Somatoform Research Articles

Peculiarities of adaptation of the cardiovascular system of combatants after exposure to combat stress and trauma

Abstract. Military operations are generally considered to be a pronounced psycho-traumatic situation due to specific factors that lead to persistent mental and somatic health disorders and a slowdown in the rate of further social adaptation of military personnel.
 Post-traumatic stress disorder (PTSD) is described as a set of complex somatic, cognitive, affective, and behavioral effects of psychological trauma.
 One of the essential features of combatants' PTSD is that after the end of the period of stay in the conditions of hostilities, a high incidence of chronic somatic diseases is manifested. There is a correlation in the neurotic symptoms (in all cases) of deterioration of the somatic condition, and exacerbation of somatic pathology aggravates mental disorders.
 The problem of morbidity and mortality from circulatory system diseases, blood poisoning and injuries is of particular relevance to combatants, as the onset of cardiovascular disease is closely related to the traumatic impact of wartime or PTSD. Particular attention to the medical and psychological consequences of the effects of extreme factors associated with combat on the body of military personnel is associated with both the prevalence of PTSD, which reaches 70-85%, and the duration of its symptoms.

Psychiatric diagnoses, somatic disorders, and emergency dispatches among individuals who used a national suicide crisis line

Crisis line responders initiate emergency dispatches by activating 911 or other local emergency services when individuals are determined to be at imminent risk for undesired outcomes. This study examined the association of characteristics, psychiatric diagnoses, and somatic symptoms with emergency dispatches in a national sample. Veterans Crisis Line data were used to identify contacts (i.e., calls, texts, chats, emails) that were linked with medical records and had a medical encounter in the year prior to contact. Hierarchical logistic regression clustered by responders was used to identify the association among demographics, psychiatric diagnoses, and somatic disorders, and emergency dispatches. Analyses examined 247,340 contacts from 2017 to 2020, with 27,005 (10.9%) emergency dispatches. Odds of an emergency dispatch increased with each diagnosis (three diagnoses Adjusted Odds Ratio [AOR] (95% CI) = 1.88 [1.81,1.95]). Odds were highest among individuals with substance use disorders (SUD) (alcohol AOR (95% CI) = 1.85 [1.80,1.91]; drugs AOR (95% CI) = 1.63 [1.58, 1.68]), which may be a result of intoxication or overdose during contact, requiring further research. Having more psychiatric and somatic conditions was associated with greater odds of an emergency dispatch, indicating that comorbidity contributed to the need for acute care.

Effect of chronic stress on the degree of acrylamide toxicity in rats

Introduction. Chronic stress plays an important role in the development of a wide range of mental, somatic and behavioural disorders, and therefore is a risk factor for the health in living organisms. A negative effect on the state of the nervous system is also observed when the body is poisoned with acrylamide, which is a substance of the second class of danger and is considered toxic and carcinogenic. Exposure of the body to mental and toxic stressors leads to autonomic and neuroendocrine activation, which, in turn, manifests itself as special behavioural patterns. 
 The purpose of the experiment was to assess the effect of chronic stress on the degree of acrylamide toxicity in rats.
 Materials and methods. The experiment was conducted on white outbred rats with an average weight of 200 g of both sexes (n=60), which were evenly distributed into five groups: negative control, chronic stress, acrylamide, acrylamide + treatment, acrylamide + chronic stress. Throughout the study, the animals were kept under standard conditions with 12 hours of artificial lighting during the day, a relatively constant level of humidity (30–70%) and an air temperature of 20–25 °C. Behavioural tests were conducted once a week for one calendar month using a 40×40 hole board, a multifunctional cage to assess general activity, and an elevated plus maze with an ANY-maze video tracking system. Biochemical parameters were assessed in accordance with the manufacturer’s instructions.
 Results. Analysis of behaviour on a board with holes did not reveal statistically significant results (H=8.987; p=0.061). When comparing vertical and horizontal motor activity between groups, statistically significant differences were found (p<0.05). AST levels were higher in the stress groups, while cholesterol levels in the same groups were lower (p<0.05).
 Limitations. Laboratory animals of only one biological species were used for the experiment. The toxicant was used only in one concentration.
 Conclusion. Chronic stress may influence on acrylamide toxicity in rats to a certain extent.

