Higher Levels Of Somatization Research Articles

Association of Ego Defense Mechanisms with Electrolyte and Inflammation Marker Levels, Interdialytic Weight Gain, Depression, Alexithymia, and Sleep Disorders in Patients Undergoing Chronic Hemodialysis.

Background/Objectives: Ego defense mechanisms are subconscious processes that help individuals cope with stressors from both external and internal realities. They are divided into three levels based on their adaptive function. Patients undergoing chronic hemodialysis are those who have been treated with this method for longer than three months. Only a few studies have examined the defense mechanisms in hemodialysis patients. Our study aimed to examine the association between ego defense mechanisms and alexithymia, depression, and sleep disorders, as well as clinical and biochemical variables, in a group of 170 hemodialysis patients. Methods: We used the Defense Style Questionnaire-40, the Toronto Alexithymia Scale-26, the Pittsburgh Sleep Quality Index, and the Hamilton Depression Inventory as our analyses methods. Clinical and biochemical variables, along with interdialytic weight gain, were measured before the hemodialysis session. Results: There was a positive correlation between the affect displacement and dissociation with leukocyte levels (Spearman's rho = 0.192, p = 0.02; rho = 0.165, p = 0.04), and between autistic fantasy and phosphorus levels (rho = -0.163, p = 0.04). Depressive HD patients had higher levels of somatization, affect displacement, and splitting compared to the HD patients without depression (Man-Whitney U test, p = 0.005, p = 0.022, p = 0.045). There were higher levels of immature defense mechanisms in the group of patients with alexithymia than in the group without alexithymia (Mann-Whitney U test, p < 0.001). Conclusions: The immature defense mechanisms were our research model's strongest predictive factor of alexithymia (OR = 1.87, 95% CI 1.27 to 2.75).

Prevalence of central sensitization and somatization in adults with temporomandibular disorders-a prospective observational study.

Temporomandibular disorders (TMD) comprise a group of conditions affecting the masticatory muscles, the temporomandibular joints and associated structures, often manifesting as orofacial pain and functional limitations of the mandible. Central sensitization (CS) is gaining increasing attention in research focused on pain syndromes and somatization, playing a significant role in the pain experience. This study investigates the prevalence of CS and somatization among TMD patients, analyzing their relationships with TMD diagnoses and the intensity of chronic masticatory muscle pain (MMP). A prospective observational study was conducted with 214 adult participants diagnosed with TMD, based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). The Central Sensitization Inventory (CSI) and the Somatic Symptom Scale-8 (SSS-8) were utilized to assess CS and the burden of somatic symptoms, respectively. Furthermore, the patients were assessed for MMP, and the average pain in these muscles was calculated. Statistical analysis investigated correlations between CSI and SSS-8 scores, specific TMD diagnoses and MMP intensity. Most participants did not surpass the subclinical level for CS as assessed by the CSI. Women reported higher SSS-8 scores than men, suggesting sex differences in somatic symptom reporting. No significant relationship was found between specific TMD diagnoses and levels of CS or the SSS-8. However, a significant correlation was observed between SSS-8 scores and the intensity of chronic MMP, underscoring the impact of the intensity of chronic MMP on the perception of somatic symptoms among TMD patients. Additionally, the group with subclinical levels of CS presented significantly lower SSS-8 scores than other groups. This study highlights a lower-than-expected prevalence of CS among TMD patients. Higher levels of somatization were related to higher levels of CS and greater MMP. The findings suggest that TMD management should not only address specific pain sources but also consider the broader psychosocial aspects of the disorders, especially in chronic types.

아동기 학대 경험이 신체화에 미치는 영향

Objectives The purpose of this study was to investigate the dual mediating effects of clarity on emotional awareness and maladaptive cognitive emotion regulation strategy between childhood abuse, somatization in adulthood.&#x0D; Methods The result of 291 adults between the ages of 20 and 59 were distrivuted to scales of childhood trauma, somatization, clarity on emotional awareness, and cognitive emotion regulation strategy. Descriptive statics, Pearson’s correlation analysis and dual mediation analysis analyzed data via SPSS 25.0, Process Macro 6 model.&#x0D; Results First, childhood abuse experience, somatization, and maladaptive cognitive emotion regulation strategy were positively correlated with each other, and these three variables were negatively correlated with clarity on emotional awareness. Second, in the relationship between childhood abuse experience and somatization, clarity on emotional awareness and maladaptive cognitive emotion regulation strategy showed a dual mediating effect. This means that the higher childhood abuse experience, the higher level of somatization in relationship, the clearer the emotional awareness as an emotional factor, and the less maladaptive cognitive emotion regulation strategy are adopted as a cognitive factor, the lower the somatization.&#x0D; Conclusions These findings indicate that it suggests factors for counseling psychological intervention in somatization due to childhood abuse experiences by revealing the dual mediating effect of clarity on emotional awareness and maladaptive cognitive emotion regulation strategy on the effects of childhood abuse experiences and adult somatization. Limitations and recommendations for future research are presented.&#x0D;

