Somatoform Research Articles

Characteristics and dynamics of the emotional condition and mental health of women during pregnancy and after childbirth in the COVID-19 pandemic

BACKGROUND: The coronavirus pandemic has been a powerful and long-term stressor, and pregnant women are among the most vulnerable groups in the population. Modern foreign studies have shown an increase in the level of anxiety, depression, and post-traumatic stress disorder in women during pregnancy and after childbirth in the COVID-19 coronavirus pandemic, which, in turn, can affect both the course of pregnancy and childbirth and the development of the child. Meanwhile, there are currently very few domestic studies of these characteristics and their dynamics in women in the pre- and postnatal period. AIM: The aim of this study was to assess the characteristics and dynamics of the emotional condition and mental health of women during pregnancy and after childbirth in the COVID-19 coronavirus pandemic. MATERIALS AND METHODS: In this study, we used the State-Trait Anxiety Inventory by Ch.D. Spilberger, adapted by Yu.L. Khanin; the Achenbach System of Empirically Based Assessment (Adult Self-Report 18–59) by T. Achenbach and L. Rescorla, adapted by E.R. Slobodskaya; the Impact of Event Scale-Revised by D.S. Weiss and C.R. Marmar, adapted by N.V. Tarabrina; socio-biographical questionnaire during pregnancy and after childbirth; and postpartum interview. At the I stage, the study included 248 pregnant women, with the average age of 30.7 (18–44) years and the average gestational age of 31.1 (4–40) weeks. At the II stage, we enrolled 98 women from the initial sample four to six months after childbirth. RESULTS: Our study showed the presence of predominantly average levels of anxiety, a high frequency of depressive disorder and avoidance, cognitive problems and withdrawal, as well as somatic problems during pregnancy. Pandemic-related post-traumatic stress disorder was identified in 7.7% of pregnant women and 6% of women after childbirth. Analysis of the dynamics of the emotional condition and mental health disorders in women before and after childbirth revealed a significant decrease in the levels of post-traumatic stress disorder (p 0.01), depressive (p 0.05) and somatic (p 0.01) disorders, and avoidance disorder (p 0.05). Predictors of the emotional condition, post-traumatic stress disorder and mental health disorders in women after childbirth are the same as those during pregnancy. CONCLUSIONS: The study showed a high incidence of post-traumatic stress disorder, depression and avoidance disorders with an average level of anxiety in pregnant women during the pandemic. After childbirth, patients experienced a decrease in depressive, somatic and avoidance disorders, as well as post-traumatic stress disorder.

Rehabilitation success after psychosomatic rehabilitation as afunction of psychotherapy dose

Increasing the effectiveness of psychosomatic rehabilitation by prolonging the treatment is a subject of controversial debate. The number of sessions over time defines the dosage in psychotherapy. While the dose-response model assumes an optimal therapy dose, the good-enough level model assumes acorrelation of the rate of change with the total sessions. Arandomized control group study was conducted to investigate the extent to which an adaptive therapy concept with atwo-week intensive phase and early intervention could increase rehabilitation success. A total of 494 rehabilitants between the ages of 21 and 64 (47% women) who completed aclassical or an integrative psychosomatic rehabilitation at the Rehazentrum Oberharz between 2020 and 2022 were analysed. Rehabilitation success was mapped by the Reliable Change Index of individual symptom reduction (depression severity or psychological and somatoform disorders) and as asocio-medical parameter (physician's assessment of potential work ability (WA) after twoweeks). Two-factorial ANOVAs and hierarchical binary logistic regressions were calculated, and sick leave before rehabilitation was statistically controlled. Dosage showed no effect on symptom reduction (p = 0.29) and potential WA after twoweeks (p = 0.90). However, when stratified by disease severity, there was amean effect of dosage (p = 0.05) and twice the probability of WA after twoweeks (odds 2.13; p = 0.01) for those with mild disease at the start of measure (p = 0.05). In the early stages of an affective disorder, early and intensified intervention can counteract the chronification of mental disorders.

