Somatic Factors Research Articles

Influence of factors of systemic inflammation and endothelial dysfunction in somatic pathologies on the success of dental implantation (literature review)

In the presented literature review, the issue of the influence of general somatic factors associated with diseases of the cardiovascular and endocrine systems on the success of dental implantation was studied. The issues of the relationship of systemic inflammatory processes and periodontal status with the dental health of patients with background pathologies associated with an imbalance of pro- and anti-inflammatory cytokines, insulin and glucose in the blood in diabetes mellitus and obesity, factors of endothelial dysfunction in atherosclerosis, hypertension and coronary heart disease are highlighted. Based on the analyzed information, it was confirmed that poor-quality history taking, the lack of a thorough diagnostic examination (biochemical blood test, coagulogram, reaction to the presence of specific infections and viral diseases), ignoring the need to correct existing local and systemic inflammatory phenomena before dental implantation can lead to a violation the process of osseointegration, the occurrence of peri-implantitis, implant rejection reactions. In this regard, it can be concluded that when planning complex dental treatment, attention should be paid not only to local dental symptoms, but also to the general history and laboratory data, which will improve the quality of dental implantation.

Modifiable dementia risk and protective factors in persons with subjective cognitive decline or mild cognitive impairment: a systematic literature review and Delphi study

AbstractBackgroundMany studies showed that addressing modifiable risk factors has an impact on dementia prevalence and incidence. Most studies have focussed on universal prevention, irrespective of individual risk stage, with risk factors for dementia mainly identified in the general population. Less is known about the most important target risk factors in persons with subjective cognitive decline (SCD) or mild cognitive impairment (MCI), and hence, whether they have a similar potential for risk reduction as the general population. Therefore, this study aims to identify modifiable risk and protective factors for cognitive deterioration and dementia in persons with SCD or MCI.MethodWe use a mixed‐methods approach combining findings from a systematic literature review and an online Delphi study. Four electronic databases (PubMed, EMBASE, PsycINFO, Web of Science) were searched to review relevant literature. A broad search term was developed in consultation with an experienced librarian and consisted of terms linked to SCD, MCI, dementia, modifiable risk factors and disease progression. Observational studies with at least 50 participants and 1 year of follow‐up were considered for inclusion. Twenty international dementia prevention experts were invited to participate in the online Delphi study. In two rounds, experts were asked to spontaneously name, rank and weigh modifiable risk and protective factors in order of importance for the target population.ResultOur search yielded 19,128 abstracts in total. After removal of duplicates, 9,862 abstracts were considered for inclusion and 203 full‐texts were read, of which 69 were included in our review. Several risk and protective factors were encountered including somatic, lifestyle and neuropsychiatric factors, and they are further scrutinized. Eighteen experts named 31 risk and protective factors in the first Delphi study round, of which physical activity, social isolation and hypertension were ranked highest. Results of round two are being collected.ConclusionFindings from the current study will result in an inventory of relevant modifiable risk and protective factors linked with clinical progression in persons with SCD or MCI. Results will serve as the basis for the development and testing of an online dementia risk reduction tool for use in clinical populations with SCD and MCI.

“Hermes” - Hemophilia Related Mental Illness: A Cross-Sectional, Multicenter Study in Switzerland