The Impact of Adverse Childhood Experiences on Mental Health and Suicidal Behaviors: A Study from Portuguese Language Countries

Background: Research on adverse childhood experiences (ACEs) demonstrates that they can be associated with physical and mental health problems throughout the lifecourse. However, few studies have examined this topic in the Community of Portuguese Language Countries (CPLC). Objective: This study aims to assess the impact of ACEs on mental health and suicidal behaviors in a sample of participants from the CPLC. Participants and Setting: The sample consists of 1006 participants aged between 18 and 80 years (mean = 41.76; SD = 14.19). Methods: This study used an online survey that included a sociodemographic questionnaire, the Brief Symptom Inventory-18 (BSI-18) to assess somatization, depression, and anxiety symptoms, and overall mental functioning, the Suicidal Behaviors Questionnaire-Revised (SBQ-R) to assess suicidal behaviors, and the Family Adverse Childhood Experiences Questionnaire to assess ACEs. Results: Emotional abuse was the most reported ACE (32.7%). Participants from Brazil had higher levels of somatization, depression, anxiety, and suicide ideation and attempt, while participants from Portugal had a higher probability of suicide in the future. ACEs were strong and significant predictors of psychological symptoms and the likelihood of suicide in the future, with emotional abuse and emotional neglect being the domains with the greatest contribution, respectively. Conclusions: ACEs are a prevalent and general phenomenon across several countries. It is urgent to alert policymakers and mental health professionals of the need to intervene with children and families to ensure their harmonious and adjusted development, thus promoting quality of life and well-being of populations.

Sex- and gender-related differences in the prevalence and burden of disorders of gut-brain interaction in Poland.

The aim of the study was to assess sex- and gender-related differences in the epidemiology and impact of disorders of gut-brain interaction (DGBI) in Poland. Data used for the current analysis were derived from the Polish population sample of 2057 subjects (1030 F, 1027 M) collected via the Internet survey that included the Rome IV diagnostic questionnaire and 80 supplementary questions. The overall prevalence of DGBI in Poland was 46.0% (51.7% in women and 40.3% in men, p < 0.001). Comparing women versus men, esophageal disorders were observed in 6.3% vs. 6.0%, respectively (p > 0.05), gastroduodenal disorders in 14.0% vs. 7.8% (p < 0.001), bowel disorders in 44.3% vs. 33.9% (p < 0.001), and anorectal disorders in 9.9% vs. 7.7% (p > 0.05). The six most common DGBI included functional constipation 14.2%, functional dyspepsia 8.3%, proctalgia fugax 6.6%, functional bloating 4.8%, functional diarrhea 4.5%, and irritable bowel syndrome (IBS) 4.4%. All these disorders, except for functional diarrhea, were more common in women. The DGBI overlap was significantly higher in women than in men (16.7% vs. 11.2%, p < 0.001). A higher number of overlapping DGBI correlated positively with IBS severity, higher level of somatization, anxiety and depression, poorer quality of life (QoL), and increased healthcare utilization. This is the first comprehensive report on significant sex/gender-related differences in the prevalence and burden of DGBI in Poland. The revealed differences between women and men with DGBI in the clinical profile, psychosocial variables, and healthcare utilization may have important diagnostic and therapeutic implications.

Fibromyalgia and nonfibromyalgia chronic pain: Differences in psychological characteristics and treatment outcomes.