School Absenteeism Longer Than Two Weeks Is a Red Flag of Somatic Symptom and Related Disorders in Hospitalised Children and Adolescents: A Matched Cohort Study

Chronic school absenteeism is a common problem in childhood and adolescence, and it is frequently observed in patients with somatic symptom and related disorders (SSRDs). This study aimed to determine whether and to what extent the presence of school absenteeism may be a risk factor for the diagnosis of SSRDs in hospitalised patients. This matched cohort study included children and adolescents aged between 8 and 17 years, admitted to the paediatric ward of the IRCCS Burlo Garofolo in Trieste from 2021 to 2023, who were divided into two groups, the first including children with at least 15 days of absence from school for medical reasons and the second including children with regular school attendance, matched to the former group by age and sex. We consecutively enrolled 70 patients, 35 in the absentee group and 35 in the control group. In the absentee group, 30/35 (85.7%) patients were diagnosed with an SSRD, while in the control group, 1/35 (2.9%) was diagnosed with an SSRD. The absentee group had a 30-fold higher risk of being diagnosed with SSRDs than the control group (RR = 30 [95% CI = 4.3–208]; p < 0.001). This study shows that in hospitalised children, a history of school absenteeism of more than two weeks is an important risk factor for the diagnosis of SSRDs.

NOSOLOGICAL STRUCTURE OF IN-PATIENT PSYCHIATRIC CARE PROVISION IN THE POLTAVA REGION IN 2023

Introduction. The importance of safeguarding mental health and providing high-quality psychiatric care became increasingly urgent following the onset of full-scale war in Ukraine. Currently, a strategy to transfer psychiatric care from specialized institutions to primary care is being implemented. Therefore, analyzing the nosological distribution of referrals to a psychiatric hospital during martial law is an extremely urgent issue. The aim of this study is to investigate the nosological structure of hospitalizations at the Communal Enterprise “Regional Institution of Mental Psychiatric Care of the Poltava Regional Council” in 2023. Results and their discussion. Schizophrenia remains the leading diagnosis among patients receiving inpatient psychiatric care. The second place is taken by neurotic, stress-related, and somatoform disorders. In third place are organic, including symptomatic, mental disorders, with vascular dementia being the leading primary diagnosis among patients with organic, including symptomatic, mental disorders. Among the substances causing mental and behavioral disorders due to the use of psychoactive substances, alcohol ranks first. Paranoid schizophrenia is the leading diagnosis in patients with schizophrenia, schizotypal states, and delusional disorders. Recurrent depressive disorder is the most common among affective disorders. Adjustment disorders occupy the first place in the structure of the incidence of neurotic, stress-related, and somatoform disorders. Among the behavioral syndromes associated with physiological disturbances and physical factors, anorexia nervosa is the most common. Emotionally unstable personality disorder is most common among patients with disorders of adult personality and behavior. Mild mental retardation is more common than others. Childhood autism has the largest share in the incidence structure of disorders of psychological development. Among behavioral and emotional disorders with onset usually occurring in childhood and adolescence, the most common are mixed disorders of conduct and emotions. Conclusion. The obtained results can be used in planning and forecasting the provision of inpatient psychiatric care to patients during the wartime.

Changes in interoceptive accuracy related to emotional interference in somatic symptom disorder

ObjectiveThe somatic symptom disorder (SSD) is characterized by one or more distressing or disabling somatic symptoms accompanied by an excessive amount of time, energy and emotion related to the symptoms. These manifestations of SSD have been linked to alterations in perception and appraisal of bodily signals. We hypothesized that SSD patients would exhibit changes in interoceptive accuracy (IA), particularly when emotional processing is involved.MethodsTwenty-three patients with SSD and 20 healthy controls were recruited. IA was assessed using the heartbeat perception task. The task was performed in the absence of stimuli as well as in the presence of emotional interference, i.e., photographs of faces with an emotional expression. IA were examined for correlation with measures related to their somatic symptoms, including resting-state heart rate variability (HRV).ResultsThere was no significant difference in the absolute values of IA between patients with SSD and healthy controls, regardless of the condition. However, the degree of difference in IA without emotional interference and with neutral facial interference was greater in patients with SSD than in healthy controls (p = 0.039). The IA of patients with SSD also showed a significant correlation with low-frequency HRV (p = 0.004) and high-frequency HRV (p = 0.007).ConclusionSSD patients showed more significant changes in IA when neutral facial interference was given. These results suggest that bodily awareness is more affected by emotionally ambiguous stimuli in SSD patients than in healthy controls.

