Somatoform Research Articles

Inflammatory Markers in Children and Adolescents with Functional Somatic Disorders: A Systematic Review

Functional somatic disorders (FSDs) are common in children and adolescents. Recent findings suggest that low-grade inflammation has a role in the development and maintenance of pediatric FSDs. This systematic review included studies with original data on systemic inflammatory markers in children and adolescents with an FSD compared to individuals without an FSD. The literature search identified 1374 articles. After assessment, a total of 15 studies met the inclusion criteria. In total, 41 serum or plasma cytokines were assayed in a population of 696 children and adolescents. Altered cytokine levels in patients with FSDs were reported in 12 studies, whereas three studies found no significant differences when comparing patients with FSDs and controls. The cytokine levels were significantly elevated in nine studies (i.e., IL-2, IL-6, IL-8, IL-12 (p70), CRP, hsCRP, IP-10, MCP-1, sTIM-3, sCD25 and TNF-). The findings indicate that inflammatory response may have a role in the pathophysiology of pediatric FSDs. However, the included studies showed limited quality with potential risk of bias, small study populations and a narrow spectrum of included FSDs, which limits the generalizability of the results. To further explore the potential link between inflammatory markers and pediatric FSDs, future research using a longitudinal study design is recommended.

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.

Treating the untreatable: Somatoform disorder in an adolescent with organic symptoms mimicking idiopathic anaphylaxis

Idiopathic anaphylaxis (IA) is a rare life-threatening disorder that may present with severe symptoms similar to other forms of anaphylaxis. It is an exclusion diagnosis and requires careful consideration of all recognizable and rare causes of anaphylaxis. Psychiatric conditions, such as somatoform disorders, should be considered in the differential diagnosis when there is a paucity or absence of clinical signs. A 17-year-old female patient was admitted to the inpatient clinic for pediatric allergy due to recurrent anaphylaxis. In the last two years, the patient was administered intramuscular epinephrine more than 200 times and was admitted to the intensive care unit four times due to severe anaphylaxis. The attacks frequently appeared as flushing, itching, shortness of breath, and rarely hypotension, but without a defined trigger. The patient was diagnosed with IA and received oral steroids, omalizumab, and rituximab. However, none of her attacks were accompanied by elevated tryptase levels and the aforementioned pharmacotherapies did not prevent relapse. After psychiatric evaluation, somatoform disorders were suspected despite striking variations in the severity of the physical symptoms. The psychiatric diagnosis was also supported by a good response to fluoxetine and supportive individual psychotherapy. The patient is currently being followed up without any anaphylactic attacks. Somatoform disorders should be considered in the differential diagnosis of IA because of overlapping physical symptoms. In the clinical practice of diagnosing and managing IA, symptoms that are not only subjective but also objective and unresponsive to conventional treatments should alert physicians to the probability of the psychiatric condition and the requirement for psychiatric consultation.

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.].

Patterns and prevalence of psychiatric morbidity among individuals with rheumatoid arthritis

ObjectivesRheumatoid 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.Material and methodsThis 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.ResultsA 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.ConclusionsPsychiatric 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 .

Study of Patients in a Private Psychiatric Unit in Eastern India

Mental illness is an important cause of morbidity, mortality and poor quality of life. In this study analysis of diagnostic distribution with respect to age, sex, and other parameters and comparison with other studies done. It is a descriptive study, done in a Private Psychiatric Clinic near Kolkata. Time period was 2 yrs (from 1st January 2018 to 31st December 2019). ICD10 is primarily used as diagnostic tool but for purpose of patient management and community need, diagnosis according to symptoms (headache, osteoarthritis, neuropathy etc) used. Data were analyzed and tabulated. Total number of patients visited during study period is 3000 . Among them 1081(36.01%) patients are male, 1919(63.99%) are female. Majority of the patients are in the age group of 20-50 years. Among the patients majority are from Generalized Anxiety Disorder (GAD), Phobiaand Somatoform Disorder (42.4%) whereas Major Depressive Disorder (MDD) consists of 22.6%, Bipolar Affective Disorder( BPAD)- 6.5%, Schizophrenia and other psychotic disorders- 10.2 %, Dementia- 3. 5%.

