Somatoform Research Articles

The development of type 2 diabetes management in people with severe mental illness in the Capital Region of Denmark from 2001 to 2015.

Type 2 diabetes (T2D) treatment has changed markedly within the last decades. We aimed to explore whether people with severe mental illness (SMI) have followed the same changes in T2D treatment as those without SMI, as multiple studies suggest that people with SMI receive suboptimal care for somatic disorders. In this registry-based annual cohort study, we explored the T2D treatment from 2001 to 2015 provided in general practices of the Greater Copenhagen area. We stratified the T2D cohorts by their pre-existing SMI status. T2D was defined based on elevated glycated hemoglobin (≥48 mmol/mol) or glucose (≥11 mmol/L) using data from the Copenhagen Primary Care Laboratory Database. Individuals with schizophrenia spectrum disorders (ICD-10 F20-29) or affective disorders (bipolar disorder or unipolar depression, ICD-10 F30-33) were identified based on hospital-acquired diagnoses made within 5 years before January 1 each year for people with prevalent T2D or 5 years before meeting our T2D definition for incident patients. For comparison, we defined a non-SMI group, including people who did not have a hospital-acquired diagnosis of schizophrenia spectrum disorders, affective disorders, or personality disorders. For each calendar year, we assembled cohorts of people with T2D with or without SMI. We used Poisson regression to calculate the rates per 100 person-years of having at least one biochemical test (glycated hemoglobin, low-density lipoprotein cholesterol, estimated glomerular filtration rate, and urine albumin-creatinine ratio), having poor control of these biochemical results, taking glucose-lowering or cardiovascular medications, or experiencing a clinical outcome, including all-cause mortality and cardiovascular mortality. Three outcomes (cardiovascular events, cardiovascular mortality, and all-cause mortality) were additionally examined and adjusted for age and sex in a post hoc analysis. From 2001 to 2015, 66,914 individuals were identified as having T2D. In 2015, 1.5% of the study population had schizophrenia spectrum disorder and 1.4% had an affective disorder. The number of people who used biochemical tests or had poor biochemical risk factor control was essentially unrelated to SMI status. One exception was that fewer LDL cholesterol tests were done on people with affective disorders and schizophrenia spectrum disorders at the beginning of the study period compared to people in the non-SMI group. This difference gradually diminished and was almost nonexistent by 2011. There was also a slightly slower rise in UACR test rates in the SMI groups compared to other people with T2D during the period. Throughout the study period, all groups changed their use of medications in similar ways: more metformin, less sulfonylurea, more lipid-lowering drugs, and more ACEi/ARBs. However, people with schizophrenia disorder consistently used fewer cardiovascular medications. Cardiovascular events were more common in the affective disorder group compared to the non-SMI group from 2009 to 2015 (rate ratio 2015 : 1.36 [95% CI 1.18-1.57]). After adjustment for age and sex, all-cause mortality was significantly higher among people with a schizophrenia spectrum disorder each year from 2003 to 2015 compared to the non-SMI group (rate ratio 2015 : 1.99 [95% CI 1.26-3.12]). Persons with schizophrenia or affective disorders demonstrated the same treatment changes for T2D as those without SMI in general practice. The lower use of most types of cardiovascular medications among people with schizophrenia disorders indicates potential undertreatment of hypertension and dyslipidemia and remains throughout the study period. Cardiovascular events were most common among people with affective disorders, but this was not reflected in a higher proportion using cardiovascular preventive medications. This knowledge should be considered in the management of this vulnerable patient group.

Broken wills and ill beliefs: Szaszianism, expressivism, and the doubly value-laden nature of mental disorder

