patients with these common syndromes.
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BAILER, J., F. RIST, A. RUDOLF, H. J. STAEHLE, P. EICKHOLZ, G. TRIEBIG, M. BADER, and U. PFEIFER. "Adverse health effects related to mercury exposure from dental amalgam fillings: toxicological or psychological causes?" Psychological Medicine 31, no. 2 (February 2001): 255–63. http://dx.doi.org/10.1017/s0033291701003233.
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Background. Possible adverse health effects due to mercury released by amalgam fillings have been discussed in several studies of patients who attribute various symptoms to the effects of amalgam fillings. No systematic relation of specific symptoms to increased mercury levels could be established in any of these studies. Thus, a psychosomatic aetiology of the complaints should be considered and psychological factors contributing to their aetiology should be identified.Methods. A screening questionnaire was used to identify subjects who were convinced that their health had already been affected seriously by their amalgam fillings (N = 40). These amalgam sensitive subjects were compared to amalgam non-sensitive subjects (N = 43). All participants were subjected to dental, general health, toxicological and psychological examinations.Results. The two groups did not differ with respect to the number of amalgam fillings, amalgam surfaces or mercury levels assessed in blood, urine or saliva. However, amalgam sensitive subjects had significantly higher symptom scores both in a screening instrument for medically unexplained somatic symptoms (SOMS) and in the SCL-90-R Somatization scale. Additionally, more subjects from this group (50% versus 4·7%) had severe somatization syndromes. With respect to psychological risk factors, amalgam sensitive subjects had a self-concept of being weak and unable to tolerate stress, more cognitions of environmental threat, and increased habitual anxiety. These psychological factors were significantly correlated with the number and intensity of the reported somatic symptoms.Conclusions. While our results do not support an organic explanation of the reported symptoms, they are well in accord with the notion of a psychological aetiology of the reported symptoms and complaints. The findings suggest that self-diagnosed ‘amalgam illness’ is a label for a general tendency toward somatization.
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Cope, H., A. Mann, A. Pelosi, and A. David. "Psychosocial risk factors for chronic fatigue and chronic fatigue syndrome following presumed viral illness: a case–control study." Psychological Medicine 26, no. 6 (November 1996): 1197–209. http://dx.doi.org/10.1017/s0033291700035923.
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SynopsisThis study investigated psychosocial morbidity, coping styles and health locus of control in 64 cases with and without chronic fatigue identified from a cohort of primary care patients recruited 6 months previously with a presumed, clinically diagnosed viral illness. A significant association between chronic fatigue and psychosocial morbidity, somatic symptoms and escape-avoidance coping styles was shown. Chronic fatigue cases were significantly more likely to have a past psychiatric history and a current psychiatric diagnosis based on a standardized clinical interview. Twenty-three of the cases fulfilled criteria for chronic fatigue syndrome (CFS). Such cases were significantly more fatigued than those not fulfilling criteria, but had little excess psychiatric disorder. A principal components analysis provided some evidence for chronic fatigue being separable from general psychosocial morbidity but not from the tendency to have other somatic complaints. Past psychiatric history and psychological distress at the time of the viral illness were risk factors for psychiatric ‘caseness’ 6 months later, while presence of fatigue, psychologising attributional style and sick certification were significant risk factors for CFS. These findings extend a previous questionnaire study of predictors of chronic ‘post-viral’ fatigue.
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Fitzcharles, Mary-Ann, Yoram Shir, Jacob N. Ablin, Dan Buskila, Howard Amital, Peter Henningsen, and Winfried Häuser. "Classification and Clinical Diagnosis of Fibromyalgia Syndrome: Recommendations of Recent Evidence-Based Interdisciplinary Guidelines." Evidence-Based Complementary and Alternative Medicine 2013 (2013): 1–9. http://dx.doi.org/10.1155/2013/528952.
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Objectives. Fibromyalgia syndrome (FMS), characterized by subjective complaints without physical or biomarker abnormality, courts controversy. Recommendations in recent guidelines addressing classification and diagnosis were examined for consistencies or differences.Methods. Systematic searches from January 2008 to February 2013 of the US-American National Guideline Clearing House, the Scottish Intercollegiate Guidelines Network, Guidelines International Network, and Medline for evidence-based guidelines for the management of FMS were conducted.Results. Three evidence-based interdisciplinary guidelines, independently developed in Canada, Germany, and Israel, recommended that FMS can be clinically diagnosed by a typical cluster of symptoms following a defined evaluation including history, physical examination, and selected laboratory tests, to exclude another somatic disease. Specialist referral is only recommended when some other physical or mental illness is reasonably suspected. The diagnosis can be based on the (modified) preliminary American College of Rheumatology (ACR) 2010 diagnostic criteria.Discussion. Guidelines from three continents showed remarkable consistency regarding the clinical concept of FMS, acknowledging that FMS is neither a distinct rheumatic nor mental disorder, but rather a cluster of symptoms, not explained by another somatic disease. While FMS remains an integral part of rheumatology, it is not an exclusive rheumatic condition and spans a broad range of medical disciplines.
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Pop-Jordanova, Nada, and Tatjana Zorcec. "Somatoform Disorders – A Pediatric Experience." PRILOZI 37, no. 2-3 (November 1, 2016): 55–62. http://dx.doi.org/10.1515/prilozi-2016-0017.
