Psychosomatic Research Articles

Network pharmacology and experimental evidence: ERK/CREB/BDNF signaling pathway is involved in the antidepressive roles of Kaiyu Zhishen decoction

Ethnopharmacological relevanceMajor Depressive Disorder (MDD) emerges as a complex psychosomatic condition, notable for its considerable suicidality and mortality rates. Increasing evidence suggests the efficacy of Chinese herbal medicine in mitigating depression symptoms and offsetting the adverse effects associated with conventional Western therapeutics. Notably, clinical trials have revealed the adjunctive antidepressant potential of Kaiyu Zhishen Decoction (KZD) alongside Western medication. However, the standalone antidepressant efficacy of KZD and its underlying mechanisms merit in-depth investigation. Aim of the studyThis research aims to elucidate the impact of KZD on MDD and delineate its mechanistic pathways through integrated network pharmacological assessments and empirical in vitro and in vivo analyses. Materials and methodsTo ascertain the optimal antidepressant dosage and mechanism of KZD, a Chronic Unpredictable Mild Stress (CUMS)-induced depression model in mice was established to evaluate depressive behaviors. High-Performance Liquid Chromatography (HPLC) and network pharmacological approaches were employed to predict KZD's antidepressant mechanisms. Subsequently, hippocampal samples were subjected to 4D-DIA proteomic sequencing and validated through Western blot, immunofluorescence, Nissl staining, and pathway antagonist applications. Additionally, cortisol-stimulated PC12 cells were utilized to simulate neuronal damage, analyzing protein and mRNA levels of MAPK-related signals and cell proliferation markers. ResultsThe integration of network pharmacology and HPLC identified kaempferol and quercetin as KZD's principal active compounds for MDD treatment. Proteomic and network pharmacological KEGG pathway analyses indicated the MAPK signaling pathway as a critical regulatory mechanism for KZD's therapeutic effect on MDD. KZD was observed to mitigate CUMS-induced upregulation of p-ERK/ERK, CREB, and BDNF protein expressions in hippocampal cells by attenuating oxidative stress, thereby ameliorating neuronal damage and exerting antidepressant effects. The administration of PD98059 counteracted KZD's improvements in depression-like behaviors and downregulated p-ERK/ERK and BDNF protein expressions in the hippocampus. ConclusionsThis investigation corroborates KZD's pivotal, dose-dependent role in antidepressant activity. Both in vivo and in vitro experiments demonstrate KZD's capacity to modulate the ERK-CREB-BDNF signaling pathway by diminishing ROS expression induced by oxidative stress, enhancing neuronal repair, and thus, manifesting antidepressant properties. Accordingly, KZD represents a promising herbal candidate for further antidepressant research.

Non-Adaptive Defense Mechanisms and Their Relationship to Psychosomatic Disorders among a Sample of University Students

Introduction In the university stage, the student is exposed to many psychological changes, pressures, and conflicts, which makes him resort to many non-consensual psychological defense mechanisms such as (repression, justification, projection, relapse, denial, delusional illness, reverse transference, daydreaming), which causes an imbalance in the personality and its psychological functions. This may lead to cognitive and mental distortions and physiological imbalances, and the appearance of symptoms that cause psychosomatic disorders that are not due to organic physiological imbalances or bacterial diseases, but rather as a result of imbalances in the psychological functions of the ego ,Which increases the symptoms of headache, vomiting, poor digestion, irritable bowel syndrome, shortness of breath, rapid heartbeat, hormonal imbalance, facial redness, and others.Objectives1.Identifying the degree of use of non-consensual psychological defense mechanisms among university students, and the differences in this according to the variable (gender and degree of academic achievement) 1. Revealing the correlation between the degree of use of non-consensual psychological defense mechanisms and the emergence of disturbed psychosomatic symptoms in the functions of (the respiratory system, the digestive system, the cardiac system, the muscular system, sleep disorders, and bodily disorders).MethodsThe correlational analysis approach was used to study the relationship between the variables of the study. The sample consisted of 300 male and female university students. A scale for psychological defense mechanisms was constructed, and a scale for psychosomatic disorders prepared by Diop (2011) was adopted, and its psychometric properties were verified.Results The responses in the degrees of non-consensual psychological defense mechanisms were varied, with a high degree in (justification, projection, repression, and delusional illness) and a moderate degree in (relapse, daydreaming, denial, and reverse transference). Differences appeared between males and females in favor of males, while differences in academic grades were in favor of the lowest grade. The results also showed a statistically significant correlation between psychological defense mechanisms and the appearance of psychosomatic symptoms, as it was high in disorders (respiratory system, cardiac system, muscular system, sleep disorders), and moderate in (emotional disorders and somatic disorders).ConclusionsThere is a positive correlation between the degrees of use of non-consensual psychological defense mechanisms and the emergence of psychosomatic disorders, in the functions of several bodily systems and behavioral and emotional disorders.Disclosure of InterestNone Declared