The aim of this study was to explore differential psychological profiles among patients with chronic pain with and without fibromyalgia, and to determine the results of the cognitive behavioral therapy (CBT) for pain. Thirty patients with chronic pain and 60 patients with fibromyalgia were referred to 10 weekly sessions of CBT in a general hospital and were evaluated in pain-related variables, psychopathological symptoms, coping strategies, resilience, and quality of life. The program was implemented in specific groups for patients with fibromyalgia and nonfibromyalgia chronic pain. After the intervention, patients with fibromyalgia showed higher levels of psychopathology, rated their health status as poorer, and presented larger amplification of symptoms, higher levels of somatization, a more ruminating style of thinking and greater distress. Patients without fibromyalgia achieved better therapeutic results in both pain intensity (d=0.39 vs. d=0.12) and psychopathological distress (d=0.77 vs. d=0.11) compared to patients with fibromyalgia. Therefore, differential profiles and limited therapeutic results in fibromyalgia patients suggest the need to outline differentiated treatments and include other therapeutic strategies.

Factors Associated With the Development of Tinnitus and With the Degree of Annoyance Caused by Newly Developed Tinnitus.

Objectives:Tinnitus is highly prevalent, but only a few risk factors for developing tinnitus are known and little is known about factors associated with the degree of annoyance of new-onset tinnitus. Longitudinal analysis can reveal risk factors associated with the development of tinnitus and might lead to targeted prevention. The aim of this study is twofold. (1) To identify risk factors that are longitudinally associated with the odds of developing tinnitus 5 years later. (2) To identify factors that are cross-sectionally associated with tinnitus annoyance in adults with new-onset tinnitus.Methods:Baseline, 5-year, and 10-year follow-up data of participants in the Netherlands Longitudinal Study on Hearing (NL-SH) were used. The NL-SH is a web-based prospective cohort study, which started in 2006 and includes both normal hearing and hearing-impaired adults aged 18 to 70 years at baseline. The NL-SH uses an online digit-triplet speech-in-noise test to asses speech recognition ability in noise, and online questionnaires on various aspects of life. At follow-up, participants are asked (1) if they suffer from tinnitus and (2) to rate tinnitus annoyance on a 0 to 100 numeric rating scale. We investigated whether demographic (age, sex, living arrangement, educational level), lifestyle (history of tobacco smoking, alcohol use), health (asthma, severe heart disease, hypertension, history of stroke, osteoarthritis, rheumatoid arthritis, epilepsy, multiple sclerosis, and migraine), hearing (speech recognition ability in noise, hyperacusis, and occupational noise exposure), and psychological variables (distress, somatization, depression, and anxiety) were potential risk factors for new-onset tinnitus, or associated with annoyance caused by new-onset tinnitus. Generalized estimating equations were used to longitudinally analyze the association between potential risk factors and new-onset tinnitus measured 5 years later. A multivariable association model was constructed using a forward selection procedure with p < 0.05 for model entry. Linear regression analysis was used to cross-sectionally analyze the association between potential factors and tinnitus annoyance in new-onset tinnitus. For this purpose, a multivariable association model was constructed using a forward selection procedure with p <0.05 for model entry.Results:In total, 734 participants without tinnitus at baseline were included, from which 137 participants reported to suffer from new-onset tinnitus 5 or 10 years later. Risk factors for new-onset tinnitus were history of smoking (odds ratio 1.5, 95% confidence interval [CI] 1.0 to 2.2, p = 0.027) and higher levels of somatization (odds ratio 2.0, 95% CI 1.2 to 3.3, overall p = 0.024). Factors associated with the degree of tinnitus annoyance were increased levels of anxiety (β = 11.6, 95% CI 2.3-20.8, overall p = 0.035) and poor speech recognition ability in noise (β = 13.5, 95% CI, 4.4 to 22.6, overall p = 0.014).Conclusions:Higher levels of somatization and a history of smoking were found to be risk factors for new-onset tinnitus 5 years later. Anxiety and poor speech recognition ability in noise were associated with higher degrees of tinnitus annoyance in new-onset tinnitus. Somatization deserves to be addressed in future research and clinical practice as it might provide part of a model for the development of chronic tinnitus.

Когнитивные ошибки и психологические особенности пациентов с ишемической болезнью сердца перед коронарным шунтированием в зависимости от пола и возраста

