Somatoform Research Articles

The impact of technostress on caregivers of primary and secondary school children during distance-learning throughout the COVID-19 pandemic

ABSTRACT The shift to online learning due to the COVID-19 pandemic has led to numerous complaints from caregivers unaccustomed to new technologies, resulting in technostress, defined as “stress or psychosomatic illness caused by working with computer technology on a daily basis.” This study investigates the prevalence and impact of technostress on caregivers of primary and middle school children attending online school from home in the United Arab Emirates (UAE). A cross-sectional study was conducted among caregivers with children in primary and middle school residing in the UAE (n = 727; males = 86, females = 641). Data was collected using an online questionnaire examining technostress and its impact on caregiver-child relationships and health, including sleep, anxiety, and appetite. Data analysis was performed using SPSS (version 26). Caregivers aged 30–39 years and females had the highest technostress scores (p < 0.05), while occupation and education levels had no effect. Technostress was significantly correlated with mental health (r2 = 0.291; p < 0.001) and caregiver-child relationships (r2 = 0.429; p < 0.001). Caregivers with two or more children in primary and middle school had higher technostress scores (p < 0.05). In conclusion, female caregivers aged 30–39 experienced higher technostress, negatively impacting their mental health and relationships with their children. We recommend targeted anti-technostress courses and enhanced communication.

Exploring Associations of Somatic Symptom Disorder with Personality Dysfunction and Specific Maladaptive Traits

Introduction: According to ICD-11, personality disorders (PDs) are defined by the severity of self and interpersonal dysfunction in terms of personality functioning (PF) and an optional assessment of specific maladaptive personality trait expressions. Also, somatoform disorders are replaced by somatic symptom disorder (SSD). This study examines associations using the novel diagnostic criteria of SSD in an unselected primary care sample, PF, and maladaptive traits in patients with and without SSD. Methods: An anonymized cross-sectional study was conducted. A questionnaire including SSD-12 (Somatic Symptom Disorder B Criteria Scale-12) and PHQ-15 (Patient Health Questionnaire-15), LPFS-BF 2.0 (Level of Personality Functioning Scale – Brief Form) and PID-5BF+M (Modified Personality Inventory for DSM-5 – Brief Form Plus) was used. A bifactor (S-1) model was calculated with PF (reference for general factor) and personality traits (specific factors) to estimate associations between PF, specific maladaptive personality traits, and SSD. Differences in personality scales between SSD and non-SSD patients were calculated with the Mann-Whitney U test. Results: A total of 624 patients in six general practices participated (mean age 47 years; 60.4% female). SSD-12 and PHQ-15, respectively, showed significant associations with PF (γ = 0.51; γ = 0.48; p < 0.001), negative affectivity (γ = 0.50; γ = 0.38, p < 0.001) and psychoticism (γ = 0.29; γ = 0.28; p < 0.010). Besides, SSD-12 was significantly associated with disinhibition (γ = −0.38; p < 0.010) and anankastia (γ = −0.16; p < 0.010). Patients with SSD showed significantly impaired PF and maladaptive traits in all scales (p < 0.001). Conclusion: Impaired PF explains moderate to large amounts of the SSD symptoms and maladaptive personality traits negative affectivity, psychoticism, disinhibition, and anankastia show specific associations beyond PF. An in-depth understanding of these relations might be helpful to improve doctor-patient communication and treatment in SSD.