Cognitive–behavioral therapy for patients with somatoform disorders: A pilot preliminary randomized controlled trial

Background and objective: Cognitive–behavioral therapy (CBT) for somatoform disorders (SFDs) is understudied in China. Western findings may not be applicable to Chinese culture. This preliminary study evaluated the efficacy of CBT for patients in China, relative to treatment-as-usual (TAU). Methods: Seventy patients with SFDs randomly received either combined CBT and TAU (CBT + TAU), or TAU alone between January 2018 to May 2019. The CBT + TAU group received 12 weekly individual 50-minute CBT sessions. Participants were blindly assessed at 4 timepoints (baseline, week 6, end of treatment: week 12; 12 weeks post-treatment: week 24) using the following outcome measures: SQSS (Self-screening Questionnaire for Somatic Symptoms); PHQ-15 (Patient-Health-Questionnaire-15) and the WI (Whiteley Index); GAD-7 (General Anxiety Disorder-7); HAMD-17 (Hamilton Depression Rating Scale-17); Family Burden Interview Schedule (FBIS); Sheehan Disability Scale (SDS); and the Short Form of Quality-of-Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF). The primary endpoint was the difference between the SQSS total score at week 24 and the baseline. A mixed model for repeated measures was used to analyze inter- and intra-group changes from the baseline. Results: At week 24, The least-squares mean (LSM) change of the total score on the SQSS was −18.87 points and −9.69 points, respectively in the CBT + TAU group and in the TAU group (LSM difference, −9.18 points; 95% confidence interval, −15.72 to −2.64; P = 0.0068). At week 24, the LSM changes from baseline in the WI, HAMD, PHQ15, FBIS and SDS total scores were significantly different between the two groups, however, there was no significant difference in the Q-LES-Q-SF. The SQSS of group effect sizes were 0.63 at 24 weeks. The dropout rates of the CBT + TAU and TAU groups were comparable (22.9% and 19.3%). Conclusions: These preliminary findings suggest that CBT may be helpful for improving the symptoms of patients with SFDs in China.

Towards agreement amongst parents, teachers and children on perceived psychopathology in children in a Kenyan socio-cultural context: a cross-sectional study

BackgroundOur objective was to determine levels of agreement between parents, teachers and children on mental symptoms in the children. Teachers, children and parents constitute the TRIAD in the perception of psychopathology in children. Analyzing the perceptions of psychopathology from the perspectives of parents, teachers, and children is essential for a comprehensive understanding of a child’s mental health.MethodsWe identified 195 participants across ten randomly sampled primary schools in South East Kenya. Potential participants were randomly selected and a sampling interval calculated to determine the study participants. The children (Class 5–8; aged 11–14) completed the Youth Self-Report (YSR) scale, the parents the Child Behavior Check List (CBCL) on their children and the teachers completed the Teachers Rating Form (TRF) on the children. Only parents and teachers who gave consent as well as children who gave assent were included in the study. Analysis was conducted using Stata 14.1 and Pearson correlation coefficients used to calculate the correlations between CBCL, YSR and TRF.ResultsThe children agreed least with the parents and more with the teachers. There was a greater agreement between the children and their teachers in 5 (2 internalizing disorders and 3 externalizing disorders) out of the 8 conditions. Children and parents agreed only on somatic disorders and conduct disorders. YSR mean scores were significantly lower than those for CBCL for all problem scales. Mean scores of TRF and YSR were comparable in the majority of the problems measured.ConclusionWe suggest broad-based psychoeducation to include children, parents/guardians and teachers to enhance shared awareness of psychopathology and uptake of treatment and for the consideration of an integrated mental health system.