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Abstract Somatization in children consists of the persistent experience and complaints of somatic distress that cannot be fully explained by a medical diagnosis. Working at the Psychophysiological Department at the University Clinic we are dealing with more than 100 children per year manifesting this kind of disorders. The aim of this article is to summarize some specific characteristics of the somatoform disorder in a group of 243 children, mean age 10.31 (± 2.75) years for both genders, selected randomly. The used psychometric instruments are: CBCL, EPQ for children, and MMPI-201 for mothers. The obtained results showed high scores for somatization, extroversion and accentuated anxiety for children; as well as a typical Hs-Hy personality profile for mothers. The treatment with cognitive-behavior therapy and biofeedback showed very positive outcome.
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Lee, Sing, King Lam Ng, Kathleen P. S. Kwok, Jennifer J. Thomas, and Anne E. Becker. "Gastrointestinal dysfunction in Chinese patients with fat-phobic and nonfat-phobic anorexia nervosa." Transcultural Psychiatry 49, no. 5 (September 21, 2012): 678–95. http://dx.doi.org/10.1177/1363461512459487.
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Although gastrointestinal and other somatic symptoms are common in patients with anorexia nervosa (AN), and a growing cross-national literature indicates that not all anorexic patients exhibit the core diagnostic symptom of fat phobia, the relationship between somatic symptoms and anorexic illness remains unclear. Our objective was to evaluate gastrointestinal dysfunction (GD) in Chinese patients with fat phobic (FP) and nonfat phobic (NFP) anorexia nervosa. A total of 113 FP- and 28 NFP-AN outpatients underwent standardized clinical assessment and completed a new 8-item GD scale and other psychopathological measures. A majority (79.4%) of AN patients reported at least some gastrointestinal complaints on the GD scale (Cronbach’s alpha = 0.78). FP-AN patients scored significantly higher than NFP-AN patients. The FP-AN with high GD group reported a higher level of specific and general psychopathology than the FP- and NFP-AN with low GD groups. Contrary to expectations, gastrointestinal symptoms were more common in FP-AN than NFP-AN patients. FP-AN with high GD was more severe than FP- and NFP-AN with low GD. The current fat phobic conceptualization of the anorexic illness may overlook its phenomenologic heterogeneity and reify a dichotomy that is inconsistent with patients’ varied experience of food restriction.
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Ling-Teo, Sieak, and Kee Jiar-Yeo. "Working Memory and Behavioural Problems in Relation to Malay Writing of Primary School Children." International Journal of Evaluation and Research in Education (IJERE) 6, no. 3 (August 22, 2017): 189. http://dx.doi.org/10.11591/ijere.v6i3.8136.
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Deficit in working memory is common among young children across multiple abilities. Teachers have pointed to poor memory as one contributing factor to inattentiveness and short attention spans as well as some behavioural problems among students. This study aimed to explore the relationship among working memory, externalizing and internalizing behavioural problems and Malay language (writing). A total of 469 children (aged 8 and 11 year-old) and 17 school teachers were involved in the current study. It was found that working memory, externalizing behavioural problems and internalizing behavioural problems played critical roles in affecting the scores of Malay language (writing) at school. Specifically, there were five predictor variables being found in the regression model namely verbal short-term memory, inattention, somatic complaints, visuospatial working memory and aggression. As a whole, the correlation for the fivefactor model yielded a great result of 0.987.
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Santed, Miguel Ángel, Bonifacio Sandín, Paloma Chorot, Margarita Olmedo, and Javier García-Campayo. "The role of negative and positive affectivity on perceived stress-subjective health relationships." Acta Neuropsychiatrica 15, no. 4 (August 2003): 199–216. http://dx.doi.org/10.1034/j.1601-5215.2003.00036.x.
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This article reviews the arguments that support the approach regarding the ‘inflationary’ influence of the negative affectivity (NA) trait, or neuroticism, on relationships between perceived stress (e.g. different means of self-report of psychosocial stress such as major life events or daily stress) and subjective physical health (e.g. somatic symptomatology, health complaints). It has been explained that the said inflationary effect could distort the interpretation of the results that are found if it is done in terms of stress-objective health relationships (known in terms of health behavior, biological markers, morbidity and mortality) and that, in this sense, the NA would be a contaminant. This is why it has been suggested that in these cases, the effect of NA on predictor and criterion relationships should be controlled. The present critical review doesn't support these conclusions. Also, this paper deals with the empirical analysis of some matters that refer to one of the arguments mentioned, namely that NA is a general and penetrating factor that impregnates perceived stress (we will focus on daily stress or hassles) and subjective health measures (we will focus on somatic symptoms), as well as its relationships. We also analyze the role of positive affectivity (PA). The empirical analysis carried out uses a combination of within and interindividual methods. Contrary to the hypothesis regarding the moderating effects (specifically, inflationary) of NA on relationships between daily stress and somatic symptomatology, NA has only presented direct significant effects on both variables (between subjects), while its moderating effects are modest and non-significant. However, PA appears not to have any direct significant effects, but it does have moderating effects (specifically, buffering effects). Finally, we discuss the implications of these findings and we make some suggestions for future research.
