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Background: Recent studies on the association between the metabolic syndrome (MetS) and depression have reported conflicting findings. This 1-year cohort study aims to evaluate the association of MetS with the development of both depression and anxiety., Methods: The cohort comprised 956 Japanese male employees of an enterprise (mean age, 42.7 years; SD, 10.2 years). MetS was diagnosed according to the International Diabetes Federation criteria. The psychological conditions of depression and anxiety were assessed in 2 successive years by using the profile of mood states (POMS) questionnaire and by conducting clinical interviews as per the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). We evaluated the temporal and dose-response relationships between MetS and the development of depression and anxiety, controlling for potential confounding factors like age and lifestyle-related factors., Results: We identified a positive relationship between MetS at baseline and new-onset depression in the subsequent year (OR 2.14, 95% CI 1.10-4.17). Of the five MetS components examined, only waist circumference was significantly related to new-onset depression (OR 2.08, 1.23-3.50). Trend analysis revealed a significant positive trend of association between the number of MetS components identified and new-onset depression (P(trend) < 0.01), but not between Mets and new-onset anxiety., Conclusions: Our results suggest that MetS is a predictive factor for the development of depression, and that waist circumference largely contributes to the association between MetS and depression.

To examine the relationship between grief reactions and alexithymia, 54 Japanese women (33 outpatients attending a psychosomatic clinic and 21 normal healthy participants) completed the Texas Inventory of Grief (TIG), the 20-item Toronto Alexithymia Scale (TAS-20), and the Profile of Mood States (POMS). Each woman had experienced the death of a spouse or a first-degree relative. The TIG scores were positively correlated to the scores on the first TAS-20 factor of Difficulty Identifying Feelings and on the POMS tension-anxiety and depression scales. The scores on the first TAS-20 factor were higher in the psychosomatic group than in the normal group. Complicated grief reactions may be closely associated with both alexithymic character and mood states in bereaved Japanese women.

Background: Cognitive-behavioral therapy (CBT) has been shown to be beneficial in the treatment of hypochondriasis. In this study, we sought to determine whether there was a differential treatment effect for patients with greater levels of anxiety at the outset of treatment. Methods: A total of 182 hypochondriacal participants (139 women, mean = 42.1 years of age) were randomly assigned to a CBT or control group. All participants completed self-report measures of hypochondriasis that exceeded a predetermined threshold on 2 successive occasions. CBT consisted of 6, weekly 90-min sessions. The control subjects received the usual medical care during the same period. Three questionnaires (the Whiteley Index, the Health Anxiety Inventory, and the Somatic Symptom Inventory) were used to assess hypochondriacal symptoms, and the Symptom Checklist 90R was used to assess anxiety and other psychological symptoms. These were administered before the intervention and at 6 and 12 months after the completion of the intervention. Results: Scores on the 3 measures of hypochondriasis were significantly decreased after treatment in the CBT compared with the control group. Anxiety and other psychological symptoms also showed significant reductions in the CBT group. High levels of pretreatment anxiety predicted decreases in the 3 hypochondriasis scores after controlling for the effects of depression, age, sex, educational level, employment status, and marital status. Conclusions: High anxiety at entry into the CBT program predicted a better treatment outcome. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

This article introduces key concepts of work-related stress relevant to the clinical and research fields of psychosomatic medicine. Stress is a term used to describe the body's physiological and/or psychological reaction to circumstances that require behavioral adjustment. According to the Japanese National Survey of Health, the most frequent stressors are work-related problems, followed by health-related and then financial problems. Conceptually, work-related stress includes a variety of conditions, such as overwork, unemployment or job insecurity, and lack of work-family balance. Job stress has been linked to a range of adverse physical and mental health outcomes, such as cardiovascular disease, insomnia, depression, and anxiety. Stressful working conditions can also impact employee well-being indirectly by directly contributing to negative health behaviors or by limiting an individual's ability to make positive changes to lifestyle behaviors, such as smoking and sedentary behavior. Over the past two decades, two major job stress models have dominated the occupational health literature: the job demand-control-support model and the effort-reward imbalance model. In both models, standardized questionnaires have been developed and frequently used to assess job stress. Unemployment has also been reported to be associated with increased mortality and morbidity, such as by cardiovascular disease, stroke, and suicide. During the past two decades, a trend toward more flexible labor markets has emerged in the private and public sectors of developed countries, and temporary employment arrangements have increased. Temporary workers often complain that they are more productive but receive less compensation than permanent workers. A significant body of research reveals that temporary workers have reported chronic work-related stress for years. The Japanese government has urged all employers to implement four approaches to comprehensive mind/body health care for stress management in the workplace: focusing on individuals, utilizing supervisory lines, enlisting company health care staff, and referring to medical resources outside the company. Good communications between occupational health practitioners and physicians in charge in hospitals/clinics help employees with psychosomatic distress to return to work, and it is critical for psychosomatic practitioners and researchers to understand the basic ideas of work-related stress from the viewpoint of occupational health. [ABSTRACT FROM AUTHOR]

This letter comments on the conclusion drawn by Shirotsuki et al. (2017) in their article entitled “The effect for Japanese workers of a self-help computerized cognitive behaviour therapy program with a supplement soft drink”, recently published in BioPsychoSocial Medicine. The authors concluded that their drink, containing L-carnosine, enhances the effects of a computerized cognitive-behavioural therapy (CCBT) on the psychological well-being of healthy Japanese workers. Yet, we argue that their conclusion is unfounded given their results and the methodological shortcomings of their study. Briefly, while the authors reported improvement on the tension-anxiety subscale of the Profile of Mood States (POMS) in the CCBT only group, they also observed a lack of improvement on this subscale in the CCBT+L-carnosine group suggesting that the drink washes out this beneficial effect of CCBT. Methodological issues include the uncontrolled levels of L-carnosine metabolized by participants jeopardize the study’s internal validity. Also, the clinical meaningfulness of the findings seems dubious as post-treatment scores remained within the range of the general Japanese population. Consequently, we argue that Shirotsuki et al.’s study should be re-conducted before drawing any valid conclusion. [ABSTRACT FROM AUTHOR]

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