Lower Symptom Severity Research Articles

Treatments for partial remission of major depressive disorder: a systematic review and meta-analysis

QuestionPartial remission of major depressive disorder (MDD) is a debilitating and distressing clinical state related to chronicity, morbidity and relapse. Although one-third of patients remit partially, evidence for treatment efficacy...

Social support against depression in young adults' group during COVID-19 pandemic.

The present study aimed at analyzing the prevalence of depressive symptoms in a group of learning young adults, as well as the social support as a predictor of depression in late adolescence during the COVID-19 pandemic. An online national survey of young adults attending schools was conducted. The semi-structured questionnaire, including a section on sociodemographic data, stressors, needs and sources of support, as well as brief version of the Kutcher Adolescent Depression Scale, was distributed to young Poles. The final sample consisted of 1,500 students aged 18-23. Multivariable logistic regression assessed the relationships between support needs and sources and depressive symptoms. The support needs that are most commonly reported by young adults are support from loved ones (family, friends) (n = 843; 56.2%) and teachers (e.g., care, appreciation) (n = 603; 40.2%). Fifty-six per cent of Polish young adults are experiencing significant depressive symptoms (95% confidence interval [CI]: 1.82-13.96). Young adults with no social support had higher KADS score than participants reporting some form of support (b = 1.794; 95% BCa CI = 0.659, 2.947). Participants receiving support from mother, both parents and siblings had a lower severity of depressive symptoms, while young people receiving support from father had more severe symptoms. This study provides initial findings in terms of depressive symptoms and support needs of young adults during the COVID-19 pandemic. It is imperative for mental health services, communities and schools to provide the necessary support to young adults.

Sex differences in Black Veterans with PTSD: women versus men have higher sympathetic activity, inflammation, and blunted cardiovagal baroreflex sensitivity.

Post-traumatic stress disorder (PTSD) is associated with greater risk of incident hypertension and cardiovascular disease (CVD). Inflammation and autonomic derangements are suggested as contributing mechanisms. Women and Black adults have higher CVD risk associated with stress; however, whether there is a sex difference in autonomic and inflammatory mechanisms among Black individuals with PTSD is not known. We hypothesized that Black women with PTSD have higher inflammation, sympathetic nervous system (SNS) activity and impaired baroreflex sensitivity (BRS). In 42 Black Veterans with PTSD (Women, N = 18 and Men, N = 24), we measured inflammatory biomarkers, continuous blood pressure (BP), heart rate (HR) and muscle sympathetic nerve activity (MSNA) at rest and during arterial BRS testing via the modified Oxford technique. Groups were matched for age and body mass index (BMI). Resting BP was similar between groups, but HR was higher (76 ± 12 vs. 68 ± 9 beats/min, p = 0.021) in women compared to men. Although women had lower PTSD symptoms severity (57 ± 17 vs. 68 ± 12 a.u.), resting MSNA (27 ± 13 vs. 16 ± 5 bursts/min, p = 0.003) was higher in women compared to men, respectively. Likewise, cardiovagal BRS was blunted (p = 0.002) in women (7.6 ± 4.3ms/mmHg) compared to men (15.5 ± 8.4ms/mmHg) while sympathetic BRS was not different between groups (p = 0.381). Black women also had higher (p = 0.020) plasma levels of interleukin-2 (IL-2). Black women with PTSD have higher resting HR and MSNA, greater impairment of cardiovagal BRS and possibly higher inflammation. These findings suggest a higher burden of autonomic and inflammatory derangements in Black women compared to Black men with PTSD.

PEP-flute selfcare in epidemic respiratory infectious diseases – high societal impact at low cost?