Critical psychiatry has recently echoed Szasz’s longstanding concerns about medical understandings of mental distress. According to Szaszianism, the analogy between mental and somatic disorders is illegitimate because the former presuppose psychosocial and ethical norms, whereas the latter merely involve deviations from natural ones. So-called “having-it-both-ways” views have contested that social norms and values play a role in both mental and somatic healthcare, thus rejecting that the influence of socio-normative considerations in mental healthcare compromises the analogy between mental and somatic disorders. This paper has two goals. Firstly, I argue that having-it-both-ways views fail to provide a compelling answer to Szasz’s challenge. The reason is that what is essential to Szasz’s argument is not that mental disorder attributions involve value judgements, but that mental attributions in general do. Mental disorders are thus doubly value-laden and, qua mental, only metaphorically possible. To illustrate this, I construe Szasz’s view and Fulford’s having-it-both-ways approach as endorsing two different kinds of expressivism about mental disorders, pointing out their different implications for the analysis of delusions. Secondly, I argue, against Szaszianism, that Szasz’s rejection of the analogy is relatively irrelevant for discussions about the appropriateness of medicalizing mental distress. Specifically, I draw from socio-normative approaches to the psychopathology/social deviance distinction and mad and neurodiversity literature to argue that a) it is still possible to distinguish social deviance from psychopathology once we reject the analogy; and b) that both medicalizing and normalizing attitudes to mental distress can harmfully wrong people from relevant collectives.

Faculty mental health and compassion fatigue: A call to the profession, a call to the institution

The mental health of faculty in the United States higher education system has been an overlooked area of concern. This study addresses the occupational health of faculty, specifically faculty mental health (i.e., compassion fatigue, generalized anxiety disorder, major depression disorder, somatic symptom disorder), along with psychosocial and occupational factors. Two aspects of compassion fatigue (i.e., secondary traumatic stress and burnout) were used to classify participants into low or elevated secondary traumatic stress and burnout groups. Given the significant rates of compassion fatigue and psychopathology among faculty members, the importance of cultivating resilience at the individual and institutional levels is discussed.

Understanding Mal de Debarquement syndrome (MdDS), persistent postural perceptual dizziness (3PD) and somatoform disorders: and the role of vestibular rehabilitation therapy (VRT)

It is well established that complaints of dizziness, vertigo, unsteadiness, and internalized motion are commonly reported by patients to health care providers. It is estimated that dizziness is the 3rd most common complaint heard in physicians’ offices across all age groups, preceded only by headache and lower back pain. It has been observed by clinicians for over 100 years, that there is a sizable segment of this population of patients with or without a precedent vertigo episode who report difficulty coping and ambulating comfortably within a visually dynamic world. The purpose of this article is to provide the reader with an understanding of these conditions. This will include definitions of the conditions and a review of their symptoms and management options. The authors will provide a case study to highlight the complex nature of these conditions and successful management approach utilizing Vestibular Rehabilitation Therapy.

Creative arts as self-care: vicarious trauma, resilience and the trainee art therapist

ABSTRACT Background Research shows that indirect trauma can negatively affect professionals in helping professions, with students and young professionals at greater risk, particularly if they have a personal history of trauma. Research suggests that engaging in the creative arts may help professionals process vicarious trauma and promote resilience. Context This paper explores the use of creative arts practice for self-care by an art therapy trainee with lived experience of somatic disorder symptoms and complex post-traumatic stress disorder (C-PTSD), working in a secure setting. Approach Using a trauma lens, the paper discusses how the creative arts can ameliorate the effects of indirect trauma when working as a trainee art therapist in a challenging context. The trainee’s early life experiences elucidate the challenges of countertransference and trauma. The creative arts process supports the reflexive skills an art therapist uses for effective practice. Outcomes The creative arts as a self-care practice supported the trainee art therapist to negotiate her dissociative defence style. It was an effective tool for managing the ill-effects of exposure to trauma, including somatic symptoms, and benefited the trainee’s development. Conclusions The creative arts helped the trainee to reconnect with her body and emotions, and subsequently benefited her clinical thinking. Implications for research Art therapy training programmes could include explicitly teaching about the risks and benefits of working in the profession, as this may promote longevity and improve therapeutic outcomes for service users. Further research on dissociative responses to trauma and creative arts as self-care for therapists would be valuable. Plain-language summary Research in the past 30 years has found that people working in helping professions are at risk of experiencing trauma symptoms through their work with service users. This can have a negative effect on their health and wellbeing, as well as their relationships with others. If unaddressed it can also negatively affect their ability to provide effective therapy. Students and people with a history of trauma are at greater risk. This paper explores the personal experience of a trainee art therapist working in a secure hospital setting. It describes how creative arts practice helped the trainee to cope with the challenging content of therapy sessions and promote their own wellbeing. It uses the trainee’s experience as a young carer to elucidate the emotional and physical toll of caring and the long-lasting impact it can have. The trainee’s experiences suggest that the creative arts can help with high levels of stress and hypervigilance, negative physical symptoms and personal trauma triggers, and promote greater wellbeing. The article calls for research into the value of including teaching around trauma, including physical symptoms, in training programmes for art therapists, and how the creative arts can be used as a self-care tool.

