Somatic Symptom Scores Research Articles

Problematic smartphone use has detrimental effects on mental health and somatic symptoms in a heterogeneous sample of German adults

Although research examining the association between problematic smartphone use and mental health has grown recently, there is a lack of studies investigating possible associations with physical (somatic) symptoms. Moreover, many studies are based on student samples from North America and China, limiting their generalizability. The current study aimed to examine problematic smartphone use in a broad sample of German adults. An online survey comprising demographic questions, problematic smartphone use scales and somatic symptom inventories, as well as depression, anxiety, stress, and sleep quality scales was completed by 930 participants. Problematic smartphone users reported longer usage per day, more interruptions to activities to check their smartphones, and higher scores for stress, depression, anxiety, sleep disturbances, and somatic symptoms than did unproblematic users. In comparison, both groups allocated similar proportions of time to various applications. The results showed small to moderate bivariate associations between problematic smartphone use and indicators of mental health and somatic symptoms, while a multivariate analysis highlighted the importance of perceived stress. Since mental health and somatic symptoms are associated with problematic smartphone use, future studies should investigate the causal direction of the associations found.

Factor Structure and Psychometric Properties of the Body Perception Questionnaire-Short Form (BPQ-SF) Among Chinese College Students.

ObjectiveBody perception, including body awareness and reactivity, is featured in a range of mental health conditions. However, research on Chinese questionnaires assessing body perception has been surprisingly absent. The present study aimed to investigate the factor structure and psychometric properties of the Body Perception Questionnaire–Short Form (BPQ-SF) among Chinese.Methodsthe current sample included 688 Chinese college students. Self-report scales were used to measure body perception, somatization, and depressive somatic and psychological symptoms.ResultsConfirmatory factor analysis supported a three-factor model of the BPQ-SF, involving body awareness, supradiaphragmatic reactivity, and subdiaphragmatic reactivity. Good internal consistency and test–retest reliability were observed. Convergent validity was established by significant correlations with scores of somatization and somatic symptoms of depression. Divergent validity was evidenced by non-significant association with ratings on psychological symptoms of depression. The very short form of the body awareness subscale of BPQ can be an alternative to the body awareness subscale when scale length is the priority.ConclusionThe BPQ-SF possessed three latent factors and demonstrated good psychometric properties that can measure body perception among Chinese in a reliable and valid way.

Linking depressive symptom dimensions to cerebellar subregion volumes in later life

The present study examined the relationship between subthreshold depressive symptoms and gray matter volume in subregions of the posterior cerebellum. Structural magnetic resonance imaging data from 38 adults aged 51 to 80 years were analyzed along with participants’ responses to the Center for Epidemiologic Studies Depression Scale. Subscale scores for depressed mood, somatic symptoms, and lack of positive affect were calculated, and multiple regression analyses were used to examine the relationship between symptom dimensions and cerebellar volumes. Greater total depressive symptoms and greater somatic symptoms of depression were significantly related to larger volumes of vermis VI, a region within the salience network, which is altered in depression. Exploratory analyses revealed that higher scores on the lack of positive affect subscale were related to larger vermis VIII volumes. These results support that depressive symptom profiles have unique relationships within the cerebellum that may be important as the field move towards targeted treatment approaches for depression.

Genetic susceptibility, inflammation and specific types of depressive symptoms: evidence from the English Longitudinal Study of Ageing

Genetic susceptibility to depression has been established using polygenic scores, but the underlying mechanisms and the potentially differential effects of polygenic scores on specific types of depressive symptoms remain unknown. This study examined whether systemic low-grade inflammation mediated the association between polygenic scores for depressive symptomatology (DS-PGS) and subsequent somatic versus cognitive-affective depressive symptoms. The sample consisted of 3510 men and women (aged 50+) recruited from the English Longitudinal Study of Ageing. DS-PGS were derived using the results of a recent genome-wide association study. Plasma C-reactive protein (CRP) was measured at wave 6 (2012/13). Depressive symptoms were assessed at wave 8 (2016/17), using the eight-item version of the Centre for Epidemiological Studies Depression Scale. Covariates (wave 2, 2004/05) included age, sex and ten principal components (PCs) to control for population stratification. Confirmatory factor analysis was performed to corroborate a previously identified two-factor structure of the CES-D, distinguishing between cognitive-affective and somatic symptoms. Longitudinal structural equation modelling was used to investigate the mediating role of CRP in the relationship between DS-PGS and cognitive-affective versus somatic symptoms. Our results showed that participants with a higher polygenic susceptibility to DS were significantly more likely to report cognitive-affective and somatic symptoms at follow-up. Mediation analyses revealed that CRP mediated the relationship between DS-PGS and somatic symptoms, but not the association between DS-PGS and cognitive-affective symptoms. These differential effects highlight the importance of considering individual differences in depression profiles in future studies. Ultimately, this will inform healthcare professionals to design more targeted treatments.