Abstract Background The COVID-19 pandemic has led to worldwide increases in mortality and disrupted healthcare systems. The necessary countermeasures have adversely affected our lives, both mentally and economically. Home-based interventions to help individuals with early COVID-19 overcome the disease with fewer symptoms are needed. This study explored if self-care using positive expiratory pressure (PEP) as airway clearance is effective in reducing respiratory symptoms and, thus hypothetically prevent COVID-19 associated pneumonia. Methods This open-label, randomized trial (ClinicalTrials.gov:NCT04530435) recruited community dwelling adults from Capital Region and Region Zealand in Denmark from 6 Oct 2020 to 26 Feb 2021. Eligible participants (verified SARS-CoV-2 infection, COVID-19 symptoms, and able to perform self-care) were randomized to usual care or to PEP-flute self-care (PEP thrice daily) as an add-on to usual care. PEP-flutes were delivered by express mail and instructions given by video-links. The primary outcome was a change (analyzed by repeated measures mixed linear models) in self-reported symptom severity from baseline to day 30, as assessed by the COPD (chronic obstructive pulmonary disease) assessment test (CAT). Another outcome was the perceived effect of PEP-selfcare. Results The PEP self-care group (n = 190) had significantly lower symptom severity (group difference -1.2 points (95% confidence interval -2.1 to -0.2; p = 0.017)) at day 30 compared to the usual care group (n = 188). The PEP self-care group reported less chest tightness, less dyspnea, more vigor, and higher level of daily activity. When asked, “How do you describe the PEP-flute effect?”, 30% (n = 56) from the PEP group reported PEP-use to provoke coughing of phlegm. No serious adverse events were reported. Conclusions In early COVID-19, PEP-flute self-care was effective in reducing respiratory symptom severity among community dwelling adults and may have a future societal impact at a low cost. Key messages • We advocate for more research in self-care interventions to confirm if campaigns and handouts of PEP-flutes to mobilize the citizens’ selfcare are suitable public health responses to the next pandemic. • More research is needed to establish efficacy of non-drug interventions like PEP-selfcare for airway clearance to prevent pneumonia.

Therapeutic Results and Survival of Patients with Myelofibrosis Treated with Ruxolitinib-A Real-Life Longitudinal Study.

The aim of this study was to analyze the therapeutic results and survival of patients with myelofibrosis treated with ruxolitinib in comparison with a group on standard therapy. It is a cross-sectional, retrospective, non-interventional, real-life study that was performed between January 2000 and February 2023. Patients treated between 2000 and 2016, before the introduction of ruxolitinib, constituted the control group (n = 45), while those treated after May 2016, after ruxolitinib inclusion, constituted the active group (n = 66). Demographic characteristics, clinical indicators, the severity of the disease, and survival were explored using Kaplan-Meier survival analyses. Spearman's correlation, linear regression, and other statistical analyses were performed. According to the Kaplan-Meier analysis, there was a 75.33% reduction in the fatality risk in the sample. On a general-population level, the fatality risk in the group treated with ruxolitinib varied between 7.9% and 77.18% compared to that of the risk in the control group. There was a decrease in blood parameters (leukocytes, hemoglobin, and platelets) and spleen size. During the first six months, the spleen size of the patients on ruxolitinib decreased by 6%, and during the second six months, it decreased by another 9%. This study shows that patients in a real-life clinical setting treated with ruxolitinib exhibited improved clinical signs of the disease, had a lower symptom severity, and survived longer than patients on standard therapy before ruxolitinib's entrance into the national market. The improvements correlate with those reported in randomized clinical trials.

Depression symptom outcomes and re-engagement among VA patients who discontinue care while symptomatic

ObjectiveEvaluate outcomes of Veterans who discontinued treatment with at least moderate ongoing depressive symptoms. MethodVeterans with elevated depression symptoms from 29 Department of Veterans Affairs facilities completed baseline surveys and follow-up assessments for one year. Analyses examined rates and predictors of treatment discontinuation, treatment re-engagement, and subsequent symptoms among patients who remained out of care. ResultsA total of 242 (17.8%; n = 1359) participants discontinued treatment while symptomatic, with Black participants, participants with less severe depression, and participants receiving only psychotherapy (versus combined psychotherapy and antidepressant medications) discontinuing at higher rates. Among all participants who discontinued treatment (n = 445), 45.8% re-engaged within the following six months with participants receiving combined treatment re-engaging at higher rates. Of participants who discontinued while symptomatic within the first 6 months of the study and did not return to care (n = 112), 68.8% remained symptomatic at 12 months. Lower baseline treatment expectancy and greater depression symptom severity were associated with remaining symptomatic while untreated. ConclusionsBlack race, lower symptom severity, and treatment modality may help identify patients at higher risk for discontinuing care while symptomatic, whereas patients with lower treatment expectations may be at greater risk for remaining out of care despite continuing symptoms.

