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Introduction: Social anxiety disorder is characterized by intense anxiety in social situations where the person is likely to be evaluated by others. Aim: The present study aimed to investigate the effectiveness of contextual schema therapy on emotion regulation and painful physical symptoms in individuals with social anxiety disorder. Method: This study employed an A-B single-subject design. The statistical population included all the people with social anxiety disorder in Mashhad city, in 2021, and 12 people were selected by convenience sampling method. Then, the contextual schema therapy was conducted during 16 sessions of 1 hour once a week for 12 subjects. The Emotion Regulation Questionnaire (2003) and the Visual Analog Scale (1921) were used in this study. The Subjects answered the questionnaires in the baseline phase, at sessions 4, 8, 12 and 16, and at 3-month follow-up. The data were analyzed using visual analysis, improvement percentage, reliable change index, and non-overlapping effect size. Results: The improvement percentage (25%

Numerous studies of the COVID-19 effects on mental health have documented increases in anxiety and depressive symptoms, panic and adjustment disorders, suicidal ideation and suicide attempts, somatic and psychological distress, feelings of loneliness, and alcohol use problems [21]. These findings suggest the need for further examination of the COVID-19 effects on mental health and adherence to preventive behavior regarding the risks of SARS-CoV-2 infection.Objective. The aim of this study was to examine the prevalence and relationship between somatic symptoms, perceived stress, and preventive behavior during the COVID-19 pandemic in Russia.Material and Methods. The participants were 1,987 volunteers who were recruited with the help of Anketolog, an empirical data collection company in Russia. All respondents completed a questionnaire with a sociodemographic form and Russian versions of the Somatic Symptom Scale-8, Perceived Stress Scale-10, and COVID-19 Preventive Behavior Index.Results. Results showed that 39.1% of Russians had clinically significant somatic symptoms, 81% of Russians experienced moderate to high perceived stress, and from 46.5% to 84.4% of Russians were willing to follow some form of COVID-19 pandemic preventive behavior. Russians with somatic symptoms experienced more perceived stress than Russians without somatic symptoms, while Russians with higher perceived stress did not differ from Russians with lower perceived stress in frequency and severity of somatic symptoms.Conclusion. Preventive and psychoeducational interventions can be useful in reducing somatization and perceived stress, maintaining and increasing the adherence of Russians to preventive behavior during the COVID-19 pandemic.

Most of the common models to examine depression are one-factor models; however, previous studies provided several-factor structure models on each depressive symptom using the Patient Health Questionnaire-9 (PHQ-9). The Nine-Questions Depression-Rating Scale (9Q) is an alternative assessment tool that was developed for assessing the severity of depressive symptoms in Thai adults. This study aimed to examine the factor structure of this tool based on the factor structure models for the PHQ-9 provided in previous studies using confirmatory factor analysis (CFA). We also examined the association of chronic diseases and depressive symptoms using the Multiple Indicators Multiple Causes model among 1346 participants aged 19 years old or more without psychiatric disorders. The results show that the two-factor CFA model with six items in the cognitive-affective domain and three items in the somatic domain provided the best fit for depressive symptoms in the study population (RMSEA = 0.077, CFI = 0.953, TLI = 0.936). Dyslipidemia was positively associated with both cognitive-affective symptoms (β = 0.120) and somatic depressive symptoms (β = 0.080). Allergies were associated with a higher level of cognitive-affective depressive symptoms (β = 0.087), while migraine (β = 0.114) and peptic ulcer disease (β = 0.062) were associated with a higher level of somatic symptoms. Increased age was associated with a lower level of somatic symptoms (β = −0.088). Our findings suggested that considering depressive symptoms as two dimensions yields a better fit for depressive symptoms. The co-occurrence of chronic diseases associated with depressive symptoms should be monitored.

For patients with chronic pain and persistent physical symptoms, understanding the mechanism of central sensitisation may help in understanding how symptoms persist. This cross-sectional study investigated the association of central sensitisation with depression, anxiety, and somatic symptoms. Four hundred and fifteen adults attending an outpatient psychosomatic clinic were evaluated. Participants completed the Hospital Anxiety and Depression Scale, Somatic Symptom Scale 8, and the Central Sensitisation Inventory. The relationships between these factors were examined using descriptive statistics and multiple logistic regression analyses. The mean age was 42.3 years, and 59% were female. The disorders included adjustment disorders (n = 70), anxiety disorders (n = 63), depressive disorders (n = 103), feeding and eating disorders (n = 30), sleep–wake disorders (n = 37), somatic symptoms and related disorders (n = 84), and others (n = 28). In multiple logistic regression analyses, higher central sensitisation was associated with more severe anxiety, depression, and somatic symptoms after controlling for potential confounders. In the disease-specific analysis, somatic symptoms correlated more positively with central sensitisation than with depression or anxiety. Central sensitisation and depression, anxiety, and somatic symptoms were associated with patients attending an outpatient clinic. These findings highlight the importance of evaluating depression, anxiety, and somatic symptoms when assessing central sensitisation.

Chronic school absenteeism is a common problem in childhood and adolescence, and it is frequently observed in patients with somatic symptom and related disorders (SSRDs). This study aimed to determine whether and to what extent the presence of school absenteeism may be a risk factor for the diagnosis of SSRDs in hospitalised patients. This matched cohort study included children and adolescents aged between 8 and 17 years, admitted to the paediatric ward of the IRCCS Burlo Garofolo in Trieste from 2021 to 2023, who were divided into two groups, the first including children with at least 15 days of absence from school for medical reasons and the second including children with regular school attendance, matched to the former group by age and sex. We consecutively enrolled 70 patients, 35 in the absentee group and 35 in the control group. In the absentee group, 30/35 (85.7%) patients were diagnosed with an SSRD, while in the control group, 1/35 (2.9%) was diagnosed with an SSRD. The absentee group had a 30-fold higher risk of being diagnosed with SSRDs than the control group (RR = 30 [95% CI = 4.3–208]; p < 0.001). This study shows that in hospitalised children, a history of school absenteeism of more than two weeks is an important risk factor for the diagnosis of SSRDs.

This study compared overall and specific aspects of health-related quality of life (HRQOL) and self-report of somatic, anxiety, and depressive symptoms between employed (n = 71) and unemployed (n = 48) patients with epilepsy (PWE). The Quality of Life in Epilepsy (QOLIE-89) and the Personality Assessment Inventory (PAI) were examined. The unemployed group reported significantly worse overall HRQOL including aspects of HRQOL related to epilepsy, physical health, mental health, and cognitive function. Among these four, physical health related HRQOL revealed the most difference between groups. While there were no differences between the groups in the level of social support and social isolation, the unemployed group reported worse social function with respect to work and driving. The unemployed group reported significantly greater somatic symptoms, but not anxiety and depressive symptoms. When specifically examining the subscales of the Somatic Concerns scale, conversion and health concerns, but not somatization, were greater in the unemployed group. Among the Depression subscales, the unemployed group reported greater physiologically manifested depressive symptoms. These findings suggest that along with optimizing seizure control, identifying and addressing presence of physical limitations, dysfunction, and somatic symptoms are also of importance in the care of PWE, particularly for those who are unemployed.

Background: Widespread functional alterations have been implicated in patients with generalized anxiety disorder (GAD). However, most studies have primarily focused on static brain network features in patients with GAD. The current research focused on exploring the dynamics within functional brain networks among individuals diagnosed with GAD. Methods: Seventy-five participants were divided into patients with GAD and healthy controls (HCs), and resting-state functional magnetic resonance imaging data were collected. The severity of symptoms was measured using the Hamilton Anxiety Scale and the Patient Health Questionnaire. Co-activation pattern (CAP) analysis, centered on the bed nucleus of the stria terminalis, was applied to explore network dynamics. The capability of these dynamic characteristics to distinguish between patients with GAD and HCs was evaluated using a support vector machine. Results: Patients with GAD exhibited disruptions in the limbic-prefrontal and limbic-default-mode network circuits. Particularly noteworthy was the marked reduction in dynamic indicators such as occurrence, EntriesFromBaseline, ExitsToBaseline, in-degree, out-degree, and resilience. Moreover, these decreased dynamic features effectively distinguished the GAD group from the HC in this study. Conclusions: The current findings revealed the underlying brain networks associated with compromised emotion regulation in individuals with GAD. The dynamic reduction in connectivity between the limbic-default mode network and limbic-prefrontal networks could potentially act as a biomarker and therapeutic target for GAD in the future.