In patients with cardiovascular diseases, including CHD, the prevalence of anxiety and depression is considerable. Cognitive behavioral therapy is believed to be an effective tool for treating anxiety and depression. In the theory underlying cognitive behavioral psychotherapy, cognitive distortions play an important role. Cognitive distortions are misperception and misprocessing of information. Cognitive distortions are not a sign of mental disorders, however, their presence when assessing any situations (for example, while waiting for cardiac surgery) can lead to a range of psychological problems, in particular, to the development of anxiety and depression. Thus, the study of cognitive distortions in patients with cardiovascular diseases is of great importance in the view of the possibility of their negative impact on the mental state. Besides, according to the theoretical foundations of cognitive behavioral therapy, the presence of cognitive distortions also affects the interpersonal interaction (distorted perception of information, incorrect interpretation of behavior in the process of communication, etc.). Accordingly, the presence of cognitive distortions can also negatively affect patientdoctor interaction and adherence to treatment. The research aims to study the cognitive distortions and psychological characteristics of patients with CHD before CABG taking into consideration sex and age. The present study involved 60 patients with CHD, including 32 men (53%) and 28 women (47%). The average age of patients was 63 ± 8 years. Two groups of subjects were identified by age criterion: up to 65 years old and over 65 years old. To study cognitive distortions, the interview, and psychological testing (SCL-90-R and BIG 5 questionnaires) were carried out. All patients had different types of cognitive distortions. Men were more likely to spontaneous conclusions (37.5%), women were more likely to have overgeneralization (35%). In patients of the older age group (65&lt;), the prevalence of dichotomous thinking was more frequent (25.92%). According to the results of the SCL-90-R questionnaire, women before CABG have higher indices of somatization, interpersonal sensitivity, and anxiety; men have higher indices of hostility. Patients over 65 years old have a higher level of somatization and depression. According to the results of the BIG 5 test, the majority of patients demonstrated a "below average" level in terms of "conscientiousness", "agreeableness", "openness to experience". For men, in terms of extraversion, the "above average" level was more common, while for women it was "level below average". When planning psychological testing and psychotherapy before CABG and during the rehabilitation, the identified psychological characteristics of patients and the specificity of cognitive distortions should be taken into account.

Overlap of Rome IV Irritable Bowel Syndrome and Functional Dyspepsia and Effect on Natural History: A Longitudinal Follow-Up Study

Disorders of gut-brain interaction, such as irritable bowel syndrome (IBS) and functional dyspepsia (FD), frequently overlap, but the impact of this on the natural history is unknown. We examined this issue in a longitudinal follow-up study conducted in a large cohort of individuals. We collected complete demographic, symptom, mood, and psychological health data from 1374 adults who self-identified as having IBS. We applied the Rome IV criteria to examine what proportion met criteria for IBS and FD, as well as the degree of overlap between them. At 12 months, we collected data regarding IBS symptom severity and impact, consultation behavior, treatments commenced, and psychological health according to degree of overlap between IBS and FD. Overall, 807 individuals met the Rome IV criteria for IBS at baseline and provided complete data. At study entry, overlap of FD occurred in 446 (55.3%) people who met Rome IV criteria for IBS. At 12 months, 451 (55.9%) individuals were successfully followed up. The proportion of individuals consulting their primary care physician (P= .001) or a gastroenterologist (P < .001) because of their IBS was significantly higher in those with overlap of IBS and FD, and the number of new IBS treatments commenced was significantly higher (P= .007). Those with overlap of IBS and FD reported significantly more severe IBS symptoms (P < .001), continuous abdominal pain, and that their IBS symptoms limited normal daily activities ≥50% of the time. Finally, those with overlap were more likely to report abnormal anxiety and depression scores at 12 months compared with those with IBS alone, and to have higher levels of somatization (P < .001 for all analyses). The natural history of people with IBS with overlap FD defined according to Rome IV criteria is more severe than those with IBS alone. This has important implications for future treatment trials in IBS.

Fear at the time of the COVID-19 pandemic: validation of the Arabic version of the Four-Dimensional Symptom Questionnaire among Saudi-based respondents.

The COVID-19 pandemic has caused unprecedented stress and fear throughout the world. To evaluate the psychological effects of the COVID-19 pandemic on the Saudi public, and to examine the performance of the Arabic version of the Four-Dimensional Symptom Questionnaire (4DSQ) scale. We conducted an online questionnaire-based cross-sectional survey of a sample of the Saudi public. The study included 347 participants, who reported significantly higher levels of distress, depressive symptoms, anxiety symptoms and somatisation compared with a normative sample. Females scored higher in terms of somatisation, depression and anxiety symptoms, and distress. Obtaining COVID-19 information from friends and relatives was associated with higher levels of somatisation, depression and anxiety symptoms, and distress. Cronbach's alpha was 0.93 for the distress scale, 0.88 for the depression scale, 0.88 for the anxiety scale and 0.86 for the somatisation scale. Levels of psychological distress were high among the Saudi public during the COVID-19 pandemic. We found high reliability for the Arabic version of the 4DSQ scale. However, three items did not conform to the four-factor structure, namely, item 1: 'During the past week, did you suffer from dizziness or feeling light-headed?', item 20: 'During the past week, did you suffer from disturbed sleep?' and item 46: 'During the past week did you ever think I wish I was dead?'.