Background: The availability of clotting factor concentrates and prophylactic home treatment for patients with hemophilia (PWH) A and B in developed countries greatly improved clinical outcomes. As the life expectancy of affected patients has increased, the management of comorbidities has become a greater focus within the comprehensive care setting. However, most studies focus on somatic complications. The past two decades revealed a growing body of work reporting increased prevalence of mental health problems in PWH. Given the severity and chronicity of the disease, internalizing disorders (i.e. anxiety, depression) as well as externalizing disorders (i.e. substance dependency, irritability and aggression) seem to go hand in hand with hemophilia. We aimed to assess the prevalence of comorbid mental health problems among PWH in Switzerland. We investigated age effects on this relationship as well as potentially influencing factors (illness factors and environmental factors) that may account for these. We also aimed to assess health-related quality of life (HRQoL) and age dependency in this setting. We are heading to identify targets of prevention/early intervention of mental health problems and foster improvement of evidence-based interdisciplinary treatment in PWH. Methods:This multicenter, cross-sectional study was conducted within six hemophilia treatment centers in Switzerland. Study participants were aged 6-99 years with congenital hemophilia of any severity. All participants or their legal guardians provided written informed consent, and the study was approved by the cantonal medical ethics committee of the responsible states. Participants aged 12 or older underwent a detailed personal psychological assessment followed by completing an online survey utilizing validated psychological measures (HRQoL, psychosocial functioning, somatic comorbidities/parental factors). Participants younger than 12 years underwent a detailed personal psychological assessment with one parent/legal guardian followed by an online survey to be completed by their parent/guardian. In all participants younger than 18 years, we assessed one parent/legal guardian additionally. Results:A total of n=164 PWH participated in the study (133 adult and 31 pediatric participants). Data analyses showed a median age of 39.26 years (SD 20.41). The majority of participants had hemophilia A (n=134, 82%), while hemophilia B was diagnosed in n=30 (18%) of participants. A severe hemophilia was reported in n=85 (52%), a moderate in n=31 (19%) and a mild hemophilia in n=48 (29%). Prophylactic treatment regimen was used in n=97 (59%). Out of n=156 participants with completed neuropsychiatric diagnostic interview, n=38 (24%) participants showed a psychiatric disorder over lifetime. This was significantly associated with disease severity, being more prevalent in moderate and severe hemophilia. We could not detect an association with age, so age does not moderate this association. In n=153 participants with available data on HRQoL, we found a lower HRQoL also to be associated with disease severity (moderate and severe). Moderation analyses could not confirm an association with age. Conclusion:Our data show an association of (lifetime) psychiatric diagnoses and a lower health-related quality of life in hemophilia depending on disease severity. This association is evident in moderate and severe hemophilia and is independent of age despite recent progress in development and use of new therapies going along with suggested lower hemophilia disease burden. Further analyses including somatic and treatment factors as well as parenting are ongoing and will be presented.

Senescence evolution under the catastrophic accumulation of deleterious mutations.

For aging to evolve, selection against mortality must decrease with age. This prevailing view in the evolutionary theory of senescence posits that mutations with deleterious effects happening late in life-when purging selection is weak-may become fixed via genetic drift in the germline, and produce a senescent phenotype. Theory, however, has focused primarily on growing populations and the fate of single deleterious mutations. In a mathematical model, we demonstrate that relaxing both of these simplifying assumptions leads to unrealistic outcomes. In density-regulated populations, previously fixed deleterious mutations should promote the fixation of other deleterious mutations that lead to senescence at ever younger ages, until death necessarily occurs at sexual maturity. This sequential fixation of deleterious mutations is not promoted by a decrease in population size, but is due to a change in the strength of selection. In an individual-based model, we also show that such evolutionary dynamics should lead to the extinction of most populations. Our models therefore make rather unrealistic predictions, underlining the need for a reappraisal of current theories. In this respect, we have further assumed in our models that the deleterious effects of mutations can only occur at certain ages, marked, for instance, by somatic or physiological changes. Under this condition, we show that the catastrophic accumulation of deleterious mutations in the germline can stop. This new finding emphasizes the importance of investigating somatic factors, as well as other mechanisms underlying the deleterious effects of mutations, to understand senescence evolution. More generally, our model therefore establishes that patterns of senescence in nature depend not only on the decrease in selection strength with age but also on any mechanism that stops the catastrophic accumulation of mutations.

Real-life diagnostic and therapeutic approach to CLL: a 2022 update from an expert panel in Tuscany.