A case of NMDAR Encephalitis with muscular pain as the main presentation

BackgroundPersistent somatoform pain disorder (PSPD) is often the initial diagnosis in patients seeking treatment in psychiatric departments, making it challenging to consider organic nervous system diseases. However, autoimmune encephalitis can present with atypical initial symptoms, leading to misdiagnosis or missed diagnosis. Lumbar puncture, with antibody support, plays a crucial role in diagnosing autoimmune encephalitis.Case presentationThis report describes a 40-year-old male adult patient who was initially diagnosed with persistent somatoform pain disorder in 2022. The patient reported a reduction in pain while resting on his back. There were no fever or relevant medical history. Despite 8 months of symptomatic treatment, the symptoms did not improve. Moreover, the patient developed confusion, gibberish speech, non-cooperation during questioning, and increased frequency and amplitude of upper limb convulsions. Lumbar puncture revealed elevated protein levels and protein-cell dissociation. The autoimmune encephalitis antibody NMDAR (+) was detected, leading to a diagnosis of autoimmune encephalitis (NMDAR).ConclusionAutoimmune encephalitis (NMDAR), starting with persistent somatoform pain (PSPD), often presents with atypical symptoms and can be easily misdiagnosed. Therefore, it is important to consider the possibility of organic nervous system disease in time, and to test serum or cerebrospinal fluid antibodies to rule out organic nervous system disease after symptomatic treatment of mental disorders is ineffective. This approach facilitates the early diagnosis of autoimmune encephalitis and other underlying organic neurological disorders.

Mental health of residents of radioactively contaminated territories of the Chelyabinsk region in the late period after the resettlement

In case of radiation accidents, one of the radical protective measures is the evacuation of residents from contaminated areas. Its purpose is to reduce the possible radiation effect to the population. At the same time, evacuation itself becomes a serious stressful factor that has a negative impact on a person’s health and mental status. The objective of this work is to assess the state of mental health of residents of the Muslyumovo settlement in the Chelyabinsk region (the territory exposed to radioactive contamination as a result of radioactive waste releases into the Techa River) who participated in the resettlement program in the period from 2006 to 2010. Mental health was assessed twice: primarily in 2008-2010 against the background of resettlement, and again in 2019-2020, 10 or more years after the resettlement. The study includes 2 groups formed by random selection. The main group consisted of 100 persons from among the participants of the resettlement program. The comparison group included 80 persons living in the territories exposed to radioactive contamination, but not participating in the resettlement program. According to the main socio-hygienic characteristics, the groups are homogeneous and comparable. The following methods were used: clinical, clinical and psychological, and the method of statistical processing of materials. As a result, it was found that both in the primary and in the repeated study, residents of the Muslyumovo settlement, Chelyabinsk region, participating in the resettlement program, were statistically significantly more likely (p<0.001) to have mental disorders and behavioral disorders (neurotic, stress-related and somatoform disorders (F 40)), compared with the control group. Also, according to the results of the survey, statistically significantly more often the psychogenic effect of resettlement (p≤0.001) was detected in patients of the main group. The data obtained suggest a long-term effect of resettlement on the mental health of the population involved. Understanding the consequences of the protective measures carried out (resettlement) will clarify the criteria for their application, as well as predict the manifestations of mental maladaptation in the population with the potential development of radiation accidents.

Neuropsychocorrection of stress disorders

The article highlights a novel method of psychotherapy, which has a wide range of indications, including pre-nosological manifestations of emotional deficiency, depression, stress disorders of various origins and associated neurotic disorders, personality, behavioral, psychosomatic, and addictive disorders, food addiction (anorexia nervosa and bulimia), psychoactive substance dependence (alcoholism, drug addiction, substance abuse, smoking), psychological dependence in relation to individuals, as well as bad habits and any other disorders associated with psychogenic factors. We applied neuropsychocorrection as part of a complex of traditional resort treatment (study group) and observed patients in the control group who received only resort treatment. The main indicators when selecting individuals for the study were a high level of anxiety, low mood, emThe statistical data obtained as a result of the study based on the analysis of the dynamics of complaints after the course of neuropsychocorrection indicate a more pronounced stabilization of the psycho-emotional state, a decrease in emotional tension, normalization of sleep, a decrease in the level of anxiety, enhancement in interpersonal relationships, and improvement and stability of mood.otional tension, increased sensitivity to external stimuli, and somatization disorders.

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.