Somatoform Research Articles

Psychometric evaluation of the somatic symptom scale − 8 in patients with somatic symptom disorder in Iran

Psychometric evaluation of the somatic symptom scale − 8 in patients with somatic symptom disorder in Iran

Measurement Properties of the Patient Health Questionnaire–15 and Somatic Symptom Scale–8

The subjective experience of somatic symptoms is a key concern throughout the health care system. Valid and clinically useful instruments are needed. To evaluate the measurement properties of 2 widespread patient-reported outcomes: the Patient Health Questionnaire-15 (PHQ-15) and Somatic Symptom Scale-8 (SSS-8). Medline, PsycINFO, and Web of Science were last searched February 1, 2024. English-language studies reporting estimates pertaining to factor analysis, taxometric analysis, internal consistency, construct validity, mean scores in relevant groups, cutoffs, areas under the receiver operating characteristic curves (AUROCs), minimal clinically important difference, test-retest reliability, or sensitivity to change. Search hits were reviewed by independent raters. Cronbach α, Pearson r, means, and between-group effect sizes indicative of sensitivity to change were pooled in random-effects meta-analysis. Study quality was assessed using 3 instruments. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 reporting guideline. Comprehensive overview of evidence pertaining to the measurement properties of the PHQ-15 and SSS-8. A total of 305 studies with 361 243 participants were included. Most concerned routine care (178 studies) and the general population (27 studies). In factor analyses, both scales reflected a combination of domain-specific factors (cardiopulmonary, fatigue, gastrointestinal, pain) and a general symptom burden factor. The pooled PHQ-15 α was 0.81 (95% CI, 0.80-0.82), but with low item-total correlations for items concerning menstrual problems, fainting spells, and sexual problems (item-total correlations <0.40), and the SSS-8 α was 0.80 (0.77-0.83). Pooled correlations with other measures of somatic symptom burden were 0.71 (95% CI, 0.64-0.78) for the PHQ-15 and 0.82 (95% CI, 0.72-0.92) for the SSS-8. Reported AUROCs for identification of somatoform disorders ranged from 0.63 (95% CI, 0.50-0.76) to 0.79 (95% CI, 0.73-0.85) for the PHQ-15 and from 0.71 (95% CI, 0.66-0.77) to 0.73 (95% CI, 0.69-0.76) for the SSS-8. The minimal clinically important difference on both scales was 3 points. Test-retest reliability could not be pooled and was inconsistent for the PHQ-15 (PHQ-15: r = 0.65-0.93; ICC, 0.87; SSS-8: r = 0.996, ICC = 0.89). The PHQ-15 showed tentative sensitivity to change (g = 0.32; 95% CI, 0.08-0.56), but data for the SSS-8 were lacking. In this systematic review and meta-analysis, findings supported use of the PHQ-15 and SSS-8 for the assessment of symptom burden, but users should be aware of the complex, multifactorial structures of these scales. More evidence is needed concerning longitudinal measurement properties.

Mental health issues of children and young people displaced by conflict: A scoping review

This research is a scoping review aimed at identifying evidence and studies that address the mental health issues of children and young people forcibly displaced by conflict. It also examines mental health interventions for this population and factors that either favor or worsen their mental health. This issue a major public health issue due to increasing global conflicts that results in the continuous displacement of large populations and the development of new communities where children and young people struggle to re-integrate. This sub-population represents a hidden and at-risk group often not prioritized in planning health interventions for displaced populations. The objective was to identify mental health issues faced by children and young people forcibly displaced by conflict, examine available mental health interventions for this population, and identify factors that favor or worsen their mental health.Four databases (PubMed, ScienceDirect, EBSCO, and ProQuest) were systematically searched for published evidence. Additionally, the King’s Fund Library, OpenGrey, DANS data archive, APA website, and WHO were searched for gray literature. After applying strict selection criteria, 27 studies were chosen for a full-text review out of the initially identified 4,548 studies. This review identified depression, post-traumatic stress disorder (PTSD), and anxiety as the major mental health issues in this population. Other issues included somatic disorders, sleep disturbances, nightmares, encopresis, and substance abuse. These disorders, when left untreated, did not diminish over time post-displacement. Mental health was positively influenced by mental health services and religious activities. Negative factors included prior trauma, female sex, poverty, child abuse, parental violence, and separation. Several psychotherapy interventions were found to be effective. In conclusion mental health issues among forcibly displaced children and young people are prevalent and troubling, yet empirical evidence is insufficient. Further research is needed, especially among internally displaced children and youth.