Effects of interoceptive training on decision making, anxiety, and somatic symptoms

BackgroundInteroception is the perception of afferent information that arises from any point within the body. Individual differences in interoception have been associated with affective processing and decision-making processing. The somatic marker hypothesis summarizes the potential effects of interoception on decision-making processes. According to this theory, individuals with interoceptive dysfunction exhibit disadvantageous decision making. Recently, enhancement of interoceptive accuracy, an element of interoception assessed by objective decision-making tasks, has been demonstrated using biofeedback. Garfinkle et al. developed an interoceptive training task, modified from the heartbeat perception task, which enhanced interoceptive accuracy and reduced anxiety symptoms. The purpose of this study was to determine the effects of interoceptive training on decision-making processes. Based on improvements in interoceptive accuracy, we hypothesized that decision-making scores would change in a manner indicative of increased rationality.MethodsThis longitudinal interventional study was performed with interoceptive training. Before and after the intervention, interoceptive accuracy and rationality of decision-making processes were assessed using a heartbeat perception task and rational decision-making tasks, respectively. Fourteen healthy volunteers (nine women; mean age, 21.9 ± 4.5 years) participated. The analysis included data from 12 participants. To detect individual differences in the effects of interoceptive accuracy on rationality of decision making, correlation analysis was conducted on change ratios of the indices of interoceptive accuracy and rationality of decision making.ResultsInteroceptive training resulted in significant enhancement of interoceptive accuracy scores and significant reductions in somatic symptom and state anxiety scores. In contrast, interoceptive training did not cause significant changes in decision-making indices. There was a significant positive correlation between change ratios of indices of interoceptive accuracy and rationality of decision making.ConclusionsThe results suggested a causal relation between interoception and rationality of decision making. These findings will enhance the understanding of mechanisms underlying alterations of decision-making related to psychotherapy by focusing on interoception.Trial registrationTrial registration number: UMIN000037548.

Chronic pain, somatic unexplained complaints and multimorbidity: A mutimorbidity painful syndrome?

IntroductionChronic illnesses are a major research challenge due to its implications in aging and quality of life of adults and elders, and it can be associated with chronic illnesses and other complaints. The objective of this study was to investigate the role of morbidities (chronic diseases with or without somatic unexplained symptoms) and somatic unexplained complaints in a hypothetical model of a multimorbidity painful syndrome. Our hypothesis is that chronic pain should be considered part of a syndrome that includes other chronic diseases and pathological states, especially conditions with somatic unexplained symptoms, and fibromyalgia is one of the evidence on that. MethodsA pilot sample of 306 subjects was investigated in this study (254; 83.0% with chronic pain). The following features were investigated: demographic data, chronic diseases (classified as with or without somatic unexplained symptoms), medications in use, pain characteristics, fulfillment of diagnostic criteria of fibromyalgia, and somatic unexplained complaints (gastric complaints, sleep disturbances, numbness, and the dry mucosa score). Statistical analysis included descriptive data, tested with chi-square, Fisher’s exact, nonparametric Kolmogorov-Smirnoff, Student’s t test; data normalization with Z-score; Pearson’s coefficient for correlation, two-steps cluster classification, multivariate linear regression, LASSO and logistic regression. ResultsBoth groups of chronic diseases were more prevalent in the group of patients (p < 0.001 and p = 0.013, respectively), which had higher frequency of somatic unexplained complaints (gastrointestinal, dry mucosa and numbness) than controls. There was a high positive correlation between number of pain areas and somatic unexplained symptoms score (R2 = 0.626; p < 0.001), and diseases with these symptoms were a risk factor for chronic pain (R2 = 0.5748) and fibromyalgia (AIC = 5.8952). ConclusionsDiseases with somatic unexplained symptoms and somatic unexplained complaints were associated with chronic pain, including fibromyalgia. They may be risks factors for pain spread. The findings support that chronic pain could be further investigated as part of a multimorbid syndrome, which should be better assessed to improve aging and quality of life of patients.