Active Visual Art Therapy and Health Outcomes

Art therapy has a long-standing tradition in patient treatment. As scientific interest in its use has recently grown, a comprehensive assessment of active visual art therapy is crucial to understanding its potential benefits. To assess the association of active visual art therapy with health outcomes across patient groups and comparators. The systematic literature search included the Cochrane Library, Embase, MEDLINE, CINAHL, ERIC, American Psychological Association PsycArticles, American Psychological Association PsycInfo, PSYNDEX, the German Clinical Trials Register, and ClinicalTrials.gov. No filters regarding language were applied. The search covered all dates before March 2021. Data analysis was conducted from April 24 to September 8, 2023. Randomized clinical trials with any type of patient population comparing the intervention with any control not using active visual art therapy were included. Two researchers independently screened the abstracts and full texts. Data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and study quality was evaluated using the Cochrane Risk of Bias tool. Data were synthesized using narrative summaries, forest plots, and random effects meta-analyses. In line with the protocol, all outcome measures of the included studies were extracted. The search identified 3104 records, of which 356 outcomes of 69 studies were included, with a total of approximately 4200 participants, aged 4 to 96 years, in the review. The meta-analyses included 50 studies and 217 outcomes of 2766 participants. Treatment indications included mental, neurological, and other somatic disorders, and prevention. Most outcome measures focused on depression, anxiety, self-esteem, social adjustment, and quality of life. Art therapy was associated with an improvement in 18% of the 217 outcomes compared with the controls (1%), while 81% showed no improvement. The standardized mean difference in the change from baseline of the meta-analyses of 0.38 (95% CI, 0.26-0.51) and posttest analysis of 0.19 (95% CI, 0.12-0.26) also indicated an improvement of outcomes associated with art therapy. Overall study quality was low. In this systematic review and meta-analysis of randomized clinical trials, visual art therapy was associated with therapeutic benefits for some outcomes, although most studies were of low quality. Further good-quality studies are needed to provide additional insights for its best possible integration into routine care.

Actualización de la tricodinia, un reto para los dermatólogos

Trichodynia is the sensation of pain in the scalp, which, in most cases, is associated with certain types of alopecia. Despite being a term coined by Rebora back in 1996 to described patients with diffuse alopecia consistent with telogen effluvium, this symptom has currently been reported in other entities. Androgenic alopecia, scarring alopecia, alopecia areata, trichotillomania, and chemotherapy-induced alopecia are common causes of trichodynia. Similarly, its association with psychiatric comorbidities, including depression, anxiety, obsessive-compulsive disorder and somatoform disorders has been reported with a higher prevalence among women. Although its pathogenesis is still to be elucidate, some factors involved are substanceP, psychiatric comorbidities and perifollicular inflammation. Clinically it exhibits pain or discomfort of the scalp, almost always in association with hair los. The sensation of pain can occur throughout the scalp or locally in some specific areas. Diagnosis is clinical and one of exclusion. Regarding treatment, there are no specific therapies for trichodynia. However, the use of botulinum toxinA, antidepressants, neuromodulators, propranolol, topical corticosteroids, oral corticosteroids and topical cannabinoids are therapeutic alternatives that should be taken into consideration. Since treatment of trichodynia is still therapeutically challenging for dermatologists more prospective studies are needed to evaluate new therapies.

Case Study: Psychological Dynamics in Women Experiencing Conversion Disorder

Conversion Disorder is classified as a somatoform disorder characterized by symptoms or deficits that are not clearly defined and affect motor or sensory functions related to neurological conditions or other general medical conditions. Hearing impairment in conversion disorder is referred to as non-organic hearing loss. This research aims to understand the dynamics in women with conversion disorder and the causes of the disorder. The approach used in this study is qualitative with a case study approach. Data collection in this study uses interviews, observations, and psychological tests (DAP, HTP, BAUM, SSCT, TAT, and SPM). The credibility test used is the triangulation technique of sources, techniques, and time. The subject in this study is a 36-year-old woman. The results of this study indicate that the individual has hearing problems not caused by a medical condition. The hearing difficulties arise due to conflicts and impulses triggered by stressful conditions in marital life, leading the person to repress to avoid threats to the issue. As a result, unconsciously, the individual transforms it into physical symptoms. This affects both the individual's work and social aspects.

Assessment of psychometric properties of the union physio-psycho-social assessment questionnaire (UPPSAQ-70) in a large sample of general hospital psychiatric outpatients