Best of 2023 in psychosomatic medicine: the contribution to the rest of psychiatry

AbstractThe field of psychosomatics has experienced many waves of “celebrity” since its origin. Its historical origin is impossible to precisely locate in time, one may argue that medicine since its very beginning has been psychosomatic in nature. In very recent times, many clinicians and researchers even from different backgrounds than psychosomatic medicine or psychiatry have expressed disappointment and worry about the excessive fragmentation of medical sciences, providing evidence in support and advocating towards the so-called holistic approach and integrated care. The old lesson of psychosomatic medicine, then, appears more contemporary than ever. This is also because it has been able to stay coherent but at the same time integrate the enormous progresses in the understanding of physiology and pathophysiology that medical sciences have witnessed in the last decades.The presentation will focus on the most striking scientific production of 2023 in the field of psychosomatics, to show the contributions in its three souls of research, training and clinical activities and to outline the stimulating though sometimes difficult dialogue between this area of behavioural sciences and the rest of psychiatry.Disclosure of InterestNone Declared

Follow-up outpatient clinics for patients with post COVID: a survey to assess and characterize aspects of care

After acute infection with the SARS-CoV-2 virus, up to 10 % of affected individuals suffer from long-term health impairments, also referred to as "Post-COVID". In Germany, specialized outpatient clinics have been established to care for patients with Post-COVID. A structured survey of the care situation is not yet available, but essential for a demand-oriented care. The present study aimed to systematically assess and describe structural and process-related aspects of care, and to perform an inventory and needs analysis of Post-COVID outpatient clinics in Germany.An online survey was developed assessing the structure and organization of the outpatient clinics, service offerings and networking of care from the perspective of the outpatient clinic directors. A total of 95 outpatient clinics were identified, and an invitation to participate in the online survey was sent via e-mail to the directors of the outpatient clinics. Data were collected between February and May 2022. Descriptive data analysis was performed.A total of 28 outpatient clinic managers (29 %) took part in the survey. Participants were between 32 and 66 years old, and 61 % (n = 17) were male. The outpatient clinics were most frequently affiliated with the specialties of pneumology (n = 10; 36 %), internal medicine, psychiatric and psychosomatic medicine, and neurology (n = 8; 29 %, respectively). Among the outpatient clinic directors, 64 % (n = 18) stated that the time spent waiting for an appointment was more than one month. Utilization (n = 25; 89 %), appointment demand (n = 26; 93 %), and the need for more Post-COVID outpatient clinics (n = 20; 71 %) were rated as high by the outpatient clinic directors. Nearly all directors reported networking with in-clinic facilities (n = 27; 96 %), with primary care physicians and with specialists in private practice (n = 21; 75 %, respectively).The main focus of care is pneumology. Internal medicine, psychiatry/psychosomatics and neurology are also equally represented. Our data further suggest a high demand for Post-COVID outpatient clinics and the need to expand this care offer.

Emotional meanings attributed to sexual experiences reported by Brazilian Men with Head and Neck Cancer seen at a Public University Oncologic Outpatient Service: A Qualitative Study