A network of transcriptomic signatures identifies novel comorbidity mechanisms between schizophrenia and somatic disorders

The clinical burden of mental illness, in particular schizophrenia and bipolar disorder, are driven by frequent chronic courses and increased mortality, as well as the risk for comorbid conditions such as cardiovascular disease and type 2 diabetes. Evidence suggests an overlap of molecular pathways between psychotic disorders and somatic comorbidities. In this study, we developed a computational framework to perform comorbidity modeling via an improved integrative unsupervised machine learning approach based on multi-rank non-negative matrix factorization (mrNMF). Using this procedure, we extracted molecular signatures potentially explaining shared comorbidity mechanisms. For this, 27 case–control microarray transcriptomic datasets across multiple tissues were collected, covering three main categories of conditions including psychotic disorders, cardiovascular diseases and type II diabetes. We addressed the limitation of normal NMF for parameter selection by introducing multi-rank ensembled NMF to identify signatures under various hierarchical levels simultaneously. Analysis of comorbidity signature pairs was performed to identify several potential mechanisms involving activation of inflammatory response auxiliarily interconnecting angiogenesis, oxidative response and GABAergic neuro-action. Overall, we proposed a general cross-cohorts computing workflow for investigating the comorbid pattern across multiple symptoms, applied it to the real-data comorbidity study on schizophrenia, and further discussed the potential for future application of the approach.

Evaluation of Event-Related Potentials in Somatic Diseases - Systematic Review.

Many somatic illnesses (e.g. hypertension, diabetes, pulmonary and cardiac diseases, hepatitis C, kidney and heart failure, HIV infection, Sjogren's disease) may impact central nervous system functions resulting in emotional, sensory, cognitive or even personality impairments. Event-related potential (ERP) methodology allows for monitoring neurocognitive processes and thus can provide a valuable window into these cognitive processes that are influenced, or brought about, by somatic disorders. The current review aims to present published studies on the relationships between somatic illness and brain function as assessed with ERP methodology, with the goal to discuss where this field of study is right now and suggest future directions.

Frontal alpha asymmetry is associated with chronic stress and depression, but not with somatoform disorders

Cardinal characteristics of somatoform disorders (SFDs) are worry of illness, and impaired affective processing. We used relative frontal alpha asymmetry (FAA), a method to measure functional lateralization of affective processing, to investigate psychobiological correlates of SFDs. With alpha activity being inversely related to cortical network activity, relative FAA refers to alpha activity on the right frontal lobe minus alpha activity on the left frontal lobe. Less relative left frontal activity, reflected by negative FAA scores, is associated with lower positive and greater negative affectivity, such as observed in depression. Due to its negative affective component (illness anxiety), we expected to find less relative left frontal activity pattern in SFDs, and positive associations with self-reported chronic stress and depression symptoms. We recorded resting-state EEG activity with 64 electrodes, placed in a 10–10 system in 26 patients with a primary SFD, 23 patients with a major depressive disorder and 25 healthy control participants. The groups did not differ in FAA. Nevertheless, across all participants, less relative left frontal activity was associated with chronic stress and depression symptoms. We concluded that FAA may not serve as an indicator of SFDs. As the relationship of FAA and depressive symptoms was fully mediated by chronic stress, future studies have to clarify whether the association between FAA and chronic stress may represent a shared underlying factor for the manifestation of mental health complaints, such as depression.

Prevalence of Autism Spectrum Disorder and Co-Morbidities in Children and Adolescents: A Systematic Literature Review.