ObjectiveTo evaluate the psychometric properties of the Union Physio-Psycho-Social Assessment Questionnaire (UPPSAQ-70) among general hospital psychiatric outpatients. MethodsA total of 2000 participants responded to the survey. Factor analyses were used to test the construct validity of the scale. Convergent validity was evaluated by the correlation between UPPSAQ-70 and symptoms measured using the Chinese versions of Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Patient Health Questionnaire-15 (PHQ-15), Somatic Symptom Disorder - B Criteria Scale (SSD-12) and Pittsburgh Sleep Quality Index (PSQI). ResultsThe nine-factor model was supported (χ2 = 8816.395, df = 2309, χ2/df = 3.818, RMSEA = 0.053, CFI = 0.929). The UPPSAQ-70 showed significant correlation with the SAS (r = 0.396, P < .001), SDS (r = 0.451, P < .001), PHQ-15 (r = 0.381, P < .001), SSD-12 (r = 0.324, P < .001) and PSQI (r = 0.220, P < .001). UPPSAQ-70 and its subscales showed good internal consistency with Cronbach's alpha coefficients ranging from 0.79 to 0.96. ConclusionsThe UPPSAQ-70 was a rating scale with good construct validity and reliability, which can measure overall health in the biological, psychological, and social domains for Chinese psychiatric outpatients, but its convergent validity still requires further empirical research.

Exploring the reality of seafarers' deaths and injuries and preventive measures from the cases of overwork-related disorders

Till date, only few studies have detailed the reality of overwork-related disorders among seafarers. Therefore, in this study, we aimed to evaluate the prevalence of overwork-related disorders among seafarers and assess factors such as patient attributes, diseases diagnosed at the time of determination, workload factors, and other aspects, thereby suggesting relevant preventative measures. Among all the patients identified with overwork-related disorders from April 2010 to March 2017, 2,280 cases of cerebrovascular and cardiovascular diseases and 3,517 cases of mental disorders were selected. To identify seafarer-related cases, keywords related to seafarers were extracted. Subsequently, 33 cases of cardiovascular disease and 19 cases of mental disorders were obtained. The average age of the patients with cerebrovascular and cardiovascular diseases was 56.7 years; for those with mental disorders, it was 45.2 years. The patients were most commonly engaged in fishing, transportation, and postal services. Most patients were employed in the deck department or were captains. The most common types of vessels were fishing and cargo ships. Among the diseases diagnosed at the time of determination, cerebrovascular diseases accounted for 20 cases (60.6%) and cardiovascular diseases accounted for 13 cases (39.4%), with cerebral and myocardial infarctions being the most frequent conditions. Among mental disorders, "mood disorders" accounted for 7 cases (36.8%), and "neurotic disorders, stress-related disorders, and somatoform disorders" accounted for 12 cases (63.2%), with major depressive episodes, post-traumatic stress disorder, and adjustment disorders being the most common. The most common workload factor for patients with cerebrovascular and cardiovascular diseases was "long-term excessive work," and among non-workload factors, "long working hours" and "irregular working hours" were prevalent. For mental disorders, 8 cases were attributed to "extreme psychological stress." Specific events leading to these diseases included "interpersonal relationships," "experiencing accidents or disasters," and "work quantity and quality." Both cerebrovascular and cardiovascular diseases, as well as mental disorders, showed a notable aging trend among seafarers. Thus, measures that consider the characteristics of elderly workers, such as their physical function, are important. Additionally, as seafarers are distributed across various industries and occupations, measures should be specifically tailored to their industry and job type. Our study confirmed that long working hours and irregular working hours were prevalent in both cases. Therefore, there is an urgent need for further efforts to prevent and mitigate overwork-related deaths among seafarers, including organizational support from onshore workplaces and enhancement of medical and operational support using information and communication technology.

Charcot and the psychology of hysteria, with special reference to a never published final case history

ABSTRACT Jean-Martin Charcot is perhaps best remembered for his contributions to organic neurology. However, his pursuit of hysteria, the most prevalent diagnosis in his hospital clinic, yielded no anatomical lesion to account for hysteria’s plethora of somatic disorders assumed due to a purely functional or dynamic lesion in the cerebral cortex. This led Charcot to turn his attention to the psychology of hysteria. Taking advantage of institutional reforms at the Salpêtrière—notably, the establishment of his professorship in nervous diseases—Charcot from the early 1880s focused his teaching increasingly on case histories of hysteria in male as well as female patients. Already renown for his earlier dramatic public lessons on female hysteria, his lessons of the 1880s, of which two volumes were published at the end of the decade, elaborated the issue of psychology in terms of altered states of patient’s suggestibility. By the decade’s end, Charcot’s worldwide reputation rested on the prospects of this work as acknowledged by numerous students, notably medical psychologists Pierre Janet and Sigmund Freud. Yet Charcot’s views remained sketchy. They were discussed at length in his unpublished notes for a lesson intended for May 1893, just a few months before his sudden death. His unpublished notes reveal a detailed case for dreams as illustrating a psychological mechanism underlying hysteria in a 17-year-old Paris artisan. I conclude by considering why this significant climactic case of Charcot’s might have been overlooked by his entourage.