ObjectiveDepressive symptoms can be assessed with self-reported questionnaires, such as the Patient Health Questionary-9 (PHQ-9). Previous studies have suggested that the PHQ-9 items can be grouped into somatic and non-somatic clusters. However, the classification of the PHQ-9 item “concentration difficulties” into somatic or non-somatic is still controversial. This controversy may be explained by difficulties experienced by subjects in accurately evaluating their attention problems. The primary objective of this study was to determine the correlation between objective attentional performance and the two clusters of depressive symptoms in hospital employees working in stressful conditions.MethodsThe participants filled out the PHQ-9 to identify their depressive symptoms. Based on the PHQ-9, the somatic or non-somatic symptoms were measured without considering the question about subjective concentration difficulties. Then, a brief version of the Continuous Visual Attention Test (CVAT) was applied to assess four attentional subdomains. The CVAT is a Go/No-go task that measures number of correct responses (focused attention), number of incorrect responses (behavior-inhibition), average reaction time of correct responses (RT-alertness), and variability of reaction time (VRT-sustained attention). The entire task lasted 90 s. Correlation analyses assessed the relationships between attentional performance and the two dimensions of depressive symptoms.ResultsAfter applying the inclusion/exclusion criteria, 359 individuals were selected. Their age ranged from 20 to 70 years (mean = 40.5, SD = 10.37), and the majority was female (67.6%). A predominance in somatic depressive symptoms was present in 231 (64%) participants, whereas 59 (16%) showed a predominance of non-somatic symptoms. Sixty-nine participants (20%) did not show any predominance. Higher somatic scores were associated with higher RTs, whereas higher non-somatic scores were related to an increase in the number of incorrect responses.ConclusionThe predominance of the somatic cluster was related to lower alertness, whereas the predominance of non-somatic cluster was associated with impulsivity/hyperactivity. This result may explain the difficulties associated with correctly classifying the item concentration difficulties. A brief attentional task can be used as an auxiliary tool to correctly identify the different dimensions of attention that are associated with different clusters of depressive symptoms.

Background: The coronavirus disease 2019 (COVID-19) pandemic placed immense pressure on frontline doctors. Burnout is a psychological syndrome that develops in response to chronic work stress. It consists of emotional exhaustion (EE), depersonalisation (DP) and reduced personal accomplishment (PA). Burnout is associated with personal dysfunction and compromises the work profession and patient safety. International studies suggest burnout is exacerbated during a pandemic. Methods: We conducted a descriptive cross-sectional observational study. Respondents included frontline doctors working in emergency medicine, family medicine and internal medicine during COVID-19 in Tshwane public hospitals. The survey included two validated questionnaires, the Maslach Burnout Inventory and the Depression, Anxiety, Stress Scale-21. The aim was to determine the prevalence and severity of burnout, psychological and somatic symptoms in frontline doctors. Results: Of the 163 participants, we found clinical burnout to be present in 58.9% (n = 96) and extreme burnout in 19.6% (n = 32). Moderate to extremely severe levels of stress, anxiety and depression were present in 55.1% (n = 90), 43.6% (n = 71) and 22.1% (n = 36) of participants, respectively. We found significant correlations between burnout and psychological symptoms. Increased levels of burnout, anxiety, depression and stress were found to be meaningfully associated with adverse somatic symptoms. Conclusion: Our study demonstrated an insufferably high prevalence of burnout and psychosomatic symptoms in frontline doctors during COVID-19. In the event of future pandemics, more measures should be taken to support frontline doctors. Contribution: Pandemic-associated burnout and its psychophysical consequences have not been studied in frontline doctors in South Africa.

Summary: Background: Medically Unexplained Physical Symptoms (MUPS) are prevalent among primary care patients and frequently lead to diminished quality of life, increased healthcare costs, and decreased work participation. We aimed to examine the effects of a work-focused structured communication tool based on cognitive-behavioral therapy in patients with MUPS. Methods: In a Norwegian two-arm cluster randomized trial, the effectiveness of the structured communication tool Individual Challenge Inventory Tool (ICIT) was compared to usual care for patients with MUPS using a two-arm cluster randomized design. Enrollment period was between March 7 and April 1, 2022. Ten groups (clusters) of 103 General Practitioners (GPs) were randomized to provide the ICIT or usual care for 11 weeks. Patients received two or more sessions with their GP, and outcomes were assessed individually. Primary outcome was patient-reported change in function, symptoms, and quality of life measured by the Patient Global Impression of Change (PGIC). Secondary outcomes included sick leave, work-related self-efficacy (RTW-SE), health-related quality of life (RAND-36), and patient experiences with consultants (PEQ). The trial was registered on ClinicalTrials.gov (NCT05128019). Findings: A total of 541 patients with MUPS were enrolled in the study. In the intervention group 76% (n = 223) showed a significant overall improvement in function, symptoms, and quality of life as measured by the PGIC, compared to 38% (n = 236) in the usual care group (mean difference −0.8 ([95% CI −1.0 to −0.6]; p

Research has revealed that homosexual and bisexual people are at higher risk of mental health problems than heterosexual people. However, most studies have focused on differences in disorders and have not examined the intersection of gender and sexual orientation. The main aim of this study is to investigate the relevance of sexual orientation in women's and men's mental symptoms, life satisfaction, and self-esteem. A cross-sectional study was conducted with 309 women and men who were homosexual or bisexual and 309 women and men who were heterosexual, aged between 17 and 54. All participants were assessed by four self-reports measuring mental symptoms, life satisfaction, self-esteem, masculine/instrumental and feminine/expressive traits, and traditional gender role attitudes. Results showed an interaction between sexual orientation and gender, with lesbian or bisexual women scoring higher in severe depression symptoms and lower in life satisfaction than heterosexual women. Homosexual and bisexual people scored higher than heterosexuals in somatic symptoms, social dysfunction, and in self-esteem. Women scored higher than men in somatic, anxiety, and insomnia symptoms and in feminine/expressive traits, whereas men scored higher than women in traditional gender role attitudes. We conclude that sexual orientation and gender are relevant to the mental health and well-being of people. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the association of somatic depressive symptoms (SDS), cognitive/emotional depressive symptoms (C-EDS), and antidepressant treatment on mortality due to cancer and other causes in a community cohort. Methods: A community-based sample recruited in 1995, 2000, and 2005 aged between 35 and 75 years was examined in two waves and followed for a median of 6.7 years. SDS and C-EDS phenotypes were assessed using the Patient Health Questionnaire-9. Medication used by participants was collected. Deaths and their causes were registered during follow-up. Cox proportional hazard models stratified by sex were performed to determine the association between depressive phenotypes and mortality. Results: The cohort consisted of 5,646 individuals (53.9% women) with amean age of 64 years (SD=11.89). During the follow-up, 392 deaths were recorded, of which 27.8% were due to cancer. C-EDS phenotype was associated with an increased risk of cancer mortality in both men (HR = 2.23; 95% CI = 1.11-4.44) and women (HR =3.69; 95% CI=1.69-8.09), and SDS was significantly associated with non-cancer mortality in men (HR = 2.16; 95 CI % = 1.46-3.18). Selective serotonin reuptake inhibitors (SSRIs) were significantly associated with both cancer (HR = 2.78; 95% CI = 1.10-6.98) and non-cancer mortality (HR = 2.94; 95% CI = 1.76-4.90) only in the male population. Conclusion: C-EDS phenotype was related to an increased risk of cancermortality at 6 years. In addition, the use of SSRIs in the male population was associated with cancer and all-cause mortality. [ABSTRACT FROM AUTHOR]