Sex Differences and Discordance Between Symptoms and Signs of Dry Eye Disease

PurposeTo examine the initial presenting symptoms in relation to sex and identify predictors of discordance between symptoms and signs of dry eye disease (DED) in Taiwan. DesignRetrospective cross-sectional study. MethodsSetting: Clinic-based cohort from a tertiary referral center in Taiwan. Study Population: 1229 patients diagnosed with DED at Keelung Chang Gung Memorial Hospital in Taiwan between August 1, 2011, and July 31, 2018. Main Outcome Measures: Initial presenting symptoms were cross-sectionally and retrospectively collected. The composite score, indicating the discordance between symptoms and signs, was derived from the difference between the DED symptom severity score and the DED sign severity score. ResultsOut of the total 1229 patients, 79.3% (975) were female, with a mean age of 56.7 ± 14.9 years. Initial presenting symptoms didn't show significant sex differences (all p > 0.05). In multivariate analysis, predictors of higher symptom severity score than sign severity score included being female (p = 0.011), and having past surgical history of cataract (p = 0.037), pterygium, or conjunctivochalasis (p = 0.014). Conversely, older age (p < 0.001) and artificial tear use (p < 0.001) were significant predictors of a lower symptom severity score than sign severity score. ConclusionsStrong predictors of incongruity between DED symptoms and signs include age, gender, surgical history for cataract, pterygium or conjunctivochalasis, and artificial tear use. Ophthalmologists should prioritize symptoms for female patients and post-surgery cases. Additionally, the absence of symptoms shouldn't dismiss DED possibility in older adult patients and those using artificial tears. Notably, early recognition and enhancement of postoperative care can improve patient satisfaction and quality of life.

Possibilities of differential diagnosis of uterine leiomyosarcoma

Uterine leiomyosarcoma is a rare malignant neoplasm consisting of smooth muscle cells, characterized by an aggressive course and poor prognosis.&#x0D; Differential diagnosis of uterine leiomyosarcoma is challenging due to the nonspecificity and low severity of symptoms, particularly in the early stages. Patients with uterine leiomyosarcoma commonly present with complaints in of pelvic pain, abnormal uterine bleeding, and symptoms of compression of nearby organs. The same clinical symptoms are characteristics of patients with uterine leiomyomas.&#x0D; Leiomyosarcoma is often detected after histologic examination of material obtained during surgery for uterine myoma. At the same time, preoperative verification of the malignant nature of the neoplasm is crucial in determining the optimal tactics of surgical treatment. For instance, the use of organ-preserving techniques and morcellation in the treatment of presumed uterine leiomyoma may result in the dissemination of tumor cells and significantly worsen the prognosis in patients with undiagnosed leiomyosarcoma.&#x0D; This review discusses existing methods of preoperative diagnosis of uterine leiomyosarcoma, their efficacy, as well as the possibilities of application in clinical practice.