Prevalence and clinical correlates of restless legs syndrome in psychiatric patients: A cross-sectional study from North India.

Restless legs syndrome (RLS) is a neuro-sensorimotor disorder which is scarcely researched and is commonly missed in routine psychiatry practice. To evaluate the prevalence of RLS and its correlates in patients with anxiety, depression, and somatoform disorders. A cross-sectional single-center study was undertaken in patients aged 18-65 years suffering from ICD-10 (International Statistical Classification of Diseases-10th edition) diagnosis of anxiety, depressive, and somatoform disorders. RLS was evaluated by using diagnostic criteria of International Restless Legs Syndrome Study Group (IRLSSG) and severity measured on IRLSSG scale. Depression and anxiety were rated on Hamilton Depression and Anxiety Rating Scales respectively, insomnia severity measured by Insomnia Severity Index (ISI), and quality of life measured by WHO Quality of Life-Brief version (WHO-QOL BREF) scale. Serum ferritin levels were measured for evaluating iron deficiency. The rate of RLS was 66.7%, 50%, and 48% in patients with depressive, anxiety, and somatoform disorders, respectively, with no significant inter-group difference. Nearly one-third of patients suffered from severe to very severe symptoms of RLS, and quality of life was poorest in those with depressive disorders. RLS was significantly higher in females (P = 0.019), who were married (P = 0.040), diagnosed with severe depression (P = 0.029), and abused benzodiazepines (P = 0.045). On binary logistic regression, female gender and presence of clinical insomnia predicted occurrence of RLS. The prevalence of RLS is very high in patients with common psychiatric disorders which is often missed. Clinical enquiry and examination for reversible causes such as iron deficiency may assist in its diagnosis and improve clinical outcome.

Prevalence of specific learning disability in children and its association with somatic symptom disorder – data from a tertiary care centre of South India

Prevalence of specific learning disability in children and its association with somatic symptom disorder – data from a tertiary care centre of South India

Comparison of Escitalopram Alone versus in Combination with Jacobson’s Progressive Muscle Relaxation in Patients with Neurotic, Stress Related and Somatoform Disorders: A Randomised Clinical Study

Introduction: Anxiety disorders have a prevalence rate of 2.57% and significantly impact well-being and productivity. The course of anxiety disorders is characterised by fluctuating symptom severity, a high relapse rate, and chronicity. Patients with anxiety disorders are typically prescribed antidepressants or anti-anxiety medications, but these treatments often have limited long-term efficacy. Combining pharmacotherapy with non-pharmacological techniques, such as Progressive Muscle Relaxation (PMR), may enhance the effectiveness of treatment for anxiety disorders. Aim: To assess and compare the Hamilton Anxiety Rating Scale (HAM-A) scores at six-month between Group-E (who received Escitalopram exclusively) and Group-E+PMR (who received Escitalopram in addition to PMR). Materials and Methods: A randomised clinical study was conducted in the Department of Psychiatry at Sri Guru Ram Das Institute of Medical Sciences and Research in Amritsar, Punjab, India, from March 2020 to March 2021. The study was carried out following approval from the Institutional Ethics Committee (IEC). Participants were individuals aged 18 to 45 years who visited the Psychiatry Department's Outpatient Department (OPD) and met the ICD-10 criteria for Neurotic, stress-related, and somatoform disorders (F40-F48). One hundred and seventeen participants were randomly allocated to the two groups using a simple randomization method. Group-E received a daily dose of 10 mg Escitalopram for six months, while Group-E+PMR received the same dosage of Escitalopram along with Jacobson’s PMR exercises lasting 20 minutes, twice daily, at their place of residence. The HAM-A scale was employed to assess anxiety levels in both groups. Paired t-tests were conducted to compare pre- and post-treatment HAM-A scores within each group, while independent t-tests were used to compare scores between the groups. Statistical analysis was carried out using SPSS version 24.0 and a significance level of p<0.05 was adopted for the statistical assessments. Results: Both groups were comparable in terms of sociodemographic variables, mean age, and baseline HAM-A scores. The majority of participants, 70 (70%), were females. Significant improvements were noted in the HAM-A scores at six-month mark compared to baseline for both, Group-E and Group-E+PMR (p<0.001). Furthermore, Group-E+PMR exhibited a significant decrease in the HAM-A score at six months compared to Group-E (p<0.001), indicating more substantial improvements. Conclusion: Escitalopram and Escitalopram combined with PMR treatment effectively lowered anxiety. However, the incorporation of PMR Exercises alongside Escitalopram demonstrated more favourable outcomes in individuals with anxiety disorders.