Recent literature highlights the complex relationship between personal identity and body-related pathology, yet there is a lack of integrative longitudinal research on the relationship between identity and somatic symptoms. The present study investigated the longitudinal associations between identity functioning and (psychological characteristics of) somatic symptoms, and examined the role of depressive symptoms in this relationship. A total of 599 community adolescents (Time 1: 41.3% female; Mage = 14.93, SD = 1.77, range = 12–18 years) participated in three annual assessments. Using cross-lagged panel models, a bidirectional relationship between identity and (psychological characteristics of) somatic symptoms, mediated by depressive symptoms, emerged at the between-person level; whereas only a unidirectional relationship from psychological characteristics of somatic symptoms to identity functioning, mediated by depressive symptoms, emerged at the within-person level. Identity and depressive symptoms were bidirectionally related at both levels. The present study suggests that adolescent identity development is closely related to somatic and emotional distress. [ABSTRACT FROM AUTHOR]

Adolescents exposed to child maltreatment are at increased risk for various somatic symptoms, but which psychological factors that contribute to this relationship need to be further investigated. Emotion dysregulation is suggested to serve as a proximal link between child maltreatment and somatic complaints. The purpose of the present study was to investigate whether individual differences in affective inhibitory control, a central component in implicit emotion regulation, contribute to the risk of somatic symptoms in adolescents exposed to child maltreatment. Data were drawn from the UEVO study, a national population-based survey of adolescents between 12 and 16 years of age (N = 9240). For this study, we included participants who completed the emotional go/no-go task measuring affective inhibitory control (N = 7241; Mage/SD = 14 years/.87; 52% girls, 47% boys), of which N = 3349 reported at least one incident of maltreatment exposure (57% girls, 41% boys). Exposure to psychological abuse and sexual abuse were associated with somatic symptoms. Affective inhibitory control was related to somatic symptoms, both in the total sample and in adolescents exposed to child maltreatment. The strength of relationships between exposure to psychological abuse and somatic symptoms, as well as sexual abuse and somatic symptoms, were moderated by individual differences in affective inhibitory control problems. Our study suggests that psychological abuse and sexual abuse increase the risk for somatic symptoms in adolescence. Affective inhibitory control, a central component in implicit emotion regulation, was related to somatic symptoms and moderated the relationships between psychological abuse and somatic symptoms, and sexual abuse and somatic symptoms. Revealing these associations in a population-based sample indicates that treatment targeting affective inhibitory control may be beneficial and should be explored further in clinical settings. [ABSTRACT FROM AUTHOR]

Firefighters are considered a high-risk group for developing stress-related psychopathologies, such as post-traumatic stress disorder (PTSD), due to repeated exposure to potentially traumatic events (PTE). Studies have indicated that PTE is also associated with the development of Somatic Symptom Disorder (SSD). However, the occurrence of this condition among firefighters is an underexplored topic. This study aimed to assess the relationships between PTE and PTSD symptoms, and the relationship between PTE and SSD symptoms. Furthermore, we aimed to assess the role of SSD in the relationship between PTE and PTSD within Portuguese firefighters who battled the 2017 violent forest fires. To this end, a sample of 116 firefighters (75% male) completed self-report measures of posttraumatic symptoms, somatic symptoms, and other psychopathological symptoms. Contrary to several literature, in the present study, neither PTSD nor SSD symptoms seem to be correlated with any sociodemographic characteristics. However, the exposure to PTE is positively correlated with both PTSD and SSD symptoms. Furthermore, SSD seems to act as a mediator in the relationship between PTE and PTSD. [ABSTRACT FROM AUTHOR]

Background: Wildfires cause significant physical and mental ill-health. How physical and mental symptoms interact following wildfire smoke exposure is unclear, particularly in the context of repeated exposures. In this cross-sectional study we investigated how posttraumatic stress and general psychological distress associated with somatic symptoms in a community exposed to multiple smoke events. Methods: A random weighted sample of 709 adults exposed to smoke during the 2014 Hazelwood coal mine fire in south-eastern Australia completed a survey in 2020. The survey coincided with the Black Summer wildfires that caused a similar period of smoke haze in the region. Participants self-reported somatic symptoms (PHQ-15) and mine fire-related posttraumatic stress (IES-R) experienced over the previous week, general psychological distress (K10) experienced over the previous four weeks, lifetime health diagnoses and demographic information. Associations between posttraumatic stress, general psychological distress, and each PHQ-15 somatic symptom were analysed using ordinal logistic regression models. Results: Overall, 36.2% of participants reported moderate- or high-level somatic symptomology. The most frequent somatic symptoms were fatigue, limb pain, trouble sleeping, back pain, headaches, and shortness of breath. After controlling for confounding factors, general psychological distress and posttraumatic stress were independently associated with all somatic symptoms (except menstrual problems in females for posttraumatic stress). Conclusions: Results highlight the high prevalence of somatic symptoms and their association with general psychological distress and posttraumatic stress within a community in the midst of a second large-scale smoke event. It is essential that healthcare providers and public health authorities consider the interconnections of these conditions when supporting communities affected by climate-related disasters. [ABSTRACT FROM AUTHOR]

Background: Adolescent patients with depressive disorders commonly exhibit somatic symptoms, which have a significant negative impact on their treatment and prognosis. Despite this, specific brain imaging characteristics of these symptoms have been poorly studied. Methods: The Hamilton Depression Rating scale (HAMD-17), Children's Functional Somatization scale (CSI), and Toronto Alexithymia scale (TAS) were used to evaluate the clinical symptoms of adolescent depression. We analyzed the correlation between brain gray matter volume (GMV) and clinical symptoms in adolescent patients with depression and somatic symptoms. Results: The depression subgroups with and without functional somatic symptoms (FSS) had higher scores on the HAMD-17, CSI, and TAS than the normal control group. The group with FSS had higher HAMD-17, CSI, and TAS scores than the depression group without FSS (p < 0.05). CSI and TAS scores were positively correlated (r = 0.378, p < 0.05). The GMV of the right supplementary motor area was higher in the depression groups with and without FSSs than in the normal control group, and the GMV was higher in the group without FSS than in the group with FSS (F = 29.394, p < 0.05). The GMV of the right supplementary motor area was negatively correlated with CSI in the depressed group with FSS (r = -0.376, p < 0.05). In the group with depression exhibiting FSS, CSI scores were positively correlated with GMV of the middle occipital gyrus (pr = 0.665, p = 0.0001), and TAS scores were positively correlated with GMV of the caudate nucleus (pr = 0.551, p = 0.001). Conclusion: Somatic symptoms of adolescent depressive disorder are associated with alexithymia; moreover, somatic symptoms and alexithymia in adolescent patients with depressive disorders are correlated with GMV changes in different brain regions. [ABSTRACT FROM AUTHOR]

The Patient Health Questionnaire-15 (PHQ-15) has been widely used as a screening instrument for Somatic Symptom Disorder (SSD) in different healthcare settings, as well as in scientific research. So far, there is no documentation of a validation of the Portuguese version of the PHQ-15. A sample of 215 subjects was selected for this study. The survey questionnaire included PHQ-15, SF-20, DASS-21, and sociodemographic and clinical characteristics. Principal component analysis was performed to reveal the structure of the internal consistency of the PHQ-15. The data was validated using Confirmatory Factor Analysis. PHQ-15 scores were correlated with SF-20 and DASS-21 dimension scores (r=.58). Three factors (general pain and discomfort; sexual and cardiac discomfort; state of dizziness) that explained 55.6% of the total variance were identified. The PHQ-15 Portuguese version has shown good reliability (Cronbach's a=.88) and good evidence of validity for detecting patients with somatic symptoms. [ABSTRACT FROM AUTHOR]