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Gorman, Jack M. "Making a Diagnosis When One is Not Apparent: Bridging the Gap Between Somatic Patient and Frustrated Physician." CNS Spectrums 11, no. 3 (March 2006): 165. http://dx.doi.org/10.1017/s1092852900014243.
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From medical school, we all know the secret code words: “functional”, “supertentorial”, “idiopathic”, and so forth. These, of course, are some of the ways that physicians may refer to patients for whom they cannot make a definitive diagnosis. Such patients, often labeled “somatisizers”, frequent primary care and specialty care physicians' offices as well as emergency rooms.They present with complaints of a variety of aches and pains, fatigue, insomnia, poor concentration, diarrhea, constipation, etc. Any one of these could be the initial signal of a serious medical problem but for this group of patients nothing can be found on physical examination or laboratory and blood tests.Depending on the specialty of the physician, somatisizers receive a variety of diagnoses. Neurologists cite tension headache, rheumatologists cite fibromyalgia, internists cite chronic fatigue syndrome, gastroenterologists cite irritable bowel syndrome, and psychiatrists cite depression or an anxiety disorder. With the exception of the latter, no treatment has proven particularly successful, and many of these patients, regardless of the diagnosis, wind up being prescribed antidepressants. Does that mean that all somatisizers are suffering from underlying depression or anxiety? Some insist that is the case, but advocacy groups and many patients themselves resist that classification. Physicians are often afraid to suggest to patients that what they are complaining about is really due to a psychiatric problem, fearful of insulting the person. Some doctors, fearing they might overlook something, send the patient for increasingly sophisticated tests, running up healthcare costs and exposing patients to some risk. Inevitably, a test result comes back on the border of abnormality, thus, creating a reason to push forward with even more tests.
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Ball, Harriet A., Sisira H. Siribaddana, Athula Sumathipala, Yulia Kovas, Nick Glozier, Frühling Rijsdijk, Peter McGuffin, and Matthew Hotopf. "Genetic and Environmental Contributions to the Overlap Between Psychological, Fatigue and Somatic Symptoms: A Twin Study in Sri Lanka." Twin Research and Human Genetics 14, no. 1 (February 1, 2011): 53–63. http://dx.doi.org/10.1375/twin.14.1.53.
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Background:Somatic symptoms often co-occur with psychological symptoms but this overlap is poorly understood. Some aspects of this overlap differ in the South Asian context, but it is not clear whether this is a reporting effect or an underlying difference in experienced illness.Methods:Home interviews were administered to 4,024 twins randomly selected from a population-based twin register in the Colombo district of Sri Lanka (the CoTASS study). These included assessments of psychological, somatic and fatigue symptoms. The data were analyzed using factor analytic and quantitative genetic approaches.Results:Confirmatory factor analysis showed that the symptoms from the three scales represented three separate dimensions, rather than all tapping into a single dimension. However, familial correlations among the data were most consistent with a common pathway model. This implies that a portion of the underlying vulnerability is common across psychological, fatigue and somatic symptoms. There were sex differences in the etiology of this model, with shared environmental and genetic influences playing different roles in men and women.Conclusions:There is a complex etiological relationship between psychological, fatigue and somatic symptoms. This is similar in Sri Lanka to Western countries, but there may be a greater influence from the family environment, suggesting that care needs to be taken when generalizing research findings between countries. People who complain of certain fatigue or somatic symptoms may well also have psychological symptoms, or may have genetic or environmental vulnerabilities to such problems.
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Pope, Alice W., and Heather T. Snyder. "Psychosocial Adjustment in Children and Adolescents with a Craniofacial Anomaly: Age and Sex Patterns." Cleft Palate-Craniofacial Journal 42, no. 4 (July 2005): 349–54. http://dx.doi.org/10.1597/04-043r.1.
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Objective To examine rates of psychosocial adjustment problems and competencies in a sample of children with congenital craniofacial anomalies (CFAs). Methods Retrospective chart review. Setting Urban hospital plastic surgery primary care unit. Patients A total of 724 children aged 2 to 18 years with completed Child Behavior Checklists in their medical charts. Main Outcome Measure Child Behavior Checklist. Results Higher rates of problems in the clinical range were seen for withdrawn, attention, social, thought, and internalizing problems and lower rates for externalizing and somatic complaints; specific patterns varied according to age and sex. Elevated rates of competency deficits were seen in some groups. Conclusions Most children with CFAs do not appear to experience psychosocial adjustment problems. Although elevated risk may be seen for certain problems, this group may be protected in other areas. Research identifying the mechanisms responsible for varying age and sex patterns of adjustment is needed.
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Mikolajczak, Moïra, James J. Gross, Florence Stinglhamber, Annika Lindahl Norberg, and Isabelle Roskam. "Is Parental Burnout Distinct From Job Burnout and Depressive Symptoms?" Clinical Psychological Science 8, no. 4 (June 1, 2020): 673–89. http://dx.doi.org/10.1177/2167702620917447.