Halifax somatic symptom disorder trial: A pilot randomized controlled trial of intensive short-term dynamic psychotherapy in the emergency department

BackgroundPatients commonly present at hospital Emergency Departments (ED) with distress that meet criteria for a Somatic Symptom and Related Disorder (SSRD). Without access to effective treatment, risk of ongoing patient disability and further ED visits is high. MethodThis pilot trial used a randomized parallel group design to test the efficacy of Intensive Short-Term Dynamic Psychotherapy (ISTDP). ED patients who met criteria for SSRD were recruited. The effects of ISTDP plus medical care as usual (MCAU) were judged through comparison against 8 weeks of MCAU plus wait-list symptom monitoring (WL-SM). The primary outcome was somatic symptom at 8 weeks. Patients allocated to WL-SM could cross-over to receive ISTDP and 6-month follow-up data was collected. Baseline measures of patient attachment style and alexithymia were collected to examine vulnerabilities to somatic symptoms. ClinicalTrials.gov: NCT02076867. ResultsThirty-seven patients were randomized to 2 groups (ISTDP = 19 and WL-SM = 18). Multi-level modelling showed that change over time on somatic symptoms was significantly greater in the ISTDP group. Between-group differences were large at 8 weeks (Cohen's d = 0.94) and increased by end of treatment (Cohen's d = 1.54). Observed differences in symptoms of depression and illness anxiety were also large, favoring ISTDP, and effects were maintained at follow-up. Patients receiving ISTDP had reduced ED service utilization at 2-year follow-up. ConclusionsISTDP appears an efficacious treatment for SSRD and a larger randomized trial is justified.

Technology Addiction and Social Connectedness in Psychiatric Illness: A Multicenter Study.

Technology addiction is an increasingly important public health problem all over the world that negatively affects people's mental and physical health. In this study, we examined technology addiction and social connectedness levels of psychiatric patients who admitted to clinics in different geographical regions of Turkey. A total of 642 people with a diagnosis of psychiatric illness who applied to psychiatry clinics in İstanbul, Elaziğ, Malatya, Yozgat, Adıyaman, and Bingöl provinces were included. Sociodemographic data form, Technology Addiction Scale (TAS), and Social Connectedness Scale (SCS) were applied to all participants. The total score of the TAS in patients diagnosed with anxiety disorder and somatoform disorder was significantly higher than the other patient groups (p<0.001). Patients diagnosed with anxiety disorder showed a significant difference from other patient groups in terms of SCS score (p<0.001). Anxiety disorder was found to be the highest in TAS total score and sub-dimensions and the lowest in SCS score, while major depressive disorder was found to be the lowest in TAS total score and sub-dimensions and the highest in SCS score. The multiple linear regression analysis showed that the total score of the TAS was predicted by the SCS score (β=-1.857, p<0.001) and the SCS score was predicted by age (β=0.046, p=0.049) and the total score of the TAS (β=-0.316, p<0.001). As a result of this study, we can say that psychiatric patients have a moderate level of technology addiction, these people have high levels of social connectedness, and psychiatric patients with technology addiction have a high level of social belonging.

Eye Movement Desensitization and Reprocessing of Maleficium: Case Study of a “Cursed” Woman Suffering From Unexplained Pain

The present case study describes the application of the eye movement desensitization and reprocessing (EMDR) approach to a patient experiencing the distressing memory of an act of apparent ‘maleficium.’ The patient was in treatment due to somatic symptom disorder. Transcripts from the EMDR desensitization session were used to qualitatively describe both the dysfunctional stored memories associated with the apparent sorcery and the healing associations contributing to the zeroing of the alleged subjective unit of disturbance. Changes in psychometric measures of symptoms showed that the patient experienced a relevant and unexpected reduction of different clinical outcomes, with a specific notable effect on the subjective evaluation of pain. An explanation based on adaptive information processing is offered to explain this last unexpected finding.