The relation of body mass index, menopausal symptoms, and lipid profile with bone mineral density in postmenopausal women

ObjectiveWe aimed to evaluate the relationship of menopausal symptoms, body mass index (BMI), and serum lipid profile with Bone Mineral Density (BMD) levels. Materials and methods452 postmenopausal women were included in this case–control study at our outpatient clinic between January 2012 and January 2015. The patients were stratified according to their BMD, based on dual-energy X-ray absorptiometer (DXA) results, as the normal group (−1 ≤ T-score), osteopenia group (−2.5 < T-score < −1), and osteoporosis group (T-score ≤ −2.5). High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), total cholesterol (TC), and triglycerides (TG), fasting plasma glucose (FPG) levels were measured. To assess the menopausal symptoms, the Menopause Rating Scale (MRS) questionnaire was used. ResultsWaist circumference (WC) and BMI were significantly lower in the osteoporosis group than in normal and osteopenia groups (p: 0.001, p: 0.001, respectively). L2-L4 measurements were negatively correlated with Low Density Lipoprotein (LDL) levels, but positively correlated with WC. BMI showed significant positive correlation with Femur Neck (FN), L1–L2, and L2–L4 measurements. Among menopausal symptoms, there was a significant negative correlation between heart discomfort and L1–L2 levels. On multiple regression analysis, a relation between FN scores and somatic symptom scores was identified. ConclusionHyperlipidemia, lower BMI, lower WC, and severe somatic symptoms may be associated with decreased BMD.

Yoga as a Therapy for Irritable Bowel Syndrome.

The aim of this state-of-the-art narrative review is to evaluate the current evidence about the effectiveness of yoga as therapy for IBS and explore its potential mechanisms of action. The current literature suggests yoga is effective and safe and may target multiple mechanisms involved in treatment of IBS. Evidence from randomized controlled trials identified yoga as more effective compared to pharmacological treatment and equally effective as dietary interventions or moderate-intensity walking. Improvements were seen in both physical health (IBS symptom severity, gastric motility, autonomic and somatic symptom scores, and physical functioning) and mental health outcomes (depression, anxiety, gastrointestinal-specific anxiety, and quality of life). Given favorable changes in IBS-related physical and mental health outcomes, preliminary data supports yoga as beneficial in this population. However, the relatively low-quality evidence resulting from heterogeneity of study designs, interventions, and outcome measures limit our ability to make specific recommendations about the use of yoga as therapy for patients with IBS.

Physical activity and somatic symptoms among hemodialysis patients: a multi-center study in Zhejiang, China

BackgroundSomatic symptoms are commonly reported by patients on maintenance hemodialysis. Based on evidence that exercise can improve psychological state among the general population, we aimed to evaluate the effects of physical activity on somatic symptoms specifically in this clinical population.MethodsThis was a multicenter, cross-sectional study that included patients receiving hemodialysis treatment ≥3 times per week for > 3 months, aged 18 years or older, and who were willing to complete our study questionnaires and wear a pedometer; they were recruited from four hemodialysis centers in Zhejiang, China. Physical activity was quantified using pedometer data, with somatic symptoms quantified using the Symptom Checklist-90 (SCL-90). Hemodialysis information and blood laboratory tests were obtained from patients’ medical record. The score on the somatic dimension of the SCL-90 (S1-score) subdivided into tertiles for analysis: ≤1.17 (Q1), 1.17–1.58 (Q2) and ≥ 1.58 (Q3). A multivariate logistic regression analysis was performed to estimate the crude and adjusted odd ratios (ORs) and 95% confidence intervals (CIs) for the S1- somatic score according to the physical activity level during the last week. For this analysis, patients were stratified in a high and low exercise group using a cutoff of 3000 MET-min/week. Model 1 was adjusted for skinfold thickness of the triceps, upper arm circumference, grip strength, 5-m walking time, and 30-s sit-to-stand test. In model 2, we further adjusted for the leukocyte count, high-sensitivity C-reactive protein level, and albumin level.ResultsAfter screening, 320 patients were enrolled into the study group (37.50% male, average age of 58.60 ± 14.2 years and mean average number of steps per day of 3725.92 ± 2663.47). The S1-score (1.51 ± 0.39) was significantly higher for patients than for the normal reference population (P < 0.001). As the S1-score increased, the average number of steps per day decreased, both on dialysis and non-dialysis days. Total physical activity, measured by pedometry, showed the best correlation to S1 scores (r = − 0.813; P < 0.01). The OR of a high S1-score was 1.97 [95% CI, 0.63–4.08] for patients in the low physical activity group.ConclusionHigher S1 (somatic symptom) score was related to low physical activity among patients on maintenance hemodialysis.