• Patients with CVDs with comorbid MDD often comorbid somatic and fatigue symptoms. • N-3 PUFAs reduced fatigue symptoms in patients with CVDs comorbid MDD. • N-3 PUFAs reduced somatic symptoms in younger patients with CVDs comorbid MDD. • Changes of EPA and n-3 PUFAs correlate negatively with changes of somatic symptoms. • Changes of BDNF correlate negatively with changes of somatic symptoms. Cardiovascular diseases (CVDs) and major depressive disorder (MDD) are the two most disabling diseases. Patients with CVDs comorbid depression had somatic and fatigue symptoms and were associated with chronic inflammation and omega-3 polyunsaturated fatty acid (n-3 PUFA) deficits. However, there have been limited studies on the effects of n-3 PUFAs on somatic and fatigue symptoms in patients with CVDs comorbid MDD. Forty patients with CVDs comorbid MDD (58% males, mean age of 60 ± 9 years) were enrolled and randomised to receive either n-3 PUFAs (2 g of eicosapentaenoic acid [EPA] and 1 g of docosahexaenoic acid [DHA] per day) or placebo in a 12-week double-blind clinical trial. We assessed the somatic symptoms with Neurotoxicity Rating Scale (NRS) and fatigue symptoms with Fatigue Scale at baseline, weeks 1, 2, 4, 8 and 12, as well as blood levels of Brain-Derived Neurotrophic Factor (BDNF), inflammatory biomarkers and PUFAs, at the baseline and week 12. The n-3 PUFAs group had a greater reduction in Fatigue scores than the placebo group at Week 4 (p =.042), while there were no differences in the changes of NRS scores. N-3 PUFAs group also had a greater increase in EPA (p =.001) and a greater decrease in total n-6 PUFAs (p =.030). Moreover, in the subgroup analyses in the younger age group (age < 55), the n-3 PUFAs group had a greater reduction on NRS total scores at Week 12 (p =.012) and NRS Somatic scores at Week 2 (p =.010), Week 8 (p =.027), Week 12 (p =.012) than the placebo group. In addition, the pre- and post-treatment changes of EPA and total n-3 PUFAs levels were negatively associated with the changes of NRS scores at Weeks 2, 4, and 8 (all p <.05), and the changes of BDNF levels were negatively associated with NRS scores at Weeks 8 and 12 (both p <.05) in the younger age group. In the older age group (age ≥ 55), there were a lesser reduction on NRS scores at Weeks 1, 2 and 4 (all p <.05), but a greater reduction on Fatigue score at Week 4 (p =.026), compared to the placebo group. There was no significant correlation between the changes of blood BDNF, inflammation, PUFAs and NRS and Fatigue scores in general and in the older age group. Overall, n-3 PUFAs improved the fatigue symptoms in patients with CVDs comorbid MDD and the general somatic symptoms in specific subpopulation of younger age patients, and perhaps via the interplay between BDNF and EPA. Our findings provide promising rationales for future studies to investigate the treatment effects of omega-3 fatty acids on fatigue and somatic symptoms of chronic mental and medical diseases. [ABSTRACT FROM AUTHOR]

Background:We aimed to explore the predictive role of serum BDNF and anxietyrelated variables in changes in somatic symptoms post-escitalopram treatment in panic disorder (PD) patients. Methods: Ninety PD patients and 99 healthy controls (HCs) were enrolled. PD patients received an 8-week escitalopram treatment. All patients were administered the Panic Disorder Severity Scale-Chinese Version (PDSS-CV) and State-Trait Anxiety Inventory (STAI) to assess panic and anxiety-related symptoms, respectively. Patient Health Questionnaire 15-item scale (PHQ-15) was performed to measure somatic symptoms, and the blood sample was collected to detect serum BDNF levels in all participants. We performed partial correlation analysis and multiple linear regression to explore correlates of PHQ-15 and predictors of PHQ-15 changes post-escitalopram treatment after controlling for age, gender, education levels (set as a dummy variable), the current duration, comorbid AP, and/or GAD. Results: Compared to HCs, PD patients had lower serum BDNF levels and higher PHQ-15 scores that could be improved post-escitalopram treatment. Lower baseline STAI state (b = -0.07, p = 0.004), and PDSS-CV scores (b = -0.25, p = 0.007), but higher baseline serum BDNF levels (b = 0.35, p = 0.007) contributed to the prediction of PHQ-15 changes post-escitalopram treatment. Conclusion: State anxiety, serum BDNF levels, and panic severity could predict changes in somatic symptoms post-escitalopram treatment, our results highlighted that serum BDNF could serve as a biological indicator for improving somatic symptoms in PD patients. [ABSTRACT FROM AUTHOR]

ObjectiveThe present study aimed to determine whether the momentary severity of women's somatic symptoms was concurrently and prospectively associated with their engagement in binge eating in naturalistic settings.MethodThirty women (Mage = 34.13, SD = 13.92) who had engaged in binge eating at least once over the month prior to study entry completed a 14-day ecological momentary assessment (EMA) protocol. During each of the 14 days, participants received five semi-random surveys via text message that assessed momentary somatic symptom severity (i.e., headaches, stomachaches/pain, chest/heart pain, faintness/dizziness, shortness of breath, fatigue) and disordered eating behaviors. Generalized estimating equations were used to determine whether momentary somatic symptoms were concurrently and prospectively (i.e., by participants' next assessment) associated with the occurrence of binge eating behavior, while controlling for age and body mass index.ResultsAt the within-person level, more severe stomachaches/pain, faintness/dizziness, shortness of breath, and fatigue were concurrently associated with an increased likelihood of engaging in binge eating. Further, at the between-person level, more severe stomachaches/pain, chest/heart pain, shortness of breath, and fatigue in general were associated with binge eating across the EMA protocol. Momentary stomachache/pain severity also prospectively predicted women's engagement in binge eating behavior at the next assessment.ConclusionsThe present results provide initial evidence that multiple somatic symptoms may serve as momentary correlates or proximal antecedents of binge eating behavior in women's daily lives. Somatic symptoms may consequently prove useful to target in eating disorder treatments, perhaps via interoceptive exposure interventions.

Changes in affect over time have been associated with health outcomes. However, previously utilized measurement methods focus on variability of affect (e.g., standard deviation, root mean squared successive difference) and ignore the more complex temporal patterns of affect over time. These patterns may be an important feature in understanding how the dynamics of affect relate to health. Recurrence quantification analysis (RQA) may help alleviate this problem by assessing temporal characteristics unassessed by past methods. RQA metrics, such as determinism and recurrence, can provide a measure of the predictability of affect over time, indexing how often patterns within affective experiences repeat. In Study 1, we first contrasted RQA metrics with commonly used measures of variability to demonstrate that RQA can further differentiate among patterns of affect. In Study 2, we analyzed the associations between these new metrics and health, namely, depressive and somatic symptoms. We found that RQA metrics predicted health above and beyond mean levels and variability of affect over time. The most desirable health outcomes were observed in people who had high mean positive affect, low mean negative affect, low affect variability, and high affect predictability. These studies are the first to demonstrate the utility of RQA for determining how temporal patterns in affective experiences are important for health outcomes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background Considerable evidence suggests that people with depressive disorder are at higher risk for somatic symptoms than normal people, but the mechanisms of susceptibility are unclear. Some studies suggest that the levels of precursor of brain-derived neurotrophic factor (ProBDNF) and inflammatory cytokines in depressive disorder patients are higher, but it is still unclear whether this is related to the accompanying somatic symptoms. Objective To explore the characteristics of somatic symptoms, and their correlations with BDNF and inflammatory cytokines in patients with major depressive disorder (MDD) . Methods A total of 59 MDD outpatients and inpatients from Mental Health Department, First Hospital of Shanxi Medical University and 32 healthy volunteers from the community were recruited from February 2019 to December 2020. Somatic symptoms were diagnosed using the Somatic Self-rating Scale (SSS, SSS score >36 and SSS score ≤36 were defined as with somatic symptoms or without, respectively) . Depression was assessed using the Hamilton Depression Rating Scale (HAMD-17) . Clinical data were collected, including gender, age, years of education, HAMD-17 score, SSS score, absorbance of ProBDNF and BDNF, and inflammatory cytokines (CRP, IL-4, IL-10, IL-18, IL-23a, HMGB1, IL-6, TNF-α, IFN-α) . Spearman's rank correlation analysis was used to investigate the correlation of somatic symptoms (including dizziness and headache, frequent and urgency of urination, cardiovascular symptoms, muscle soreness, gastrointestinal symptoms, tingling and twitching of hands and feet, choking and sighing, blurred vision, and discomfort of the throat) , SSS-S factor score and HAMD-17 score with ProBDNF and BDNF, and inflammatory cytokines. Results MDD patients with somatic symptoms had higher total HAMD-17 score than those without (P

Abstract Background Loneliness is increasingly acknowledged as a serious public health issue. This longitudinal study aimed to assess the extent to which psychological distress and alexithymia can predict loneliness among Italian college students before and one year after the COVID-19 outbreak. Methods A convenience sample of 177 psychology college students were recruited. Loneliness (UCLA), alexithymia (TAS-20), anxiety symptoms (GAD-7), depressive symptoms (PHQ-9), and somatic symptoms (PHQ-15) were assessed before the COVID-19 outbreak and one year after the spread of COVID-19 worldwide. Results After controlling for baseline loneliness, students with high levels of loneliness during lockdown showed worsening psychological distress and alexithymic traits over time. Suffering from depressive symptoms before COVID-19 and the aggravation of alexithymic traits independently predicted 41% of perceived loneliness during the COVID-19 outbreak. Conclusions College students with higher levels of depression and alexithymic traits both before and one year after the lockdown were more at risk of suffering from perceived loneliness and may constitute the target sample for psychological support and intervention.