Individuals with autism spectrum disorder often present somatic and/or psychiatric co-morbid disorders. The DSM-5 allows for consideration of additional diagnoses besides ASD and may have impacted the prevalence of co-morbidities as well as being limited in capturing the true differences in prevalence observed between males and females. We describe the prevalence of ASD and frequently observed co-morbidities in children and adolescents (<18 years) in the United States and five European countries. Two systematic literature reviews were conducted in PubMed and Embase for the period 2014-2019 and focusing on the prevalence of ASD and nine co-morbidities of interest based on their frequency and/or severity: Attention Deficit Hyperactivity Disorder (ADHD), anxiety, depressive disorders, epilepsy, intellectual disability (ID), sleep disorders, sight/hearing impairment/loss, and gastro-intestinal syndromes (GI). Thirteen studies on prevalence of ASD and 33 on prevalence of co-morbidities were included. Prevalence of ASD was 1.70 and 1.85% in U.S children aged 4 and 8 years respectively, while prevalence in Europe ranged between 0.38 and 1.55%. Additionally, current evidence is supportive of a global increase in ASD prevalence over the past years. Substantial heterogeneity in prevalence of co-morbidities was observed: ADHD (0.00-86.00%), anxiety (0.00-82.20%), depressive disorders (0.00-74.80%), epilepsy (2.80-77.50%), ID (0.00-91.70%), sleep disorders (2.08-72.50%), sight/hearing impairment/loss (0.00-14.90%/0.00-4.90%), and GI syndromes (0.00-67.80%). Studies were heterogeneous in terms of design and method to estimate prevalence. Gender appears to represent a risk factor for co-morbid ADHD (higher in males) and epilepsy/seizure (higher in females) while age is also associated with ADHD and anxiety (increasing until adolescence). Our results provide a descriptive review of the prevalence of ASD and its co-morbidities in children and adolescents. These insights can be valuable for clinicians and parents/guardians of autistic children. Prevalence of ASD has increased over time while co-morbidities bring additional heterogeneity to the clinical presentation, which further advocates for personalized approaches to treatment and support. Having a clear understanding of the prevalence of ASD and its co-morbidities is important to raise awareness among stakeholders.Appeared originally in Front Psychiatry 2021; 12:744709.

Strategies to improve implementation of collaborative care for functional disorders and persistent somatic symptoms: A qualitative study using a Research World Café design

IntroductionPersistent somatic symptoms and functional disorders (PSS/FD) are often complex conditions requiring care from multiple disciplines. One way of bringing the different disciplines together is through collaborative care. Little is known about the implementation barriers faced and relevant strategies to tackle the barriers in this field. Therefore, using expert knowledge, we aim to develop realistic strategies for dealing with implementation barriers of collaborative care in PSS/FD. MethodsThe Research World Café method is a single-session, expert-based method with multiple focus-groups forming and reforming to answer a set of inter-related questions, under the guidance of moderators. Using this method, participants involved in PSS/FD care across different areas of healthcare in the Netherlands developed several realistic strategies for dealing with ten implementation barriers for collaborative care in PSS/FD that were previously identified in a Delphi study. Strategies were grouped into strategy clusters using a card-sorting task. ResultsThirty-three participants took part, representing ten different disciplines, most commonly physiotherapists, psychologists, and physicians. In total, 54 strategies, identified in response to the ten barriers, were grouped into eight strategy clusters. The strategy clusters were professional education, communication, care coordination, care pathways, joint consults, funding, patient involvement, and prevention. ConclusionWe identified a number of useful strategies for dealing with implementation barriers for collaborative care in PSS/FD. Many strategies provided ways to deal with multiple barriers at once. The effects of applying these strategies in collaborative care in PSS/FD will need testing through implementation studies, as well as in other areas needing multidisciplinary care.

Efficacy of patient education and duloxetine, alone and in combination, for patients with multisystem functional somatic disorder: Study protocol for the EDULOX trial