Effect of motivational interviewing on health literacy and quality of life of patients on maintenance hemodialysis

Objective To investigate the effect of motivational interviewing on literacy and quality of life of patients on maintenance hemodialysis. Methods Using convenience sampling method, 100 patients on maintenance hemodialysis were selected from March 2016 to March 2018 in a blood purification center of a Class Ⅲ Grade A hospital. According to dialysis time, the patients were divided into the intervention group (n=50) and control group (n=50) . Motivational interviews were conducted in the intervention group. Traditional education methods were used in the control group. The two groups' scores in literacy and quality of life from Health Literacy of Patients with Chronic Diseases Questionnaire and Kidney Disease Questionnaire (KDQ) before and after intervention were compared. Results After 6 months of intervention, the total score of literacy in the intervention group increased from (87.34±2.85) to (97.34±3.02) . The scores of three dimensions of information acquisition ability , communication and interaction ability and willingness to improve health were higher than those before intervention, and the total score of literacy and above three dimensions in the intervention group were higher than those in the control group with statistical differences (P<0.05) . The total score of quality of life in the intervention group increased from (100.64±17.62) to (115.60±16.15) , among which the scores of somatic symptoms , fatigue and relationship with others in the intervention group were higher than those before intervention, and the total score of quality of life and the above three dimensions in the intervention group were higher than those in the control group, the differences were statistically significant (P<0.05) . Conclusions Motivational interviews can improve the literacy level of maintenance hemodialysis patients, enhance their awareness of improving health, change their bad behaviors, and improve their quality of life. Key words: Dialysis; Quality of life; Health literacy; Motivational interviewing

Somatic symptoms and their association with anxiety and depression in Chinese patients with cardiac neurosis.

ObjectiveWe sought to investigate somatic symptoms detected by the Somatic Self-rating Scale and to evaluate whether they were associated with the psychological symptoms of anxiety and depression in patients with cardiac neurosis.MethodsA total of 180 patients with cardiac neurosis at the Third Xiangya Hospital, Changsha, China, were surveyed from January 2017 to July 2018. Participants completed a general information questionnaire, the Somatic Self-rating Scale, the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder Scale-7.ResultsThe mean (±standard deviation) somatic symptom score in patients with cardiac neurosis was 40.83 ± 7.12. The most severe symptoms were cardiovascular symptoms, fatigue and muscle soreness. A total of 90 patients (46.4%) had anxiety and 80 (50.0%) had depression. Multiple stepwise regression analysis showed that somatic symptoms in patients with cardiac neurosis were associated with both anxiety and depression.ConclusionSomatic symptoms in patients with cardiac neurosis were associated with both anxiety and depression. Therefore, it is important to provide effective emotional interventions to promote patient rehabilitation.

Differences in male climacteric symptoms with aging among rotating night shift workers

Objective The aim of this study was to clarify the actual status of male climacteric symptoms in rotating night shift workers and how to cope with the symptoms. Methods We planned a self-administered questionnaire survey in male rotating night shift workers. Male climacteric symptoms were evaluated by using the Aging Males’ Symptoms (AMS) scale. Results Of 1891 questionnaires that were sent, 1561 were collected. There were significant differences in total AMS scores among the age groups. In all age groups, there were high proportions of men with increased need for sleep and often feeling tired (64.9%) and decrease in muscular strength (60.7%). There were significant differences in AMS scores for somatic symptoms between men in their 20 s and those in their 40 s or 50 s and between men in their 30 s and those in their 50 s and in AMS scores for sexual symptoms between men in their 20 s and those in their 30 s, 40 s, 50 s or 60 s, between men in their 30 s and those in their 40 s, 50 s or 60 s and between men in their 40 s and those in their 50 s or 60 s. Conclusion Significant age-dependent differences are found in somatic symptoms and sexual symptoms in rotating night shift workers.