Comorbidity rates of autism spectrum disorder and functional neurological disorders: A systematic review, meta-analysis of proportions and qualitative synthesis.

Autism spectrum disorder (ASD) and functional neurological disorders (FND) are relatively common conditions, and there has been recent interest in the overlap between them. Both conditions share core features of alexithymia, impaired interoception and deficits in attentional focus. To date, relatively little is known about the comorbidity rates between ASD and FND. This is the first meta-analysis and qualitative synthesis on the subject. We found that around 10% of children presenting with functional seizures have a comorbid ASD diagnosis. People with ASD are more likely than the neurotypical population to have functional somatic disorders, and there is also evidence that ASD rates are higher for other FNDs such as functional motor disorders. Since FND comes with risks of unnecessary medical procedures and investigations, it is important to recognize the potential for people with ASD to have an FND comorbidity.

Cigarette Smoking in Women Victims of Police-Reported Intimate Partner Violence: The Role of Childhood Maltreatment, Type of Partner Abuse, and Psychological Distress Symptoms

ABSTRACT Existing research on the relationship between intimate partner violence (IPV) and cigarette smoking primarily involves low-risk, physical IVP-focused studies on community women. As a result, the risks associated with cigarette smoking in women victims of severe IPV have not been fully explored. This study examined the association between exposure to different forms of childhood maltreatment, exposure to physical, psychological, and sexual IPV, and current psychological distress symptoms with cigarette smoking in a high-risk sample of women victims of police-reported severe IPV. Participants included 162 women victims of police-reported severe IPV recruited in shelters for domestic violence and Child Protective Services in Portugal. Participants provided self-reports on childhood maltreatment physical, psychological, and sexual violence), physical, psychological, and sexual IPV, psychological distress symptoms (anxiety, depressive, somatic, and posttraumatic stress disorder symptoms), and daily cigarette consumption. Results revealed significant associations between daily cigarette consumption and exposure to IPV, physical abuse during childhood, psychological IPV, and anxiety symptoms in women experiencing police-reported severe IPV. Childhood maltreatment may increase vulnerability for emotion dysregulation, promoting addictive behaviors to regulate distress. Smoking can be an unhealthy regulating strategy to reduce the distress related to chronic exposure to psychological IPV. Future effective health promotion interventions in women facing severe forms of IPV may target emotional regulation and incorporate a trauma-focused approach.

Mentally ill people with means-tested benefits at the job center : Diagnosis spectrum and care-First results from the LIPSY project

Although people receiving means-tested benefits are regularly taken care of at the job center, little is known about their mental health situation and mental health care. The aim of the study was to describe the diagnostic spectrum and the functional status as well as the mental health care utilization of individuals with mental illnesses who are receiving means-tested benefits. Mentally ill people with means-tested benefits were recruited at the job center as part of the "Leipzig Individual Placement and Support for Mentally Ill People" (LIPSY) project, where they were initially diagnosed according to ICD-10 and included in the project if they had amental disorder. Mental healthcare utilization was recorded. In the present study, data from n = 583 consecutively included persons were analyzed descriptively and by multivariate statistics. Of the study participants 60.7% (n = 583; 51.5% female; average age36years; unemployed for an average of 4.8years) suffered from affective disorders, followed by neurotic, stress and somatoform disorders (42.5%). With amean global assessment of functioning (GAF) value of 49.4 (SD 7.7), there was on average aserious impairment. Nearly half of the subjects (48.5%) had never received psychotherapeutic, psychiatric or neurological treatment in the 6 months prior to inclusion in the project. It could be shown that there is abroad spectrum of mental disorders with substantial functional impairment. The data suggest that this group is significantly undertreated and difficult to reach.

