Development Of Somatic Symptoms Research Articles

Соматизована депресія: медико-психологічний супровід

Various disorders of the affective sphere of the psyche are one of the most frequently diagnosed forms of mental pathology. As medical practice shows, hidden depression occupies a significant share among somatized mental disorders. Despite the large number and volume of research, the problem of somatized depression is one of the most difficult in modern psychiatry and medical psychology. Often, primary care physicians do not detect mental disorders in their patients. According to research results, doctors "miss" patients' mental health problems 20-80% of the time. Most patients do not attach due importance to the symptoms they have, devalue them, do not realize the need for proper specialized diagnosis, or engage in self-medication. This is what precedes serious consequences, such as difficulty in diagnosis, differential diagnosis, and the appointment of inappropriate treatment in the form of symptomatic therapy instead of pathogenetic therapy. Currently, depressive disorders are diagnosed in people of working and creative age (20-40 years old), which strengthens the socio-economic significance of the problem of depression detection. The problem of somatized depression is that patients do not complain about any symptoms of depression, but also somatic complaints, which can be manifested, for example, by chronic pain in various organs and systems, disorders of the gastrointestinal tract and cardiovascular system, or sleep disturbance, remain despite the presence of drug treatment in the form of analgesics, barbiturates, cardiac glycosides, etc. The purpose of the work: to investigate the features and essence of masked depression, its influence on the development of somatic symptoms, exhaustion depression, its prevention, and methods of combating it. Research methods: clinical material for the study was 35 respondents aged 18 to 50 years. In addition to the socio-demographic study, the following were used: the Beck Depression Scale, which makes it possible to determine the presence of depression in a person and the degree of its severity, and the Hamilton Anxiety Rating Scale (HARS). Examination results. During the work, according to the results of the survey, it was established that 16 people have no depressive symptoms, 10 people have a mild degree of depression (sub-depression), which corresponds to 10-15 points, 3 people have a moderate level of depression, which is expressed in 16-19 points, 6 interviewees have depression of moderate severity (pronounced depression corresponding to 20-29 points) and no persons with a severe level of depression were found.

Somatic Symptoms: Association Among Affective State, Subjective Body Perception, and Spiritual Belief in Japan and Indonesia.

This study aimed to examine differences in the following somatic symptoms: affective state (i.e., health concerns, anxiety, and positive and negative affect), somatosensory amplification, spirituality in Japan and Indonesia, and associations among all variables from each culture. Previous studies and a potential bio-psycho-spiritual model has identified the association of each variable in the development of somatic symptoms. Moreover, they demonstrated that individuals who describe themselves as more religious and spiritual report better physical and mental health. A total of 469 and 437 university students from Japan and Indonesia, respectively, completed the questionnaires for assessing somatic symptoms, health concerns, trait anxiety, positive and negative affect, somatosensory amplification, and spiritual belief. This study found significant differences in health concerns, positive and negative affect, state anxiety, and spiritual belief. Moreover, the difference in somatosensory amplification was negligible. There is a shared association in both cultures among somatic symptoms, affective state, subjective body perception, and spirituality. Health concerns and trait anxiety moderated somatosensory amplification in the development of somatic symptoms. However, the role of spirituality belief in somatic symptoms was observed in the Japanese and Indonesian cultures in relation to positive affect.

Evaluation of the COVID-19 pandemic effect on the development of somatic symptoms in patients with mood disorders: a case-control study

Somatic symptoms are one of the most common complaints among patients with psychiatric disorders and are considered as one of the most common psychiatric disorders in the new coronavirus pandemic. This study aimed to evaluate the effect of the COVID-19 pandemic on the physical symptoms in patients with mood disorders and compare it with healthy individuals.In this case-control study, 67 patients with mood disorders were referred to the psychiatric clinic of 5 Azar Hospital in Gorgan, who met the inclusion criteria, and 68 healthy individuals as control group were entered into the study. For all participants after informed consent, a demographic information questionnaire was completed along with Screening for Somatic Symptoms-7 (SOMS7) and Patient Health Questionnaire-15 (PHQ-15), and the data were analysed by SPSS software version 25.The mean score obtained for the SOMS-7 questionnaire for the group of patients with mood disorders and the control group was 32.37 ± 8.19 and 35.42 ± 11.3, respectively. The mean obtained for the PHQ-15 questionnaire for the mood disorders group and the control group was 8.56 ± 5.93 and 5.86 ± 4.63, respectively. In the mood disorder group, 26.9% of patients had no risk for physical symptoms, 31.3% of patients had a low risk, 25.4% of patients had a moderate risk, and 16.4% of patients had a high risk for physical symptoms. The statistical test showed that although the risk of physical symptoms was high in both groups, this rate was higher in the group with mood disorders, and there is a significant difference between the two groups (P < 0.05). The results also showed a significant and direct relationship between the two questionnaires (P < 0.05).According to the results, although the prevalence of somatic symptoms increased in both groups, the prevalence of somatic symptoms is significantly higher in the mood disorder group.

A Systematic Literature Review of the Association Between Somatic Symptom Disorder and Antisocial Personality Disorder.

Somatic symptom disorder (SSD) and antisocial personality disorder (APSD) are found at higher rates within families compared to the general population. Both disorders are characterized by low serotonin levels, which may be attributed to polymorphisms in the dopa decarboxylase (DDC) gene. The polymorphism rs11575542 of the gene leads to decreasing the efficiency of aromatic l-amino decarboxylase (AADC) and serotonin levels in a person. The polymorphism is also associated with the development of somatic symptoms and sensation-seeking behavior, a trait underlying APSD. Hence, the role of this polymorphism as an underlying feature that may predispose a person to develop APSD or SSD should be explored further in future studies.