A panel of chronic lymphocytic leukemia (CLL) experts from Tuscany propose a real-life diagnostic and therapeutic approach CLL that considers the role of genomic and somatic prognostic factors in risk stratification and treatment decisions. Safety and efficacy of new agents has been demonstrated now not only in clinical trials but also in many real-world series. The BTK inhibitors, ibrutinib and acalabrutinib, and BH3 mimetic venetoclax are now indicated as first-line therapy and chemoimmunotherapy can be spared to the majority of CLL patients, thus preventing unnecessary hematological and non-hematological toxicity and second primary tumors. For treatment, FISH for 17 p and P53 mutational status are essential. IGHV mutation can be done at diagnosis or before treatment. Echography is the gold standard radiological investigation in CLL, at both diagnosis and response evaluation. Chemotherapy is virtually abandoned. Age, genetic risk, and patient comorbidities have to be carefully evaluated for treatment decision. With the availability of different drugs, there is a need for a uniform and shared approach in daily therapeutic choice. The proposed approach is based on current evidence and guidelines as well as results from clinical trials and daily clinical experience.

It’s Time to Invest in Geriatric Nutrition: A Systematic Review

Introduction: Nutrition in the elderly can affect immunity as well as functional abilities, making it a significant domain in this age group. Objective: The current study is designed with the objective of highlighting nutritional problems and their association with different factors among the elderly in India. Methods: The literature search was conducted using PubMed, Medline, PubMed Central, and citation tracing, which provide access to full-text research articles published during the last 15 years. Result: A total of 1040 studies were identified, and 19 studies were included in the review. Lifestyle (inadequate intake of food, including vegetables and fruits), somatic (presence of comorbidity, more than three medication uses, psychological stress, chewing problems), functional (ADL/IADL dependency), and social (low socio-economic status, low education, single living, unemployment, older age) risk factors were found to be associated with malnutrition among the elderly in India. Conclusion: The burden of malnutrition and ‘at risk of malnutrition’ is very high, which may cover more than half of the elderly population and affect their quality of life. A multi-disciplinary approach, including nutritional screening, early diagnosis and treatment, and interventional dietary approaches, should be planned with sustainability assurance to ensure their healthy ageing.

Exploring Factors of Sexual Function and Sexual Satisfaction Among Nonworking Women: A Qualitative Study

Background: Sexual function and satisfaction are 2 important components of sexual health. Both sexual function and satisfaction of women are influenced by various internal and external factors over their life cycle. This study aims to explore the factors of sexual function and satisfaction among nonworking married women in Bengaluru using a qualitative exploratory study. Materials and Methods: This is a qualitative exploratory research study that adopted an inductive thematic data analysis. In-depth qualitative interviews were conducted with 11 nonworking working married women of Bengaluru. The interviews were audio recorded, and the transcribed data were analyzed with ATLAS.ti software. The results were presented thematically. Results: It was found that somatic and personal factors such as health and appearance, pregnancy and postpregnancy issues, compatibility between couples, and spousal qualities; psychological factors such as stressors and stabilizers that related to emotional and mental health; and situational and extrinsic factors such as pressure to conceive, child-rearing, types of family, traditional beliefs and practices, societal stigma and taboo, daily schedules of couples, and ambiance and privacy were influencing the sexual function and satisfaction of women. Conclusion: The study could find positive and negative factors of sexual function and satisfaction. These factors need further exploration with larger studies from other cultures and groups.

Chronic tinnitus: An interplay between somatic and psychological factors

Chronic tinnitus is acommon, sometimes highly distressing phenomenon that can be triggered and maintained by an interplay of physical and psychological factors. Partnering with clinical psychology and psychosomatic medicine, modern otolaryngology integrates both medical (e.g., hearing loss) and psychological influences (e.g., interactions between biographical experiences, personality traits, subjective evaluation of intrapsychic and interpersonal stimuli, emotional states, and intrapsychic or interpersonal emotion regulation strategies). Both groups of variables can influence the intensity and course of chronic tinnitus symptomatology both directly and indirectly, whereby the quality and relative degrees of psychological and physical components in aperson's self-experience can fluctuate. With this in mind, the present article distinguishes between chronic tinnitus symptomatology with or without hearing loss-and strongly advocates for an integrated understanding of the symptomatology within aholistic psychological frame of reference. After abrief introduction to the principles of psychosomatic medicine and psychotherapy, the article discusses psychological case conceptualization using avulnerability-stress-coping (VSC) model as an example, outlines clinical aspects and diagnostics of chronic tinnitus symptomatology, and concludes with aconceptualization of chronic tinnitus-related distress as afunction of person-centered VSC interactions.