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Parenting can be difficult, and when difficulties are experienced as being chronic or overwhelming, parental burnout may occur. It is not yet clear, however, to what extent parental burnout can be distinguished from job burnout (which shares core definitional features) or depressive symptoms (which often co-occur with parental burnout). Here we present two studies ( N = 3,482) that suggest the distinctiveness of parental burnout. First, items aimed at measuring parental burnout, job burnout, and depressive symptoms loaded on different factors. Second, although job burnout, parental burnout, and depressive symptoms had some common consequences (e.g., problematic alcohol use, disordered sleep, somatic complaints), parental and job burnout also each had specific consequences (e.g., parental neglect and parental violence for parental burnout; intent to leave the company for job burnout) that are not explained by depressive symptoms. These results support the distinctiveness of parental burnout and the added value of this construct.
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Agarwal, Anil K., Nirmala Kiron, Rajesh Gupta, Aditi Sengar, and Preeti Gupta. "A study of assessment menopausal symptoms and coping strategies among middle age women of North Central India." International Journal Of Community Medicine And Public Health 5, no. 10 (September 24, 2018): 4470. http://dx.doi.org/10.18203/2394-6040.ijcmph20183995.
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Background: Menopause is one of the most significant events in a woman's life and brings in a number of physiological changes that affect the life of a woman permanently and can be influenced by various socio-demographic factors and coping activities. The objectives of the study were to determine the commonly reported menopausal symptoms among middle age women and to correlate identified menopausal problems with coping strategies found in participants.Methods: By using modified MRS questionnaire, 150 menopausal women aged 40-60 years were interview to document of 12 symptoms (divided into somatic, psychological and urogenital domain) commonly associated with menopause.Results: The mean age of menopause was 49.8 years (±4.9) (range 43 - 57 years). The most prevalent symptoms reported were joint and muscular discomfort (70.6%); physical and mental exhaustion (61.3%); and sleeping problems (59.3%). Followed by symptoms of anxiety (48.6%); irritability (45.3%) hot flushes and sweating (38.6; dryness of vagina (37.9%); depressive mood (38.0%). Other complaints noted were incontinence/Frequency of urine (27.3 and heart discomfort (23.3%). Perimenopausal women (47.2%) experienced higher prevalence of somatic and psychological symptoms compared to premenopausal (n=15.6) and postmenopausal (37.2%) women. However urogenital symptoms found more in postmenopausal group of women. There is a strong significant association between the menopausal symptoms and coping strategies adopted by the menopausal women.Conclusions: Symptoms have variable onset in relation to menopause. Some women experience symptoms earlier during perimenopause while some experience them at a later time. The application of various coping methods, including the establishment of social support networks, is warranted to enhance postmenopausal women’s behaviors in different aspects.
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Jamilian, H., M. Jamilian, and F. Doroodgar Hezaveh. "The comparison of mental health in fertile and infertile women." European Psychiatry 26, S2 (March 2011): 1666. http://dx.doi.org/10.1016/s0924-9338(11)73370-3.
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IntroductionInfertility affects life of couples and family function. Infertility can cause mental disturbances in some studies.AimsThe goal of this study was the comparison of mental health in fertile and infertile women.MethodsA case-control study was done in Arak-Iran, Taleghani hospital which is a center of Gynecology, in 2010. 60 infertile women as case group and 60 fertile women as control group participated in the study, randomly. Both groups were assessed by GHQ questionnaire and data were analyzed by T-Test and logistic regression.ResultsThe severity of mental disturbances were much more in infertile women (P < 0.001). Social dysfunction (P < 0.001) and somatic complaints (P < 0.001) were also higher in infertile women. The probability of mental disturbances was much higher in infertile women (P < 0.001 and OR = 5.57).ConclusionMental health of infertile women is very critical and disturbed. The findings of our study necessitate the multidimensional interventions in the treatment of infertility.
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Koshelev, konstantin, Nikolay Belousov, Irina Sokolova, and Denis Sokolov. "FORECASTING DURATION OF USE OF VARIOUS TYPES OF DENTURES IN PATIENTS WITH HYPERTENSIVE DISEASE." Actual problems in dentistry 16, no. 1 (May 14, 2020): 143–48. http://dx.doi.org/10.18481/2077-7566-20-16-1-143-148.
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Subject. The increase in the number of works devoted to the influence of somatic diseases on dental health is steadily growing in the specialized literature. On the other hand, the requirements of the work of orthopedic dentists are dictated by the need for a clear assessment of the possible long-term results of prosthetics of teeth and dentitions, taking into account a number of factors, one of which is the presence and severity of general somatic pathology and associated diseases.
The goal is to analyze the effect of hypertension on the life of some types of dentures.
Methodology. As research methods, standard clinical and paraclinical methods for examining patients were used, recommended for use in the considered nosologies of the dental spectrum. A specially designed questionnaire was used that included the issues under consideration. As a study material, data from three hundred and ten patients are presented, who for various reasons needed repeated prosthetics and were divided into groups according to several criteria. Statistical data processing was carried out in accordance with the requirements for research of this type.
Results. A correlation was found between the terms of comfortable use of dentures and the presence of a history of hypertension in patients. The main complaints of patients when applying for repeated prosthetics are identified and the reasons are structured that lead to a decrease in the service life of removable and non-removable prostheses for the somatic pathology under consideration.
Conclusions. The data obtained can be used by orthopedic dentists in the clinical appointment of patients with partial and complete loss of teeth at the stage of planning the expected result when dentures are prosthetized and serve as the basis for further scientific work in the indicated direction.