The Structural Relationships Between Temperament Dimensions of Personality and Psychological Symptoms of Somatic Symptom Disorder with the Mediation of Emotional Dysregulation

Background and Objective: The aim of this study was to determine the structural relationships between temperament dimensions of personality and psychological symptoms of somatic symptom disorder with the mediation of emotional dysregulation. Methods and Materials: For this purpose, 380 students from the University of Tabriz were selected using multi-stage cluster random sampling during the academic year 2021-2022. The variables were measured using the Difficulties in Emotion Regulation Scale, the Somatic Complaint Questionnaire, the short form of the Symptom Checklist, and Cloninger's Temperament and Character Inventory (TCI). Findings: Data analysis using structural equation modeling showed that novelty seeking, reward dependence, and persistence negatively and significantly explain the variations in psychological symptoms. Harm avoidance and emotional dysregulation positively and significantly explain the variations in psychological symptoms. Reward dependence and persistence negatively and significantly explain the variations in emotional dysregulation. Novelty seeking and reward dependence negatively, and harm avoidance positively, can explain the variations in psychological symptoms through emotional dysregulation. Conclusion: The three temperament variables—novelty seeking, harm avoidance, and reward dependence—could explain the changes in somatic symptoms through the mediation of emotional dysregulation. These findings indicate that somatic symptom disorder is influenced by personality factors and that inefficiency in emotion regulation exacerbates this disorder. Additionally, these findings suggest that emotional dysregulation is a significant variable in the relationship between temperament dimensions and somatic symptoms.

Prevalence and sociodemographic determinants of common mental disorders (CMDs) symptoms in a rural adult population of Haryana, North India.

Common mental disorders (CMDs), including depression, anxiety, and somatoform disorders, affect all stages of life and impact individuals, families, and communities. This study aimed to determine the magnitude of CMDs and their sociodemographic determinants in the adult population of a rural block in North India. A cross-sectional, quantitative, community-based study was conducted among adult residents of a rural block in Haryana, North India, using a multistage random sampling technique. The Hindi version of the General Health Questionnaire (GHQ-12), a well-validated tool, was used to screen participants for CMDs. Scores of 4 or above denoted the presence of CMDs. Bivariate analyses were performed to determine the associations between CMDs and sociodemographic characteristics. Of the 180 residents selected for the study, most were women (60.0%) and aged between 31 and 50 years (52.3%). The prevalence of CMDs symptoms in the study population was 20.0%. The presence of CMDs symptoms was significantly higher among those who were aged 60 years or older [OR=12.33, 95% CI 3.21-47.38], widowed, divorced or separated [OR=7.50, 95% CI 1.09-51.52], illiterate [OR= 6.25, 95% CI 2.84-13.77], had monthly family income below 10,000 INR [OR=3.33, 95% CI 1.54-7.20], had any chronic physical illness [OR=8.28, 95% CI 3.70-18.56] and had a family history of any psychiatric illness [OR=5.56, 95% CI 1.52-19.42]. The burden of CMDs was quite high among adults in rural North India. The presence of CMDs was closely associated with sociodemographic characteristics. Primary care and community-based settings need to screen for, diagnose, and manage CMDs to address this growing problem.

Preventing the risk of iatrogenic harm when assessing and diagnosing functional neurological disorders and other functional somatic symptoms.