Адаптация русскоязычной версии детского опросника соматических симптомов на выборке детей-сирот и детей, оставшихся без попечения родителей

<p>This study was aimed to adapt the Russian version of the Children’s Somatic Symptoms Inventory-8 (CSSI-8). The participants were 160 orphans and children and adolescents left without parental care, including 80 girls and 80 boys aged 9 to 17 years (M=14,51; Me=15 years; SD=1,79). All participants completed CSSI-8 and the Revised Child Anxiety and Depression Scale-30 (RCADS-30). The Russian version of the inventory was reliable and valid: firstly, it has a high Cronbach’s α, showing its internal reliability; secondly, it has a one-factor structure, indicating its factor validity; thirdly, the relationship of somatic symptoms with anxiety and depressive symptoms proves convergent validity. Thus, 76,2% of children and adolescents had at least one specific somatic symptom, 44,4% complained of pain in stomach or abdomen, 58,7% of headaches, 30,6% of pain in lower back, 19,4% of faintness or dizziness, 29,4% of pain in arms or legs, 28,7% of heart palpitations, nausea or upset stomach, 47,5% of weakness in some parts of the body. In conclusion, it is important to make future psychometric examinations of the adapted questionnaire, which allow us to recommend it for school diagnosis and psychological counseling of children and adolescents, as well as screening and monitoring of somatoform disorders.</p>

Illness Anxiety Disorder: A Review of the Current Research and Future Directions.

We review recent evidence on Illness Anxiety Disorder (IAD), including risk factors and precipitants, diagnostic classification, clinical characteristics of the disorder, and assessment and treatment in both children and adults. IAD places a substantial burden on both individuals and society. Despite its impact, understanding of the disorder is lacking and debates remain about whether IAD should be classified as an anxiety disorder and whether it is distinct from Somatic Symptom Disorder. Cognitive behavioural therapy (CBT) is an effective treatment for IAD and there are multiple validated measures of health anxiety available. However, research on health anxiety in children and youth is limited. IAD is chronic, and debilitating, but when identified, it can be effectively treated with CBT. Research using DSM-5 IAD criteria is lacking, and more research is needed to better understand the disorder, particularly in children and youth.

Cannabinoid Drugs in the Treatment of Psychiatric Disorders - Data from the German Federal Institute for Drugs and Medical Devices

Since 2017 physicians in Germany can prescribe cannabis based medicines or medical cannabis with subsequent funding by the statutory health insurance system. Physicians prescribing cannabinoid drugs were legally required to take part in a survey conducted by the Federal Institute for Drugs and Medical Devices. This study analyses data from 16.809 case reports that were collected from 30.3.2017 to 31.12.2021. There were 5582 cases documenting the use of cannabinoid drugs in psychiatric disorders. More than half of the prescriptions were Dronabinol. 80% of the treatments concerned somatoform disorders. Most of the treatments for other psychiatric disorders also targeted pain. Doctors reported a positive effect on symptoms in at least 75% of the cases. Most patients with psychiatric disorders received cannabinoid drugs for pain. The evidence from randomized controlled clinical trials for the use of cannabinoid drugs in psychiatric indications is weak.

Health, behavior, and social outcomes among offspring of parents with criminal convictions: a register-based study from Sweden.