Background: Somatic symptoms especially in the early postpartum period may be common, but their frequency and severity may indicate underlying childbirth-related Post Traumatic Stress Disorder (PTSD) and postpartum depression. Materials and Methods: This study aimed to assess somatic symptoms in women during the early postpartum period and their association to childbirth-related PTSD and depression. This was a community-based cross-sectional study conducted in South India. The Scale for Assessment of Somatic Symptoms (SASS), Childbirth Experience Questionnaire (CEQ), PTSD Checklist (PCL), and Edinburgh Postnatal Depression Scale (EPDS) were used to assess somatic symptoms, negative childbirth experience, PTSD symptoms, and depression, respectively. Results: Among 95 primigravida women who were in their 2–6 weeks postpartum, the occurrence of somatic symptoms varied from 4% to 79% depending on the nature of symptoms. Pain symptoms, fatigue and weakness, and alteration in biological functions such as libido, sleep, and appetite were more commonly noted. The total severity score on SASS correlated negatively with the CEQ (r = −0.544, p = .001) and positively with scores on the PCL (r = 0.494, p = .001) and EPDS (r = 0.565, p = .001), indicating that somatic symptoms were associated with negative childbirth experience, childbirth-related PTSD, and depression. The frequencies of somatic symptoms were noted to be higher in women with childbirth-related PTSD and depression. Conclusion: Women presenting with multiple and severe somatic complaints in the early postnatal period may have underlying PTSD or depression following a negative childbirth experience. A detailed and sensitive enquiry along with appropriate care should be provided to such women to enhance maternal well-being.

Abstract Background Despite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of Swedish youth, the extent to which these problems correspond to an increase in adult mental problems is unknown. The present study investigates whether Swedish adolescents with high levels of psychosomatic symptoms are at risk of developing depression and anxiety problems in adulthood and whether sex moderates any association. Moreover, we aim to understand whether different clusters of youth psychosomatic symptoms – somatic, psychological and musculoskeletal – have different impacts on adult mental health. Methods One thousand five hundred forty-five Swedish adolescents – aged 13 (49%) and 15 (51%) – completed surveys at baseline (T1) and 3 years later (T2); of them, 1174 (61% females) also participated after 6 years (T3). Multivariate logistic models were run. Results Youth with high levels of psychosomatic symptoms had higher odds of high levels of depressive symptoms at T2 and T3. Moreover, psychosomatic symptoms at T1 predicted a high level of anxiety symptoms and diagnoses of anxiety disorders at T3. When analyzed separately, musculoskeletal symptoms predicted higher odds of having high levels of depressive symptoms at T2 and T3 while somatic symptoms predicted high levels of anxiety symptoms at T2. Moreover, somatic symptoms at T1 predicted diagnoses of depression and anxiety disorders at T3. Sex did not moderate any of the relationships. Conclusions The study supports the idea that an increase in mental health problems, such as psychosomatic symptoms, can seriously impact the psychological health of new generations of young adults.

Abstract Background Subclinical anxiety, depressive and somatic symptoms appear closely related. However, it remains unclear whether somatic symptoms mediate the association between subclinical anxiety and depressive symptoms and what the underlying neuroimaging mechanisms are for the mediating effect. Methods Data of healthy participants (n = 466) and participants in remission of major depressive disorder (n = 53) were obtained from the Human Connectome Project. The Achenbach Adult Self-Report was adopted to assess anxiety, depressive and somatic symptoms. All participants completed four runs of resting-state functional magnetic resonance imaging. Mediation analyses were utilized to explore the interactions among these symptoms and their neuroimaging mechanisms. Results Somatic symptoms partially mediated the association between subclinical anxiety and depressive symptoms in healthy participants (anxiety→somatic→depression: effect: 0.2785, Boot 95% CI: 0.0958–0.3729; depression→somatic→anxiety: effect: 0.0753, Boot 95% CI: 0.0232–0.1314) and participants in remission of MDD (anxiety→somatic→depression: effect: 0.2948, Boot 95% CI: 0.0357–0.7382; depression→somatic→anxiety: effect: 0.0984, Boot 95% CI: 0.0007–0.2438). Resting-state functional connectivity (FC) between the right medial superior frontal gyrus and the left thalamus and somatic symptoms as chain mediators partially mediated the effect of subclinical depressive symptoms on subclinical anxiety symptoms in healthy participants (effect: 0.0020, Boot 95% CI: 0.0003–0.0043). The mean strength of common FCs of subclinical depressive and somatic symptoms, somatic symptoms, and the mean strength of common FCs of subclinical anxiety and somatic symptoms as chain mediators partially mediated the effect of subclinical depressive symptoms on subclinical anxiety symptoms in remission of MDD (effect: 0.0437, Boot 95% CI: 0.0024–0.1190). These common FCs mainly involved the insula, precentral gyri, postcentral gyri and cingulate gyri. Furthermore, FC between the triangular part of the left inferior frontal gyrus and the left postcentral gyrus was positively associated with subclinical anxiety, depressive and somatic symptoms in remission of MDD (FDR-corrected p

ObjectiveThis study sought to evaluate Terror Management Theory (TMT) assumptions about death awareness and its psychological impact in the context of a real-world war situation with high external validity. We examined if factors such as habituation to war circumstances and psychological resilience could buffer the effects on civilians’ anxiety, physical and mental health, and affect.MethodWe implemented a pre-registered smartphone-based experience sampling method study over four weeks, with 307 participants (k = 7,824) living in war-affected areas in Ukraine whereby participants were regularly exposed to war situations, including air-raid alarms, explosions, and infrastructural problems.ResultsThe data indicated that war situations significantly increased anxiety, negatively impacting mental health, and raising somatic symptom severity. While habituation showed a mild buffering effect on these impacts, resilience did not.ConclusionThis real-world investigation supports TMT’s fundamental assumptions about death awareness and its psychological implications. However, even amidst the presence of real, life-threatening situations, the buffering effects of habituation were surprisingly minimal. This suggests that further exploration of TMT’s buffering factors in real-world scenarios is warranted.