Factorial validity and comparability of the six translations of the Rivermead Post-Concussion Symptoms Questionnaire translations: results from the CENTER-TBI study

BackgroundComparison of patient-reported outcomes in multilingual studies requires evidence of the equivalence of translated versions of the questionnaires. The present study examines the factorial validity and comparability of six language versions of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) administered to individuals following traumatic brain injury (TBI) in the Collaborative European NeuroTrauma Effectiveness Research (CENTER-TBI) study.MethodsSix competing RPQ models were estimated using data from Dutch (n = 597), English (n = 223), Finnish (n = 213), Italian (n = 268), Norwegian (n = 263), and Spanish (n = 254) language samples recruited six months after injury. To determine whether the same latent construct was measured by the best-fitting model across languages and TBI severity groups (mild/moderate vs. severe), measurement invariance (MI) was tested using a confirmatory factor analysis framework.ResultsThe results did not indicate a violation of the MI assumption. The six RPQ translations were largely comparable across languages and were able to capture the same construct across TBI severity groups. The three-factor solution comprising emotional, cognitive, and somatic factors provided the best fit with the following indices for the total sample: χ2 (101) = 647.04, {chi }^{2}/df= 6.41, p < 0.001, CFI = 0.995, TLI = 0.994, RMSEA = 0.055, CI90%[0.051, 0.059], SRMR = 0.051.ConclusionThe RPQ can be used in international research and clinical settings, allowing direct comparisons of scores across languages analyzed within the full spectrum of TBI severity. To strengthen the aggregated applicability across languages, further analyses of the utility of the response scale and comparisons between different translations of the RPQ at the item level are recommended.

Fear of Falling as a Behavioral Symptom in Neurocognitive Impaired Patients: Evidence from an Underrepresented Population.

Fear of falling (FoF) is a condition associated with falls, multi-morbidity, and functional impairment. To date it remains unknow which clinical, somatic, socio-demographic, behavioral, and emotional factors are associated with FoF and how these factors interact in people with Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Identify the association of FoF with clinical, socio-demographic, and neuropsychiatric factors in patients with AD and bvFTD. We evaluated 98 participants, 58 with AD and 40 with bvFTD at mild or moderate stages and assess FoF using the Falls Efficacy Scale-International. Additionally, we analyzed cognitive, physical performance variables, functional impairment, and affective and behavioral symptoms associated with FoF using standardized scales and a regression model analysis. The prevalence of FoF in AD and bvFTD was 51% and 40%, respectively. In the AD group, physical performance [F (3, 53) = 4.318, p = 0.009], the behavioral symptoms model [F (19, 38) = 3.314, p = 0.001], and the anxiety model [F (1, 56) = 13.4, p≤0.01] showed statistically significant values. In addition, the presence of hallucinations assessed with the Neuropsychiatric Inventory and social behavior assessed with the Mild Behavioral Impairment Checklist were significant. In contrast, in the bvFTD group, a homologous group of models was evaluated but we did not find any significant results. FoF in people with AD was related to physical performance, neuropsychiatric symptoms such as apathy and hallucinations, and affective symptoms such as anxiety. However, this pattern was not seen in the bvFTD group, and therefore further studies are required.

Which can Predict the Outcome of Antidepressants: Metabolic Genes or Pharmacodynamic Genes?