There is currently insufficient understanding of the health and behavior of children whose parents engage in criminal behavior. We examined associations between parental criminal convictions and wide range of offspring health, behavioral, and social outcomes by age 18 in a large, national sample, aiming to get a comprehensive picture of the risks among children of offending parents. We studied 1,013,385 individuals born in Sweden between 1987 and 1995, and their parents. Using data from several longitudinal nationwide registers, we investigated parental convictions and 85 offspring outcomes until the end of 2013, grouped into birth-related conditions, psychiatric and somatic disorders, accidents and injuries, mortality, school achievement, violent victimization, and criminality. Cox proportional hazards regression and logistic regression models were used to examine the associations. The role of genetic factors in intergenerational associations was studied in children-of-siblings analyses. We also examined the co-occurrence of multiple outcomes using Poisson regression. A total of 223,319 (22.0%) individuals had one parent convicted and 31,241 (3.1%) had both parents convicted during the first 18 years of their life. The strongest associations were found between parental convictions and offspring behavioral problems, substance use disorders, poor school achievement, violent victimization, and criminality, with an approximately 2 to 2.5-fold increased risk in children with one convicted parent and 3- to 4-fold increased risk in children with two convicted parents. The risks were particularly elevated among children of incarcerated parents with a history of violent convictions. The associations appeared to be at least partly explained by genetic influences. Parental convictions were also associated with an increased likelihood of experiencing multiple outcomes. Our findings help to calibrate the risks of a wide range of adverse outcomes associated with parental convictions and may be used to guide prevention efforts and identify key areas for future research.

Разработка и анализ психометрических свойств новой русскоязычной версии Международного опросника неблагоприятного детского опыта (ACE-IQ)

<p style="text-align: justify;">Background. Adverse childhood experiences (ACE) is one of the most important risk factors for mental and somatic disorders and needs to be considered and evaluated in clinical and research practice. The aim of this study was to develop, adapt and validate the new Russian version of ACE-IQ. Methods. A total of 123 people (88 women, Me = 25 years) were included, of which about a half (n = 68) of the sample were patients with depression, the rest of the participants had no psychiatric diagnoses based on the results of the diagnostic interview. Results. ACE-IQ showed good reliability and internal consistency (Cronbach's alpha = 0.801). A six–factor structure of the questionnaire was identified («Sexual abuse», «Family violence», «Violence outside the family», «Mental disorders and substance abuse in the family», «Dysfunctional family factors», «Social Cataclysms»). Conclusions. We developed, adapted and validated the new Russian–language version of the ACE-IQ, retaining the structure and semantic equivalence of the original version of the questionnaire. Although confirmation of factor structure in other samples is needed, our data allows to recommend the new Russian version of the ACE-IQ for use in clinical and research practice.</p>

Association of categorical diagnoses and psychopathologies with quality of life in patients with depression, anxiety, and somatic symptoms: A cross-sectional study

ObjectiveMajor depressive disorder (MDD), anxiety disorders, and somatic symptom disorder (SSD) are associated with quality of life (QoL) reduction. This cross-sectional study investigated the relationship between these conditions as categorical diagnoses and related psychopathologies with QoL, recognizing their frequent overlap. MethodsWe recruited a total of 403 clinical patients and healthy individuals, administering diagnostic interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. QoL and psychopathologies were assessed using the WHO Quality of Life-BREF (WHOQOL-BREF) and several self-administered questionnaires, respectively. Multiple linear regression analyses examined the associations between psychiatric diagnoses, psychopathologies, and QoL. ResultsSSD and MDD were independently associated with impaired global (β = −0.318 and − 0.287) and all QoL domains (β = −0.307, −0.150, −0.125, and − 0.133, in physical, psychological, social, and environmental domains respectively for SSD; β = −0.278, −0.344, −0.275, and − 0.268 for MDD). The Beck Depression Inventory-II score showed pervasive associations with QoL (β = −0.390, −0.408, −0.685, −0.463, and − 0.420, in global, physical, psychological, social, and environmental domains). The Patient Health Questionnaire-15 and Health Anxiety Questionnaire scores were associated with global (β = −0.168 and − 0.181) and physical (β = −0.293 and − 0.121) QoL domain, while the Cognitions About Body and Health Questionnaire score was only associated with environmental QoL domain (β = −0.157). ConclusionSSD and MDD were independently associated with QoL impairment. Depressive symptoms were associated with all QoL domains, whereas somatic symptom burden and health anxiety primarily affected the physical QoL domain. Clinicians should consider concomitant psychopathologies when managing patients with depression, anxiety, or somatic symptoms.