Mental disorders characterized by preoccupation with distressing bodily symptoms and associated functional impairment have been a target of major reconceptualization in the ICD-11, in which a single category of Bodily Distress Disorder (BDD) with different levels of severity replaces most of the Somatoform Disorders in ICD-10. This study compared the accuracy of clinicians' diagnosis of disorders of somatic symptoms using either the ICD-11 or ICD-10 diagnostic guidelines in an online study. Clinically active members of the World Health Organization's Global Clinical Practice Network (N = 1065) participating in English, Spanish, or Japanese were randomly assigned to apply ICD-11 or ICD-10 diagnostic guidelines to one of nine pairs of standardized case vignettes. The accuracy of the clinicians' diagnoses as well as their ratings of the guidelines' clinical utility were assessed. Overall, clinicians were more accurate using ICD-11 compared to ICD-10 for every presentation of a vignette characterized primarily by bodily symptoms associated with distress and impairment. Clinicians who made a diagnosis of BDD using ICD-11 were generally correct in applying the severity specifiers for the condition. This sample may represent some self-selection bias and thus may not generalize to all clinicians. Additionally, diagnostic decisions with live patients may lead to different results. The ICD-11 diagnostic guidelines for BDD represent an improvement over those for Somatoform Disorders in ICD-10 in regard to clinicians' diagnostic accuracy and perceived clinical utility. • ICD-11 Bodily Distress Disorder simplifies the ICD-10 Somatoform Disorder diagnoses. • Clinicians were more accurate using ICD-11 BDD than ICD-10 Somatoform diagnoses. • Training should focus on distinguishing subthreshold cases of somatic problems. [ABSTRACT FROM AUTHOR]

Objectives: To identify the prevalence of psychiatric morbidity among patients visiting Internal Medicine outpatient clinic; mainly anxiety, depressive, somatic symptoms and insomnia, as well as their association with socio-demographic and clinical variables. Method: This cross-sectional study was conducted at Ali Kamal Internal Medicine outpatient clinic in Sulaimani city, throughout the period from 15th of July to 15th of September 2021. A convenience sample of 100 patients was chosen, using the General Health Questionnaire -28 form with socio-demographic and clinical characteristics which were filled by the participants. Results: Among the 45% of participants whose scores were indicated presence of psychiatric morbidity, 20% had symptoms of anxiety, 14% had depressive symptoms and 11% had somatic symptoms. Among socio-demographic and clinical variables, statistically significant differences were observed with the past psychiatric disorders and family history of mental illness. Conclusion: This study revealed that a large proportion of patients attending Internal Medicine out-patient clinics in Sulaimani city have mental symptoms comorbid with medical diseases. This emphasizes the need for more awareness among clinicians in medical specialties. Appropriate mental health education targeting physicians may support achieving a better identification of mental illness and subsequently an improved quality of life for the patients. [ABSTRACT FROM AUTHOR]

Background and Aims: There is lack of research on somatic symptoms in schizophrenia. We aimed at finding prevalence and types of somatic symptoms in patients with schizophrenia and assessed their association with socio-demographic and clinical characteristics. Methods: We assessed somatic symptoms using Patient Health Questionnaire-15 (PHQ-15) in 93 patients with schizophrenia diagnosed on ICD10-DCR. Scale for Assessment of Positive Symptoms and Scale for Assessment of Negative Symptoms, WHO Disability Assessment Schedule 2.0, WHO Quality of Life (BREF) Hindi version and Liverpool University Neuroleptic Side-Effect Rating Scale were used to assess psychopathology, disability, quality of life and side effects. Results: Significant somatic symptoms (n ≥5 on PHQ-15) were present in 62 (67.7%) patients with schizophrenia. Forty three (69.4%) had mild (n = 5-9 on PHQ-15), 17 (27.4%) had moderate (n = 10-14 on PHQ-15), and only 2 (3.2%) had severe (n = ≥15 on PHQ -15) somatic symptoms. Mean somatic symptoms score on PHQ-15 was 7.28 (± 3.83); 96.8% reported feeling tired, 76.3% had constipation or diarrhoea, 67.7% trouble in sleeping, 61.3% nausea or indigestion, 52.7% back pain and 51.6% headache. Patients with somatic symptoms were older in age, had longer duration of illness and treatment, and had more negative symptoms. They had higher disability and poor quality of life especially in physical domain. Conclusion: Somatic symptoms are common in patients with schizophrenia and are associated with chronicity, refractoriness and negative symptoms, significant disability and poor quality of life. Thus during routine clinical practice, somatic symptoms should be assessed and managed in these patients. [ABSTRACT FROM AUTHOR]

The current study adopted a daily diary design to examine associations of daily stressors and hurt feelings to three unfavorable daily outcomes, including verbal aggression, physical aggression, and somatic symptoms and the moderation of rejection sensitivity and negative emotion regulation on the relations between these daily variables. A total of 248 college students participated in the daily diary study in which they responded to the assessment on a daily basis for 7 consecutive days. The results indicated that daily stressors predicted daily verbal aggression; daily stressors, daily hurt feelings, and rejection sensitivity predicted somatic symptoms. Negative emotion regulation moderated the association between stressors and verbal aggression such that more stressors and high negative emotion regulation predicted more frequent daily verbal aggression. Rejection sensitivity moderated the association of hurt feelings to verbal and physical aggression. Perception of hurt feelings and high rejection sensitivity predicted more verbal aggression but less physical aggression. Rejection sensitivity also moderated the association of stressors to somatic symptoms such that more stressors and high rejection sensitivity predicted more somatic symptoms. The findings collectively highlight the importance of supporting individuals with high rejection sensitivity to encode social cues in a healthy way. It is imperative to provide emotion regulation skills to cope with negative emotions derived from social interactions. [ABSTRACT FROM AUTHOR]

Aim and Objective: The purpose of this study is to examine the effects that dance interventions have on the somatic symptoms and psychological health of teenage girls and it also provides scientific guidance for mental health education in schools. Methodology: The participants in the research were female adolescents between the ages of 10 and 18 years old (mean years: 15.89±2.85). The criteria for inclusion were internalizing difficulties that were connected to stress, as well as several visits to the school nurse for both physical symptoms (such as headaches, stomachaches, weariness, and hurting shoulders) and emotional discomfort (e.g. persistent feelings of stress, nervousness, and anxiety). There were a total of one hundred teenage girls with stress-related internalizing disorders who participated in the research study. Of them, fifty were assigned at random to the dance intervention group, while the remaining fifty were assigned to the control group. Results: The majority of the females are between the ages of 14 and 16. Girls were present at a rate of 44% in the intervention group and 40% in the control group respectively. This was followed by a rate of 42% in the age group for 16-18 years old and 38% in the age group for 12-14 year olds. In the age group of 10-12 year olds, only 4% of girls were present. 78% of boys and 70% of girls engage in physical activity. For those participating in the dancing intervention and those serving as the control, respectively. At the beginning of the study, the total mean value for somatic symptoms was 3.25±1.25, and the mean value for emotional distress was 3.89±1.33. The emotional distress and somatic symptoms connection has a Pearson value of r=0.84, which indicates a strong relationship between the two. The levels of emotional distress before and after the intervention were as follows: stress 47 (94%) and 6 (12%), nervousness 45 (90%) and 5 (12%), anxiety 49 (98%) and 6 (12%), sadness 46 (92%) and 5 (12%), irritation 44 (88%) and 4 (8%), and powerlessness 47 (94%) and 4 (8%). Conclusion: According to the findings of the current research, dance therapies can alleviate stress-related physical symptoms as well as mental discomfort in teenage females. Nevertheless, the impact of the intervention was not sustained one year after the session had been completed, which suggests that participants need to continue frequent involvement in the intervention for the outcomes to be permanent. To assess the efficacy of the intervention in a variety of contexts, more randomized trials are necessary. [ABSTRACT FROM AUTHOR]

Background: The purpose of this research was to compare the effectiveness of family care based on the health belief model, and health-promoting styles training on the illness perception and somatic symptoms of patients with asthma. Methods: This semi-experimental research was conducted with a pretest-posttest design, follow-up, and a control group. The statistical population of this research included patients with mild asthma who were referred to Shahid Fayaz Bakhsh Hospital in Tehran, Iran, in the spring of 2019. Using purposive sampling, 45 of them were selected and randomly assigned to 2 intervention groups and 1 control group. The research tools included a demographic questionnaire, and the Illness Perception Questionnaire (IPQ) and St. George Respiratory Questionnaire (SGRQ). After the implementation of the health belief and health-promoting style interventions, repeated measures analysis of variance was used to analyze the data. Results: The results of the Bonferroni post hoc test indicate a significant difference between the averages of the experimental and control groups, as well as in the pretest stage with the posttest, and pretest with follow-up in terms of the severity of the somatic symptoms. Moreover, they indicate the positive effect of the health promotion intervention and the health belief intervention in the experimental group and the continuation of these effects in the follow-up phase. Conclusion: It can be concluded that there was a significant difference between the averages of the experimental and control groups, as well as in the pretest stage with the posttest, and pretest with follow-up in terms of the illness perception variable, which indicate the positive effect of the health promotion intervention and the health belief intervention in the experimental group and the continuation of these effects in the follow-up phase. [ABSTRACT FROM AUTHOR]