Once-daily versus divided dosing regimens of clozapine: A cross-sectional study in Singapore

IntroductionClozapine is recognized as the gold standard medication for treatment-resistant schizophrenia. Despite the general recommendation of administering in a divided dosing regimen, clozapine is often prescribed once daily at night in clinical practice. This study aims to compare patient characteristics, psychiatric symptoms, side effects, and plasma concentration of clozapine between once-daily dosing and divided dosing regimens. MethodsThis cross-sectional study included 159 participants with treatment-resistant schizophrenia or schizoaffective disorder. Participant's demographic information, anthropometric data, and medical history were collected. Their psychiatric symptoms, cognition, functioning, and side effects were evaluated. ResultsOnce-daily dosing regimen was associated with younger age and competitive employment. Lower clinical symptom severity, better functioning and cognitive performance were observed in the once-daily dosing group. Lower daily dose of clozapine, trough plasma concentrations of clozapine and norclozapine were also significantly associated with once-daily dosing regimen. ConclusionThe study results support once-daily dosing of clozapine as a viable option to selected patients in clinical practice, as no association of severe symptoms or side effects were associated with once-daily dosing regimen. More studies are needed to examine the relationship between clinical outcomes and clozapine dosing regimen.

Satisfaction With Life in IBS Is Associated With Psychological Burden Rather than Gastrointestinal Symptom Severity.

Irritable bowel syndrome (IBS) has a major impact on emotional, social, and professional life. This study aimed to evaluate general life satisfaction, a subjective measure of well-being, in IBS patients, and to determine which factors are associated with higher life satisfaction. IBS patients (n = 195, mean age 51.4 ± 16.5 years, 73.8% female) recruited from primary and secondary/tertiary care completed questionnaires regarding gastrointestinal symptoms, quality of life, psychological factors, and life satisfaction (Satisfaction With Life Scale, 5 items, range 5-35). A finite mixture model analysis was performed to identify latent classes. Multivariable linear regression was used to identify variables associated with life satisfaction. Overall, 71.3% of the patients were satisfied about their life (Satisfaction With Life Scale-score ≥21). Three latent subgroups could be identified with significantly higher life satisfaction in the subgroup with higher mental quality of life, fewer anxiety and depressive symptoms, lower gastrointestinal specific anxiety, and lower gastrointestinal symptom severity, compared with the other 2 groups. Multivariable linear regression showed that higher physical quality of life (B0.168, P < 0.001) and higher mental quality of life (B0.199, P < 0.001) were associated with higher life satisfaction. Using multivariable regression, no significant association was found between gastrointestinal symptom severity and life satisfaction. Higher physical and mental quality of life, but not gastrointestinal symptom severity, were independently associated with higher general life satisfaction in IBS. These findings reinforce the clinical need in IBS treatment to focus on the full extent of the disorder and not merely on gastrointestinal symptom improvement. ClinicalTrials.gov Identifier: NCT00775060.

The effect of genetic variation in estrogen transportation and metabolism on the severity of menopause symptoms: A study from the RIGHT 10K cohort.

The severity of menopause-related symptoms varies considerably among women. The determinants of this variation are incompletely understood. The aim of this study was to assess the association between genetic variation in estrogen metabolism and transport pathways and the severity of menopause symptoms. This was a cross-sectional study of 60 peri- and postmenopausal women in the Mayo Clinic RIGHT study (which involved sequencing of genes involved in drug metabolism and transport), who had also been evaluated in the Women's Health Clinic at Mayo Clinic in Rochester, MN. All participants completed the Menopause Rating Scale (MRS) for assessment of menopause symptoms, including hot flashes. The association between severity of menopause symptoms and the variation in genes encoding 8 enzymes and transporters involved in estrogen metabolism was evaluated. Lower CYP3A4 activity and higher COMT activity were associated with lower severity of somatic menopause symptoms (p=0.04 and 0.06, respectively). These associations did not persist after adjustment for hormone therapy use. No differences in MRS scores or hot flash severity were noted among other genetic variant groups. Age at natural menopause was not affected by variations in the genes studied. The current study did not show an association between genetic variation in estrogen metabolism and transport pathways and the severity of menopause symptoms. Further studies with larger sample sizes may be required to understand this potentially complex association.

Minority stress and mental health in lesbian, gay, bisexual, transgender, and queer survivors of sexual assault.