Introduction“What can and what cannot I do in a sexual relationship?” |In this way, a middle-aged man with HNC - Head and Neck Cancer, under chemotherapy or radiotherapy, asks. This doubt is raised to the oncologist, radiotherapist, nurse or psychotherapist. Apparently, his concern is objective, considering he has a severe diagnosis and important treatments. However, underlying the manifest doubt, there are symbolic constructions in his mind that generate anguish. The health professionals’ response must go beyond information. They also must understand the symbolic emotional meanings associated with the patient’s speech. This attitude will bring a psychotherapeutic effect to the ill man.ObjectivesTo interpret symbolically sexual and emotional experiences reported by male patients diagnosed with HNC under outpatient treatment in a public specialized clinical unit.MethodsWe used the CQM - Clinical-Qualitative Method (Turato. Portuguese Psychos. J, 2000 2(1): 93-108). For data collection, the main researcher used the Semi-Directed Interview with Open-ended Questions In-Depth and Field Notes. The employ of the Seven Steps of the CQCA - Clinical-Qualitative Content Analysis (Faria-Schützer et al. Cien Saude Colet. 2021; 26(1): 265-274) brings us to discussion categories. The sample was closed with 12 patients according to the information saturation strategy (Fontanella et al. Cad Saude Publica. 2008; 24(1): 17-27). The interviews were conducted by the first author of this abstract, a male nurse, as part of his master’s research at a postgraduate course in Oncology. The findings were validated by peer reviewers from the Lab of Clinical-Qualitative Research at the State University of Campinas.ResultsTwo categories were chosen for this presentation: ‘The dyad perceived in the felt body and the experienced body’, and ‘The body re-signified between the sexual and affective dimensions’. The body symbolized before and after the illness experiences a movement in phenomenological consciousness that leads to external changes in its attitudes. The patient needs now to ask himself and others what this body can - or cannot - do. The severely ill body imposes new meanings for life and sexuality. It does not cancel the wish but asks for a new channelling of your psychic/sexual energies.ConclusionsThese findings indicate that patients with HNC want to talk about sexuality and ask about the risks of sexual activity, contrary to what the common view supposes. Traditional Balint groups met with the multidisciplinary team can be beneficial for doctors and nurses to deal with their own emotional limitations. Furthermore, the Consultation-Liaison Psychiatry, under the approach of psychosomatic medicine, focuses on the care of patients with behavioural and emotional manifestations, together with the work of the oncologists.Disclosure of InterestNone Declared

Article Summaries for April 2024 Psychosomatic Medicine, Volume 86, Issue 3.

Article Summaries for April 2024 Psychosomatic Medicine, Volume 86, Issue 3.

Manas (Mind) Structure: Exposing the Mysterious Functional Anatomy in the Indian System of Medical Philosophy

The mind is not structured anatomically, as emphasized by modern pathology. Instead, it is expanded as a whole in a subtle form behind the physical body. In the Indian system of medical philosophy, the mind is considered as the astral nerves made third body, which identified as the ‘Manomaya-sharira’ (subconscious mind). The mind is composed of millions of astralnadis, through which Pranic-energies circulate freely into the astral anatomy of mind. Seven-chakras are found parallel to the spine, serving as the major seven innovation centres in the body. These Chakras facilitate the connection of the mind with the seven dimensions of the inner world. From these dimensions the Pranic-energies including Sattva, Raja, Tama are exported to the mind and its Nadi-tantras, influencing both the outer and inner subconscious minds. Subsequently, these elements, viz., Sattva, Raja and Tama are thrown from the mind to the outer world through the seven sense organs, manifesting as either constructive or destructive activities. Thus the mind exists due to ‘Prana’, (energy of Omkara) which increases through deeper meditation, sound sleep, and breathing exercises (O2). The positional behaviour of the mind shifts according to the physical and mental temperament, namely Triguna and Tridosha, or Panchavikara. The negative energy (Tama-guna) of the fourth dimension enters the astral Nadis-system of the mind via the interspace of the solar plexus, which crushes the mind’s structures, and consequently, all the Chakras are corrupted and the Nadis are blocked, so it generates a break in the circulation of ‘Prana’ into the Nadis. As a result, many socio-economic challenges and psychosomatic disorders occur.

Особливості розширеного гінекологічного обстеження в жінок із рецидивним вульвовагінальним кандидозом