In order to evaluate the fit of a theoretical model to explain Mental Well-being from Positive and Negative Affect, Somatic Symptoms and Psychological Pain, 260 university students from Chile participated voluntarily, who answered the EBMWE, PANAS, SSS-8 and MBPPAS scales. The multivariate statistical technique of Path Analysis was used and the results indicated that Mental Well-Being is explained by direct relationships with Positive Affect, Negative Affect and Psychological Pain. Somatic Symptoms would have an indirect effect through Negative Affect and Psychological Pain. It is concluded that the variables of the model explain 72% of the variance of Mental Well-being. [ABSTRACT FROM AUTHOR]

Objective: To determine the relationship between over commitment and somatic symptoms among nurses in a type II hospital in Peru. Methods: A cross-sectional study with a probabilistic sample of 106 participants was carried-out. The Siegrist and Meter questionnaire was applied to measure over commitment and imbalance effort-recompense and the Health Questionnaire (PHQ15) was applied to evaluate somatic symptoms. A logistic regression model was built considering sociodemographic and labor variables. Results: The 68.3% of nurses that presented with moderate to severe somatic symptoms had a high level of over commitment. The regression model showed that over commitment (OR = 6.25, p < 0.01), time in the working place (OR = 0.74, p < 0.01) and labor status (staff or hired temporarily OR = 49.20, p < 0.01) influenced the level of somatic symptoms. The model discriminated well the 79% (95% CI: 95%: 0.70 - 0.88) of somatic cases. A value of 0.43 was selected to discriminate between mild to moderate-severe with a sensitivity of 73% and 74% specificity. Conclusions: A significant correlation between over commitment and somatic symptoms was found. The regression model attained a high discriminative level to identify nurses at risk. [ABSTRACT FROM AUTHOR]

Introduction: Knee osteoarthritis (KOA) is a common joint condition associated with aging, leading to pain, functional limitations, disability, and reduced quality of life. This clinical randomized controlled trial aimed to investigate the effectiveness of a cryotherapy intervention in combination with a home-based conventional exercise (HBE) program in reducing somatic symptoms in patients with KOA. Material and methods: Patients diagnosed with KOA were randomly assigned to 2 groups: an experimental group (n = 16) receiving HBE with cryotherapy and a control group (n = 15) receiving HBE alone for 2 months. Results: The results showed that patients in the HBE with cryotherapy group had significantly lower scores on somatic symptoms (SDS) compared to those in the HBE group (2.00 vs. 4.53; mean difference: -2.53, 95% CI: -4.50 to -0.57) with a large effect size (Cohen's d: 0.94). Additionally, both the HBE and HBE with cryotherapy groups exhibited a significant decrease in SDS scores, 20.87-4.53 and 18.75-2.00, respectively (p < 0.001). Conclusions: This study showed that combining HBE with cryotherapy is an effective approach for improving somatic symptoms in patients with KOA. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the nature and prevalence of nonspecific somatic symptoms, pain and catastrophizing in children with Heritable Connective Tissue Disorders (HCTD), and to determine their association with disability. This observational, multicenter study included 127 children, aged 4–18 years, with Marfan syndrome (MFS) (59%), Loeys‐Dietz syndrome (LDS) (8%), Ehlers‐Danlos syndromes (EDS) (12%) and hypermobile Ehlers‐Danlos syndrome (hEDS) (23%). The assessments included the Children's Somatization Inventory or parent proxy (CSI, PCSI), pain visual‐analogue scale (VAS), SUPERKIDZ body diagram, Pain Catastrophizing Scale Child or parent proxy (PCS‐C, PCS‐P) and Childhood Health Assessment Questionnaire (CHAQ‐30). Data from children aged ≥8 years were compared to normative data. In children ≥ 8 years (n = 90), pain was present in 59%, with a median of 4 (IQR = 3–9) pain areas. Compared to normative data, the HCTD group reported significantly higher on the CSI (p ≤ 0.001, d = 0.85), VAS pain intensity (p ≤ 0.001, d = 1.22) and CHAQ‐30 (p ≤ 0.001, d = 1.16) and lower on the PCS‐C (p = 0.017, d = −0.82) and PCS‐P (p ≤ 0.001, d = −0.49). The intensity of nonspecific somatic symptoms and pain explained 45% of the variance in disability (r2 = 0.45 F(2,48) = 19.70, p ≤ 0.001). In children ≤ 7 years (n = 37), pain was present in 35% with a median of 5(IQR = 1–13) pain areas. The mean(SD) VAS scores for pain intensity was 1.5(2.9). Functional disability was moderately correlated to the number of pain areas (r = 0.56, p ≤ 0.001), intensity of nonspecific somatic symptoms (r = 0.63, p ≤ 0.001) and pain (r = 0.83, p ≤ 0.001). In conclusion, this study supports the need for comprehensive assessment of nonspecific somatic symptoms, pain, and disability in children with HCTD to allow tailored treatment. [ABSTRACT FROM AUTHOR]

Studies show that loneliness was higher during the pandemic than in the pre-pandemic periods, with negative consequences on individual happiness. This study extends current knowledge by investigating the indirect effects of somatic symptoms and psychological distress in the loneliness-happiness relationship during the COVID-19 lockdown. The cross-sectional sample comprises 538 Nigerian adults (Meanage = 36.48 ± 12.03) with 43% females. Data were collected using structured self-report instruments and subjected to path analyses in SPSS AMOS. Results showed that loneliness and happiness were negatively related. Loneliness and happiness were indirectly related through the successive association between somatic symptoms and psychological distress. Specifically, greater loneliness was associated with increased somatic symptoms, which in turn were associated with greater psychological distress and reduced happiness levels. Clinicians can manage the decline in happiness from loneliness during the pandemic lockdown by administering treatments that mitigate somatic symptoms and psychological distress in concerned clients. [ABSTRACT FROM AUTHOR]

Patients with cancer might be particularly prone to stress caused by the COVID-19 pandemic. The aim of this study was to investigate the impact of pandemic-related stressors on oncological patients' psychological well-being. During the second wave of the COVID-19 pandemic in Germany 122 cancer out-patients of the Comprehensive Cancer Center Munich reported on COVID-19-related stressors (information satisfaction, threat perception, and fear of disease deterioration) and answered standardized questionnaires for psychosocial distress (DT) as well as depression and anxiety symptoms (PHQ-2, GAD-2). Multiple linear regression analyses were used to identify associations of the COVID-19-related stressors with psychological symptoms, controlling for sociodemographic, psychological (self-efficacy, ASKU) and clinical (somatic symptom burden, SSS-8) variables. Initially, satisfaction with information was significantly negatively associated with all three outcome variables. Fear of disease deterioration was associated with distress and depressive symptoms. After controlling for additional variables, only satisfaction with information remained an independent determinant of anxiety (β = -0.35, p < 0.001). All three outcomes were most strongly determined by somatic symptom burden (β ≥ 0.40, p < 0.001). The results of this study tentatively suggest that physical well-being overrides the relevance of some COVID-19-related stressors for oncological patients' psychological wellbeing. Physical symptoms are strongly tied to personal wellbeing as they are associated with suffering from cancer, which might be more central to personal wellbeing than the possibility of getting infected with SARS-CoV-2. However, satisfaction with the information received seems to be important beyond physical wellbeing, as this emerged as an independent determinant of anxiety. [ABSTRACT FROM AUTHOR]

Somatic symptoms are common among Syrian refugees. To quantify somatic symptom load, sum score models derived from the Patient Health Questionnaire (PHQ-15) have been frequently applied without psychometric justification. Across two studies (total N = 776), we (a) tested different PHQ-15 factor solutions in Syrian refugees, (b) investigated measurement invariance (MI) of the factor solutions compared with German residents, and (c) scrutinized whether sum score models adequately represent the data and differ in associations with external validators compared with factor scores. One-factor, three-factor, four-factor, and a reduced one-factor solution all displayed acceptable to good model fit. The four-factor solution showed the best fit, enabling differential symptom analyses. Sum score models often had poor model fit, necessitating independent investigations before applying them. For all factor solutions, (partial) strict MI between residents and refugees could be established. All scoring methods displayed high and comparable associations with functional impairment, depressive, and anxiety symptoms. [ABSTRACT FROM AUTHOR]