The present commentary raises some concerns about the risk of iatrogenic harm arising out of the diagnosis of functional neurologic and somatic disorders. These concerns are supported by evidence from the history of hysteria and findings from contemporary brain imaging. We discuss their implications for practice.

Health Locus of Control and Psychological and Somatization Disorder in Icelandic Outpatients with Cancer: A quantitative study

The aim of this study was to investigate locus of control amongst outpatients with cancer and its association with symptoms of depression, anxiety, and somatic symptoms. Women scored higher on the anxiety scale than men. The age group <50 had significantly higher anxiety than the other age groups (p<0.001). Participants who belonged to the age group 61-70 years old reported significantly higher scores for faith in ELC-physicians than those who were in the age group <50 (p<0.001). Those who were in treatment for symptom control only, reported significantly higher scores for MDASI total than those in treatment aiming for cure (p<0.001). For them interference with daily life was also found to be significantly worse (p<0.001). Chemotherapy treatment had significantly more impact on total scores for MDASI total (p<0.001), symptoms severities (p<0.001), and interference with daily life (p<0.001), wen compared to those receiving radiotherapy or combination of both.

Mental Disorders in Chronic Pain Patients Seeking Treatment at a Tertiary Pain Hospital

Abstract: Background: The high co-occurrence of chronic pain and mental disorders is well-established. Yet, an up-to-date account of the prevalence of mental disorders according to revised diagnostic criteria is lacking. Aims: The present study investigated the point and lifetime prevalence of a broad range of mental disorders according to DSM-5 in patients with chronic pain and examined associations of current mental health comorbidity with pain catastrophizing and health-related quality of life (HRQoL). Method: In this cross-sectional, observational study, patients with self-reported chronic pain receiving inpatient treatment at a specialized tertiary hospital were recruited for participation. Structured clinical interviews were conducted to assess current and lifetime diagnoses of mental disorders. Pain catastrophizing and HRQoL were assessed via questionnaires. Results: 145 patients (63.5% female; Mage = 54.9 years) participated in the study. 57.2% of the sample met the criteria for any current and 77.9% for any lifetime mental disorder. The most prevalent diagnostic groups of current mental disorders were substance-related and addictive disorders (26.2%), somatic symptom and related disorders (17.9%), depressive disorders (17.2%), and anxiety disorders (15.9%). Current mental health comorbidity was significantly associated with increased levels of pain catastrophizing and poorer HRQoL outcomes. Limitations: Chronic pain was only assessed by self-report, and no data regarding the exact medical diagnoses of the participants were collected. Conclusion: Comorbid mental disorders are highly prevalent in patients with chronic pain. Given the adverse effects of this comorbidity, the findings emphasize the need for addressing comorbid mental disorders in the management of chronic pain.

Identification of Psychological Symptom Clusters and Their Influencing Factors in Women Undergoing Assisted Reproductive Technology in China: a Cross-Sectional Study.

There are multiple psychological symptoms in women undergoing assisted reproductive technology, which seriously affect health-related quality of life and even cause patients to stop treatment. This study aimed to identify psychological symptom clusters and their influencing factors in women undergoing assisted reproductive technology. A cross-sectional survey was conducted from June to November 2023 at the reproductive centers of Nanjing Women and Children's Healthcare Hospital. Data on demographic and clinical characteristics and Symptom Checklist-90 were collected. Exploratory factor analysis was performed to identify psychological symptom clusters. Univariate logistic regression analysis and multivariate logistic regression analysis were performed to explore influencing factors. A total of 213 patients were recruited. The study found that the included participants scored higher on all SCL scales than the general Chinese females. The three most common were trouble remembering things (81.7%), feeling easily annoyed or irritated (81.2%), and feeling low in energy or slowed down (70.9%). Six symptom clusters were identified: paranoid ideation, depression, obsessive-compulsive disorder, interpersonal sensitivity, somatization, and sleep disorders. Multivariate logistic regression analysis showed that duration of infertility treatment (>12 months) was identified as a risk factor for sleep disorder cluster (OR=2.833, 95% CI:1.355~5.922), adverse pregnancy history was identified as a risk factor for paranoid ideation cluster (OR=2.961,95% CI:1.406~6.253), depression cluster (OR=2.404,95% CI:1.240~4.660), and obsessive-compulsive cluster (OR=1.810, 95% CI:1.016~3.233), financial burden during treatment was identified as risk factors for all symptom clusters[(OR=5.869, 95% CI:1.717~20.057),(OR=6.490,95% CI:2.210~19.063),(OR=3.034,95% CI:1.560~5.898),(OR=7.078,95% CI:2.420~20.698),(OR=4.532,95% CI:1.845~10.397),(OR=2.151,95% CI:1.129~4.098)]. Women undergoing ART experience various psychological symptoms that are interrelated and exist in the form of symptom clusters. More attention should be paid to the psychological status of patients with longer duration of infertility treatment, adverse pregnancy history, and financial burden during treatment. This study guides the development of targeted and effective psychological interventions to facilitate symptom management in women undergoing ART.