Application of percutaneous neurostimulation in treatment complexes for psychosomatic pathology

The article is devoted to the combined use of psychological relaxation and transcutaneous electrical stimulation in post-stress disorders in persons of hazardous professions.Materials and methods. There were 90 men with a high level of stress aged 40 to 55 years, whose clinical picture was distinguished by the interweaving of neuropsychiatric and cardiovascular disorders. The assessment of the mental status of patients was supplemented by the results of testing; the reserve capabilities of the body were assessed based on a test of dosed physical activity. Electro- and echocardiography were used to analyze cardiovascular activity. The patients were divided into three treatment groups, in which, in addition to the previously prescribed drug treatment in a third of cases, respiratory relaxation training and percutaneous neurostimulation were used. In the first two groups, these methods were used separately, in the 3rd group – in combination.Research results. Initially, the features of neuropsychic and somatic manifestations in the observed contingent were specified. At the same time, in most of the observations, neurotic manifestations prevailed, combined with somatic disorders, mainly in the form of arterial hypertension and angina pectoris. In the course of assessing the results of treatment, the proposed complex was significantly more effective than the compared groups in terms of improving indicators of mental status and cardiovascular activity. The catamnesis analysis confirmed the stability of the results achieved even in the case of combined exposure.Conclusion. The therapeutic complex of psychorelaxation and hardware equipment provides the effectiveness and therapeutic reliability of the effect due to the addition of several therapeutic mechanisms, and the work itself opens up prospects for optimizing corrective programs for the pathology under study.

Childhood sexual abuse as a predictor of Complex Posttraumatic Stress Disorder: A meta-analysis

Sexual abuse, especially when it occurs during childhood, is an experience that causes deep and lasting harm. Currently, its study as a risk factor for the development of trauma-related pathologies is of great relevance. In 2018, Complex Post-Traumatic Stress Disorder (CPTSD) was officially recognized as a distinct syndrome in the 11th Revision of the International Classification of Diseases (ICD-11), with the aim of distinguishing it from neurotic disorders secondary to stressful situations, somatoform disorders, and those specifically associated with stress. The inclusion of CPTSD in the ICD-11 marked the culmination of two decades of research dedicated to understanding its symptoms, treatments, and risk factors. This article aims to conduct a meta-analysis that explores the relationship between sexual abuse and the development of CPTSD. Fifteen studies were selected for analysis, and the results revealed several key risk factors associated with the development of CPTSD, with the primary one being childhood sexual abuse (k = 15; OR = 3.007).

Interoceptive disturbances in patients with functional movement disorders

Abstract. Functional movement disorders (FMD) are frequently encountered in the clinical practice of a neurologist. They are on the border of neurology and psychiatry, but the pathogenesis of the disease is still an open question. One of the causes of FMD development is considered to be interoception disorder.Objective. The aim of this study was to investigate interoceptive awareness in patients with FMD and its relationship with the severity of motor, affective, and other somatic disorders and quality of life.Material and methods. The study included 34 patients with FMD and 31 healthy volunteers, in whom interoceptive awareness was assessed using the MAIA-R scale, quality of life (SF-36), concomitant somatic symptoms (PHQ-15), and affective symptoms (HADS). The severity of FMD was assessed using the PMDRS scale. Results. The findings revealed that patients with FMD exhibit less trust in the sensations of their own bodies and tend to focus primarily on discomfort sensations. Patients with FMD also showed greater expression of concomitant somatic symptoms, anxiety, and depression. Quality of life was reduced due to the physical component of health.Conclusion. Interoceptive awareness is related to patients’ emotional characteristics and is not associated with the severity of motor impairment. The results demonstrate changes in the processing of an interoceptive information.

Suicidal behavior in ADHD: the role of comorbidity, psychosocial adversity, personality and genetic factors.