Drug therapy is the primary modality for depression; however, its outcome is often unpredictable, ranging from beneficial effects to serious adverse effects. Genetic variations in drug metabolizing enzymes and pharmacodynamic molecules are responsible for a considerable proportion of interindividual differences in the effectiveness and toxicity of antidepressants. For the improvement in the use of antidepressants, the focus is mainly on personalized treatment emphasizing interindividual differences in genes. This study provides a comprehensive review of the literature on the clinical applications of pharmacogenomics for antidepressant therapy. The polymorphisms of metabolizing enzymes (CYP2D6, CYP2C19, and others) governing the pharmacokinetic behavior of drugs are potential predictors of side effects or treatment failure with medications and there are good pharmacogenetic clinical recommendations for a wide selection of psychopharmacological agents based on functional diplotypes of CYP2C19 and CYP2D6. The relationship between pharmacodynamic genes, including FKBP5, SLC6A4, BDNF, ABCB1, HTR1A, and HTR2A, and clinical outcomes varies in different races. Receptors that are currently used as drug targets for antidepressant drugs are evolutionarily conserved to a higher extent than genes encoding drug metabolism, and the actionability of pharmacodynamic-related genotyping is currently still questionable. The limited availability of largescale, long-term clinical studies on different races and medications currently impedes the implementation of pharmacogenomics in antidepressant treatment. The use of pharmacokinetic and pharmacodynamic modeling, and therapeutic drug monitoring combined with genetic, somatic, dietary, and environmental factors represents a promising avenue for improving the precision and effectiveness of antidepressant therapy.

The role of somatic factors in early childhood and adolescent psychosomatic disorders

Objective. This study aimed to establish practical evidence of the leading role of somatic factors in psychosomatic health disorders in the early stages of the mental development of children and adolescents.&#x0D; Materials and methods. An interview method was used to obtain complete and reliable historical data for children and youth who applied for primary medical care. In addition, an anonymous questioning method was implemented. It allowed gathering of a reliable database of basic information on the psychosomatic health of children and adolescents in the Western European region. A study enrolled a sample of 1000 children, including 498 girls and 502 boys, aged 13 to 18 years.&#x0D; Results and Discussion. Psychosomatic pathologies were detected in 54% of cases, of which 63% were female. The influence of somatic factors on psychosomatic pathology progression was found to be greater in the early stages of mental development.&#x0D; Conclusion. The study’s findings may serve as a primary basis for understanding the role of somatization factors on psychosomatic disorders in children and adolescents in the early stages of mental development. The study also highlights the need to enhance the methodological basis for preventing psychosomatic disorders in children and adolescents.&#x0D; Bangladesh Journal of Medical Science Vol. 22 No. 03 July’23 Page : 687-694

Functional (Nonorganic) Enuresis and Daytime Urinary Incontinence in Children and Adolescents: Clinical Guideline for Assessment and Treatment

Functional (Nonorganic) Enuresis and Daytime Urinary Incontinence in Children and Adolescents: Clinical Guideline for Assessment and Treatment Abstract: Objective: Enuresis and daytime urinary incontinence are common disorders in children and adolescents and are associated with incapacitation and a high rate of comorbid psychological disorders. This interdisciplinary guideline summarizes the current state of knowledge regarding somatic and psychiatric assessment and treatment. We formulate consensus-based, practical recommendations. Methods: The members of this guideline commission consisted of 18 professional associations. The guideline results from current literature searches, several online surveys, and consensus conferences based on standard procedures. Results: According to the International Children's Continence Society (ICCS), there are four different subtypes of nocturnal enuresis and nine subtypes of daytime urinary incontinence. Organic factors first have to be excluded. Clinical and noninvasive assessment is sufficient in most cases. Standard urotherapy is the mainstay of treatment. If indicated, one can add specific urotherapy and pharmacotherapy. Medication can be useful, especially in enuresis and urge incontinence. Psychological and somatic comorbid disorders must also be addressed. Conclusions: The recommendations of this guideline were passed with a high consensus. Interdisciplinary cooperation is especially important, as somatic factors and comorbid psychological disorders and symptoms need to be considered. More research is required especially regarding functional (nonorganic) daytime urinary incontinence.