The Psychosomatic Health Status of Polish Psychiatric Nurses in Relation to Socio-Demographic Variables

Objective: The main aim of the study was to assess the psychosomatic health status of psychiatric nurses based on sociodemographic variables. Materials and Methods: The research was conducted at the Mazovian Provincial Hospital in Ząbki on a group of 101 individuals working in nursing positions. All participants gave voluntary and free consent to participate in the study. The study obtained approval from the bioethical committee. The health status of the respondents was assessed using a standardized, validated GHQ-28 questionnaire. The level of significance was set at p=0.05. Results: Social dysfunction among participants increased with age and length of employment at the current workplace (p < 0.05). Significantly higher scores (p < 0.05) in this area were observed in individuals in marital relationships and those with higher education. The intensity of anxiety and insomnia was significantly higher (p < 0.05) in individuals in marital relationships, respondents with secondary education, and those with a total work experience exceeding 30 years and over 15 years in the current workplace. The intensity of depressive symptoms was associated with a lack of higher education among respondents. The factor with the greatest impact on somatic symptoms among surveyed nurses (p < 0.05) was age over 50. Conclusions: There is a significant association between the intensity of somatic symptoms, anxiety, insomnia, and functional disorders and the age of participants. There is a significant association between the intensity of anxiety and insomnia symptoms, functional impairments, and the marital status of participants. There is a significant association between the intensity of depressive symptoms, anxiety, insomnia, and social dysfunction and the education level of participants.

Pathogenetic basis of modern approaches to the therapy of sleep disorders in the clinic of depression

Epidemiological studies indicate that about 35% of the world's population periodically suffer from insomnia. Many authors in their studies note sleep disturbances in the clinic of both somatic and mental disorders, often considering sleep disturbances as one of the predictors of these diseases. In psychiatric practice, sleep disorders are most often described in the clinic of depression, which is determined by the general pathophysiological mechanisms of their development due to disruption of the activity of the main neurotransmitter systems of the brain. The results of clinical studies show that the drug of choice in the treatment of sleep disorders in the depression clinic is the antidepressant Mirtazapine, which has a unique profile of pharmacological activity. According to international recommendations, Mirtazapine is a first-line drug in the treatment of anxiety and depressive disorders with sleep disorders and sexual dysfunction caused by taking other antidepressants.

Can internal medicine specialists diagnose functional somatic disorders (FSDs)? Training and comparison with FSD specialists.

Functional somatic disorders (FSD) are a common problem across medical settings and remain challenging to diagnose and treat. Many patients with FSD undergo sequential and unnecessary extensive diagnostic work-up, which is costly for society and stressful for patients. Previous studies have shown that the empirically based FSD diagnostic entities are interrater reliable and stable over time. The aim of this study was to investigate whether internists who have received adequate training and with sufficient time per patient could diagnose FSD. This was a prospective diagnostic accuracy study. The study was conducted from May 2020 to April 2022. The study included 27 consecutive patients referred by their general practitioner to a non-psychiatric diagnostic clinic for assessment of physical symptoms on suspicion of FSD. The internists received a 30-hour training course in the use of a tailored version of the SCAN interview. The main outcome measure was the agreement between the diagnoses of the internists and the reference diagnoses made by specialists in FSD on the basis of the full SCAN interview. The interrater agreement between the internists and the FSD experts was substantial for any FSD (kappa = 0.63) as well as multi-organ vs. single-organ FSD (kappa = 0.73), indicating good diagnostic agreement. Internists with proper training and sufficient time (3-4 hours) per patient can proficiently diagnose FSD employing a tailored version of the SCAN interview for use in a non-psychiatric diagnostic setting.