BackgroundMultisystem functional somatic disorder is characterized by specific patterns of persistent physical symptoms with a complex biopsychosocial etiology. The disorder can lead to disability and personal suffering. Current treatment options require specialized settings, therefore patients often wait a long time to receive specific treatment.Patient education is considered important in most treatment programs, but has only been investigated sparsely as a stand-alone treatment. Pharmacological treatment is limited to tricyclic antidepressants in low doses with no antidepressant properties. Duloxetine has been found effective in single organ functional disorders. As a treatment for multisystem functional somatic disorder, duloxetine could reduce symptoms and treat comorbid anxiety and depression. It may furthermore enhance the effect of patient education through a hypothesized effect on cognitive functioning. The purpose of the EDULOX trial is to study psycho-EDUcation and duLOXetine alone and in combination. MethodsThis is a nested study design. The parent trial “EDULOX1” (n = 424) will compare a patient education program with enhanced usual care in an open-labelled, randomized controlled trial. In addition to this, eligible participants will furthermore receive either duloxetine or active placebo in the nested, double-blinded, randomized controlled trial, “EDULOX2” (n = 212). Patient and clinician reported outcomes will be collected through questionnaires. ConclusionThe EDULOX trial may establish evidence for treatments applicable for the majority of patients with multisystem functional somatic disorder. If effective, duloxetine would be a more tolerable pharmacological treatment option that can target comorbid depression and anxiety, and potentially boost the effect of patient education.Trial registration numberThe study is registered at www.clinicaltrials.gov (NCT06232473) and the internal list of research projects at the Region of Central Denmark (Case number 1-16-02-305-23). Approval from the Danish Medical Research Ethics Committees (Case number: 2212291) and the Danish Medicines Agency was obtained under EudraCT Number: 2022-002780-30 and Sponsor's Protocol Code Number: 9515.

INTERNET-BASED COGNITIVE BEHAVIORAL THERAPY FOR SOMATIC SYMPTOM DISORDER

Introduction – Somatic symptom disorder (SSD), before known as somatoform disorder (SD), is characterized by a preoccupation that is nondelusional and general with fears of having, or the idea that the body has a serious disease based on his or her misinterpretation of bodily symptoms in six or more months. In SSD management there is a multifaceted approach that is tailored to each patient. Psychological interventions specifically cognitive behavioral therapy reported can improve the symptoms and reduce the healthcare cost significantly. Internet-delivered cognitive behavior therapy (ICBT) has an accepted evidence base for a range of psychiatric problems, especially for SSD treatment also has been suggested as one possible approach that could adapted to this situation. Methods – In this article, researchers used the review method by collecting several kinds of literature from 2011-2021 that discuss somatic symptom disorder, cognitive behavioral therapy, and internet-based cognitive behavioral therapy for somatic symptom disorder. Results – A referral system for patients with SSD to a mental health expert is needed if they do not find any progress when handled by the physician in primary care. Proven therapies for SSD such as CBT and mindfulness-based therapy. ICBT was approved and increased usage within the pandemic of COVID-19 and brought some highly standardized courses consistent across patients. Discuss – The effectiveness of ICBT has been evaluated in the management of generalized anxiety disorder (GAD), depression, panic disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), adjustment disorder, chronic pain, bipolar disorder, and phobias. CBT in multicenter randomized controlled trials reported effectiveness in the treatment of SSD and medically unexplained symptoms, “Health anxious” patients get over two years of sustained symptomatic benefit, without any different impact on total costs, and also decreased the physical symptoms, disability, and psychological distress. Conclusion – Internet-based Cognitive Behavioral Therapy (ICBT) can be highly effective in the treatment of somatic symptom disorder (SSD). ICBT can provided in therapist-guided, unguided, or as a bibliotherapy. This tool is already recommended as a treatment of choice during the pandemic. Although wider RCT on the use of ICBT in clinical practice, particularly in SSD therapy, with a variety of demographic characteristics to provide additional evidence of the effectiveness of this technique, as well as increased awareness among clinicians and the general public. Keywords: SSD, somatic, CBT.