Влияние различных факторов риска на формирование вторичных органических психических расстройств у лиц пожилого возраста с алкогольной зависимостью, сформированной в среднем и пожилом возрасте

Background. Alcohol slows down the work of the brain and central nervous system, leads to deterioration of memory and concentration, cognitive disorders, and the formation of organic mental disorders. Due to the retirement of elderly people, some of them resort to taking alcohol as an adaptogen to alleviate various social, mental and psychological disorders, which can lead to the emergence of new or exacerbation of existing somatic disorders, the formation of alcoholism, as well as organic mental disorders. Aim. To investigate the risk factors (RF) for the formation of secondary organic mental disorders (SOMD) in elderly people with alcohol dependence (AD), formed in middle and old age. Patients and methods. The study included only male patients for the purity of the study aged 60 to 74 years (average age 67.5±7.2), who were divided into 2 groups depending on the age of occurrence of AD: group 1 – 21 people (36.2%), AD occurred at the age of 51.6±1.2 years, and the symptoms of SOMD at 61.8±2.1 years; group 2 – 37 people (63.8%), AD occurred at the age of 64.5±2.5 years, and SOMD at 71.3±2.8 years. The following methods were used: questionnaire – using the developed "Anamnestic chart", clinical (anamnesis collection), statistical (parametric and nonparametric). Results. The main factors of the formation of SOMD in people with formed AD in middle and old age are combinations of various RF, as well as a monofactor in the form of chronic alcohol abuse, the proportion of which varies depending on the age of AD formation. Conclusion. When AD is formed in old age, combinations of RF have a greater influence on the development of SOMD. And in the formation of AD in middle age, both alcohol, as an exogenous mono-damaging factor, and a combination of RF contribute to the formation of SOMD. Hereditary burden of alcoholism affects the progrediency of alcoholism, but does not play a role in the rate of formation of SOMD. The formation of alcoholism in middle age is combined with a relatively slow rate of formation of SOMD and a smaller number of associated somatic pathology, and when formed in old age – with a relatively fast rate of development of SOMD and a large number of associated somatic pathology.

Применение Мебикса в психиатрии и общей медицине: актуальность, перспективы, клинические примеры

Anxiety disorders, except the manifestations of anxiety itself, are characterized by a broad spectrum of cognitive and somatic symptoms significantly reducing the individual’s quality of life and increasing the risk of somatic disorders. The rate of cardiovascular, respiratory, gastrointestinal, and other disorders throughout life is significantly higher in people suffering from anxiety. Furthermore, many symptoms of anxiety and panic/fear mimic manifestations of somatic disorders. Optimal treatment of anxiety disorders includes both pharmacological and psychotherapeutic interventions. At the same time, psychotherapy is not always available for patients, and internists not always decide to prescribe psychotropic medication, for example antidepressants. In such situations, nonbenzodiazepine anxiolytics showing high efficacy and tolerability can be used. Mebix, having an adaptogenic effect on the central nervous system and a stabilizing effect on the autonomic nervous system, that affects almost all neurotransmitters can be considered one of such drugs. The paper reports clinical cases of patients with anxiety disorders, who were treated with Mebix as monotherapy or in combination with antidepressants.

Neuropsychological features of somatic symptom disorder and depression/anxiety in Taiwan: An analysis based on the comorbidity status

Individuals with somatic symptom disorder (SSD) often have comorbid depression or anxiety, but whether SSD is associated with specific neuropsychological functions has yet to be fully examined. We analyzed which neuropsychological features are more closely associated with SSD, anxiety, and depression. In this case-control study, we recruited 140 individuals with SSD, 104 individuals with affective disorders without SSD, and 159 healthy controls in Taiwan. We collected DSM-5 diagnoses, questionnaire scores, and performance on eight tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB) for each participant. Several CANTAB tasks involving attention, executive function, and social cognition showed significant group differences. In the adjusted analysis, the tasks significantly associated with SSD were the Match to Sample Visual Search (MTS) and the Emotion Recognition Task (ERT). Among the questionnaires, the Cognitions about Body and Health Questionnaire showed the most significant associations with the tasks, specifically with Rapid Visual Information Processing, MTS, Paired Associates Learning, Spatial Working Memory, Intra-Extra Dimensional Set Shift, and ERT. We conclude that the MTS and ERT tasks show significant relationships with both SSD diagnosis and related questionnaires. These tasks primarily involve selective attention and negative emotion regulation.