Adult ADHD is associated with increased risk for suicide attempts, as indicated by investigations of population- and community-based cohorts. However, there is little data regarding suicide attempts in a clinical setting. To address this, we used a comprehensively phenotyped clinical adult ADHD (aADHD) cohort to assess to which extent comorbidity, psychosocial adversity, personality, and ADHD symptoms contribute to suicidal behavior in ADHD. Furthermore, we investigated a triallelic variation in the serotonin transporter-linked polymorphic region (5-HTTLPR), which has previously been associated with suicidal behavior. Depression, substance use, eating, and posttraumatic stress disorders were independently associated with past suicide attempts, whereas anxiety, somatoform, and obsessive-compulsive spectrum disorders showed no association. Pulmonary diseases also showed an association with suicidal behavior. Psychosocial factors including occupational status, marital status/living situation, externalizing behavior and psychiatric family history were strongly associated with past suicide attempts. ADHD symptoms of inattention and hyperactivity/impulsivity were not associated with past suicide attempts after adjustment for psychiatric comorbidity and psychosocial adversity. However, the personality trait of neuroticism fully mediated the association between depression and suicidal behavior. 5-HTTLPR was not associated with suicidal behavior, but an interaction with ADHD symptoms and subtype was found. Our data suggest that psychiatric comorbidity and psychosocial adversity are key factors for suicidal behavior in aADHD, with neuroticism representing a critical mediator of the association between depression and suicidality. Further research, preferentially with longitudinal study designs is needed to better understand causal factors for suicidal behavior to enable effective preventive action.

The often missed diagnosis of somatic symptom disorder in sexual dysfunction: recognizing symptoms and management tips for clinicians.

The often missed diagnosis of somatic symptom disorder in sexual dysfunction: recognizing symptoms and management tips for clinicians.

Modifiable factors for somatic symptom persistence in patients with somatic symptom disorder: study protocol for a longitudinal cohort with an embedded ecologically momentary assessment (SOMA.SSD)

IntroductionSomatic symptom disorder (SSD) is a distressing mental disorder characterised by the presence of at least one persistent somatic symptom and a significant psychological burden due to the symptom(s), as well as excessive thoughts, feelings or behaviours related to them or associated health concerns. The primary aim of our study is to deepen the understanding of risk factors and mechanisms for somatic symptom persistence. Specifically, we will investigate the role of patients’ expectations and somatic comorbidity regarding symptom persistence.Methods and analysisIn a prospective 12-month cohort study, n=240 patients with SSD will be recruited from the outpatient clinics of the Department of Psychosomatic Medicine and Psychotherapy at the University Medical Center Hamburg-Eppendorf. The roles of two hypothesised predictors (ie, expectations and comorbidity) will be analysed together with known predisposing and maintaining factors of persistent somatic symptoms. The study entails macrolevel and microlevel assessments to investigate symptom severity over different timespans. Assessments at the macrolevel take place at baseline, 6 and 12 months. At the microlevel, a 10-day ecological momentary assessment study will be implemented to elucidate patients’ dynamic experience with somatic symptoms in their natural environments. In order to elicit possible framing effects on the 10-day course of symptom severity, participants are randomised to either a positive or a negative expectation framing group. Cross-lagged panel models will be used to analyse data at the macrolevel. At the microlevel, multivariate latent growth curve models will be conducted to relate temporal changes in predictor and outcome variables to one another.Ethics and disseminationThe study was approved by the Ethics Committee of the Medical Associations Hamburg, Germany (2020-10197-BO-ff). The results will enable us to draw conclusions regarding the role of expectations for future targeted treatment options and regarding the utility of somatic comorbidity as a potential diagnostic specifier of SSD. Dissemination of our results will be achieved through scientific publications, and lay summaries for study participants, patient advocacy groups and the general public.Trial registration numberISRCTN36251388.

Living with Mental Illness.

Objective: The situation of patient's relatives is still not broadly studied in psychiatry. Their needs are often overlooked. Method: We developed a digital questionnaire concerning the patient's sociodemographic, disease-related, and family-related data and had the patient's therapist fill it out. The patients included (N = 1766) were persons hospitalized on a selected date. Results: One-third of patients had at least one relative with mental illness, prior treatment, or need for treatment. The main diagnoses in relatives were affective, substance use, and somatoform disorders, often in concordance with their index patient. Teenage patients had the most affected relatives. The therapists of the minors included were better informed about their familial situation, whereas the therapists of the 30-59-year-olds knew the least. Conclusions: The comparably lower rate of affected relatives in adults stems most likely from underassessment and needs further investigation.