Overview of approved psychiatric medications 2008-2023: A systematic review

Objective: The purpose of this systematic review is to enumerate the psychiatric medications approved by the Food and Drug Administration (FDA) over the past 15 years, from 2008 to 2023, and describe their mechanism of action, approved indications, dosing ranges, and adverse effects. Methods: Studies published from 2008 to 2023 were identified from the PubMed database, using the keywords: ‘psychiatric’ OR ‘psychopharm*” AND ‘medic*’ OR ‘pharm*’. An independent focused analysis was conducted, and a consensus was reached on the studies for approved medications to be included in this systematic review. Key findings were derived from the full-text and tables of the selected studies. Results: From 2008-2023, the FDA approved 118 medications including: 26 for Schizophrenia, 12 for Bipolar Disorders, 16 for Depressive Disorders, two for Anxiety Disorders, one for Feeding and Eating disorders, 13 for Sleep-Wake Disorders, five for Sexual Dysfunctions, 16 for Substance Use Disorders, six for Neurocognitive Disorders, and 18 for Neurodevelopmental Disorders (specifically, Attention-Deficit/Hyperactivity Disorder, ADHD), in addition to three for Psychiatric Medication-Related Movement Disorders. It is important to note that 37 out of the 118 medications were New Drug Application (NDA) approvals by the FDA, i.e., they have not been previously approved for another indication. We also noted that nine medications were discontinued by the manufacturer, with no reported safety or effectiveness concerns. Over the past fifteen years, several novel treatment approaches and modalities have been introduced, such as monoclonal antibodies for the treatment of Alzheimer’s Disease, very long-acting injectable antipsychotic drugs, targeting the glutamate neurochemical system for depression and depressive symptoms in other disorders, medications for conditions without any previously approved medicines (e.g., Binge Eating Disorder), and tablets with sensors to monitor treatment adherence. Of note, no new medications were approved from 2008-2023 for: Anxiety Disorders (with the exception of two extended-release preparations of previously approved agents), Obsessive-Compulsive Disorder, Trauma- and Stressor-Related Disorders, Dissociation Disorders, Somatic Symptom Disorders, and Disruptive, Impulse-Control, and Conduct Disorders. Conclusion: Approved psychiatric medications from 2008-2023 show substantial promise in the treatment of psychiatric conditions. More than 100 psychiatric medications were approved over the past 15 years for the major psychiatric conditions including a combination of newly introduced medications and new indications and drug formulations for already approved medications. It behooves psychiatric clinicians to keep up to date with this ever evolving and fast changing field. As the overview article, this manuscript will be followed by in-depth, disorder-based descriptions of approved medications, as well as those currently under development in Phase III.

COVID-19-Related Stressors and Psychophysical Health Conditions among Italian University Students: A Post Pandemic Insight.

This study aims to assess and compare COVID-19-related stressors (relationships and academic life; isolation; and fear of contagion) and psychophysical symptoms reported by 637 university students at three times, i.e., April 2020 (n = 197), April 2021 (n = 200), and April 2022 (n = 240). The impact of COVID-19-related stressors on psychophysical symptoms within each time was also tested. In April 2022, perceived isolation and fear of contagion decreased from the peak registered in April 2021, but stress related to relationships and academic life remained high. An ongoing increase in psychophysical symptoms was found. More than 50% of students reported clinical levels of sleep disorders, depression, psychoticism, and interpersonal sensitivity. In April 2022, students still perceiving stress related to relationships and academic life and isolation were at risk for anxiety, somatization, and sleep disorders. Students still perceiving stress related to fear of contagion were also at risk for depression, obsessive-compulsive symptoms, and psychoticism. The findings emphasized the long-lasting effects of COVID-19-related stress on students' psychophysical health. Interventions must aim at supporting students in dealing with the complex post-pandemic adjustment process.