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Perzyńska-Starkiewicz, Aneta. "Neurotic symptoms in clinical practice: Mieczysław Kaczyński’s approach." Current Problems of Psychiatry 19, no. 2 (June 1, 2018): 125–30. http://dx.doi.org/10.2478/cpp-2018-0011.
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Abstract The aim of this study is to acquaint the readers with some pieces of practical guidance on the therapy of neurotic disorders offered by Professor Mieczysław Kaczyński to his colleagues and students at the Lublin Clinic of Psychiatry. Patients who report so-called neurotic complaints are a group that requires a very thorough clinical analysis. Professor Kaczyński emphasized that it was necessary to make a distinction among patients with a neurotic reaction, a pseudoneurotic syndrome, and ‘neurosis proper’ or psychoneurosis. The first group includes patients who report a psychological trauma as a trigger of their complaints. Therapeutic intervention brings good outcomes leading to resolution of the condition. A group of patients that is very important from the point of view of diagnosis are those in whom neurotic complaints are masking an onset of a somatic or mental illness or an existing illness which is running a mild course. In such cases, a cursory examination leading to a mistaken diagnosis of neurosis can have devastating effects. A misdiagnosis is easy to make, for example, in patients with increased intracranial pressure (“the neurasthenic stage of a brain tumour”) or an onset of a mental illness (the pseudoneurotic syndrome of early schizophrenia). Therefore, often, before the final diagnosis is arrived at, multiple follow-up examinations are needed to monitor the structure and dynamics of the disease. Only when the first two diagnostic options have been excluded, can the physician classify the disorder as a neurosis (psychoneurosis). In such cases, it is necessary to find the etiological agent, which, more often than not, is a situation of conflict or frustration that the patient is unconscious of. A failure to analyze a case in this way may result in the patient’s resignation response, potentially leading to suicide. It appears that Professor Kaczyński’s remarks on the clinical picture of neurotic disorders largely round out the information provided in ICD-10 under F.40–F.48.
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Abdel-Khalek, Ahmed M. "The Multidimensional Child and Adolescent Depression Scale: Psychometric Properties." Psychological Reports 93, no. 2 (October 2003): 544–60. http://dx.doi.org/10.2466/pr0.2003.93.2.544.
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Based on previous factor analyses of child and adolescent depression inventories, the following eight basic dimensions were identified, i.e., Pessimism, Weak Concentration, Sleep Problems, Anhedonia, Fatigue, Loneliness, Low Self-esteem, and Somatic Complaints. Each dimension was assessed by five items, so the Multidimensional Child and Adolescent Depression Scale has 40 brief statements answered on a 3-point intensity scale, i.e., None, Some, and A lot. The eight dimensions have good factorial validity and acceptable to good alpha and test-retest reliability, and good criterion-related validity using three self-report depression scales. The total scale score has from good to high coefficients of reliability and validity. The highest mean scores were on Fatigue and Anhedonia for Kuwaiti boys and girls, respectively, while the Loneliness subscale has the lowest mean score for both sexes. Girls attained significantly higher mean scores than boys for the total score as well as on all dimensions, with the exception of weak concentration. The scale has two compatible Arabic and English versions. It was designed to be useful in defining the profile of children's and adolescents' depression.
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Белых, E. Belykh, Несмеянов, A. Nesmeyanov, Борисова, O. Borisova, Фудин, and N. Fudin. "The effects of shungite on somatoform disorders in athletes." Journal of New Medical Technologies. eJournal 9, no. 1 (April 17, 2015): 0. http://dx.doi.org/10.12737/10421.
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The article demonstrates the importance of the application of new biomedical technologies in the correction of somatoform disorders in athletes. In observation were 86 athletes playing sports. Comprehensive clinical, psychological and instrumental examination showed that 11, 3% of them have some somatic pathology, but the complaint didn’t match up to this pathology, she had overdone character. Moreover, in this group in 36.4% of cases, there are previous histories of acute infectious diseases. The athletes were divided into two equal groups (main and control) by 43 people. In the main group, the athletes were treated orally with shungite in the form of tablets, in the control group - the psycho-pharmacotherapy. The same clinical and instrumental effect was observed in both groups. In the control group the undesirable effect of reducing muscle tone, drowsiness was detected. This allowed the authors to consider that it is expedient to use shungite for the correction of sym-tomatics in athletes with somatoform disorders.
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Scott, Marcia. "Clinical Update: Subjective Illness and Disability." Guides Newsletter 3, no. 3 (May 1, 1998): 6–7. http://dx.doi.org/10.1001/amaguidesnewsletters.1998.mayjun03.
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Abstract Symptoms are the body's major signaling device, but symptoms often are frustratingly vague, subjective, and ill reported. In addition, challenges attend making decisions about an individual's ability to function based solely on the medical diagnosis, particularly when impairment is subtle or subjective. Chronic fatigue syndrome (CFS) is a model for understanding the limits of the medical approach to determining impairment and disability. A protocol from the Center for Disease Control and Prevention (CDC) is used to define CFS. This protocol is not a list of diagnostic criteria, and some patients with chronic fatigue may not meet the CDC definition. The syndrome reflects dysfunction in the neuroendocrine system similar in some ways to that seen with depressive illness, and most patients seen for this condition fulfill the criteria for depression, which is another illness characterized by fatigue and somatic complaints. Physicians who evaluate and treat patients with subtle persistent illness know that employers and coworkers respond less positively to an employee's needs when illness is subtle than when impairment is obvious. Physicians must be clear about the family, job, and employment risks patients take when they stay out of work for medical reasons; they also must recognize the risk these patients take when they continue to work despite impaired performance.