Morphological changes of the brain in mood disorders.

Brain morphological changes in affective disorders occur mainly in the fronto-limbic cortex, hippocampus and amygdala - the structures regulating emotional and cognitive functioning, as well as development of somatic symptoms in the course of disorders. The largest number of reports of structural changes in the cerebral cortex include the dorsolateral prefrontal cortex, the orbitofrontal cortex and the anterior cingulate cortex. The results of neuroimaging and sectional studies reveal changes in the volume of structures involved in the creation of neuronal circuits that affect development of mood disorders. Microscopic studies show changes in cell count, density, and morphology in these areas. Some of those changes are observed only in certain layers of the cerebral cortex. A valuable addition to this data are histochemical studies of neuronal survival markers, proinflammatory cytokines, trophic factors, and markers specific for particular cellular structures. The role of monoaminergic, GABA-ergic and glutamatergic neurotransmission is confirmed by the studies on concentration of neurotransmitters, their receptors and transporters. Some of the results correlate quantitatively with the type and severity of symptoms, duration of the disorder, as well as pharmacotherapy and nonpharmacological treatment.

Polyunsaturated fatty acids levels and initial presentation of somatic symptoms induced by interferon-alpha therapy in patients with chronic hepatitis C viral infection

Objectives: Somatic symptoms are common in depressive disorder and are similar to sickness behaviors due to inflammatory activation after cytokine administration. Omega-3 polyunsaturated fatty acids (PUFAs) are natural anti-inflammatory agents and may reduce inflammation-induced behavioral changes. The aim of this study was to investigate the role of PUFAs on the development of somatic symptoms and depression in patients of hepatitis C virus infection (HCV) receiving interferon-alpha therapy (IFN-α) in a prospective manner.Methods: In this 24-week, prospective cohort study, 43 patients with chronic HCV ongoing IFN-α therapy were assessed with the mini-international neuropsychiatric interview for major depressive episodes and neurotoxicity rating scale (NRS) for somatic symptoms.Results: One-third later developed IFN-α-induced depression (depression (DEP) group). As compared to subjects without depression, DEP group had higher NRS scores (P < 0.001), lower eicosapentaenoic acid (EPA) levels (P = 0.038) at week 2. Somatic symptoms, regardless of painful/non-painful characteristics, had positive association with arachidonic acid (P < 0.05), and negative association with EPA (P < 0.05).Conclusion: This study implies that early intervention with omega-3 PUFAs might be a promising strategy to prevent depression and somatic symptoms in patients receiving cytokine therapy.

The effect of brief exercise cessation on pain, fatigue, and mood symptom development in healthy, fit individuals

Objective Abnormalities of the biological stress response (hypothalamic–pituitary–adrenal axis and the autonomic nervous system) have been identified in both fibromyalgia (FM) and chronic fatigue syndrome (CFS). Although these changes have been considered to be partly responsible for symptom expression, we examine an alternative hypothesis that these HPA and autonomic changes can be found in subsets of healthy individuals in the general population who may be at risk of developing these conditions. Exposure to “stressors” (e.g., infections, trauma, etc.) may lead to symptom expression (pain, fatigue, and other somatic symptoms) in part by precipitating lifestyle changes. In particular, we focus on the effect of deprivation of routine aerobic exercise on the development of somatic symptoms. Methods Eighteen regularly exercising (≥4 h/week) asymptomatic, healthy adults refrained from physical activity for 1 week. We predicted that a subset of these individuals would develop symptoms of FM/CFS with exercise deprivation, and this manuscript focuses on the baseline HPA axis, immune, and autonomic function measures that may predict the development of symptoms. Results Eight of the subjects reported a 10% increase in one or more symptoms (pain, fatigue, mood) after 1 week of exercise deprivation. These symptomatic subjects had lower HPA axis (baseline cortisol prior to VO2max testing), immune (NK cell responsiveness to venipuncture), and autonomic function (measured by heart rate variability) at baseline (prior to cessation of exercise) when compared to the subjects who did not develop symptoms. Conclusions A subset of subjects developed symptoms of pain, fatigue, or mood changes after exercise deprivation. This cohort was different from the individuals who did not develop symptoms in baseline measures of HPA axis, immune, and autonomic function. We speculate that a subset of healthy individuals who have hypoactive function of the biological stress response systems unknowingly exercise regularly to augment the function of these systems and thus suppress symptoms. These individuals may be at risk for developing chronic multisymptom illnesses (CMIs) (e.g., FM or CFS among others) when a “stressor” leads to lifestyle changes that disrupt regular exercise.

Voluntary hyperventilation: the influence of duration and depth on the development of symptoms

Hyperventilation is considered an important factor in the development of somatic symptoms or even panic attacks, though its role has recently been disputed. Arguments are often based on findings from the so-called Hyperventilation Provocation Test (HVPT), which is a procedure consisting of voluntarily overbreathing. The HVPT has been widely used for diagnosing Hyperventilation Syndrome and for experimentally eliciting panic attacks. Almost no attention, however, has been paid to standardizing the test and determining critical values with respect to depth and duration of hyperventilation. In the present study, symptom development was examined in 16 healthy subjects who underwent four HVPTs that differed in depth of hyperventilation (end-tidal PCO 2 < 2.4 kPa or < 1.9 kPa), as well as duration of hyperventilation (2 or 5 min). Both depth and duration appeared to have an independent effect on the development of symptoms. In the 5-min condition, symptoms appeared mainly within the first 3 min. To be sure that the HVPT is long enough and deep enough to elicit symptoms in most people, a minimum duration of 3 min is advised, with end-tidal PCO 2 decreasing to at least 1.9 kPa or dropping well over 50% of baseline.