Neuropsychological aspects of stress manifestation

Modern life, unfortunately, is not devoid of stressful situations. This article explores how stress affects various cognitive functions, making us more vulnerable. Memory, attention, decision-making, inhibition, and abstract thinking are just some aspects of the effects of stress. Studies show that prolonged or repeated stress can weaken the immune system, increasing inflammation and even destroying neurons in the hippocampus responsible for memory. Maturation of the frontal cortex, which is accompanied by an increase in gray matter volume and the number of synapses, can be disrupted by stress, leading to cognitive decline. Recent research on the impact of stressful situations on psychological and physical health is characterized by a wide range of methodological approaches and a variety of sources. Sapolsky R. highlights the impact of stress on memory-related processes, as well as on the formation of certain parts of the brain. In the work of D. Nakazawa, we get acquainted with neural development and the natural processes associated with this development. Thus, the latest research and publications in the field of stress psychology are an important contribution to our understanding of this complex problem and the development of practical recommendations for overcoming the negative effects of stress. Sleep is crucial for restoring energy and consolidating memory, but it also becomes a victim of stress. Lack of sleep and deterioration in its quality make us more vulnerable to the negative effects of stress. Children who have experienced stress risk losing even more neurons than their peers, as the natural neuronal pruning at puberty can be intensified. Chronic stress can lead to neurotic reactions, psychophysiological symptoms, and psychosomatic illnesses. This emphasizes the importance of nervous system rehabilitation and neuropsychological interventions.

Awareness of somatisation disorder among Swedish physicians at emergency departments: a cross-sectional survey

BackgroundSomatisation is a highly prevalent psychiatric syndrome in both women and men, in which psychological distress is manifested in physical symptoms without a medical explanation. Many patients with somatisation disorder are high healthcare utilisers, particularly at emergency departments. Unnecessary investigations and diagnostic operations occur frequently, which cause both patient suffering and a significant burden on the healthcare system. Emergency department physicians’ awareness of somatisation and its manifestations has not previously been studied. This study aimed to investigate awareness about somatisation disorder among physicians working at emergency departments in western Sweden, and to explore differences between gender, specialty, and work experience.MethodsA web-based, cross-sectional survey consisting of six dichotomous questions about somatisation disorder was conducted, in December 2021 – January 2022, among licensed physicians of various specialties working at emergency departments in western Sweden. Descriptive analyses and comparative analyses were performed to investigate differences between gender, type of specialty, and years of practice. Data were analysed using chi2 tests and Fisher’s exact test.ResultsOf the 526 eligible physicians who received the survey, 241 responded; response rate 45.8%. The majority of the respondents (56.4%) were women, and most (35.3%) were specialised in obstetrics/gynaecology. Average years of work experience was 11.1 (SD 8.7) years. Although 71% of respondents were aware of the diagnosis, only 7% knew the diagnostic criteria and only 6% had ever diagnosed a patient with somatisation disorder. Female physicians were more aware of underlying factors than their male colleagues (55.7% vs. 38.2%; p = .010). Type of specialty or years of practice did not affect awareness.ConclusionsAwareness of somatisation disorder is low among physicians working at emergency departments in western Sweden. The findings suggest a need to increase awareness and knowledge and provide training in diagnosing the condition, to ensure correct decisions and optimal patient management. Clinical guidelines need to be developed to support diagnosis, investigation, and treatment, in Sweden as well as internationally.

The structure of clinical and psychopathological consequences of coronavirus disease COVID-19 in people with a history of mental disorders

The impact of the COVID-19 pandemic on mental health indicates the need to define psychopathological manifestations to highlight diagnostic criteria. The purpose of the study is to determine the structural features of clinical and psychopathological manifestations of mental disorders after the coronavirus disease COVID-19 in people with a history of mental disorders. In the Department of Border Psychiatry of the State Institution “Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine", 95 patients with a history of mental disorders who had suffered the coronavirus disease COVID-19 were examined. The group examined included patients with recurrent depressive disorders (F32), with mental disorders of organic origin (F06.3, F06.4) and with neurotic, stress-related and somatoform disorders (F41.1, F42.3), F48.0). It was determined that the clinical manifestations of mental disorders in the examined patients are characterized by a predominance of affective symptoms in combination with pronounced specific cognitive, ideational, and somato-vegetative disorders, as well as disorders of the effector-volitional sphere. The results of a psychodiagnostics study (on the MADRS, HARS, GAD-7 and CGI-S scales) showed that the structure of clinical manifestations in these patients was characterized by a predominance of affective disorders of the anxiety-depressive spectrum of varying severity, which had certain differences among nosological groups. Determining the clinical and psychopathological features of the structure of mental disorders after suffering from COVID-19 is important not only for their diagnosis, but also for early and adequate therapy, taking into account the identified features that can act as targets for therapeutic intervention. Key words: clinical-psychopathological consequences, mental disorders, coronavirus disease COVID-19