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Vorvolakos, Theofanis, Aikaterini Arvaniti, Aspasia Serdari, and Maria Samakouri. "The challenge of treating Roma outpatients in the Eastern Macedonia and Thrace region of Greece." BJPsych International 18, no. 3 (February 3, 2021): 58–60. http://dx.doi.org/10.1192/bji.2021.3.
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The Roma people are one of the most unknown and interesting nations in Europe. Although they are severely marginalised within European societies, they have greatly influenced European culture. Despite this fact, there is a deep prejudice against them. In the region of East Macedonia and Thrace, a significant proportion of the population are Roma. Their marginalisation leads to many problems and also affects their mental health. Their psychopathological manifestations differ from the majority population. They express more somatic complaints and higher overall stress in a histrionic background. The main obstacles regarding their mental health issues and treatment appear to be the following: gender inequality, illiteracy and lack of cultural sensitivity in healthcare system. Although all of these obstacles must be removed, some are easier to remove than others. Cultural sensitivity could be applied by using more culturally sensitive diagnostic tools, improving overall training for mental health professionals and treating Roma wherever they seek help, because they often have a nomadic style of living. Telemedicine can be quite useful in serving this goal. Improving their educational status and addressing gender inequalities issues, on the other hand, are more difficult and long-term goals.
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Monten, Lina, Axel Forman, and Karl-Erik Andersson. "Pelvic organ cross-talk: A new paradigm for endometriosis-related pelvic pain?" Journal of Endometriosis and Pelvic Pain Disorders 10, no. 4 (November 14, 2018): 208–15. http://dx.doi.org/10.1177/2284026518810573.
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Endometriosis patients often complain about pelvic and abdominal pain with varying bowel and bladder symptoms unrelated to the location and extent of the disease. The pathophysiology can be multifactorial, but one possibility is that pelvic organ cross-talk may play a role. The aim of this review was to evaluate the scientific support for this hypothesis. A search was performed in PubMed to identify relevant experimental and clinical studies. Data achieved in animal models and clinical evidence suggest that endometriosis-related pain may implicate interactions between pelvic structures like the urinary tract, the bowel and the vagina, mediated by the autonomous nervous system. Such pelvic organ cross-talk with involvement of nerve fibre outgrowth into endometriosis lesions, peripheral sensitisation and convergence of afferent nerve fibres could be an explanation for the varying pain problems in endometriosis, but the precise mechanisms are still poorly understood. Some patients with chronic pelvic pain, including those with endometriosis, also seem to have a more general somatic, musculoskeletal hyperalgesia, indicating a potential viscero-somatic convergence. This might be due to continuous nociceptive input to the brain, resulting in changes in brain structures and finally leading to central sensitisation. Thus, pelvic organ cross-talk seems to represent a new paradigm for endometriosis-related pain with novel possibilities for the development of therapeutic strategies.
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Wang, Zaijie J., Diana J. Wilkie, and Robert Molokie. "Neurobiological Mechanisms of Pain in Sickle Cell Disease." Hematology 2010, no. 1 (December 4, 2010): 403–8. http://dx.doi.org/10.1182/asheducation-2010.1.403.
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Abstract Pain is a frequent complaint of people living with sickle cell disease (SCD); however, the neurobiology of pain in SCD remains poorly understood. Whereas this pain has been thought to be primarily related to visceral and somatic tissue injury subsequent to vaso-occlusion events, emerging evidence from human and animal studies has suggested that a component of SCD pain may be related to neuropathic processes. Significant knowledge has been obtained from studies of molecular and neurobiological mechanisms leading to and maintaining neuropathic pain. Some of the most promising evidence has implicated major roles of protein kinase C and Ca2+/calmodulin-dependent protein kinase II, and their interaction with the N-methyl-D-aspartate receptors and the transient receptor potential vanilloid 1 receptor in the development of neuropathic pain. The latest evidence from our studies suggests that these pathways are important for SCD pain as well. Coupled with emerging animal models of SCD pain, we can now start to elucidate neurobiological mechanisms underlying pain in SCD, which may lead to better understanding and effective therapies.
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Chebotaeva, G. N., and D. S. Lebedev. "The structure of somatic dysfunctions in women with a nodular form of uterine myoma." Russian Osteopathic Journal, no. 3 (September 18, 2020): 29–40. http://dx.doi.org/10.32885/2220-0975-2020-3-29-40.