Persistent psychological distress in resettled refugee women-at-risk at one-year follow-up: Contributions of trauma, post-migration problems, loss, and trust.

The mental health of women has been largely neglected in the refugee literature, notwithstanding the specific gender-related issues that confront women seeking asylum. Furthermore, a specific category of women, deemed to be women-at-risk, face particular challenges in their journey and resettlement process. This longitudinal study investigated psychological distress in refugee women-at-risk one year after resettlement in Australia. Follow-up survey of 83 women-at-risk (mean age = 33.41 years; SD = 11.93) assessed: trauma events and symptoms; loss events and loss distress; level of post-migration problems; anxiety, depression, and somatic symptoms; and absence of trust in community members. Participants demonstrated no symptom change since initial assessment (p > .05). Substantial proportions of women reported traumatization (39%), PTSD (20%), anxiety (32%), and depression (39%) above clinical cut-offs, and high levels of somatization and loss distress. Post-migration problems, trauma events, and region of birth were associated with all symptoms, with post-migration problems the strongest predictor. Absence of trust in community members was associated with trauma, depression, and somatic symptoms. Initial trauma and somatic symptoms were associated with follow-up traumatic and somatic symptoms. Loss and trauma events were associated with loss distress. Findings underline the role of post-migration problems on psychological distress and the need to consider women's psychological wellbeing in the context of their trauma and loss history, potential impacts of ethnicity, and complex socio-cultural dynamics underpinning issues of trust within communities. Effective service delivery requires that practitioners screen for and address psychological distress in women-at-risk at least up to 18 months after resettlement.

Impact of Pacemakers and Implantable Cardioverter Defibrillators on the Psychosocial Functioning of Paediatric Patients.

Although implanted cardiac devices improve patients' physical health, long-term psychosocial effects especially in the paediatric population are still unknown. The aim of this study was to evaluate the psychosocial effects of cardiac devices in a paediatric population.Pediatric Quality of Life Questionnaire (PedsQoL) was used to evaluate life quality, Connor-Davidson Resilience Scale was used to evaluate resilience and Brief Symptom Inventory was used to evaluate psychiatric symptoms in a paediatric population with cardiac devices.Seventy-one patients were enrolled in the study. Fifty of them (70.5%) had a cardiac pacemaker and 21 of them (29.5%) had implantable cardioverter defibrillator. When compared to the control group both implantable cardioverter defibrillator and pacemaker using patients had lower quality of life (79.5 ± 12.4 versus 86.7 ± 12.1, p = 0.001) but no difference was observed in resilience and psychological pathologies. Age, gender, family size, and education level had no effect on quality of life. Implantable cardioverter defibrillator bearing patients had higher levels of anxiety than pacemaker patients (0.58 versus 0.30 p = 0.045), and implantable cardioverter defibrillator patients who had received shock in the last year had higher levels of somatisation than the group that did not receive device shock (0.17 versus 0.44 p = 0.022).In conclusion study showed that cardiac devices have negative effects on the psychosocial health of children. Cardiologist working with these patients should be aware of these pathologies and monitor not only physical health but also psychosocial health too.

The impact of the COVID-19 epidemic on mental health of undergraduate students in New Jersey, cross-sectional study.

ObjectiveThe COVID-19 pandemic has been a period of upheaval for college students. The objective of this study was to assess the factors associated with the increased levels of mental health burden among a sample of undergraduate college students in Northern New Jersey, the region of the U.S. severely impacted by the outbreak of COVID-19.MethodsCollege students (N = 162) enrolled in an introductory core curriculum course completed a cross-sectional survey. The survey collected information on demographics, knowledge levels and sources of COVID-19 information, behavior changes, academic and everyday difficulties, and mental health measurements (depression, anxiety, somatization, and stress). Multivariable regression analysis was performed to identify factors associated with mental health outcomes.ResultsDescriptive findings indicate that students have a fundamental knowledge of COVID-19 transmission and common symptoms. Students tend to use and trust the official sources and have changed their behaviors in accordance with public health recommendations (i.e., increased hand washing, wearing mask). However, students reported a number of academic and everyday difficulties and high levels of mental health distress. High levels of depression were associated with difficulties in focusing on academic work and with employment losses, while higher levels of anxiety were more likely to be reported by students other than freshmen and those who spend more than one hour per day looking for information on COVID-19. Inability to focus on academic work and an elevated concern with COVID-19 were more likely to be associated with higher levels of somatization, while trusting news sources was associated with lower levels of somatization. Those with higher levels of perceived stress were more likely to be females, unable to focus on academic work, and report difficulties in obtaining medications and cleaning supplies.ConclusionsThe COVID-19 pandemic is making a significant negative impact on mental health of college students. Proactive efforts to support the mental health and well-being of students are needed.