Extant research has shown that sexual violence disproportionately affects lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals, conferring risk for the development of posttraumatic stress symptoms (PTSS) and related mental health conditions. However, little research has focused on specific vulnerabilities among LGBTQ+-identified sexual assault (SA) survivors (e.g., minority stress) and their associations with post-SA psychopathology. To address this gap, we examined associations between experiences of minority stress and post-SA psychopathology in a sample of LGBTQ+ individuals who experienced SA (N = 92) and completed a battery of self-report measures. Results revealed significant differences in internalized stigma, community connectedness, alcohol use, and cannabis use across sexual orientation and gender modality groups, ηp 2 = .08-11. Additionally, regression analyses indicated that experiences of violence and victimization were significantly associated with higher PTSS, β = .31, p = .020; anxiety, β = .39, p = .003; and alcohol use severity, β = .31, p = .027, over and above other experiences of minority stress and psychopathology risk factors. Internalized stigma was significantly associated with cannabis use severity, β =.34, p = .011. Finally, community connectedness was significantly associated with lower anxiety symptom severity, β = -.42, p = .001. Although longitudinal work is needed, findings indicate that experiences of minority stress may serve as risk or maintenance factors for post-SA psychopathology. These results offer important considerations for future treatment approaches tailored to LGBTQ+ survivors of SA.

Comparison of physiological outcomes after dynamic exertion between athletes at return to sport from concussion and controls: Preliminary findings

ObjectivesCompare physiological (heart rate, heart rate variability, and blood pressure), performance (change-of-direction task completion time and errors), and clinical (symptoms and rating of perceived exertion) outcomes during dynamic exertion between athletes at return to sport after concussion to healthy athlete controls. DesignCase control. MethodsA sample of 23 (Female = 10; 43.5 %) athletes at medical clearance to play/activity from concussion (CONCUSS) and 23 sex-, age-, and sport-matched healthy athletes (CONTROLS) completed a 5-min seated rest before and after the dynamic exertion test. Independent sample t-tests were used to compare CONCUSS and CONTROLS for completion time, heart rate, and blood pressure; and Mann–Whitney U tests for symptoms, perceived exertion, and errors. A series of ANOVAs were conducted to compare heart rate variability between groups across pre- and post-exercise rest periods. ResultsThere were no differences in heart rate, blood pressure, symptoms, perceived exertion, and errors. CONCUSS were faster on Zig Zag (p = .048) and Pro Agility (p = .018) tasks, reported lower symptom severity (p = .019), and had lower post-EXiT HRV (p < .049) than CONTROLS. ConclusionsPerformance, symptoms, perceived exertion, and blood pressure outcomes from dynamic exertion were equivocal between athletes at medical clearance from concussion and healthy controls, which provide empirical support for dynamic exercise to inform medical clearance clinical decision making for sport-related concussion. However, differences in autonomic nervous system functioning indicate that additional research is needed to examine temporal changes in heart rate variability and other physiological outcomes following dynamic exertion.

Predictors of Treatment Outcome and Length of Stay in a Partial Hospital Program for Pediatric Obsessive-Compulsive Disorder

ABSTRACT Partial hospital programs (PHPs) represent an important part of the continuum of care for youth with severe and/or refractory OCD, yet little is known about clinical or utilization outcomes in this setting. The current study aimed to characterize symptom improvement and length of stay (LOS) among 185 youth with OCD treated in a PHP setting and to identify demographic, clinical, and treatment characteristics that predict these outcomes. Results demonstrate a 77.3% treatment response rate and a median LOS of 52 days. Holding other predictors constant, less symptom improvement was observed for youth with lower symptom severity at admission, in a racial or ethnic minoritized group, without comorbid anxiety, and receiving more treatment hours per day. Shorter LOS was observed among youth with public (vs. commercial) insurance, receiving more hours of treatment per day, and not taking a serotonin reuptake inhibitor (SRI). Clinical implications and directions for future research are discussed, including a critical need to understand and improve outcomes for minoritized youth.

Pharmacogenetics of Long-Term Outcomes of Schizophrenia Spectrum Disorders: The Functional Role of CYP2D6 and CYP2C19.