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Introduction. Uterine myoma (leiomyoma) occupies one of the first placesin the structure of gynecological diseases.This disease negatively affects both the state of health and the reproductive function of women. Now the problem of the effective methods for the treatment of leiomyoma (including non-medicinal methods, one of which is the osteopathic correction of somatic dysfunctions) is still acutedespite some progress in understanding the mechanisms of this disease pathogenesis. However, the structure of these functional disorders has not been practically studied.The goal of research — to investigate the structure of somatic dysfunctions (SD) in women with uterine myoma before and after osteopathic correction and its relationship with the severity of subjective indicators.Materials and methods. A simple longitudinal randomized study was conducted in 2018–2019 on the basis of a women’s consultation in Kirov, it included 30 women aged 35 to 44 years being under the medical supervision of an obstetrician-gynecologist, with a diagnosis of intramural uterine myoma, nodular form. All women with intramural nodular leiomyoma were divided into 2 groups of 15 people, comparable in age, presence of comorbidities and duration of the disease, using a simple randomization method (a random number generator was used). The main group received osteopathic treatment, and for patients of the control group it was carried out dynamic monitoring. According to the scheme, all patients underwent a clinical gynecological examination, a clinical osteopathic examination, and the dynamics of the severity of subjective manifestations (complaints) was evaluated.The collected data was processed by nonparametric statistics.Results. In the course of osteopathic diagnostics in women with uterine fibroids the following SD were identified: the somatic dysfunctions of the pelvic region dominated among the regional SD, and the most common among the local SD were the somatic dysfunctions of the segment С0–СI and the thoracic diaphragm. As the result of osteopathic correction of diagnosed SD in patients with leiomyoma, the decrease of the total number of SD (p<0,05) and the change of their structure has occurred (before treatment the SD at the regional level prevailed, after treatment there was a reduction in their number, and the increasing of the number of SD local level due to the carried out correction of most existing regional violations); and the severity of subjective symptom (algodismenorrhea) has decreased (p<0,05).Conclusion. In women with uterine myoma (leiomyoma), SD can manifest at different levels. Osteopathic correction of SD in women with uterine myomasignificantly reduces the severity of subjective manifestations (algodismenorrhea), which allows us to continue the research in studying of the impact of the SD osteopathic correction in the complex treatment of women with intramural nodular form of uterine myoma.
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Verbitskaya, M. S., N. A. Tyuvina, G. L. Krenkel, E. N. Efremova, and A. E. Stolyarova. "Atypical depression in bipolar affective disorder: a clinical case study." Neurology, Neuropsychiatry, Psychosomatics 12, no. 6 (December 12, 2020): 144–50. http://dx.doi.org/10.14412/2074-2711-2020-6-144-150.
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Atypical depression (AtD) is contrasted with classical endogenous melancholic depression and is characterized by the presence of its uncharacteristic abnormalities, but the list of the latter varies from individual symptoms (increased appetite, weight gain, drowsiness, weakness, and anxiety) and their concurrence to syndromes accompanying depression (anxiety-phobic, obsessive-compulsive, panic attacks, derealization-depersonalization, hypochondriacal syndrome). In accordance with the DSM-5 diagnostic criteria, AtD is a symptom complex that includes mood reactivity and at least two of the following symptoms: hyperphagia, hypersomnia, lead-palsy, and personality sensitivity. AtD has been described within a variety of disorders: recurrent depressive disorder, bipolar affective disorder, dysthymia, cyclothymia, and psychogenic depression. The paper describes a clinical case of atypical depressive syndrome within the framework of type 2 bipolar disorder in a 51-year-old patient. AtD was concurrent with dermatitis herpetiformis (Dühring's disease) in some depressive episodes; it was accompanied by various somatic complaints in other cases. The latest episode of AtD occurred during the COVID-19 pandemic and included obvious reactive anxiety-phobic disorders. A detailed clinical and psychopathological analysis of history data, mental state, and ongoing therapy was carried out, which clearly reflects difficulties in the differential diagnosis of AtD and the use of adequate treatment.
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King, Anna Lucia Spear, Alexandre Martins Valença, Valfrido Leão de Melo-Neto, Rafael Christophe Freire, Marco André Mezzasalma, Adriana Cardoso de Oliveira e. Silva, and Antonio Egidio Nardi. "Efficacy of a specific model for cognitive-behavioral therapy among panic disorder patients with agoraphobia: a randomized clinical trial." Sao Paulo Medical Journal 129, no. 5 (2011): 325–34. http://dx.doi.org/10.1590/s1516-31802011000500008.
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CONTEXT AND OBJECTIVE: Cognitive-behavioral therapy is frequently indicated for panic disorder. The aim here was to evaluate the efficacy of a model for cognitive-behavioral therapy for treating panic disorder with agoraphobia. DESIGN AND SETTING: Randomized clinical trial at Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro. METHODS: A group of 50 patients with a diagnosis of panic disorder with agoraphobia was randomized into two groups to receive: a) cognitive-behavioral therapy with medication; or b) medication (tricyclic antidepressants or selective serotonin reuptake inhibitors). RESULTS: Although there was no difference between the groups after the treatment in relation to almost all variables with the exception of some items of the Sheehan disability scale and the psychosocial and environmental problems scale, the patients who received the specific therapy presented significant reductions in panic attacks, anticipatory anxiety, agoraphobia avoidance and fear of body sensations at the end of the study, in relation to the group without the therapy. On the overall functioning assessment scale, overall wellbeing increased from 60.8% to 72.5% among the patients in the group with therapy, thus differing from the group without therapy. CONCLUSION: Although both groups responded to the treatment and improved, we only observed significant differences between the interventions on some scales. The association between specific cognitive-behavioral therapy focusing on somatic complaints and pharmacological treatment was effective among this sample of patients with panic disorder and the response was similar in the group with pharmacological treatment alone.