Clinical and psychopathological features of first-episode bipolar affective disorder

The article analyzes the clinical and gender features of clinical and psychopathological phenomenology of the first-episode bipolar affective disorder (BAD).The aim of the work was to study the features of the psychopathological phenomenology of the first-episode of BAD in the context of the clinical variant and taking into account the gender factor.Materials and methods. In total, 65 men and 88 women with first-episode BAD were clinically examined using the Symptom Check List-90-Revised Psychopathological Symptom Expression Questionnaire.Results. In the depressed type of the first-episode BAD in men, the levels of depression were significantly higher – 2.80 ± 0.48 points versus 2.61 ± 0.49 points (P = 0.044); interpersonal sensitivity – 1.39 ± 0,31 points versus 1.28 ± 0.28 points (P = 0.037), and in women – insignificantly higher levels of somatization, obsessive compulsive symptoms, anxiety, hostility, phobic anxiety. In patients with a manic episode, the level of somatization, hostility and psychosis was insignificantly higher in men, and obsessive-compulsive symptoms, phobic anxiety – in women. In the mixed episode, men had insignificantly higher indicators of obsessive-compulsive symptoms, interpersonal sensitivity, phobic anxiety, paranoid symptoms, and women - somatization, depression and anxiety.Significantly stronger association between psychopathological symptoms severity and the clinical variant of BAD was revealed, in particular, significantly higher levels of all psychopathological symptoms severity, with the exception of paranoid, as compared to patients with depressive and manic episodes; comparing patients with depressive and mixed episodes, there were differences in interpersonal sensitivity (P = 0.000), depression (P = 0.000) in men, obsessive-compulsive symptomatology (P = 0.012), interpersonal sensitivity (P = 0.000), depression (P = 0.000) in women, and obsessive-compulsive symptomatic (P = 0.021), interpersonal sensitivity (P = 0.000), depression (P = 0.000) in all patients. The comparison between groups with manic and mixed episodes found differences in somatization (P = 0.002), obsessive compulsive symptoms (P = 0.007), depression (P = 0.001), anxiety (P = 0.001), hostility (P = 0.012) in men (P = 0.004), somatization (P = 0.003), depression (P = 0.004), anxiety (P = 0.004), hostility (P = 0.011), psychosis (P = 0.019) in women, somatization (P = 0.000), obsessive-compulsive symptoms (P = 0.003), interpersonal sensitivity (P = 0.017), depression (P = 0.000), anxiety (P = 0.000), hostility (P = 0.000), psychosis (P = 0.006) in all subjects.Conclusions. The data obtained suggest a pivotal role of psychopathological symptoms severity in first- episode BAD and its clinical variant while the gender factor plays a secondary one.

Механізми формування та система психотерапевтичної корекції станів дезадаптації у студентів медичного закладу вищої освіти

Проведено комплексне обстеження 412 студентів ІІ–V курсів Харківського національного медичного університету обох статей, віком 17–22 років. Усіх обстежуваних було розділено на три групи: I група – 215 студентів, мешканців Східної України; II група – 87 студентів, мешканців Луганської та Донецької областей, які вступили на навчання до ХНМУ до початку АТО; III група – 110 студентів, переселенців з зони АТО. Як показали результати дослідження, студенти-переселенці виявляють більш високий рівень розладів адаптації, порівняно зі студентами І та ІІ груп. Встановлено, що структура розладів адаптації представлена депресивним, неврастенічним, тривожним та дисоціативним синдромокомплексами. Патогенетичну значущість у формуванні дезадаптивних станів у студентів-медиків мають: зміна життєвого стереотипу, важкий навчальний матеріал, недосконалість механізмів психологічного захисту, відсутність навичок саморегуляції, неконструктивні копінг-стратегії, ситуації тривалої психічної напруги. Для студентів-переселенців стресогенним чинником є необхідність адаптації у новому та статус вимушеного переселенця. Прогностично значущими у формуванні розладів адаптації є збудливість і неврівноваженість, конфліктність у відносинах, тривожна помисливість, дезорганізація поведінки, неспроможність до саморегуляції, нездатність успішно долати стресові ситуації, діяти в умовах невизначеності, ригідність, фіксованість на травматичних і негативних переживаннях. Базисом розвитку станів дезадаптації студентів є високі рівні соматизації, депресії та тривоги за шкалою SCL-90-R; переважання важкого депресивного та тривожного епізодів за шкалою Гамільтона; клінічні прояви за лікарняною шкалою тривоги і депресії, переважання інтенсивної та екстенсивної нервово-психічної напруги. Базуючись на отриманих даних, нами розроблено систему медико-психологічної підтримки студента-медика в період навчання, що передбачає застосування комплексного психотерапевтичного, психоосвітнього та психопрофілактичного впливів та доведено її ефективність.