The aim of the study - to determine the features of extended gynecological examination in patients with recurrent vulvovaginal candidiasis (RVVC): data from gynecological history, examination, colposcopy, cytological and histological examination to increase the effectiveness of prevention of recurrences in these patients. Materials and methods. A prospective study and clinical-statistical analysis of gynecological history, examination, colposcopy, cytological and histological examination in patients with RVVC was carried out. The main group (MG) consisted of 70 women of reproductive age with RVVC and 40 healthy women of reproductive age, who made up the control group (CG). Results. The most frequent complaint was itching in the vagina - in 32 (45.7%) and itching in the area of the external genitalia, which bothered 29 (41.4%) patients; complaints of dysuric disorders in 19 (27.1%) patients became the reason for an earlier visit, usually to a urologist; dyspareunia occurred in 24 (34.3%) patients. Cervical ectopy with signs of exocervicitis and endocervicitis was found in 20 (28.6%) patients with RVVC; an atypical transformation zone was noted in 15 (21.4%) and was represented by an acetowhite epithelium with clear contours in the transformation zone in 37 (52.8%) p<0.05. At the same time, acetobilious epithelium with punctation was found in 19 (27.1%) patients, acetobilious epithelium with mosaic in 12 (17.1%), simultaneously with punctuation and mosaic in 6 (8.6%) patients. In CG, ectopy without signs of exo- and endocervicitis was observed in 7 (17.5%) patients. A rather high percentage of CIN attracts attention - in 37 (52.8%) of 70 women of MG: of them, CIN I - in 26 (37.1%) women, CIN II - in 9 (12.8%) patients, CIN III - in 2 (2.9%) patients. Conclusions. Subjectively, RVVC was characterized by mild clinical symptoms, at the same time marked inflammatory changes in the lower parts of the genital tract with involvement in the pathological process of the cervix. Every third patient had dysuric disorders against the background of chronic inflammatory diseases of the pelvic organs, which are present in the anamnesis. In most patients, the long recurrent course of the disease was accompanied by psychosomatic disorders, emotional lability. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.

Allostatic overload in the medically ill patients: Results from an observational study

The present study aimed at evaluating the prevalence of allostatic overload (AO) among subjects with different medical diseases and explore whether medically ill patients with or without AO differ for specific clinical features (i.e., co-occurring mental or psychosomatic disorders). An observational cross-sectional study was carried out. Outpatients with a diagnosis of blood cancer, systemic sclerosis, or migraine received a clinical assessment which included the Mini International Neuropsychiatric Interview or the Structured Clinical Interview for DSM-5 and the Diagnostic Criteria for Psychosomatic Research-Revised Semi-Structured Interview (DCPR-R SSI). Four hundred and thirty-nine outpatients were enrolled. Among them, 39 (8.9%) had a diagnosis of blood cancer, 200 (45.5%) had a diagnosis of systemic sclerosis, and 200 (45.5%) had a diagnosis of migraine. A total of 104 (23.7%) patients had a DCPR-R diagnosis of AO. Patients with a diagnosis of blood cancer, migraine, or systemic sclerosis did not differ for DCPR-R AO prevalence (P = 0.082). Based on multiple regression analysis, medically ill patients with DCPR-R AO were more likely to satisfy the diagnosis of DCPR-R illness denial (odds ratio [OR] = 2.99, 95% confidence interval [CI] = 1.04 – 8.58), conversion symptoms (OR = 5.32, 95% CI = 1.16 – 24.38), or demoralization (OR = 2.57, 95% CI = 1.08 – 6.11) and a DSM-5 diagnosis of major depressive episode/disorder (OR = 1.90, 95% CI = 1.03 – 3.50), if compared to those without DCPR-R AO. DCPR-R AO is a clinically useful transdiagnostic feature potentially associated with other psychosomatic syndromes and mental disorders that may contribute to the disease burden and the poor global health conditions of medically ill patients.

Music therapy in eating disorder treatment and its synergy with systemic and family-based therapy approaches: A systematic review

Eating disorders are serious psychosomatic disorders and constitute the most common chronic disorder of female adolescence. Men experience a later onset but appear to constitute around 25% of adult cases. Due to their comorbidities and high mortality rate, these conditions pose a significant health risk. Although systemic and family therapy are considered among the most successful treatment modalities in adolescence, there is a need for expanded treatment options. With this background, the question arises as to what extent music therapy is already integrated into treatments. This review aims to include studies on music, music therapy, and eating disorders in general and covering all age groups. In all, 26 studies met the criteria for review, with a total of 1026 participants. None of the studies used music therapy combined with systemic or family-based therapy. However, despite differences between study designs, the individual studies show commonalities in their interventions and a relationship to the systemic and family-based approach. This review suggests that music therapy may be a valuable complement to the treatment modalities of systemic and family-based therapies as well as to constellations and sculpture approaches in eating disorders treatment. Further research is recommended to evaluate the effectiveness of such combined approaches.