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Khaustova, O., and N. Kovalenko. "Psychopathological features of mental disorders in IDPs." European Psychiatry 41, S1 (April 2017): s494—s495. http://dx.doi.org/10.1016/j.eurpsy.2017.01.609.
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ObjectivesViolation of mental health is common in forced migrants. Lack of positive motivation to move and physical impossibility of further stay at home, mental trauma caused by the history and causes of migration; difficulties in adapting to new location determine the formation of specific experience IDPs. The most common are psychogenic depression, anxiety and somatoform disorders.MethodsWe had observed 60 IDPs aged 18 to 80 years: medical history, current complaints and mental state.ResultsWe allocated 3 groups: persons of retirement age with severe chronic physical illness or disability on physical illness (1 group); persons with disabilities to mental disease (group 2) and persons without chronic diseases or disability (relatively healthy, caring for the sick) (group 3). Group 1 patients have anxiety (51.4%) and depression (42.8%) syndromes; 25.7% of subjects showed suicidal thoughts and intentions; 25.7% have some PTSD symptoms, including avoidance, overexcited, emotional numbness, pointing to adjustment disorder. In group 2 patients, changes were not found in mental state. Despite traumatic events delusional story does not change, recurrence and relapse rating was stable. In some cases, patients begin to abuse alcohol. In 3 group 31.3% persons experienced depression, 25%-anxiety symptoms, combined with a severe somatic symptoms; 12.5% showed suicidal thoughts; in 18.7% were diagnosed adjustment disorders. So among IDPs the individuals with severe medical conditions are most vulnerable population in the formation of stress-related and neurotic disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Wanders, Rob B. K., Rob R. Meijer, Henricus G. Ruhé, Sjoerd Sytema, Klaas J. Wardenaar, and Peter de Jonge. "Person-fit feedback on inconsistent symptom reports in clinical depression care." Psychological Medicine 48, no. 11 (November 27, 2017): 1844–52. http://dx.doi.org/10.1017/s003329171700335x.
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BackgroundDepressive patients can present with complex and different symptom patterns in clinical care. Of these, some may report patterns that are inconsistent with typical patterns of depressive symptoms. This study aimed to evaluate the validity of person-fit statistics to identify inconsistent symptom reports and to assess the clinical usefulness of providing clinicians with person-fit score feedback during depression assessment.MethodsInconsistent symptom reports on the Inventory of Depressive Symptomatology Self-Report (IDS-SR) were investigated quantitatively with person-fit statistics for both intake and follow-up measurements in the Groningen University Center of Psychiatry (n = 2036). Subsequently, to investigate the causes and clinical usefulness of on-the-fly person-fit alerts, qualitative follow-up assessments were conducted with three psychiatrists about 20 of their patients that were randomly selected.ResultsInconsistent symptom reports at intake (12.3%) were predominantly characterized by reporting of severe symptoms (e.g. psychomotor slowing) without mild symptoms (e.g. irritability). Person-fit scores at intake and follow-up were positively correlated (r = 0.45). Qualitative interviews with psychiatrists resulted in an explanation for the inconsistent response behavior (e.g. complex comorbidity, somatic complaints, and neurological abnormalities) for 19 of 20 patients. Psychiatrists indicated that if provided directly after the assessment, a person-fit alert would have led to new insights in 60%, and be reason for discussion with the patient in 75% of the cases.ConclusionsProviding clinicians with automated feedback when inconsistent symptom reports occur is informative and can be used to support clinical decision-making.
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Аrtemenkо, Аda R., Olga A. Shavlovskaya, Vera V. Оsipovа, Gennadiy V. Kovrov, and Rovshan L. Gasanov. "Sleep-related headaches: clinical features and treatment approaches." L.O. Badalyan Neurological Journal 1, no. 1 (April 19, 2020): 35–46. http://dx.doi.org/10.17816/2686-8997-2020-1-01-35-46.
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Headaches occurring during sleep are one of the most common types of night time pain complaints, along with back pain. Sleep-related headaches can be a manifestation of both primary headaches (migraine, cluster headache, chronic paroxysmal hemicrania, hypnic headache) and secondary headaches associated with somatic pathology (anemia, hypoxemia), neurological disorders (brain tumors, arteriovenous malformations), psychiatric (depressive, anxiety) and sleep disorders (obstructive sleep apnea). The relationship between headaches and sleep depends on the patients age, frequency and severity of the headaches, provoking factors (excessive sleep, sleep deprivation, overuse of painkillers), the stage of sleep (REM sleep or slow-wave sleep) and possible genetic predisposition (hemiplegic migraine).
The connections between sleep and headaches are complex and interrelated. Sleep can both provoke and relieve headaches. On the other hand, headaches can cause sleep disorders, which are typical for a severe type of cephalgia with the development of chronic daily headache syndrome, medication overuse, and psychiatric comorbidity. General anatomical structures, neurochemical and neurophysiological mechanisms involved in sleep and headache regulation are assumed. According to polysomnography data, objective changes in the structure of night sleep were detected in patients with a sleep-related headache: a reduction in the sleep duration and a decrease in the slow-wave sleep representation. Most nighttime headache attacks are linked with the REM sleep phase.
Management of patients with sleep-related headaches should include the diagnosis and treatment of both headache and sleep disorder, which will significantly improve the results of treatment or even cure headaches in some cases.