Associations of mood symptoms with NYHA functional classes in angina pectoris patients: a cross-sectional study

BackgroundDepression and anxiety are prevalent and associated with a worse prognosis in coronary heart disease (CHD) patients. However, the influence of disease severity on mood symptoms is unknown. The specific associations of mood symptoms with NYHA classes remain unexplored.MethodsIn this cross-sectional study, 443 consecutive inpatients with angina pectoris (AP) confirmed by angiography were included into analysis. Somatic and cognitive symptom scores derived from Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) were used to assess mood symptoms. Predictors for depression and anxiety with strict and lax standards were compared. We hypothesized NYHA classification to be an indicator of disease severity through analyses with clinical features using ordinal logistic model. Applying both binary and ordinal logistic models, we evaluated the associations of mood symptoms with NYHA classes.ResultsDiscrepancy of disease severity existed between the depressed and nondepressed. NYHA classification was proved to be an integrated index under influence of age, coronary stenosis, heart failure and diabetes. NYHA class I and II individuals with AP were at equivalent risk for depression (NYHA II vs I: binary model OR 1.32 (0.59,2.96), p = 0.50; ordinal model OR 1.17 (0.73,1.88), p = 0.52), however NYHA class III/IV patients shared a sharply higher risk (NYHA III/IV vs I: binary model OR 3.32 (1.28,8.61), p = .013; ordinal model OR 3.94 (2.11,7.36), p < .001). Analyses on somatic and cognitive depressive symptoms confirmed this finding and hinted a greater impact of education background on mood when patient’s condition is unstable. Anxiety seemed in the whole picture irrelevant with NYHA classes. Comparing with NYHA class I/II, AP patients in NYHA class III/IV tended to be less anxious. However, when CHD became unstable, the calmness may immediately be broken up. A great distinction of the ratio of anxiety and depression symptom scores between NYHA class III/IV stable and unstable AP patients (p = .018) was observed.ConclusionsMood symptoms in CHD patients are to a great extend derived from disease itself. Only for patients with relatively serious physical condition, unexpected discomforts caused by disease notably impact the emotions. Education background tends to influence the mood especially when disease is still unstable.

Prevalence and environmental impact factors of somatization tendencies in eastern Chinese adolescents: a multicenter observational study.

The aim of this study is at examining the prevalence and impact factors of adolescent somatization tendencies (ST) across three eastern Chinese provinces. A multicenter school-based cross-sectional study was conducted in these provinces from 2015 to 2016. The sample included 11,153 middle-school students aged 13-18 years, who were randomly selected using a multi-phase stratified cluster sampling technique. We also designed a multicenter school-based case-control study to evaluate the potential environmental impact of ST factors on this population. The overall positive rate of ST among the eastern Chinese adolescents was 12.1%. Somatic symptoms score (SSS) and positive ST rate were higher in females than males. Additionally, the SSS and positive ST rate for the 18-year-old group were significantly higher than in other age groups. In comparison to those in urban areas, adolescents in rural areas had significantly higher SSS and positive ST rate. Multiple conditional regression analyses revealed that family medical history, anxiety and depression scores; superstitious beliefs; left-behind adolescents; teacher-student support; family conflict; and family independence and achievement orientation were significantly linked to ST in adolescents. The models also indicated family medical history was the strongest impact factor to adolescent ST, even though ST were prevalent in the three studied eastern Chinese provinces. Gender, age, and dwelling differences were very significant in the SSS and positive ST rate in adolescents. This study concludes that adolescent ST are influenced by multiple environments.

Protocol for the insight study: a randomised controlled trial of single-dose tocilizumab in patients with depression and low-grade inflammation

IntroductionObservational studies indicate a potentially causal role for interleukin 6 (IL-6), a proinflammatory cytokine, in pathogenesis of depression, but interventional studies based on patients with depression have not been conducted....