ELECTROMYOGRAPHY AS A METHOD FOR ASSESSING THE EFFECTIVENESS OF ORTHOPEDIC TREATMENT OF PATHOLOGICAL ABRASION OF HARD TISSUES OF TEETH

The combination of pathological wear of the teeth with defects of the dental rows causes significant changes in the maxillofacial complex, which leads to substantial morphofunctional disorders and creates difficulties in the orthopedic rehabilitation of such patients.
 The combination of pathological tooth wear and defects of the dental rows causes significant changes in the maxillofacial complex, which leads to substantial morphofunctional disorders and creates difficulties in the orthopedic rehabilitation of such patients.
 Thirty four persons aged from 35 to 60 years with a generalized form of pathological wear of grades I-II, in combination with defects of dentition of classes I, II and III according to Kennedy, were treated. The examination has included the data of the anamnesis, general clinical examination, measuring interalveolar height, study of diagnostic models, X-ray examination, and EMG of the masticatory muscles.
 The results. The EMG data of the research groups before treatment showed a different degree of the rhythm of chewing movements, a clear alternation of the phases of activity and rest, uneven inclusion of motor units in the contraction process compared to healthy patients, the habitual side of chewing was determined, as a result of which an extension of chewing time, a decrease in its rhythm and chewing efficiency.
 Thirty days after the appropriate treatment, the electromyographic study showed morphological and functional changes in the maxillofacial apparatus of the patients of the experimental groups, which were reflected in the quantitative indicators of the EMG of the masticatory muscles. In the I group, the EMG parameters significantly approached those in the control group, and in the II group, a tendency to approach the norm was determined.
 Appropriate orthopedic treatment of pathological attrition, complicated by existing dentition defects, various structures contributed to the emergence of new myotatic reflexes, the creation of a new chewing stereotype.
 A positive change in EMG indicators, especially the "K" coefficient, and their approach to the indicators of the control group indicates the appropriate choice of the prosthetic method, which will contribute to the process of adaptation to the orthopedic structure and improve the psycho-somatic condition of patients in general.
 Conclusions. Analyzing the variance in biopotentials of the masticatory muscles enables the evaluation of both the extent and the characteristics of existing disorders in patients with pathological attrition.
 The positive dynamics of electromyography indicators in the treatment of patients with a generalized form of pathological wear, complicated by defects of the dental rows, indicates the quality of the treatment, the feasibility of choosing an orthopedic structure, and the smoothness of the process of adaptation to it.
 The future research involves continued monitoring of long-term treatment outcomes, including the potential for determining the duration required for complete adaptation to the orthopedic prosthesis.

Daoyin therapy in chronic neck pain: study protocol for a randomized controlled trial

BackgroundDaoyin therapy (DT), an ancient therapeutic approach with a history spanning thousands of years, has traditionally been employed to address musculoskeletal pain and psychosomatic disorders. However, the application of DT for chronic neck pain (CNP) has received limited attention in the existing literature, and systematic randomized clinical trials (RCTs) in this context remain scarce. This manuscript outlines an RCT protocol designed to investigate whether DT is more effective at alleviating CNP in adult individuals compared to other interventions.MethodsA 12-week RCT was conducted, with participants undergoing randomization into one of three groups: DT, Meditation + Fitness Exercise (M+FE), or a control group. Participants in the DT and M + FE groups attended their respective training classes three times per week for 12 weeks. Participants in the control group were required to attend health education workshops every 2 weeks. Following the 12-week intervention period, all participants underwent follow-up assessments at the 16th week. Outcome measures encompassed the Simplified Chinese Neck Pain and Disability Scale (SC-NPAD) and Visual Analog Scale (VAS) for pain assessment, Static Neck Posture Assessment (SNPA) to evaluate neck and shoulder posture and function, Short Form-36 (SF-36) to assess quality of life, and blood tests measuring 5-Hydroxytryptamine (5-HT), Norepinephrine/Noradrenaline (NE/NA), γ-aminobutyric acid (GABA), Adreno-Cortico-Tropic-Hormone (ACTH), β-Endorphin (β-EP), and Calcitonin-Gene-Related Peptide (CGRP) levels via high-performance liquid chromatography (HPLC), chemiluminescence immunoassay (CLIA), enzyme-linked immunosorbent assay (ELISA), and radioimmunoassay (RIA). Brain activity changes were monitored through MRI scans. Repeated measures analyses of variance (ANOVAs) will be used to evaluate the outcomes at baseline, at the 12th week, and at the 16th week. Generalized Estimating Equation (GEE) models will be applied to analyze changes in outcomes over time and differences between groups.DiscussionThis trial aims to evaluate the efficacy of DT in comparison to other interventions and explore the neuroendocrine mechanisms underlying its effects in adults with CNP. If the intervention and procedures demonstrate feasibility and acceptability, there are plans to conduct a more extensive controlled trial. This could potentially pave the way for the broader application of DT, not only in the context of CNP but also for other chronic diseases.Trial registrationThis trial has been registered with the Chinese Clinical Trial Registry (Registration ID: [ChiCTR2400079571]).