Orthorexiceating behavior in patients with somatoform disorders.

Although anecdotal reports suggest a relation between orthorexiceating behavior and symptoms of somatoform disorders, this issue has not yet been investigated. The aim of this study was to compare orthorexiceating behavior and other characteristics of disordered eating behavior in patients with somatoform disorders to a sample of healthy controls. 31 patients with somatoform disorders and 30matched controls completed eight questionnaires, i.a., the Düsseldorf Orthorexia Scale, three scales of the Eating Disorder Inventory-2, Eating Attitudes Test-26, Multidimensional Inventory of Hypochondriacal Traits, Attitudes Towards Body and Health Questionnaire, and Screening for Somatoform Disorders. The patients displayed higher levels of orthorexic eating behavior, drive for thinness, body dissatisfaction, bulimia, and dieting than the control group. In both groups, orthorexiceating behavior was associated with higher levels of somatization in eating and health habits. The control group showed an association of orthorexic eating behavior with catastrophizing cognitions and the perceptual component of health anxiety. The results support the hypothesis of a connection between orthorexiceating behavior and somatoform disorders. However, patients with somatoform disorders do not seem to be at particular risk for orthorexia. Future studies should investigate causes for the relationship between orthorexiceating behavior and characteristics of somatoform disorders in samples of healthy individuals. Level V, descriptive study with matched control group.

Targets of medical-psychological assistance for medical university students with adaptation disorders

Background. In the course of work is to identify and develop a system of measures for psychotherapeutic correction on the basis of identification and comprehensive evaluation of clinical and psychological manifestations and mechanisms of formation of maladaptive states in medical students.&#x0D; Objective – to comprehensively study the mechanisms of formation of students’ maladaptation states and develop a system of their psychotherapeutic correction and psychoprophylactic support in a medical institution of higher education.&#x0D; Materials and methods. Complying with the principles of bioethics and deontology, 412 students of the 2-5 academic years of the Kharkiv National Medical University (KhNMU), of both sexes, at the age of 17-22 years, were examined. All the surveyed people were divided into three groups: Group 1 included 215 students-inhabitants of the Eastern Ukraine; Group 2 consisted of 87 students-residents of Luhansk and Donetsk regions, who entered the study at the KhNMU before the ATO; Group 3 consisted of 110 students-migrants from the ATO zone.&#x0D; Results. Students-migrants have a higher level of adaptation disorders, compared with the students of the first and second groups. It was established that the structure of adaptation disorders is represented by depressive, neurasthenic, anxious and dissociative syndrome complexes. Prognostically significant elements in the formation of adaptation disorders are excitability and imbalance, proneness to conflicts in relationships, disturbing confidence, disorganization of behavior, failure to self-regulation, inability to successfully overcome stressful situations, act in conditions of uncertainty, rigidity, and focusing on traumatic and negative feelings. According to the results of the pathopsychological examination, high levels of somatization, depression and anxiety by the SCL-90-R scale; the prevalence of severe depressive and anxiety episodes by the Hamilton scale; clinical manifestations by the hospital anxiety and depression scale were characteristic for the examined students with disorders of adaptation. Based on the data obtained, a system of medical and psychological support of the medical student during the study period was developed, which envisages the use of complex differentiated psychotherapeutic, psychoeducational and psychoprophylactic influences.&#x0D; Conclusions. Against the background of the psychotherapeutic correction, a positive dynamic of the psychological state was noted: rapid reduction of anxiety and depressive symptoms, reduction of the level of neuro-psychic tension, increase of students’ psychophysical activity, positive change of coping strategy.