Background: Previous epidemiologic studies in Sweden have only covered some of the disorders of gut–brain interaction (DGBI) and are not representative of the general population. This study aimed to define the prevalence and impact of DGBI in Sweden. Methods: We used Swedish data from the Rome Foundation Global Epidemiology Study which include information on DGBI diagnoses, psychological distress, quality of life (QoL), healthcare utilization, and the impact of stress on GI symptoms. Key Results: The prevalence of having any DGBI was 39.1% (95% CI 37.0–41.2); esophageal disorders 6.1% (5.1–7.3), gastroduodenal disorders 10.7% (9.3–12.0), bowel disorders 31.6% (29.6–33.6), and anorectal disorders 6.0% (5.1–7.2). Subjects with a DGBI more commonly reported anxiety and/or depression, reduced mental and physical QoL, and more frequent doctor visits due to health problems. Subjects with a DGBI reported bothersome gastrointestinal (GI) symptoms to a greater extent and more than 1/3 had visited a doctor due to GI problems and of those 1/3 had seen multiple doctors. Prescription medications were available among 36.4% (31.0–42.0) who had bothersome GI symptoms and a DGBI, with sufficient symptom relief in 73.2% (64.0–81.1). Psychological factors and eating were reported to worsen GI symptoms and stress during the last month was greater in subjects with a DGBI. Conclusions and Inferences: DGBI prevalence and its impact in Sweden is in line with global data, including increased healthcare utilization. GI symptoms are commonly affected by psychological factors and eating, and a high proportion of those on prescription medication report sufficient GI symptom relief. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the treatment outcomes of agomelatine on anhedonic state, anxiety/somatic symptoms, and sexual function in Chinese patients with major depressive disorder (MDD). Method: In total, 93 adult patients with MDD were enrolled, and 68 of them were included in a prospective, open-label, multicenter clinical study. All patients received agomelatine monotherapy during a 9-week treatment phase. The effectiveness of the treatment was reflected by the improvement of anhedonia and somatic symptoms based on the 17-item Hamilton Depression Rating Scale (HAMD-17). In addition, the Arizona Sexual Dysfunction Scale (ASEX), Sheehan Disability Scale (SDS), and Short Form of Quality-of-Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF) were administered to all participants at baseline and at the 3-, 6-, and 9-week follow-ups. Results: After 9 weeks of treatment with agomelatine, the response and remission rates were 73.5% and 39.7%, respectively. Somatic symptoms significantly improved at week 9 (p < 0.001), and significant effects were also observed on the HAMD anhedonia items (p < 0.001). The patients exhibited lower levels of disease severity (the SDS score dropped from 15.52 ± 4.7 to 7.09 ± 5.62 at week 9; the ASEX score dropped from21.89±4.06 to 16.19±4.79, p<0.001) and higher levels of QOL (the Q-LES-Q-SF score dropped from 41.02 ± 5.99 to 50.49 ± 8.57, p < 0.001) during the follow-up. Furthermore, treatment with agomelatine improved depressive symptoms without causing serious adverse events. Conclusion: These analyses indicate that agomelatine is a treatment option for improving anhedonic status, anxiety/somatic symptoms, and sexual dysfunction in MDD patients. [ABSTRACT FROM AUTHOR]

Introduction : Social anxiety disorder is characterized by intense anxiety in social situations where the person is likely to be evaluated by others. Aim : The present study aimed to investigate the effectiveness of contextual schema therapy on emotion regulation and painful physical symptoms in individuals with social anxiety disorder. Method : This study employed an A -B single -subject design. The statistical population included all the people with social anxiety disorder in Mashhad city, in 2021, and 12 people were selected by convenience sampling method. Then, the contextual schema therapy was conducted during 16 sessions of 1 hour once a week for 12 subjects. The Emotion Regulation Questionnaire (2003) and the Visual Analog Scale (1921) were used in this study. The Subjects answered the questionnaires in the baseline phase, at sessions 4, 8, 12 and 16, and at 3 -month follow -up. The data were analyzed using visual analysis, improvement percentage, reliable change index, and non -overlapping effect size. Results : The improvement percentage (25%<), the reliable change index (1.96<) and the non - overlapping data (75<) indicated the significant effect of the treatment in increasing the reappraisal subscale of all subjects (except subject 12), reducing the expressive suppression subscale of all subjects and reducing painful physical symptoms of all subjects (except subject 7). The improvement percentage at the follow -up showed that the intervention was effective in increasing the reappraisal, reducing expressive suppression and painful physical symptoms. Conclusion : Based on the findings, contextual schema therapy was effective in improving emotion regulation and reducing painful physical symptoms by modifying the modes and the third wave methods. Therefore, contextual schema therapy can be suggested as a suitable intervention for social anxiety disorder. [ABSTRACT FROM AUTHOR]

ObjectiveThis study aimed to assess the association of somatic depressive symptoms (SDS), cognitive/emotional depressive symptoms (C-EDS), and antidepressant treatment on mortality due to cancer and other causes in a community cohort.MethodsA community-based sample recruited in 1995, 2000, and 2005 aged between 35 and 75 years was examined in two waves and followed for a median of 6.7 years. SDS and C-EDS phenotypes were assessed using the Patient Health Questionnaire-9. Medication used by participants was collected. Deaths and their causes were registered during follow-up. Cox proportional hazard models stratified by sex were performed to determine the association between depressive phenotypes and mortality.ResultsThe cohort consisted of 5,646 individuals (53.9% women) with a mean age of 64 years (SD = 11.89). During the follow-up, 392 deaths were recorded, of which 27.8% were due to cancer. C-EDS phenotype was associated with an increased risk of cancer mortality in both men (HR = 2.23; 95% CI = 1.11–4.44) and women (HR = 3.69; 95% CI = 1.69–8.09), and SDS was significantly associated with non-cancer mortality in men (HR = 2.16; 95 CI % = 1.46–3.18). Selective serotonin reuptake inhibitors (SSRIs) were significantly associated with both cancer (HR = 2.78; 95% CI = 1.10–6.98) and non-cancer mortality (HR = 2.94; 95% CI = 1.76–4.90) only in the male population.ConclusionC-EDS phenotype was related to an increased risk of cancer mortality at 6 years. In addition, the use of SSRIs in the male population was associated with cancer and all-cause mortality.

Objectives: To study sociodemographic and clinical variables, including psychiatric co-morbidities, in patients with irritable bowel syndrome. Methods: A total of 158 patients attending a medical gastroenterology clinic in a tertiary care center in Northern India were screened, from whom 100 were selected for the study. Rome IV criteria were used to diagnose IBS, and the severity of symptoms was assessed by the Irritable Bowel Syndrome Symptom Severity Scale (IBS-SSS). Psychiatric co-morbidities were screened via clinical evaluation, and if present, a diagnosis was made as per DSM-5. The Depression, Anxiety, and Stress Scale-21 (DASS-21) and Somatic Symptom Scale-8 (SSS-8) were used to assess depression, anxiety, stress, and somatic symptoms. Result: The mean age of cases was 35.6 years’ old, and the majority of cases (i.e., 38.0%) were between 18 and 29 years’ old. Males comprised 62.0% of the sample and females 38.0%. Moderate IBS was present in 61.0% of the cases. Evaluation via DASS-21 revealed that 53.0% were in the moderate category of depression, 43.0% had moderate anxiety, and 36.0% had moderate stress. The somatic symptom scale revealed that 48.0% patients were in the high category. Psychiatric co-morbidities were present in 29.0% of cases. Depressive disorders were the most common psychiatric co-morbidity. Conclusions: Patients with IBS presenting to a tertiary care center in Northern India were primarily young males living in semi-urban areas who belonged to the Hindu religion, were married, and had a nuclear family. Patients with IBS commonly have associated psychiatric disorders; anxiety disorders and depression are most common.