Göç Olgusunun Göçmen Bireyler Üzerindeki Ruh Sağlığına Etkisi

Migration is a complex structure that has existed throughout human history of individuals and units. There are different types of migration. Internal migration means displacement within the borders of the country. Emigration means leaving the regions they belong to for certain reasons. Brain drain, on the other hand, occurs when people who have developed their own personality are academically educated elsewhere due to the country's conditions. As a result of this move, immigrant individuals are affected by spiritual and emotional changes. The psychological effects of immigration on immigrants are known. Immigrant individuals may experience difficulties in three different categories: before migration, during migration and after migration. As a result of research on common pathologies seen in immigrants, post-traumatic stress disorder, anxiety disorders, self-alienation, schizophrenia, somatization disorder, and increased psychotic features have been expressed. It is known that the life disruption of immigrants has also been reduced. There are definitions of these immigrant types, as well as the psychological transitions of immigrant individuals and the common problem seen in immigrants. Literature research is included in their content. It can be stated that the results of the research showing that migration disrupts the daily life of the students and that psychological problems arise in their lives in a negative way can be expressed. Keywords: Types of migration, migrants, psychology, mental health, trauma.

Features of the oropharyngeal microbiota of healthy children and those with acute respiratory infections. A prospective single-center randomized study

Background. The oropharyngeal microbiota is involved in the development of colonization resistance, affecting viral adhesion and metabolism. Any deviations in the stability of the environmental microbial niches of the oropharynx alter the local immune response and can trigger severe chronic somatic disorders. Aim. To compare the composition of the microbiota of children during an episode of respiratory infection and healthy volunteers examined in different periods of convalescence. The obtained data can be used to predict the course of the disease, analyze the risk of complications, and assess the frequency of the diseases in the future. Materials and methods. From 20.01.2022 to 23.12.2022, an open-label prospective single-center randomized comparative study was conducted, which included 120 children aged 5-10 who presented with symptoms of acute respiratory infection. The control group consisted of 15 asymptomatic children examined at different periods of convalescence. The study compared changes in the oral microbiota composition of patients and healthy children. The evaluation was performed using complete 16S rRNA gene sequencing on the Oxford Nanopore platform. Taxonometric analysis at the species and genera level was performed using the Knomics-Biota platform. The R programming language was used for statistical processing. In addition, the parameters of α- and β-diversity of the microbiota were assessed. The Chao1 and Shannon indices were calculated to assess α-diversity (diversity within one community). The Chao1 index is based on the number of species found in the sample and also rare species that are found only 1 or 2 times, thus preventing underestimation of diversity. The Shannon index includes both the number of species and their uniformity in the community. A change in the index indicates the dominance of one or more species. The following indicators were used to assess the β-diversity describing the differences between two microbiota samples at the species and genera level: Bray–Curtis dissimilarity (characterizing the ratios of common and different microorganisms between the samples) and the Aitchison distance (reflecting the differences in the proportions of microorganisms). In addition, the balance between the two groups of microorganisms was evaluated using the NearesBalance method, which characterizes the differences between the microbiota of the main and control groups. Results. The results of our study show that during respiratory infection, the state of the oropharyngeal microbiota is characterized by an increase in α-diversity, which is associated with an increase in the proportion of species of Streptococcus salivarius, Streptococcus pneumoniae, Streptococcus pseudopneumoniae, Streptococcus pyogenes, Streptococcus thermophilus and A12 versus the proportion of Streptococcus mitis, Streptococcus oralis, Streptococcus gwangjuense, Streptococcus sanguinis, Streptococcus gordonii and FDAARGOS_192. In the control group, the oropharyngeal microbiota was divided into two clusters. The dominance of streptococci was observed in the first group (control), while the second group had a more uniform representation. Analysis of the changes in microbial communities in the main and control groups can show the stages of oral microbiota recovery after an acute respiratory infection episode. Conclusion. More research is needed in the field of the oropharyngeal microbiome on a larger sample of healthy children, to standardize the communities of the oropharyngeal microbiota, to study the interaction within communities and with the body as a whole. Analysis of the impact of the microbiota on the frequency and course of respiratory infections and the rate of complications opens up new prospects in treating, rehabilitating, and preventing diseases. These research areas can contribute to improving children's health and quality of life and introducing new approaches into clinical practice.