Problematic smartphone use among russian and foreign medical students: prevalence, content consumed, associations with other forms online behavior

Aim of the study was to investigate the prevalence of problematic smartphone use, the characteristics of the content consumed and associations with other forms of online behavior among Russian and foreign medical students. Material and methods. 296 medical students were examined using the online survey method: 219 Russians (main group) and 77 foreigners (comparison group); 107 (36.2 %) boys and 189 (63.8 %) girls; age 20 [18; 21] years (median [lower quartile; upper quartile]). The structure of online behavior was assessed: adaptive, non-adaptive, and pathological (PIU) Internet use; specific forms of PIU: problematic use of computer games and social networks, mixed and undifferentiated form of PIU. The values of the total score of the scales of the applied psychometric questionnaires were determined. The indicators were compared in the general group of subjects, in groups of Russians and foreigners, including gender. Results. Problematic smartphone use is typical for 14.2 % of all surveyed. The share of smartphone addicts is higher among foreigners than among Russians (27.3 and 8.0 %, respectively), both boys and girls. PIU prevailed among foreigners (16.1 and 7.4 %), they are more often dependent on social networks (34.5 and 2.4 %). Foreign women were distinguished by a high incidence of problematic use of computer games (20.0 and 3.6 %) and social networks (25.0 and 3.1 %), as well as a mixed form of PIU (20.0 and 2.5 %). The content consumed by Russians (boys + girls) was dominated by being on social networks (77.6 Russians and 46.7 % foreigners) and listening to music (50.7 and 31.2 %, respectively). Gender differences in content included more frequent use of social networks by Russian students, both boys (81.1 and 48.1 %) and girls (76.5 and 43.5 %); more frequent listening to music by Russian males in comparison with foreign males (66.0 and 29.6 %) and Russian females (66.0 and 45.8 %). Foreign boys use smartphones for games more often than foreign girls, the preoccupation with smartphone games is higher among Russian women as well. Conclusions. The prevalence of problematic smartphone use, the characteristics of the content consumed and associations with other forms of PIU among Russian and foreign students were established. In our opinion, it is necessary to carry out further research aimed at solving an urgent medical and social problem of timely diagnosis of smartphonedependent behavior and prevention of somatic and neuropsychic health disorders associated with it in young people. The current range of indicators to be studied in people with problematic smartphone use should include an analysis of comorbid psychosomatic disorders (recurrent pain: headaches, abdominal pain, back pain) and features of psychosocial characteristics, taking into account age, sex and ethnic differences of electronic gadget users.

A Study to Assess the Role of Psychological Stress in the Severity of Oral Lichen Planus, OSMF, and Leukoplakia and its Correlation with Serum Cortisol Levels.

The most prevalent oral mucosal conditions in humans are leukoplakia, oral lichen planus (OLP), and oral submucous fibrosis (OSMF). These conditions should be studied as psychosomatic conditions, but little research has been done on how these conditions relate to stress. A total of 280 patients of both genders with ages 35-60 years were divided into four groups: leukoplakia, OSMF, OLP, and control. Whole blood samples were collected from all the participants and analyzed for serum cortisol by using ELISA with a commercial kit. Detailed case history and DASS-21 questionnaire were recorded for psychological assessment. To assess the variables, the student t test and Chi-square test were used. P values of <0.05 were regarded as significant. In this study, it was found that higher levels of serum cortisol were found in OLP patients, with advanced erosive lesions showing the highest levels of serum cortisol, followed by OSMF and leukoplakia. Patients with Oral Lichen Planus showed higher levels of stress, anxiety and depression than patients of OSMF and leukoplakia. This study emphasized stress and anxiety as a predisposing factor in the occurrence and progression of OSMF apart from re-establishing the role of stress and anxiety in OLP with consideration to depression in triggering role for OLP. Furthermore, it demonstrated that serum cortisol levels play a significant role as an indicator of psychological stress.

Hypnotic Modulation of Autonomic Nervous System (ANS) Activity.