Relationships Between Catecholamine Levels and Stress or Intelligence.

Catecholamines, including epinephrine (E), norepinephrine (NE), and dopamine (DA), are associated with the response to stressful conditions. However, the relationships of catecholamines with intelligence and their interactions with stress remain unclear. This study assessed stress, intelligence quotient (IQ), and catecholamine levels in 70 healthy subjects to elucidate associations between catecholamines and stress, and between catecholamines and IQ. Additionally, the associations of catecholamines with stress and IQ were analyzed according to hemispheric dominance using the Brain Preference Indicator (BPI). There were positive correlations between the NE/E ratio and the somatization of stress but negative correlations between the E/NE ratio and the somatization of stress among the total number of subjects. In the right-brain-dominant group, a high E/DA ratio was correlated with low levels of stress, somatization and depression, and high NE/E and DA/E ratios were associated with high levels of somatization. In the left-brain-dominant group, high E levels were correlated with low levels of depression. In the total subjects, there were positive correlations between the NE/E and DA/E ratios and the sum of the vocabulary, arithmetic, picture arrangement, and block design IQ subtests. Thus, these catecholamines were associated with stress and IQ, which suggests that the autonomic functional regulation of catecholamine levels in relation to stress may also affect cognitive functions related to intelligence in the brain. Furthermore, the relationships between catecholamines and stress or IQ differed depending on hemispheric dominance, which suggests that the present results could be used to inform the development of personalized therapies based on hemispheric asymmetry.

Fatigue and its associated factors in microscopic colitis.

Background:Fatigue is a well-recognized symptom in patients with inflammatory bowel disease and irritable bowel syndrome (IBS), and has been associated with psychological comorbidity and impaired quality of life in both. However, features associated with fatigue in patients with microscopic colitis (MC) are less clear.Materials and methods:We conducted a cross-sectional survey of patients with a new diagnosis of MC including levels of anxiety, depression, somatization, quality of life, and IBS-type symptoms. Levels and impact of fatigue were assessed using the Inflammatory Bowel Disease Fatigue self-assessment scale. Mean scores were compared against various patient characteristics, and were also correlated with anxiety, depression, somatization, and quality-of-life scores.Results:In total, 129 patients with MC diagnosed between 2010 and 2015 returned completed postal questionnaires. Common histological subtypes were collagenous colitis (53.5%, n = 69) and lymphocytic colitis (38.8%, n = 50). Higher mean fatigue severity and impact scores were associated with the presence of irritable-bowel-syndrome-type symptoms, abnormal levels of anxiety and depression, and high levels of somatization (p < 0.0001 for all), but those reporting ongoing symptoms attributable to MC did not report significantly higher scores. There were significant positive correlations between total anxiety, depression, or somatization scores and fatigue severity and impact scores, and significant negative correlations with quality-of-life measures (p < 0.001 for all).Conclusions:Fatigue in MC appears to be associated with reporting IBS-type symptoms, psychological comorbidity and impaired quality of life. It may therefore represent an important target for treatment.

Alexithymia and psychopathology in patients with acute myocardial infarction.

The purpose of this study was to investigate alexithymia in acute myocardial infarction (AMI) patients and its relationship with associated anxious-depressive co-morbidity. We studied 71 participants: 30 consecutive patients with cardiac biomarkers and electrocardiographic criteria for acute myocardial infarction (AMI) in a coronary care unit, with a mean age of 65.23 ± 11.95 years (80% male) and a control group of 41 healthy subjects with a mean age of 62.85 ± 7.83 (46% male). We used the Identification Form (sociodemographic data) and clinical diagnostic, the 20-item Toronto Alexithymia Scale (TAS-20), the Symptom Check List – 90 Revised (SCL-90R) and the Hospital Anxiety and Depression Scale (HADS). Results show that patients with acute myocardial infarction had alexithymia scores significantly higher (P = 0.000) than the control group (60.0 ± 12.8 vs 49.9 ± 8.91) and also higher scores in psychopathological traits screened by the SCL-90R, namely high levels of somatization and depression. We also observed a positive correlation between psychopathological symptoms and alexithymia. A significant prevalence of alexithymia was found in patients with AMI suggesting that psychopathological symptoms have a significant relation with alexithymia. In this clinical setting the deficit of emotion expression points to the need of psychotherapeutic intervention in patients after an AMI event occurs, to improve prognosis and well-being.