The QSP-31: a multidimensional questionnaire for assessing psychosocial / psychodynamic aspects in patients with somatoform pain

ABSTRACT Somatoform pain poses major challenges in medicine. There is a lack of quantitative instruments that systematically assess psychosocial aspects of somatoform pain. A better knowledge of such aspects could contribute (1) to gaining further insight into the relationship between psychodynamic and psychosocial components of pain, and (2) to facilitating the development and monitoring of improved interventions targeting psychodynamic and psychosocial mechanisms of pain. An item pool on biopsychosocial aspects of pain was developed and completed by 200 patients with somatoform pain disorder. In addition, anxiety (STAI), depression (BDI II), somatization (SOMS-2), and quality of life (SF-36) were assessed. As compared to norm data, patients reported higher scores for anxiety (STAI), depression (BDI-II) somatization (SMOS-2), and lower quality of life (SF-36). Applying item and factor analyses, a new questionnaire (QSP-31) was developed to identify psychodynamic and psychosocial aspects of pain. There was evidence for the construct validity of the six scales through confirmatory factor analysis: Relationships between pain and negative emotions, Negative attitudes towards help-seeking, Negative pain-related childhood experiences, Negative attitudes towards own body, Negative aspects of the doctor-patient relationship, and Perceived pain control. Cronbach's alpha coefficients for these scales lay within the range of .81-.92. Regarding criterion validity, moderate correlations in expected directions were found between all scales and anxiety, depression, somatic symptom severity, and quality of life, except for the scale Perceived pain control. The QSP-31 appears promising for the identification of relevant psychosocial aspects associated with the experience of pain and might be a useful instrument.

THE IMPACT OF PSYCHOSOMATIC ILLNESSES ON THE MENTAL HEALTH OF SOCIETY AFTER THE COVID-19 PANDEMIC

Introduction: Psychosomatic illnesses are conditions in which psychological factors significantly influence the development and progression of physical illnesses. The impact of the COVID-19 pandemic, with its context of social isolation and uncertainty, has brought to light an increase in psychosomatic illnesses, highlighting the complex interconnection between mental and physical health. Objective: The general objective of this study is to identify the relationship between mental disorders and post-pandemic social isolation. Methodology: This is a systematic literature review. The following criteria were used for inclusion: articles published between 2019 and 2024, articles written in Portuguese, English, and Spanish. Results: The results indicate that social isolation imposed by the pandemic, associated with economic uncertainty and fear of contagion, led to a significant increase in psychosomatic disorders, such as panic attacks, anxiety, and depression. Conclusion: There is an urgent need to develop prevention and treatment strategies for psychosomatic illnesses, emphasizing the importance of humanized and multidisciplinary approaches.

Having paid work 1 year after disability claim in different types of mental and behavioural disorders

Abstract Background The majority of claimants diagnosed with a mental and/or behavioral disorder have residual work capacity, however, the chance of actual (return to) work after a disability claim assessment may differ within this diagnosis group depending on the specific type of disease. The aim of this study is to examine the associations of different mental and behavioural diseases with having paid employment one year after the claim assessment. Methods This longitudinal register based cohort study included all work disability applicants with mental and behavioural disorders assessed with residual work capacity in the Netherlands in 2016. Data were derived from the Dutch Social Security Institute (UWV) and were linked to register data on paid employment. ICD codes were used to categorize 11 disease groups (mental retardation, autism spectrum disorders, ADHD, somatoform disorders, adjustment disorders, PTSS, anxiety, personality disorders, mood affective disorders, addictions and delusional disorders. Multivariable logistic regression analyses were conducted separately for applicants who work and not work at time of the claim assessment. Results A total of 8544 claimants (mean age 45, 56% female; n = 1915 work at baseline) were included. In the working group being diagnosed with ADHD (OR 3.05, CI 1.08-8.61) or PTSS (OR 1.45, CI 1.04-2.02) was associated with paid work, and adjustment disorder was negatively associated (OR 0.74, CI 0.56-0.97). In the not-working group, autism spectrum disorder (OR 1.51, CI 1.02-2.22), personality disorder (OR 1.36, CI 1.02-1.81) and addiction (OR 1.94, CI 1.32-2.86) was associated with return to work, and somatoform (OR 0.51, CI 0.31-0.84) disorders and mood affective disorders (OR 0.83, CI 0.70-0.99) were negatively associated. Conclusions The findings of this study show different associations between type of mental and behavioural disease groups and paid employment one year after the claim assessment. Key messages • The association of either remaining at work or return to work is different among mental and behavioural diagnosis groups, therefore a different approach is indicated. • Active interventions to facilitate return to or remain at work might be indicated in specific diagnosis groups.