A post-traumatic stress disorder in military servicemen and war veterans

Aim. To analyze the characteristics of the incidence of a post-traumatic stress disorder in military servicemen and war veterans in order to search for new methods of diagnosis and treatment. Materials and methods. The analysis of the data of a secret questionnaire of doctors (psychiatrists, neuropathologists) regarding changes in character, complaints about anxiety after returning from the war zone in military servicemen and war veterans was used. Results and discussion. Since the start of russia’s full-scale invasion of Ukraine, there has been a brutal, exhausting war bringing a post-traumatic stress disorder (PTSD) on a par with Ukraine’s leading health problems. By monitoring foreign sources and literature, which more broadly highlight the problems of military personnel and war veterans with experience of working in such harsh conditions, a study on the prevalence of a post-traumatic stress disorder was conducted. Conclusions. Therefore, it is promising to conduct further research to improve understanding of the prevalence of a post-traumatic stress disorder in military servicemen and war veterans, which remains one of the “young” diagnoses in Ukraine and in world psychiatry. In the International Classification of Diseases (ICD-10), it is designated by the code F43. 1 and is included in the section F40-F48 “Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders”.

Eating disorders in preschool and primary school children with autism spectrum disorder and its clinical significance

Autism spectrum disorder is the fastest growing form of nervous and mental development disorder in the world. In this regard, there is a special need to resolve issues of diagnosis and correction of not only the main symptoms of this disease, but also numerous associated somatic disorders. One of the common clinical manifestations in children with autism spectrum disorder is pathological eating behavior, which includes disturbances in eating habits and preferences, frequency of meals, etc. Despite the fact that eating disorders can also occur among normotypical coevals, in children with autism spectrum disorder, these manifestations are clinically more diverse, vary in severity and often appear earlier than the main symptoms of the disease. It must be emphasized that the correction of certain nutritional disorders in this group of children is often difficult due to the characteristics of the course of the underlying disease. This may be further exacerbated by increased parental anxiety. A timely solution to the problem of eating behavior in children with autistic disorder is of great importance for strengthening their health and reducing the severity of the underlying disease, since the connection between neuropsychic and somatic health is inseparable. In the review, we tried to identify the main factors involved in the formation of eating disorders in children with autism spectrum disorder, and presented existing practical tools for analyzing this medical problem and managing their nutrition for preventive and therapeutic purposes.

Personality and psychopathology in stand-up comedians

ObjectiveThere is a widely held popular belief that comedians are prone to mental illness and fall into the “mad artist” archetype. The present study aims to examine personality, mental illness, and tangible markers of psychological functioning in comedians compared to adults in the general population. MethodsThe sample included 108 comedians and 99 adults from the general population. Participants provided demographic information and psychiatric history. They completed self-report measures that screened for the most common DSM-IV Axis I disorders, personality characteristics and pathology, and malignant self-regard. ResultsComedians reported significant levels of symptomatology for Generalized Anxiety Disorder (GAD) and Somatization Disorder, and they screened positive for alcohol and substance use problems at higher rates. The comedian sample also scored significantly higher on measures of Openness to Experience, Extraversion, and Malignant Self-Regard (MSR). MSR and GAD became non-significant after controlling for regional differences. ConclusionSome of our findings, such as higher Openness to Experience, are replications of previous research, while other findings, such as elevated anxiety-related symptoms, are novel and warrant replication. We discuss the psychological profile of comedians and the roles of underlying personality versus entertainment industry forces.