Somatic Manifestations Of Anxiety Research Articles

Using the hospital anxiety and depression scale in people with epilepsy: Is overlapping symptomatology a problem?

The Hospital Anxiety and Depression Scale (HADS) is designed to screen for anxiety and depression in clinical settings. However, some items on the HADS may reflect symptoms associated with epilepsy and antiseizure medications rather than anxiety and depression. This study examined whether these items on the HADS contributed disproportionately to the reporting of anxiety and depression on the HADS in people with epilepsy (PWE). As part of a routine clinical assessment, 546 adults with epilepsy completed the HADS. In our sample, 56.2% reported elevated levels of anxiety, and 27.3% reported symptoms of depression with a score of 8 or more on the respective subscales. Scores on the anxiety and depression subscales were not associated with age, sex or epilepsy type. We did not find a relationship between endorsement of items related to panic, feelings of dread or butterflies in the stomach and a diagnosis of temporal lobe epilepsy. The most frequently endorsed item on the anxiety subscale of the HADS in the sample as a whole related to worrying thoughts, rather than the more somatic manifestations of anxiety. The item ‘I feel as if I am slowed down’ was endorsed by the majority of people with epilepsy and may not reflect a symptom of depression in this group. Careful analyses of the pattern of endorsement of specific items on the HADS may improve the sensitivity of this screening measure to the presence of depression in people with epilepsy.

Psychophysiological parameters in rosacea patients after complex therapy with Cortexin

Introduction: Taking into account the influence of the psycho-emotional sphere and its disorders on the pathogenetic mechanisms of rosacea, a comparative assessment of the clinical efficacy of a standard therapy and the complex therapy using Cortexin in papulopustular rosacea patients with moderate severity and concomitant neurological pathology was performed. The therapy influence on changes in the patients’ psycho-emotional state was also studied.
 Materials and methods: The study involved 216 papulopustular rosacea outpatients with moderate severity with a concomitant neurological pathology, aged 20 to 60 years. The patients were divided into 2 groups: 109 people (37 men and 72 women) in the study group, and 107 people (37 men and 70 women) in the control. All the patients received a treatment according to the ”Standard of Medical Care for Patients with Rosacea” of the Ministry of Health of the Russian Federation. The study group patients additionally received Cortexin. The study was carried out using the Zung Self-Rating Anxiety Scale (SAS), the Taylor Manifest Anxiety Scale, the Spielberger State-Trait Anxiety Inventory, and the Eysenck Personality Questionnaire.
 Results and discussion: The patients showed an increase in somatic manifestations of anxiety, levels of trait and state anxiety, and neuroticism initially before the start of treatment. The inclusion of Cortexin in the rosacea treatment re­duced the somatic manifestations of anxiety more effectively than standard therapy against the background of a more considerable decrease in proportion of patients with its moderate and high levels. The severity of trait and stateanxiety, neuroticism was also significantly lower against the background of the Cortexin use than with the standard treatment.
 Conclusion: The Cortexin inclusion in the rosacea pharmacotherapy against the background of a concomitant neu­rological pathology contributes to a more pronounced correction of psychophysiological parameters, reflecting the neuroticism levels, trait and state anxiety, and somatic manifestations of anxiety, compared to standard treatment.

Clinical Study of the Effectiveness of Pluralist Homeopathy in Generalized Anxiety Disorder

Introduction and objectives: Generalized anxiety disorder (GAD) is mainly observed in the primary care setting and may reach a prevalence of 5%. This retrospective study was conducted with the aim of assessing the results obtained using a therapeutic method based on pluralistic homeopathy. Material and Methods: An observational study of a cohort of 220 patients treated by a pluralistic homeopathic physician was performed. A total of 460 medical records were reviewed, among which 220 patients who met DSMIV-TR criteria for the diagnosis of GAD were selected. In relation to homeopathic remedies, remedy of temperament was prescribed in all cases. A complementary remedy, a remedy of autonomic regulation, causal remedy, constitution remedy and remedy of terrain or diathesis was prescribed when necessary. Criteria for grouping patients according to response to treatment were defined. On the basis of this response, levels of cure or lack of response were grouped. A specific database was designed for the purpose of the study. Results: The mean age of patients was 38 years. Women accounted for 78% of the cases. Associated general pathologic conditions were found in only 16% of patients. The duration of symptoms exceeded 12 months in 45% of the cases. At presentation, 31% of patients were taken conventional treatment (anxiolytics and/or antidepressants). The remedy of temperament was prescribed to all 220 cases. Starting of improvement was already observed at the first control visit in 73% of cases (158 patients) after 30 days of the baseline visit. In 157 of the 220 cases (71%), patients considered to be cured due to resolution of all symptoms. In 56.4% of cases (n=124), the length of follow-up was shorter than 2 years, and in 38.2% of cases (n=84) the follow-up ranged between 2 to 6 years. Nine cases (4%) have been followed between 6 and 10 years, and in 3 cases the follow-up was longer than 10 years. Cure achieved by means of homeopathic treatment was significantly associated with younger age, shorter duration of symptoms and absence of conventional pharmacologic treatment prior to consultation with the homeopathy. Conclusions: Data of this retrospective review shows that the applied homeopathic treatment may be effective in the management of patients with GAD. The scope of treatment may include both somatic manifestations of anxiety and deepest vital discomfort affecting the subject.