Associations between an individual’s need for cognitively stimulating activities, brain damage and cognitive functioning: Results from The Maastricht Study

AbstractBackgroundDementia is a global health challenge. Currently, there is no curative treatment for dementia and therefore risk reduction through lifestyle modifications has become more prominent with high cognitive activity as a promising target. This study explored the association between an individual’s need to engage in cognitively stimulating activities, brain damage and cognitive functioning in the Dutch general population.MethodThis study used cross‐sectional data from the population‐based cohort The Maastricht Study (N = 4,209; mean age 59.06 ± 8.58 years, 50.11% women). Need For Cogntion (NFC) was measured with the Need For Cognition Scale. Cognitive functioning was tested in three domains: verbal memory, information processing speed and executive functioning and attention. Standardized volumes of white matter hyperintensities (WMH) and cerebrospinal fluid (CSF) and presence of cerebral small vessel disease (CSVD) were derived from 3 Tesla MRI. Multiple linear regression analysis was used to explore the association between NFC and cognitive functioning, NFC and WMH and NFC and CSF. Binary logistic regression analysis was used to assess the association between NFC and CSVD. Interaction between brain damage or cognitive impairment (a score of &lt;1.5 standard deviation below the mean on any of the three cognitive domains) and NFC on cognitive functioning was tested by including interaction terms in the regression analyses.ResultHigh NFC was positively associated with cognitive functioning (β: 0.21, p = &lt;0.001) and negatively associated with CSVD (OR: 0.74, p = 0.005). These associations were independent of demographic and somatic factors. A dose‐response relationship between NFC and cognitive functioning was observed. There was no statistically significant association between NFC and WMH or CSF. No interaction between CSVD, WMH or CSF and NFC on cognitive functioning was found. Cognitive impairment did not moderate the association between NFC and cognitive functioning.ConclusionA high need for engaging in cognitively stimulating activities is associated with better cognitive functioning and less brain damage. This is in line with previous research. These results indicate that, in middle‐aged populations, stimulating cognitive activity may be an opportunity for risk reduction of cognitive decline and dementia.

Mirror Therapy in Patients with Somatoform Pain Disorders-A Pilot Study.

Patients with chronic pain report reduced quality of life and high symptom burden while often responding insufficiently to treatment options. Mirror therapy has been proven to be effective in treating phantom limb pain and other conditions such as CRPS. This study was designed to investigate the efficacy of mirror therapy in patients with somatoform pain disorders on symptom severity and associated physiological parameters. Fifteen patients with persistent somatoform pain disorder (F45.40) or chronic pain disorder with somatic and psychological factors (F45.41) participated and received four weeks of tablet-based mirror therapy. Symptom severity was measured with established questionnaires, and their thermal detection, pain thresholds, and heart rate variability (HRV) were also assessed. After mirror therapy, pain intensity was reduced (z = -2.878, p = 0.004), and pain thresholds for cold stimuli were also diminished, i.e., the subjects became more sensitive to cold stimuli (z = -2.040, p = 0.041). In addition, a reduction of absolute power in the low-frequency band of HRV (t(13) = 2.536, p = 0.025) was detected. These findings indicate that this intervention may reduce pain intensity and modulate associated physiological parameters. As these results are limited by several factors, e.g., a small sample size and no control group, they should be validated in further studies investigating this novel intervention in these patients.

Factors Associated With Weight Loss After Laparoscopic Adjustable Gastric Banding in Adolescents With Severe Obesity.

The primary outcome was to identify somatic or psychosocial factors associated with success at 24 months after a laparoscopic adjustable gastric banding (LAGB) procedure in our cohort of adolescents with severe obesity. Secondary endpoints were to describe weight loss outcomes, comorbidity resolution, and complications. We have retrospectively reviewed medical records of patients who had LAGB placed between 2007 and 2017. Factors associated with success at 24 months after LAGB were researched, with success being defined as positive percentage of excess weight loss (%EWL) at 24 months. Forty-two adolescents underwent a LAGB procedure, the mean %EWL was 34.1% at 24 months, with improvement in most comorbidities and without major complications. Having lost weight before surgery was associated with success, whereas a high body mass index at surgery was associated with a higher risk of failure. No other factor was found to be associated with success. Comorbidities mostly improved 24 months after LAGB and no major complication occurred. Having lost weight before surgery was associated with a successful surgery, whereas a high body mass index at surgery increases the risk of failure.