Prevalence and severity of insomnia in adult outpatients attending Kasralainy Psychiatry and Addiction Treatment Hospital

BackgroundInsomnia is common among patients with psychiatric disorders and affects the clinical presentation and outcomes of the psychiatric disorder. The presentation of insomnia varies according to the type and severity of the psychiatric disorder.ObjectivesThis cross-sectional study aimed to assess the prevalence and severity of insomnia in adult psychiatric outpatients attending Psychiatry and Addiction Medicine Hospital, Faculty of Medicine, Cairo University. The study included 390 patients diagnosed with the following disorders: depressive disorders (n = 126 (32.2%)), anxiety disorders (n = 69 (17.6%)), psychotic spectrum disorders (n = 67 (17.1%)), bipolar and related disorders (n = 50 (12.8%)), trauma and stress-related disorders (n = 46 (11.8%)), obsessive–compulsive disorder (n = 30 (7.7%)), and somatic symptoms disorders (n = 2 (0.5%)). Patients were assessed using the Sleep Disorder Interview, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Global Assessment of Functioning Scale (GAF).ResultsAmong the assessed patients, 314 (80.5%) had insomnia, with a higher prevalence in females (91.5%) compared to males (67.2%). The prevalence of insomnia was 96% in depressive disorders, 97.1% in anxiety disorders, 49.3% in psychotic disorders, and 32% in bipolar and related disorders; while all patients with trauma and stress-related disorders, obsessive–compulsive disorders, and somatic symptoms disorders had insomnia.The severity of insomnia as measured by ISI was positively correlated with the global functioning score (r = 0.341, p = < 0.001) and negatively correlated with the duration of the psychiatric illness (r = − 0.285, p = < 0.001).ConclusionsInsomnia is highly prevalent in outpatients with psychiatric disorders.

Age-dependent associations with the risk of mental disorders in patients with myocardial infarction: a UK Biobank cohort study

Abstract Background Despite an overall decrease in cardiovascular mortality in recent decades due to effective preventive strategies, a concerning trend is emerging among young adults, with a rising incidence of myocardial infarction (MI) and its poor prognosis. Previous studies report that a significant association between mental disorders and the incidence and prognosis of MI. However, a detailed age-specific information is still lacking. Purpose We aimed to determine whether the risk of developing mental disorders after MI differs based on age and to stratify individuals at a higher risk. Methods From the UK Biobank prospective database (n=502,386), we collected data on patients with a prior MI (n=10,840) and compared them to age- and sex-matched controls (n=54,197) in a 1:5 ratio. Diagnoses of mental disorders were ascertained through linked hospital admission and mortality data, using the appropriate ICD-10-CM codes. Mental disorders were defined by at least two inpatient or outpatient claims within 1 year. The primary outcome was a composite of incident mental disorders, including depression, anxiety, stress-related, and somatoform disorders. Follow-up was done until the first diagnosis of mental disorders or the end of 2022. Results During a median follow-up of 13.7 years (interquartile range 12.8-14.5 years), the incidence rate of the primary outcome was 9.28 vs. 5.37/1,000 person-years among patients with MI and controls, respectively (p&amp;lt;0.001). A prior MI history demonstrated an independent association with the risk of incident mental disorders, yielding an adjusted hazard ratio (aHR) of 1.41 (95% confidence interval [CI], 1.29–1.54; p&amp;lt;0.001) after adjusting for confounders. This was comparable to heavy drinking and family history of depression. Notably, the risk of mental disorders attributed to previous MI was more prominent in younger individuals aged &amp;lt;55 years than their older counterpart (aHR 1.61 vs. 1.33) (p-for-interaction 0.020). Similar results were observed in the analysis of two important components: depression and anxiety disorder. Furthermore, in younger patients with MI (&amp;lt;55 years), mental disorders significantly increased the risk of mortality, while not in older patients. Conclusion MI was associated with a higher risk of incident mental disorders, resulting in poor prognosis, particularly in young individuals. Active surveillance and prevention for incident mental disorders after young MI may be beneficial.Cumulative Incidence of Mental Disorders