Hypnosis, a time-honored therapeutic approach, has gained widespread recognition for its effectiveness in addressing a range of psychological and somatic disorders. While its primary effects are mediated by central top-down mechanisms, hypnosis also exerts peripheral influence by modulating the autonomic nervous system (ANS). Psychophysiological measures, such as heart rate (HR) and its variability (HRV), electrodermal activity (EDA), respiratory rate (RR), and the analgesia nociceptive index (ANI), serve as reliable indicators of ANS activity. Studies have consistently demonstrated hypnosis' ability to significantly impact ANS functions, lowering sympathetic activity and enhancing parasympathetic tone. This effect is particularly pronounced during relaxation procedures and is influenced by mediating factors like hypnotizability and task conditions. Despite methodological limitations, this review highlights the potential of enhanced ANS modulation through hypnosis, including its connections to the central nervous system (CNS), to optimize therapeutic outcomes in patients with psychosomatic disorders associated with ANS dysfunction.

Methods of correction and treatment of psychosomatic disorders

The purpose of this review is to generalize and systematize the scientific works of domestic and foreign researchers, which are aimed at identifying the causes of psychosomatic disorders, as well as their diagnosis and psychotherapy. As a result of theoretical analysis, several scientifically proven effective methods of psychosomatic disorders (psychosomatoses) have been identified: rational psychotherapy, cognitive behavioral therapy. The following methods were used in the work: comparative analysis of literary sources of the causes of psychosomatic disorders, as well as their diagnosis and psychotherapy. The main materials for the study are articles on psychosomatic disorders (psychosomatoses) by foreign and domestic scientists. Currently, the number of people with various psychosomatic disorders is increasing, therefore, methods of correction and treatment of psychosomatic disorders are increasingly in demand. Effective non-drug methods of psychotherapy, psychohygiens and psychoprophylaxis: autogenic training, biofeedback method. Thus, it is necessary to carry out psychoprophylactic measures of psychosomatic disorders at the premorbid stage, both in adults and children, in adolescence, significantly improves their psychological and somatic well-being in terms of health, which is more beneficial for the economy than the treatment of various psychosomatic disorders and neurotic conditions that reduce the quality of life of the population and accordingly, they reduce the country's economy.

Predicting psycho-somatic disorders in online activity using multi-layer perceptron

&lt;p&gt;Internet services such as social media, blogs, and websites make it possible for people to acquire knowledge instantly. Due to these websites, it is now considerably easier to communicate information. As a result, individuals increasingly devote a higher amount of time to social networking programmes. This study provides estimates about the potential future ramifications of how individuals will utilise social networks. This work presents an accurate and applicable model for forecasting undesirable consequences. The model is of sufficient quality to be useful. This has been the case throughout. Using the model that has been proposed, significant properties are identified from datasets. After recovering the properties, they are categorised using the complicated computational method of multi-layer perceptron-based (MLP) artificial neural networks (ANN). 70% of this data was utilised during the training phase of the machine learning algorithm, while the remaining 30% was utilised during the validation phase of model construction. The proposed model's results were compared to those of more standard machine learning techniques. The approach utilises social networks to predict the issue. The simulation results indicate that the suggested model generates more precise predictions than the support vector machine, logistic regression, and random forest decision tree classifier techniques combined.&lt;/p&gt;

A cross-sectional study of the relationship between premenstrual syndrome and missed nursing care among female nursing staff

PurposePremenstrual syndrome (PMS) is a cyclical psychosomatic disorder prevalent among women of reproductive age. However, research on the potential impact of PMS on routine nursing schedules and activities is limited. This study aims to identify the prevalence of PMS among female nursing staff and to examine the relationship between PMS and missed nursing care (MNC). MethodBetween November 1, 2022, and April 30, 2023, this study was conducted among female nursing staff working in nine inpatient departments at Sun Yat-sen University Cancer Center. This study used a cross-sectional design. The participants were recruited through convenience sampling. Data were collected using the standardized Menstrual Distress Questionnaire, the Oncology Missed Nursing Care self-rating scale, and a sociodemographic questionnaire. One-way analysis of variance, Fisher's least significant difference test for post-hoc comparisons, and Spearman's correlation coefficient were utilized for data analysis. A trend test was also performed to explore patterns in the severity of PMS and MNC over time. ResultsWe collected a total of 224 questionnaires, with 154 (68.7%) female nursing staff reporting PMS. The most common symptoms were low back pain (91.1%), abdominal discomfort (90.6%), cold hands and feet (87.1%), and lethargy (87.1%). Moreover, 91.5% of the 224 female nursing staff reported at least one MNC activity. The nursing activities most frequently missed or left incomplete were liquid intake and output monitoring as ordered (43.3%), medication administration within 30 min before or after the scheduled time (43.3%), and electrocardiogram monitoring as ordered (42.9%). “Abdominal discomfort” from the Menstrual Distress Questionnaire was significantly correlated with the majority of MNC activities (p < 0.001). ConclusionsThis study provides evidence for a strong association between PMS and MNC among female nursing staff, suggesting that administrators should take the premenstrual conditions of female nursing staff into consideration. It is necessary to provide appropriate understanding and support to mitigate the impact on patient care and safety.