E092 Confirmatory factor analyses of the Tampa Scale of Kinesiophobia 11-item version and Pain Catastrophising Scale: A cross-sectional study in people living with axial spondyloarthritis

Abstract Background/Aims The Fear Avoidance Model (FAM) proposes pain-related fear of movement and pain catastrophising to be prominent psychological experiences that compromise physical function and activity behaviour in people living with chronic pain. Yet, little research has tested the FAM in people living with axial spondyloarthritis (axSpA) despite the evidenced benefits of physical activity and exercise. This study examines the structural aspect of construct validity of the 11-item Tampa Scale of Kinesiophobia (TSK-11) and Pain Catastrophising Sale (PCS) as an important first step, to establish valid measurement tools to effectively test the relevance of the FAM for people with axSpA. Methods An online survey was distributed via the National Axial Spondyloarthritis Society including the TSK-11 and PCS. Ninety-eight people with axSpA (M Age = 45.62 SD = 12.16, M BASFI = 3.7 SD = 2.60, Female = 70%, NSAID use = 58.76%, bDMARDS use = 62.24%) completed the survey (December 2020- April 2021). Internal consistency was examined via Cronbach alpha values and confirmatory factor analysis tested the TSK-11's two-factor structure and PCS's three-factor structure. A model has excellent fit to the data with values &amp;lt; 3 for the CMIN/DF, and around .95 for CFI, .06 for RMSEA, .08 for SRMR. Factor loadings &amp;lt; .40 support deletion. Results Alpha values supported the internal consistency of participant responses to the somatic (.78), avoidance behaviour (.80) and overall fear of movement (.89) TSK-11 items. Fit indices also showed a good fit to the data for the TSK-11’s two-factor structure once two error terms were correlated (CMIN/DF = 1.77/42, CFI = .93, RMSEA = .09 (.05 - .12), SRMR= .06). Standardised factors loadings for the somatic and avoidance factors ranged from .43 - .80 and .60 - .72, respectively. Internal consistency for the responses to the PCS-Helplessness (.92), PCS-Magnification (.82), PCS-Rumination (.94) and overall pain catastrophising (.95) scales were also supported. A good fit to the data was shown for the three-factor structure of the PCS (CMIN/DF = 2.15/61, CFI = .94, RMSEA= .11 (.08-.14), SRMR = .04) when two errors were correlated. Standardised factors loadings ranged from .67-.90, (Helplessness), .89 - .92 (Rumination) and .73 - .85 (Magnification). Conclusion The TSK-11 and PCS can be used to measure axSpA patient’s pain related fear of movement and pain catastrophising, but data support continued examination of their construct validity in larger samples of axSpA patients. One TSK-11 item revealed a border line factor loading (.43) for the somatic factor (“pain lets me know when to stop exercising so that I don’t injure myself”). Psychometrically valid instruments will help examine the role of pain related fear of movement and pain catastrophising on important health related outcomes for axSpA patients including physical function and physical activity behaviour. Disclosure P.C. Rouse: Grants/research support; PhD studentship matched funded by Bath Institute for Rheumatic Diseases (RAG-PR-33-120318). T.A. Ingram: None. M. Standage: None. R. Sengupta: Honoraria; Received honoraria for giving talks from Abbyie, Biogen, UCB, Novartis and Pfizer. Grants/research support; Research grants have been received from UCB, Abbvie, and Novartis.