Asthenic disorders: contradictions and paradigms

Asthenic disorders are a pressing problem for modern medicine. The lack of specificity of this disease makes it difficult to make a nosological diagnosis, since these disorders occur not only in somatic pathologies and infections, but also in various neurological and mental diseases. Attempts at systematization taking into account clinical variability did not lead to a single paradigm, since they did not reflect all possible variants of disorders. In ICD-10, conditions, the main manifestation of which is asthenia, are considered under various headings: Neurasthenia – F48.0; Organic emotionally labile (asthenic) disorder - F06.6; Other specified neurotic disorders – F48.8; Fatigue syndrome after a viral infection – G93.3; Condition after COVID-19 - U09.9; Overwork (burnout syndrome) – Z73.0; somatoform disorders – F45. Currently, there is no single concept in the treatment strategy for patients. With these disorders, the number of active receptors in the brain is reduced, the response to medications is reduced, even the addition of energy correctors does not fully stimulate the restructuring of the functional state of the central nervous system only with specific effects on neurotransmitter systems. Correction of the functional state of the central nervous system through nonspecific effects is necessary. Phenylpiracetam is the first drug with a neuromodulatory effect. The antiasthenic effect of the drug appears after a single use, prolonged action has its advantages for increasing the effectiveness of therapy, which allows reducing the pharmacological burden on the patient and thereby reduce the risk of developing polypharmacy.

Risk Phenotypes, Comorbidities, Pharmacotherapy, and Electroconvulsive Therapy (ECT) in a Cohort with Difficult-to-Treat Depression in Comparison to an Unmedicated Control Group.

Approximately 15-25% of depressed patients suffer from difficult-to-treat depression (DTD). Patients with DTD require a thorough examination to avoid the oversight of treatable (psychiatric/somatic) comorbidities or (pseudo-)resistance to antidepressant drugs (ADs). Polymorphisms of the cytochrome P450 (CYP) enzymes 2D6 and 2C19, which play a major role in the metabolism of ADs, may contribute to resistance to ADs. Patients with DTD might benefit from electroconvulsive therapy (ECT). We enrolled 109 patients with DTD and 29 untreated depressed controls (UDC). We assessed risk phenotypes, comorbidities, and treatment, including ECT. We also performed pharmacokinetic analyses of CYP2D6 and CYP2C19. DTD patients significantly more often suffered from comorbid psychiatric diseases, especially ICD-10: F40-F48 (DTD:40.4%, UDC:17.2%, OR 11.87, p=0.011) than UDC patients. DTD patients receiving ECT were more likely to achieve remission (37.7% vs. 11.8%, OR=3.96, p=0.023). Treatment with ADs did not differ between remitters and non-remitters. No significant differences were observed in the distribution of CYP2D6 and CYP2C19 variants between both groups. Patients with DTD appear to experience comorbid neurotic stress and somatoform disorders (ICD-10: F40 - F48) more frequently. Therefore, a comprehensive differential diagnosis is crucial when patients do not respond sufficiently to antidepressant medication. Genotyping CYP2D6 and CYP2C19 should be considered.

Chest pain as an interdisciplinary problem – emphasis on somatoform disorders

Chest pain of a non-cardiac nature is one of the extremely significant problems of clinical medicine, which is associated with the widespread prevalence of this condition and the high healthcare costs for diagnosing and treating such patients. Along with neurological, gastroenterological and pulmonological diseases, mental disorders make a major contribution to the formation of chest pain. Moreover, the formation of pain in the chest area can be associated not only with such well-known psychopathological conditions as depression and anxiety disorders, but also with the pathology of the somatoform circle. This review presents data on the frequency of chest pain associated with mental disorders (pain as a symptom of a mental disorder, mental disorders as a consequence of a previous episode of chest pain, etc.), the nature of the relationship between pain symptoms and mental disorders, as well as the clinical picture somatoform disorders manifesting in the form of thoracalgia. Information is summarized on approaches to diagnosing mental disorders in patients with chest pain and the possibilities for their psychopharmacotherapy and psychotherapy. When discussing psychopharmacotherapy, emphasis is placed on the possibilities of using the atypical tranquilizer tofisopam in this category of patients, and a brief description of its effectiveness and safety is given. To illustrate the main points of the review, a clinical case of a patient with chest pain of non-cardiac origin, which manifested itself after a traumatic event, which in turn provoked a myocardial infarction, is also presented. Positive dynamics with subsequent recovery during therapy with tofisopam are described.