Schizophrenia spectrum disorders (SSD) are complex mental disorders, and while treatment with antipsychotics is important, many patients do not respond or develop serious side effects. Genetic variation has been shown to play a considerable role in determining an individual's response to antipsychotic medication. However, previous pharmacogenetic (PGx) studies have been limited by small sample sizes, lack of consensus regarding relevant genetic variants, and cross-sectional designs. The current study aimed to investigate the association between PGx variants and long-term clinical outcomes in 691 patients of European ancestry with SSD. Using evidence from the literature on candidate genes involved in antipsychotic pharmacodynamics, we created a polygenic risk score (PRS) to investigate its association with clinical outcomes. We also created PRS using core variants of psychotropic drug metabolism enzymes CYP2D6 and CYP2C19. Furthermore, the CYP2D6 and CYP2C19 functional activity scores were calculated to determine the relationship between metabolism and clinical outcomes. We found no association for PGx PRSs and clinical outcomes; however, an association was found with CYP2D6 activity scores by the traditional method. Higher CYP2D6 metabolism was associated with high positive and high cognitive impairment groups relative to low symptom severity groups. These findings highlight the need to test PGx efficacy with different symptom domains. More evidence is needed before pharmacogenetic variation can contribute to personalized treatment plans.

The Intersection Between COVID-19, Cardiovascular Disease, and Diet: a Review.

Cardiovascular disease (CVD) is one of the top comorbidities associated with COVID-19-both pre- and post-infection. This review examines the relationships between COVID-19 infection and cardiovascular health, with a specific focus on diet as an important modifiable risk factor. Pandemic era studies of individuals battling and recovering from COVID-19 infection suggest a strong link between metabolic diseases, such as CVD, and SARS-CoV-2 infection susceptibility and severity. Other studies also demonstrate how COVID-19 lockdown policies and quarantine recommendations led to drastic lifestyle changes associated with increased CVD risk, such as reduced physical activity and lower diet quality. At the same time, new research is emerging that plant-based diets, which have previously been associated with lower CVD risk, may lower COVID-19 infection rates and severity of symptoms. Diet, COVID-19, and CVD intersect through complex biological mechanisms and related behavioral factors evidenced by clinical trials and epidemiological studies. Diet may be a critical tool for modifying risk of communicable and non-communicable conditions in the post-pandemic world.

Estimated plasma volume status in COVID-19 patients and its relation to comorbidities and clinical outcomes.

Blood plasma is a large reservoir of circulating mediators of inflammation and its expansion has been associated with unfavorable outcomes in patients with inflammatory and cardiovascular diseases. The aim of this study was to determine clinical and prognostic value of estimated plasma volume status (ePVS) in hospitalized patients with COVID-19. We retrospectively investigated 5871 consecutive COVID-19 patient hospitalized in our tertiary-level institution in period 3/2020-6/2021. ePVS was determined using the Strauss-derived Duarte formula and was correlated with clinical characteristics and unwanted outcomes. Median ePVS was 4.77dl/g with interquartile range 4.11-5.74. Higher ePVS was significantly associated with older age, female sex, higher comorbidity burden, worse functional status, less severe COVID-19 clinical presentation with lower severity and longer duration of symptoms, but more pronounced inflammatory profile with higher C-reactive protein, interleukin-6 and D-dimer levels (P < 0.05 for all analyses). In the multivariate regression analysis U shaped relationship of ePVS with mortality was revealed, present independently of age, sex, COVID-19 severity and comorbidity burden. In addition, higher ePVS was independently associated with higher tendency for mechanical ventilation, intensive care unit treatment, venous thromboembolism, major bleeding and bacteriemia and lower ePVS was independently associated with tendency for arterial thrombotic events. Higher ePVS, indicative of plasma volume expansion and inflammatory cytokine accumulation, may predispose respiratory deterioration and venous thromboembolism, despite less severe initial clinical presentation. Lower ePVS, indicative of hemoconcentration, may predispose arterial thrombotic events. Both may be associated with higher mortality in hospitalized COVID-19 patients.