Painful Bladder Symptoms Related to Somatic Syndromes in a Convenience Sample of Community Women with Overactive Bladder Symptoms

We investigated the relationship of painful bladder filling and urinary urgency to somatic and chronic pain symptoms in women with overactive bladder without an interstitial cystitis/bladder pain syndrome diagnosis. Women who met overactive bladder criteria based on symptoms were recruited, including 183 (83.9%) from the community and 35 (16.1%) from the urology clinic to complete validated questionnaires assessing urinary symptoms, somatic symptoms and pain syndromes. Participants were categorized into 1 of 3 groups, including 1) neither symptom, 2) either symptom or 3) both symptoms, based on their reports of painful urinary urgency and/or painful bladder filling. Multivariable regression analyses were performed to determine factors predictive of having painful urgency and/or painful filling. Of 218 women with overactive bladder 101 (46%) had neither painful bladder filling nor urinary urgency, 94 (43%) had either symptom and 23 (11%) had both symptoms. When controlling for age, women with either or both urological pain symptoms were more likely to have irritable bowel syndrome, chronic pelvic pain and temporomandibular disorder than women in the neither group. Additionally, these women had higher pain intensity and somatic symptoms scores than women with neither symptom. The majority of women with overactive bladder who had not been diagnosed with interstitial cystitis/bladder pain syndrome reported painful urgency and/or painful filling. Experiencing painful urgency and/or filling was associated with an increased somatic symptom burden and greater pain intensity. These findings support the hypothesis that overactive bladder and interstitial cystitis/bladder pain syndrome diagnoses may represent a continuum of bladder hypersensitivity.

Association between depressive symptom clusters and food attentional bias

BackgroundThe mechanisms underlying the depression-obesity relationship are unclear. Food attentional bias (FAB) represents one candidate mechanism that has not been examined. We evaluated the hypothesis that greater depressive symptoms are associated with increased FAB. MethodParticipants were 89 normal weight or overweight adults (mean age = 21.2 ± 4.0 years, 53% female, 33% non-white, mean body mass index in kg/m2 = 21.9 ± 1.8 for normal weight; 27.2 ± 1.5 for overweight). Total, somatic, and cognitive-affective depressive symptom scores were computed from the Patient Health Questionnaire-8 (PHQ-8). FAB scores were calculated using reaction times (RT) and eye-tracking (ET) direction and duration measures for a food visual probe task. Age, gender, race/ethnicity, and body fat percent were covariates. ResultsOnly PHQ-8 somatic symptoms were positively associated with RT-measured FAB (β = 0.23, p = .04). The relationship between somatic symptoms and ET direction (β = 0.18, p = .17) and duration (β = 0.23, p = .08) FAB indices were of similar magnitude but were not significant. Somatic symptoms accounted for 5% of the variance in RT-measured FAB. PHQ-8 total and cognitive-affective symptoms were unrelated to all FAB indices (ps ≥ 0.09). ConclusionsOnly greater somatic symptoms of depression were linked to food attentional bias as measured using reaction time. Well-powered prospective studies should examine whether this bias replicates, particularly for eye-tracking measures, and whether it partially mediates the depression-to-obesity relationship.

Religion and mental health among Nepal earthquake survivors in temporary tent villages

ABSTRACTThe aim of this study was to explore the relationship between mental health and the perceived importance of religion and the frequency of prayer among 200 children ages 10–18 years who lived in temporary camps for earthquake survivors in Nepal. The participants were examined using the Child Behavior Checklist (CBCL) 6–18 and were asked about the importance of religion in their lives. In contrast to expectation that high perceived importance of religion and prayer frequency have positive impacts on mental health after earthquakes, the results indicated significantly higher levels of withdrawal/depression. The group that prayed less frequently after the earthquakes had significantly higher scores for somatic symptoms, withdrawal/depression, anxiety/depression, social immaturity, internalising problems, and total CBCL scores. However, the clinical risk group (T score of 65 or higher in the CBCL total score), no significant difference according to the importance of religion showed and frequency of daily prayer.