An integrated mental health video consultations model for patients with somatic symptom disorder in primary care: The randomized VISION pilot trial

ObjectiveSymptoms of somatic symptom disorder (SSD) are one of the most common reasons for consultations in primary care. However, specialized psychological services are mostly unavailable. This pilot trial aimed to determine the feasibility, acceptability, and safety of the integrated mental health video consultations VISION model for patients with SSD in primary care. MethodsWe conducted a parallel group, randomized controlled pilot trial involving fifty-one patients with SSD from ten primary care practices in Germany, who we randomized to the VISION model or enhanced treatment-as-usual (eTAU). The VISION model comprised five video consultations which featured diagnostic clarification, psychoeducation (acknowledging and legitimizing of symptoms), and brief psychological therapy. eTAU included training primary care practice teams on the DSM-5 concept of SSD guideline recommendations for its treatment in primary care. We assessed feasibility as the primary outcome at 6-months, measuring efficiency of recruitment, intervention acceptability, safety. ResultsRecruitment was efficient reflected in an overall recruitment yield (number randomized per number screened) of 55% (51/92) and a consent rate (number randomized per number eligible) of 94% (51/54). Acceptability of the intervention was high with 98% (123/125) of the video consultations conducted as planned. No serious adverse events were reported in either group. ConclusionAn integrated mental health video consultations VISION model for patients with SSD presenting to primary care is feasible, acceptable, and safe. Potential clinical effectiveness of the model should be evaluated in confirmatory trial putting the multifaceted approach tailored to the individual patient with SSD directly into primary care practice. Trial registrationThe trial protocol was registered at German Clinical Trials Register (number: DRKS00026075, https://www.drks.de).

Treatment of Anxiety Disorders in Primary Care: What Nurse Practitioners Need to Know.

Anxiety disorders are the most common mental illnesses and frequently co-occur with other mental and somatic symptoms or disorders. Primary care nurse practitioners (NPs) are key in reducing the treatment gap through early identification, treatment, and/or referral to behavioral health providers. Confronting primary care NPs are problems with time constraints, multiple comorbidities, and limited mental health training, particularly in relation to the differences in pharmacokinetic and pharmacodynamic actions of first-line anxiety disorder medications across age groups. The current article provides a brief summary of evidence-based treatment focusing on pharmacotherapy for anxiety disorders in the primary care setting. [Journal of Psychosocial Nursing and Mental Health Services, 62(5), 7-10.].

Inflammation and weight change related to neurocognitive and functional impairment in diabetes and psychiatric disorders

Introduction: Obesity is a global pandemic associated with various cardio-metabolic and psychiatric disorders. Neurocognitive and functional deficits have been associated with several somatic and psychiatric disorders. Adiposity-related inflammation has recently emerged as a key risk factor for neurocognitive and functional impairments. This prospective transdiagnostic study aimed to investigate the role of adiposity-related inflammatory markers in neurocognitive and functional outcomes associated with weight changes.Methods: Peripheral blood inflammatory and oxidative stress biomarkers and neurocognitive and functional performance were assessed twice over 1 year in 165 individuals, including 30 with schizophrenia, 42 with bipolar disorder, 35 with major depressive disorder, 30 with type 2 diabetes mellitus (T2DM), and 28 healthy controls. Participants were stratified by body mass index into categories of type 2 obesity (T2OB; n=30), type 1 obesity (T1OB; n=42), overweight (OW; n=53), and average weight (NW; n=40). Mixed one-way analysis of covariance and linear and binary logistic regression analyses were performed.Results: Compared with NW, T2OB and T1OB were significantly associated with impaired neurocognitive and functional performance (p<0.01; η²p=0.06–0.12) and higher levels of C-reactive protein and platelets (PLT) (p<0.01; η²p= 0.08–0.16), with small-to-moderate effect sizes. IL-6, IL-10, and PLT were key factors for detecting significant weight changes in T1OB and T2OB over time. Regression models revealed that inflammatory and oxidative stress biomarkers and cellular adhesion molecules were significantly associated with neurocognitive and functional performance (p<0.05).Discussion: Obesity is characterised by neurocognitive and functional impairments alongside low-grade systemic inflammation. Adiposity-related inflammatory biomarkers may contribute to neurocognitive and functional decline in individuals with T2DM and psychiatric disorders. Our data suggest that these biomarkers facilitate the identification of specific subgroups of individuals at higher risk of developing obesity.