Comparing Kundalini Yoga, cognitive behavioral therapy, and stress education for generalized anxiety disorder: Anxiety and depression symptom outcomes

Increasingly, individuals with anxiety disorders are seeking mind-body interventions (e.g., yoga), but their effectiveness is unclear. This report summarizes seven additional, secondary outcomes measuring anxiety and depression symptoms from a study of 226 adults with generalized anxiety disorder who were randomized to 12-week Kundalini Yoga, Cognitive-Behavior Therapy (CBT) or stress education (control). At post-treatment, participants receiving CBT displayed significantly lower symptom severity, compared to those in the control group, on 6 of the 7 measures. Participants who received Yoga (vs. those in the control group) displayed lower symptom severity on 3 of the 7 measures. No significant differences were detected between participants receiving CBT vs those receiving Yoga. At the 6-month follow-up, participants from the CBT continued to display lower symptoms than the control group.

Effects of a culturally adapted counselling service for low-income ethnic minorities experiencing mental distress: a pragmatic randomised clinical trial

BackgroundCulturally competent early mental health interventions for ethnic minorities (EMs) with no formal diagnoses are needed.ObjectivesTo determine whether 8–12 weeks culturally adapted counselling (CAC) is better than waiting (waitlist (WL)...

Demographic and condition-specific factors influencing how symptoms are experienced over time: results of the MOMENT study

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Australian Catholic University Background Adults with chronic illness (e.g., heart disease, diabetes) commonly experience intractable symptoms. The response to symptoms is often delayed until hospitalization is required. Acute symptoms prompt treatment-seeking, but variability in severity and bothersomeness of chronic symptoms may contribute to a delay in response. Purpose The purpose of this study was to describe symptom severity, bothersomeness, and variability over time and how explore these differ by demographic and clinical groups. Methods We conducted a longitudinal observational study, consenting and enrolling a convenience sample of adults ≥ 18 years with one or more symptomatic chronic conditions living in Italy, the Netherlands, Sweden, or the United States. Recruitment was done through social media. Inclusion criteria were ≥ 3 months experience with heart failure (HF), diabetes mellitus (DM), arthritis, asthma, and/or chronic obstructive pulmonary disease (COPD) and experiencing symptom(s) ≥ 3 times weekly. Symptoms characteristics were assessed twice daily on smartphones using ecological daily assessment methods to minimize recall bias. Data were analyzed using descriptive statistics, and Cohen’s d as an effect size when not significant. Results Eighty people completed the study. Most participants were middle-aged, female, and well-educated. Most lived in the EU. Variability in symptom severity and bothersomeness over time were strongly associated (r = 0.62, p&amp;lt;0.001) but this variability was not associated with either average symptom severity or bothersomeness (all p&amp;gt;0.05). There was a significant association between age and variability in symptom bothersomeness, with less variability and more stability in symptom bothersomeness over time as age increased (r = -0.29, p = 0.011). Women had lower average symptom severity and average bothersomeness than men (d = 0.33), but the differences were not significant. Comparing respondents with and without various conditions, in HF, there was a slight but non-significant difference in variability in symptom bothersomeness over time (d = 0.55). In DM, average symptom severity over time was less in persons with DM (t=-2.0, p = 0.024). Average symptom bothersomeness over time was less in DM (t=2.2, p = 0.007). In asthma, variability in symptom severity was greater over time (t=2.3, p = 0.012). In COPD, average symptom bothersomeness over time was greater (t=3.2, p = 0.001), variability in symptom bothersomeness over time was less (t=-1.9, p = 0.034), and the average symptom severity over time was greater (t=3.7, p&amp;lt;0.001). In arthritis, bothersomeness was higher and there was a slight but non-significant difference in average bothersomeness over time (d = -0.44). Conclusion There are both demographic (age, gender) and condition-specific factors that influence how symptoms are experienced over time in adults with chronic illness. Understanding of these patterns can be useful in designing interventions for chronic illness groups.