Efficacy of sequential primary motor and prefrontal cortices intermittent Theta burst stimulation in persistent somatoform PAIN disorder (TAP-PAIN): A randomized sham-controlled pilot trial

Aim: There is a need to elucidate intermittent Theta burst stimulation (iTBS) as a novel treatment in persistent somatoform pain disorder (PSPD). Methods: Twenty patients were randomly allocated to active iTBS (n = 11) and sham iTBS (n = 9) and received 10 iTBS sessions, 2 sessions per day, sequentially to primary motor and dorsolateral prefrontal cortices for 5 days in a week. Each iTBS session comprised of 2 sec. per train of 10 bursts (3 pulses per burst at 50 Hz; total 30 pulses) and were given with a gap of 5 Hz, total of 20 trains, and 600 pulses. Visual Analogue Scale, Brief Pain Inventory and Global Pain Scale (GPS), Montgomery and Asberg Depression Rating Scale, Hamilton Anxiety Rating Scale - Anxiety, World Health Organization Quality-of-Life Scale-brief, and Pittsburgh Sleep Quality Index were applied at baseline, after last session, and at 2 weeks after last TBS session. Intention to treat analysis was conducted. Results: Both groups were comparable for baseline psychopathology scores including clinical variables like age (t = 0.865; P = 0.398), duration of illness (t = 1.600; P = 0.127), and motor threshold (t = 0.304; P = 0.765). On repeated measures ANOVA, a significant within-group time effect for VAS, BPI-Severity, BPI-Interference, BDI – II, MADRS, HAM-A, and WHOQOL- BREF was found for active and sham TBS groups, respectively. GPS scores had significant within-group (active) * time interaction (F = 11.651; P = .001; ηp2 = 0.538) and between-group * time interaction (F = 3.407; P = 0.044; ηp2 = 0.159). However, between-group * time effect interaction was lost after covariance (F = 1.726; P = 0.196; ηp2 = 0.110). Conclusion: No major adverse effects were reported. Our pilot trial concludes that safe therapeutic efficacy of iTBS in PSPD is inconclusive. Lower total number of sessions along with small sample size may limit the study findings.

Somatic Symptoms and Its Association With Anxiety and Interoception

In Somatic Symptom Disorder, individuals may misinterpret their symptoms as signs of disease. Meanwhile, interoception refers to an individual’s perception to sense internal body sensations. Interoception may play a role in the regulation of state and trait anxiety. Anxiety, in turn, is associated with somatic symptoms. A comprehensive study regarding somatic symptoms is still required to fill the knowledge gap regarding its relationships with other variables. In this study, 101 university students from Nagoya, Japan, fulfilled four questionnaires related to the study variables. The participants also completed the heartbeat counting task (HCT) to assess interoceptive accuracy and heart rate variability (HRV) measurement. The results showed that health concerns and trait anxiety are associated with somatic symptoms. In addition, the sub-scales Attention Regulation and Self-Regulation determined trait anxiety in an inverse correlation. These results suggest that interoception, particularly interoceptive sensibility, is negatively associated with trait anxiety regarding somatic symptoms. The inverse relationship could be expected, as interoceptive sensibility is a set of positive beliefs about aspects of the individual’s abilities and the tendency to consciously sense signals originating from inside their body.

Direct effects of heroin and methadone on T cell function

Opioid addiction presents a relevant health challenge, with chronic heroin use linked to detrimental effects on various aspects of physical, mental, and sociological health. Opioid maintenance therapy (OMT), particularly using methadone, is the primary treatment option for heroin addiction. Previous studies using blood samples from current heroin addicts and OMT patients have shown immunomodulatory effects of heroin and methadone on T cell function. However, various additional factors beyond heroin and methadone affect these results, including the consumption of other substances, a stressful lifestyle, comorbid psychological and somatic disorders, as well as additional medications. Therefore, we here investigated the direct effects of heroin and methadone on purified human T cells in vitro. Our results reveal that both, heroin and methadone directly suppress Tcell activation and proliferation. Strikingly, this inhibitory effect was markedly stronger in the presence of methadone, correlating with a decrease in secretion of pro-inflammatory cytokines. While heroin did not interfere with the in vitro differentiation and expansion of regulatory Tcells (Tregs), methadone significantly impaired the proliferation of Tregs. Overall, our findings suggest a direct inhibitory impact of both opioids on effector T cell function in vitro, with methadone additionally interfering with Treg induction and expansion in contrast to heroin.