Factors associated with having previously received a diagnosis of fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome: A cross sectional DanFunD study

ObjectivesFibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome are highly prevalent conditions and part of the functional somatic syndromes (FSS) diagnosis, that are classified under the unifying umbrella term functional somatic disorder (FSD). Multiple factors are associated with FSD symptom development; However, few studies have explored these associations in relation to the diagnosis status. This study aims to examine associations with a previously received FSS diagnosis from a physician in participants fulfilling the FSD diagnostic criteria in a population-based sample. MethodsThis research employs a comprehensive observational approach using a cross sectional design with data from the DanFunD part two cohort. Information about received FSS diagnoses was obtained from self-reported questionnaires. Participants fulfilling the FSD diagnostic criteria were identified with both self-reported questionnaires and diagnostic interviews. Validated questionnaires were used to assess the examined factors. Results1704 cases fulfilled the diagnostic criteria for an FSD according to questionnaires or interviews in the DanFunD study. In participants fulfilling the diagnostic criteria, having previously received an FSS diagnosis by a physician was strongly associated with female sex, negative illness perceptions and poor health-related quality of life for questionnaire and interview-based diagnoses. Less consistent associations were observed for lower socioeconomic status, anxiety, and adverse life events. ConclusionPreviously received FSS diagnoses showed associations with multiple factors with a particular strong association with female sex and poor health related quality of life.

Patterns and prevalence of psychiatric morbidity among individuals with rheumatoid arthritis.

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that affects the joints, causing inflammation, pain, and potential joint damage. Patients with RA are at high risk of developing psychiatric morbidity; it is important to recognize these psychiatric manifestations. The relationship between psychiatric symptoms and RA is complex and can involve various factors, including the impact of chronic pain, inflammation, medications, and the overall burden of managing a chronic illness.Aim of the study was to systematically investigate and analyze the patterns and prevalence of psychiatric morbidity among individuals diagnosed with RA, with the aim of identifying common mental health conditions, understanding the interplay between RA and psychiatric disorders, and providing valuable insights for improved holistic patient care. This was a prospective, observational cross-sectional study conducted over a period of three years in patients with RA. Psychiatric morbidity was assessed using International Classification of Diseases-10 criteria and Mini-Plus by dedicated psychiatrists. The diagnosis of RA was confirmed using the 2010 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) diagnostic criteria for RA and the disease activity was calculated by Disease Activity Score with 28-joint count (DAS28) using the calculator from the RheumaHelper application. The data were analyzed using SPSS, version 23.0. A total of 1,000 patients with RA were included in this study. Nearly two-thirds of the patients were female (64.8%). The majority of patients belonged to the age group of 41 to 54 years. Total 47.5% of the patients were unemployed, 27.0% were salaried, 19.0% were businessman, while 6.5% of the patients were students. More than half of the patients (53.2%) had moderate disease activity. Major depressive disorder was the most commonly observed comorbidity (41.0%), followed by somatoform disorder (28.5%), and generalized anxiety disorder was found in 13.5%. No psychiatric manifestations were found in 17% of studied individuals. Psychiatric morbidity is associated with RA and there is a need for psychiatric services to be made available to these patients.

Psychosomatic Disorder

Abstract: The word psychosomatics comes from the Greek word “psyche (mind) and “soma” (body) psychosomatic illness is on illness that affects the mind And body in some case mentl and emotions disorders can increases many studies have shown that chronic diseases . mouth burns etc. Psychosomatic disorder include physical and mental disorders. The physical symptoms of the diseases are caused by mental or emotional problems if often lead to stress , anixiety ,and depression when menatal disorder are not recognized ,physical pain wil occure due to hystriea although oral and paraoral patterns indicate psychosomatic disorders . The term psychosomatic diseases ,oral diseases , stress etc .relevent articles were selected and filtrated from the database using .