Neuroticism, perceived stress, adverse life events and self-efficacy as predictors of the development of functional somatic disorders: longitudinal population-based study (DanFunD).

Functional somatic disorder (FSD) is a unifying diagnosis that includes functional somatic syndromes such as irritable bowel, chronic widespread pain (CWP) and chronic fatigue. Several psychological factors are associated with FSD. However, longitudinal population-based studies elucidating the causal relationship are scarce. To explore if neuroticism, perceived stress, adverse life events (ALEs) and self-efficacy can predict the development of FSD over a 5-year period. A total of 4288 individuals who participated in the DanFunD baseline and 5-year follow-up investigations were included. FSD was established at both baseline and follow-up, with symptom questionnaires and diagnostic interviews. Neuroticism was measured with the short-form NEO Personality Inventory, perceived stress with the Cohen's Perceived Stress Scale, ALEs with the Danish version of the Cumulative Lifetime Adversity Measure and self-efficacy with the General Self-Efficacy Scale. Associations were investigated with multiple logistic regression models. Perceived stress predicted incident FSD, irritable bowel, CWP and chronic fatigue (odds ratios: 1.04-1.17). Neuroticism predicted incident FSD and chronic fatigue (odds ratios: 1.03-1.16). ALEs predicted incident FSD, CWP and chronic fatigue (odds ratios: 1.06-1.18). An increase in perceived stress from baseline to follow-up was associated with incident FSD, irritable bowel, CWP and chronic fatigue (odds ratios: 1.05-1.22). Contrary, an increase in self-efficacy seemed to be a protective factor (odds ratios: 0.89-0.99). High neuroticism, high perceived stress and a high number of ALEs are risk factors for the development of FSD. Particularly perceived stress seems to be an important contributor to the onset of FSD.

The impact of workplace harassment on the level of mental disorders: the moderating role of gender.

Studies prove a positive relationship between mobbing in the workplace and the level of mental disorders. In the present research, it was decided to test whether gender is a moderator of the relationships under consideration. It is well known that women and men experience differences in the general clinical manifestations of certain disorders such as depression, anxiety and addiction. Furthermore, women are more likely to experience mobbing than men. Therefore, it was decided to test whether gender could be a moderator of the relationship between workplace harassment and the level of mental disorders. Accordingly, a survey was conducted with 220 people aged 22-65 years employed in various Polish workplaces with at least one year of work experience, including 108 women and 112 men, using tools with verified psychometric properties. These were the Negative Action Questionnaire (NAQ) and the General Health Questionnaire (GHQ-28). The analyses conducted showed that gender significantly alters the relationship between mobbing and general mental health, levels of somatic disorders, anxiety and insomnia, and symptoms of depression. In terms of psychological wellbeing, men, compared to women, have a much stronger reaction to harassment, both of a personal nature and directly aimed at the work sphere. The aforementioned relationships may find practical application in the development of effective methods for the prevention and treatment of the effects of workplace harassment.

Promoting Awareness Among New Generations of Dental Instructors about Essential Knowledge and Expertise for Recognizing and Managing Dental Patients with Somatic Symptom Disorder in Undergraduate Dental Clinics - A Review

Dental instructors are equipped with the fundamental dental knowledge and expertise to efficiently supervise dental students for managing their patients in the undergraduate dental school clinics. However, they do not have the basic knowledge for identifying and managing patients with Somatic Symptom Disorder (SSD) at chairside prior to initiating the dental treatment. Lack of such knowledge is a major reason for problems in diagnosis and management of these dental patients which could result in repeated, ineffective dental treatments, such as dental filling, root canal, or even extraction. The aim of this review is to promote awareness among new generations of dental instructors of the need to acquire the basic knowledge about SSD. Several recommendations are made to assist dental instructors in gaining the essential knowledge for assisting dental students at chairside in identifying and managing dental patients with such psychiatric disorder.