Physician resilience and perceived quality of care among medical doctors with training in psychosomatic medicine during the COVID-19 pandemic: a quantitative and qualitative analysis

BackgroundAt an individual level, physician resilience protects against burnout and against its known negative effects on individual physicians, patient safety, and quality of care. However, it remains uncertain whether physician resilience also correlates with maintaining a high level of healthcare quality during crises such as a pandemic. This study aimed to investigate whether higher resilience among physicians, who had received training in resilience-related competences in the past, would be associated with higher quality of care delivered during the COVID-19 pandemic.MethodsThis study enrolled physicians working in family medicine, psychiatry, internal medicine, and other medical specialties, who had obtained at least one of three consecutive diplomas in psychosomatic medicine in the past. Participants completed a quantitative and qualitative anonymous online survey. Resilience was measured using the Connor-Davidson Resilience Scale, and healthcare quality was assessed through single-item quality indicators, including perceived quality of care, professional autonomy, adequate time for patient care, and job satisfaction.ResultsThe study included 229 physicians (70 males/159 females) with additional training in psychosomatic medicine, working in family medicine (42.5%), psychiatry (28.1%), internal medicine (7.0%), or other medical specialties (22.4%). Participants represented four intensity levels of training background (level 1 to level 4: 9.2%, 32.3%, 46.3%, and 12.2% of participants). Training background in psychosomatic medicine was positively associated with resilience (B = 0.08, SE = 0.04, p <.05). Resilience and training background independently predicted perceived quality of care, even after controlling for variables such as own health concerns, involvement in the treatment of COVID-19 patients, financial strain, percentage of working hours spent on patient care, age, and gender (resilience: B = 0.33, SE = 0.12, p <.01; training background: B = 0.17, SE = 0.07, p <.05). Both resilience and training background predicted job satisfaction (resilience: B = 0.42, SE = 0.12, p <.001; training background: B = 0.18, SE = 0.07, p <.05), while resilience alone predicted professional autonomy (B = 0.27, SE = 0.12, p <.05). In response to an open question about their resources, resilient physicians more frequently reported applying conscious resilient skills/emotion regulation (p <.05) and personal coping strategies (p <.01) compared to less resilient medical doctors.ConclusionPhysician resilience appears to play a significant role in the perceived quality of patient care, professional autonomy, and job satisfaction during healthcare crises.

Patient Experiences and Challenges in the Management of Autoinflammatory Diseases-Data from the International FMF & AID Global Association Survey.

Autoinflammatory diseases (AIDs) are rare, mostly genetic diseases that affect the innate immune system and are associated with inflammatory symptoms. Both paediatric and adult patients face daily challenges related to their disease, diagnosis and subsequent treatment. For this reason, a survey was developed in collaboration between the FMF & AID Global Association and the Erlangen Center for Periodic Systemic Autoinflammatory Diseases. The aim of the survey was to collect the personal assessment of affected patients with regard to their current status in terms of diagnostic timeframes, the interpretation of genetic tests, the number of misdiagnoses, and pain and fatigue despite treatment. In total, data from 1043 AID patients (829 adults and 214 children/adolescents) from 52 countries were collected and analyzed. Familial Mediterranean fever (FMF) (521/50%) and Behçet's disease (311/30%) were the most frequently reported diseases. The average time to diagnosis was 3 years for children/adolescents and 14 years for adults. Prior to the diagnosis of autoinflammatory disease, patients received several misdiagnoses, including psychosomatic disorders. The vast majority of patients reported that genetic testing was available (92%), but only 69% were tested. A total of 217 patients reported that no increase in acute-phase reactants was detected during their disease episodes. The intensity of pain and fatigue was measured in AID patients and found to be high. A total of 88% of respondents received treatment again, while 8% reported no treatment. AID patients, particularly adults, suffer from significant delays in diagnosis, misdiagnosis, and a variety of symptoms, including pain and fatigue. Based on the results presented, raising awareness of these diseases in the wider medical community is crucial to improving patient care and quality of life.