Depressive symptoms and hormonal profile in climacteric women

Objectives: The aims of the study were: evaluation of depressive symptoms in climacteric women, comparison of depressive symptoms between peri- and post-menopausal women, and assessment of a possible relationship between the presence of depressive symptoms and the hormonal profile of the studied women. Materials and Methods: The study included 45 peri-menopausal and 95 post-menopausal women admitted to the Department of Gynecological Endocrinology, Poznań University of Medical Sciences, because of climacteric symptoms. The following parameters were evaluated in all studied women: intensity of climacteric symptoms (Kupperman Index), intensity of depressive symptoms (Hamilton depression scale), serum concentrations of hypothalamic-pituitarygonadal axis hormones (FSH, LH, 17β-estradiol), prolactin (PRL) and androgens [total testosterone, dehydroepiandrosterone sulfate (DHEAS)]. FSH, LH, 17β-estradiol, PRL, and total testosterone were evaluated by the immunoenzymatic methods and DHEAS was measured by the radioimmunological method. Results: Psychic and somatic manifestations of anxiety and fear, shallow sleep, and general somatic symptoms were the most frequent depressive symptoms in both studied groups. Both investigated groups differed in relation to the incidence and intensity of symptoms from the genital system (observed more often in post-menopausal women) and hypochondria (noted more frequently in peri-menopausal women). Numerous relationships between the incidence and intensity of certain symptoms and serum concentrations of the investigated hormones were found in both groups. The correlations were different in periand post-menopausal subjects.

Le syndrome de la guerre du Golfe vingt ans après

Resume Le syndrome de la Guerre du Golfe (S2G) semblait etre un nouveau trouble qui associait une kyrielle de symptomes fonctionnels integrant les systemes locomoteurs, digestifs, tegumentaires et neurosensoriels. Mais malgre des investigations scientifiques tres poussees, vingt ans apres la fin de la guerre, aucun marqueur de souffrance physique objectif n’est retenu pour rendre compte des troubles presentes qui seront finalement attribues au stress. Les facteurs de stress ne manquaient pas pour les troupes deployees : alertes repetees d’attaques chimiques, hostilite du milieu avec ses vents de sable et ses animaux venimeux, conditions climatiques rendant difficiles de longues heures de soutien et d’observation statique, ramassage des corps et incertitude sur la duree du conflit. La tenue militaire de protection antinucleaire–bacteriologique–chimique permettait un confinement certes protecteur grâce a la fermeture au monde hostile duquel viendrait la menace, mais dans le meme temps, cet isolement majore la peur d’un risque hypothetique alors que les perceptions internes sont majorees et peuvent ouvrir la voie a des somatisations. Dans un tel contexte, les manifestations somatiques de l’anxiete (palpitations, sueurs, paresthesies, cephalees…) s’associent volontiers a des troubles fonctionnels somatises auxquels peuvent encore s’adjoindre des surinterpretations de sensations corporelles selon un mecanisme d’analyse hypochondriaque. Le S2G existe bel et bien : il ne s’agit pas d’une « maladie imaginaire » mais d’un trouble psychogene impliquant un serieux probleme de sante publique qui a occasionne des dizaines de milliers de plaintes et englouti des millions de dollars. Si une souffrance psychique et psychosomatique survenant chez les veterans est immuable au cours de l’histoire, l’expression de ces difficultes possede des specificites en fonction du contexte culturel, politique et scientifique d’alors. Pour repondre aux souffrances humaines, une « nouvelle » entite nosographique peut se repandre dans la societe en prenant l’expression epidemique d’un trouble somatise via des mecanismes d’identification, d’imitation et de suggestion.

Chemical Composition and Anti-Stress Effects of Yeast Hydrolysate

In the present study, the anti-stress effects of yeast hydrolysate (YH) were investigated. The YH consisted of crude carbohydrate (23.6%) and crude protein (68.3%) with low contents of crude ash (3.1%) and crude fat (0.3%). Also, acidic amino acids (glutamic acid + aspartic acid) were present in large quantities (14.2 and 5.0 mol%, respectively). Pronase digestion had little effect on the affinity of the YH on 5-hydroxytryptamine (serotonin) and norepinephrine transporters, whereas NaIO(4) oxidation of the hydrolysate decreased the affinity by about 10% at 1,000 microg/mL, indicating that the periodate-labile carbohydrate moiety played a leading role in the affinity effects of the carbohydrate in YH. As a result of brain mapping after the administration of the YH for 3 days in human subjects, a symmetrical distribution of theta and alpha waves in the central and parietal lobes was observed. This brain mapping pattern of theta and alpha wave distribution appears in a psychologically stable state. The YH groups showed improvements in Beck Depression Inventory and Beck Anxiety Inventory scores after YH administration for 2 weeks. Treatment also seemed to have a more significant (P < .05) impact on the somatic manifestations of anxiety as indexed by the Beck Anxiety Inventory scores. Food materials used as a source of YH have been found to be associated with increases in alertness and adaptation to stress.

NEUROSIS AND ALCOHOL

Sixteen cats were trained to adapt to situations of increasing complexity; first they opened a box of food, then they were taught to feed only after specific sensory stimuli, and finally they learned to manipulate a switch in various positions to actuate their own feeding signals. When alcohol was administered, these patterns disappeared in the order of decreasing complexity of integration, until only the original, primitive feeding reactions remained. After recovery, the animals were subjected to a severe motivational conflict, and developed inhibitions, phobias, loss of dominance, somatic manifestations of anxiety, and other behavioral abnormalities typical of an experimental neurosis. Alcohol partially disintegrated these complex responses, restored direct goal-behavior and thereby temporarily relieved the neurosis. Ten of the animals, after sufficient experience with this effect, continued to prefer alcohol to non-alcoholic liquids until their neuroses were relieved by various experimental procedures....