An Unusual College Experience: 16-Month Trajectories of Depressive Symptoms and Anxiety among Chinese New Undergraduate Students of 2019 during the COVID-19 Pandemic

This study examines the trajectories of the mental health conditions of 13,494 new undergraduate students who enrolled in 2019 in China from the beginning of the pandemic to the local recurrence of the pandemic, and found factors which may be associated with diverse trajectories. The trajectories of depression-anxiety outcomes were modeled using the growth mixture model. The multinomial logistic regression model was used to identify variables associated with different trajectory groups. Both depression and anxiety in the new college students slightly increased during the 16-month period. The slopes of depression and anxiety were lower after the local outbreak. From the trajectories of depression and anxiety, five heterogeneous groups were identified: low-stable (64.3%), moderate-increased (18.2%), high-stable (11.1%), recovery (4.5%), and rapid-increased (1.8%). Environmental, somatic, and social factors were used to differentiate the low-stable group from the other groups. We found that college students with female gender, more conflict with parents, and feelings of loneliness during the pandemic were more likely to enter a high stability trajectory compared to a recovery trajectory. Most participants showed a stable mental health status, while others experienced deteriorating or chronic mental health problems, especially those who had sleep disturbances, less social support before the pandemic, or conflicts with parents during the pandemic. These students may need additional support and monitoring from college mental health providers to improve their wellbeing.

Risk factors for insomnia and burnout: A longitudinal population-based cohort study.

Insomnia and burnout are highly prevalent in the general population, calling for understanding of its causes. Taking a broad approach, the aim of this study was to determine various mental and somatic risk factors for development of insomnia and burnout and stratifying for sex and age group. Questionnaire data were used from a Swedish population-based sample aged 18-79years, from which cohorts without insomnia (n=1702) and without burnout (n=1972) at baseline were followed-up after 3 years. Self-reports of eight mental and somatic conditions at baseline were used as independent variables in logistic regression analyses to predict development of insomnia and burnout at 3-year follow-up. All eight studied conditions were significant risk factors for development of both insomnia (odds ratio, OR=1.62-2.73) and burnout (OR=2.20-3.21). Burnout and poor self-rated health had the highest ORs for insomnia, and poor self-rated health, anxiety and somatic symptoms had the highest ORs for burnout. The ORs were generally similar between men and women, whereas age groups tended to differ in some of the risk factors. The study highlights the importance of a broad assessment of both mental and somatic conditions in the prevention of insomnia and burnout.

Functional Constipation and Nonretentive Fecal Incontinence in Children and Adolescents: Clinical Guideline for Assessment and Treatment

Functional Constipation and Nonretentive Fecal Incontinence in Children and Adolescents: Clinical Guideline for Assessment and Treatment Abstract. Objective: Constipation and fecal incontinence are common disorders in children and adolescents and are associated with incapacitation and a high rate of comorbid psychological disorders. Functional constipation and nonretentive fecal incontinence can be differentiated according to the current Rome-IV classification systems. This interdisciplinary guideline aims to summarize the current state of knowledge regarding somatic and psychiatric assessment and treatment. It formulates consensus-based, practical recommendations. Methods: The members of the Guideline Commission consisted of 11 professional associations and a parental organization. The guideline was based on current literature searches, several online surveys, and consensus conferences based on standard procedures. Results: Functional constipation is much more common than nonretentive fecal incontinence. Constipation requires a detailed medical assessment to exclude somatic causes, especially in young children. Red flags are useful indicators of organic causes to be considered. Most cases of constipation are functional (approximately 95 %). Counseling, toilet training, disimpaction, and long-term oral laxatives, combined with cognitive-behavioral interventions, are most effective. The assessment and treatment of nonretentive fecal incontinence are similar. The rate of somatic factors is much lower (approximately 1 %). Laxatives can worsen outcomes and should be avoided. Comorbid psychological disorders are common (approximately 30 % to 50 %). They should be assessed and treated additionally according to evidence-based guidelines. Conclusions: The recommendations of this guideline were approved with a high consensus. Interdisciplinary cooperation is especially important, as somatic factors and comorbid psychological disorders and symptoms need to be considered. More research is required, especially regarding nonretentive fecal incontinence.