MP39-08 PAINFUL URGENCY AND/OR PAINFUL FILLING PREDICTIVE OF SOMATIC SYMPTOMS AND CHRONIC PAIN IN WOMEN WITH OVERACTIVE BLADDER

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Interstitial Cystitis1 Apr 2018MP39-08 PAINFUL URGENCY AND/OR PAINFUL FILLING PREDICTIVE OF SOMATIC SYMPTOMS AND CHRONIC PAIN IN WOMEN WITH OVERACTIVE BLADDER Casey G Kowalik, Sophia Delpe, Melissa R. Kaufman, Roger R. Dmochowski, and W. Stuart Reynolds Casey G KowalikCasey G Kowalik More articles by this author , Sophia DelpeSophia Delpe More articles by this author , Melissa R. KaufmanMelissa R. Kaufman More articles by this author , Roger R. DmochowskiRoger R. Dmochowski More articles by this author , and W. Stuart ReynoldsW. Stuart Reynolds More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1255AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Current theories hypothesize that overactive bladder (OAB) and Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) comprise a spectrum of bladder hypersensitivity with overlapping symptoms. Symptoms of painful urgency and filling are common in women with OAB and may be correlated with more severe urologic symptoms and decreased quality of life. This analysis investigated the relationships of painful urgency and filling with somatic symptoms and chronic pain conditions in women with OAB without an IC/BPS diagnosis. METHODS Women with OAB symptoms and without IC/BPS diagnosis were recruited to complete validated questionnaires assessing urinary symptoms (OAB symptom scale [OAB-ss] and Health Related Quality of Life [OABq-HRQL]), somatic symptoms, and pain syndromes. Participants were categorized into 3 groups, (1) Neither (2) Either or (3) Both, based on their report of painful urgency and/or painful filling. Multivariable regression analyses were performed to determine factors predictive of have either or both painful urgency and/or painful filling. RESULTS Of 218 women with OAB symptoms, 46% (n=101) had neither painful urgency nor painful filling, 43% (n=94) had either, and 11% (n=23) had both. There was an increase in average OAB-SS, pain intensity, and somatic symptom score, and a decrease in OAB-HRQL from neither > either > both. Controlling for age, women with either or both urologic pain symptoms had an increase in somatic symptom score by 1.5 and 3 points and an increase in pain intensity by 3 and 6.5 points, respectively, compared to women in the neither group. Additionally, women with either or both symptoms were 2.9 and 3.5 times more likely to have irritable bowel syndrome and 3.3 and 4.5 times, respectively, more likely to have chronic pelvic pain. CONCLUSIONS In this group of women with OAB, without IC/BPS, the majority reported either painful urgency, painful filling, or both. Experiencing painful urgency and/or filling was associated with increased somatic symptom burden and pain intensity. Additionally, women with either or both symptoms were more likely to have chronic pain conditions, hypothesized to have a common central pathophysiology. These findings support the hypothesis that OAB and IC/BPS diagnoses may represent a continuum of bladder hypersensitivity with women experiencing pain being more likely to also have underlying central sensitization mechanisms. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e512-e513 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Casey G Kowalik More articles by this author Sophia Delpe More articles by this author Melissa R. Kaufman More articles by this author Roger R. Dmochowski More articles by this author W. Stuart Reynolds More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Can the use of a single integrated unitary autonomic index provide early clues for eventual eligibility for olympic games?

Optimal autonomic regulation and stress resilience might be considered critical elements of athletic performance. We hypothesize that a novel unitary autonomic index for sports (ANSIs), together with a somatic stress related symptom score (4SQ) might help characterize athletes who were eventually selected for the Rio 2016 Olympic Games Italian team (Rio +). In this retrospective study we examined 778 athletes (age 24.4 ± 6.7 yrs) who underwent a planned yearly pre-participation screening. All athletes underwent clinical, autonomic and exercise ECG evaluation. The combination of vagal and sympathetic indices from RR variability into ANSIs was performed by radar plot and percent ranking of index variables. We assessed (Rio +) versus (Rio -) athletes also after subdivision into three sport intensity groups (low, mid and high intensity). Overall there were no significant differences between (Rio +) and (Rio -) athletes when considering individual spectral derived variables. Conversely, the unitary Index ANSIs was significantly higher in (Rio +) compared to (Rio -) athletes (respectively 54.5 ± 29.5 and 47.9 ± 28.4 p = 0.014). This difference was particularly evident (p = 0.017) in the group of athletes characterized by both high static and dynamic components. 4SQ was smaller in the (Rio +) group, particularly in the groups of athletes characterized by both low-medium static and dynamic components. ANSIs, a proxy of integrated cardiac autonomic regulation and simple assessment of resilience to stress, may differentiate Italian athletes who were eventually selected for participation in the 2016 Rio Olympic Games from those who were not, suggesting the possibility of a "winning functional phenotype".