Integrating psychiatry and family medicine in the management of somatic symptom disorders: Diagnosis, collaboration, and communication strategies

AbstractSomatic symptom disorders (SSDs) present a complex interplay of physical and psychological factors, necessitating an integrative approach to diagnosis and management. This article explores the collaborative efforts between family medicine and psychiatry in addressing SSDs, emphasizing the importance of a multidisciplinary strategy for comprehensive patient care. Effective diagnosis involves recognizing the significance of both somatic symptoms and the patient's psychological response, with tools like structured clinical interviews and self‐report questionnaires playing crucial roles. Management strategies include psychotherapeutic interventions such as cognitive behavioral therapy (CBT), pharmacological treatments, and lifestyle modifications, all tailored to the patient's needs. Communication strategies are vital in validating patients' experiences while addressing underlying psychiatric issues. Techniques such as active listening, biopsychosocial framing, and the teach‐back method foster trust and improve treatment adherence. Cultural considerations and the use of interpreters enhance communication with diverse patient populations. Training programs for healthcare providers further improve competency in managing SSDs. This integrative approach aims to enhance patient outcomes by addressing the multifaceted nature of SSDs through collaborative care, effective communication, and comprehensive treatment planning.

Adverse childhood experiences and dissociation among Italian public psychology service users

Different studies have provided evidence that adverse childhood experiences (ACEs) are associated with mental health problems as a function of racial and ethnic diversity. The aim of the present study was thus to study the association between ACEs and dissociation in a sample of Southern Italian public psychology service (PPS) users. A sample of 183 adults who requested psychotherapeutic treatment within an Italian PPS was recruited. ACEs were assessed via the Adverse Childhood Experiences Questionnaire (ACE-Q). Dissociative symptoms were assessed via the Dissociative Experiences Scale (DES-II) and the Somatoform Dissociation Questionnaire (SDQ-20). Dissociative syndromes were assessed via two scales of the Millon Clinical Multiaxial Inventory (MCMI-III): the Somatoform Syndrome (H) and the Post-Traumatic Stress Disorder Syndrome (R) scales. The most common types of ACEs in our sample were emotional neglect and emotional abuse. The number of ACEs showed a significant association with all the different measures of dissociation administered. Logistic regression analysis for the DES-II resulted in a solution made up of sexual abuse and parental separation or divorce. The regression analysis for the SDQ-20 resulted in a solution made up of emotional abuse, physical neglect, and parental separation or divorce. Sexual abuse positively predicted PTSD scale scores, while no solution was found for somatoform disorder. ACEs and dissociation were strongly associated in this study, but the nature of this association depended on the aspect of dissociation under investigation, particularly when we considered the distinction between dissociative symptoms versus syndromes. Cultural characteristics and clinical implications for public services are discussed.

Substance use and lifestyle risk factors for somatic disorders among psychiatric patients in Greenland

ABSTRACT Patients with psychotic disorders exhibit elevated mortality and morbidity rates compared to the general population primarily due to comorbid somatic diseases. This study aims to describe the prevalence of selected risk factors and somatic disorders among psychiatric patients with a diagnosis of psychotic disorder. Material and methods: Data were retrieved from Greenland’s nationwide electronic medical record. The study population consists of 104 patients diagnosed with a psychotic disorder, encompassing schizophrenia or schizotypal and delusional disorders, residing in Nuuk. The study population comprised 104 patients (68 males and 36 females) with a mean age of 40 years. More than 80% were daily smokers, and 68% had harmful use of cannabis. More than half had dyslipidemia (any imbalance in lipids), while over a quarter were classified as obese with body mass index of 30 kg/m2 or higher. Eighteen percent had hypertension, and six percent suffered from diabetes. This study revealed a notable prevalence of risk factors for somatic diseases, particularly smoking and cannabis use among patients with schizophrenia in Nuuk, indicating that a high prevalence of somatic diseases might be expected as the population gets older and the risk of developing somatic diseases becomes greater. Increased focus on monitoring and preventing those as part of the health care is recommended.