Subjective Physical Complaints Research Articles

Objective physical function declines in the absence of subjective physical complaints among patients with amnestic mild cognitive impairments and mild alzheimer's disease.

To examine the extent to which patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's disease (AD) perceive their own physical decline. This study included 4450 outpatients (1008 normal cognition [NC], 1605 aMCI, and 1837 mild AD) who attended an initial visit to a memory clinic between July 2010 and June 2021. Their physical function was assessed by the Timed Up and Go test, one-leg standing test, and grip strength. For physical complaints, data were obtained on reports of fear of falling and dizziness or staggering. Logistic regression analysis was performed to compare the patients' physical function and complaints for each stage of NC, aMCI, and mild AD. Objective physical function declined from aMCI and the mild AD stage, but subjective physical complaints decreased by 20-50% in aMCI and 40-60% in mild AD compared with the NC group. As objective physical functional declined from the aMCI stage onward, subjective physical complaints decreased. This suggests a need for objective assessment of physical function in aMCI and mild AD patients even when they have no physical complaints in the clinical setting.

The Impact of Cybervictimization on the Self-Management of Chronic Conditions: Lived Experiences.

Cybervictimization of people with long-term conditions is a disturbing phenomenon with a documented impact on health and well-being. These experiences are primarily examined using quantitative methods, focusing on children and young people. However, research centered on the cybervictimization of adults with chronic conditions is scarce, with limited qualitative input from the victims as experts in their own experiences. This study aims to understand the impact of cybervictimization on the self-management of long-term conditions among adults with chronic conditions and disabilities in the United Kingdom. This paper reports the findings from the qualitative phase of a phenomenologically informed mixed methods study. The biographical disruption concept was used to conceptualize the study. In-depth semistructured interviews were conducted with 13 participants with chronic conditions who experienced cybervictimization. A codebook was developed, and a zigzag approach to thematic analysis was used to define and refine themes. Ethical considerations and risk assessment were ongoing during the research process because of the sensitivity of the topic and cases of harassment. Cybervictimization has direct and indirect impacts on the self-management of chronic conditions. This impact was verified across 6 overarching themes that emerged from this study. First, biomedical events included overall health deterioration because of existing conditions, new diagnoses, and subjective physical complaints. Second, the impact on mental health was perceived through psychological consequences and psychiatric disorders that developed after or during this traumatic experience. Third, the multilevel impact theme focused on disrupting the strategies for coping with health conditions and involved unplanned changes to victims' health management priorities. Fourth, the impact of complexity reflected the perceived uniqueness in each case, intersectionality, struggle to obtain formal support, and subsequent health complications. Fifth, social network involvement comprised the effects of social isolation, victim blaming, and deception. Finally, the disability discrimination theme focused on prejudice, issues on inclusion, and hostility in society, with subsequent effects on well-being. People with long-term conditions experienced different forms of cybervictimization, all disruptive with various effects on health. Disability discrimination was a prominent finding to be further investigated. This paper reports the impact as themes to guide further research and practice, with the recognition that long-term conditions and impairments are not a homogeneous group. Despite the devastating consequences, there are positive points that strengthen potential interventions. Awareness-raising campaigns, training of support channels, and multidisciplinary research are recommended to tackle this issue and initiate change.

Analysis of social demographic factors and its effect on work-related musculoskeletal disorders in front shovel operators of a mining company

Worker comfort is one important factor in the production operation. The attention to comfort in the workplace will be able to reduce the occurrence of complaints. Facilities and workplace conditions that are not ergonomic increase worker’s complaints, such as musculoskeletal disorders are often experienced. Many factors affect the occurrence of work-related musculoskeletal disorders. In this research, social demographic factors retrieved and the influence its effect on musculoskeletal experienced by front shovel operators at a mining company in South Sulawesi was analyzed. This research was based on subjective questionnaries and data obtained were processed by using bivariate statistical method. Dependent and independent variables are musculoskeletal disorder, social demography factor, handgrip strength, subjective physical complaint and environmental factors (temperature, noise, vibration, lighting, and dust). Results concluded from 28 front shovel operators, they have a senior high school education background (86%), with over 3 years work (3-5 years 32%,> 5 years 39%), generally slept in a day for 5-8 hours (71%), and most operators are smokers (75%) with the number of cigarettes consumed in an average a day 4-12 sticks (57%), generally operators are having a breakfast (89%) by consuming rice and side dishes (88%). Statistical tests showed no significant relationship between social-demographic factors to muscle complaints. The influence of environmental factors has a significant relationship to subjective physical complaints but the results obtained inconsistent because the number of samples is still limited.

THERAPEUTIC CASE REPORT: SHORT-TERM PSYCHOLOGICAL ASSISTANCE TO A PATIENT WITH ANXIETY AND PRONOUNCED PSYCHOSOMATIC SYMPTOMS

The purpose of this paper was to present and analyze a therapeutic case report of short-term psychological assistance to a client with anxiety and pronounced psychosomatic complaints. The article describes the psychosomatic manifestations presented by the client, the assessment of her mental status, the analysis of findings obtained by psychodiagnostic examination, the course of the client's psychotherapeutic intervention and the outcomes achieved. The methodology included Hospital Alarm and Depression Scale (HADS), A. Beck Depression Scale, Alarm Scale (HAM-A), SF-36 Quality of Life Questionnaire, the Gisen Psychosomatic Complaint Questionnaire, Psychosomatic Disorders Questionnaire by Chaban O. and Haustova O., the self-esteem scale of depression and anxiety according to Chaban O. and Haustova O., diagnostic techniques of psychosomatic complaints according to Chaban O. and Haustova O. Results: According to the results of the psychodiagnostic examination, the client was found to have expressed anxiety and mild depression, low level of anxiety disorder, lowered indicators of viability, psychological and physical health and social functioning according to the scales mentioned above. The patient demonstrated an increased overall rate of subjective physical complaints with prevalence of psychosomatic complaints of pain in different parts of the body, exhaustion and cardiac symptoms, as well as moderate manifestation of somatic symptoms. A significant impairment of the patient’s psychological health component was diagnosed. The client's physical health component was slightly above average, vital energy was reduced. Integrated counselling and psychotherapy were conducted with the patient. Conclusions. Following the psychotherapeutic assistance, and in particular, psychosomatic therapy, the anxiety level significantly decreased that resulted in somewhat amelioration in the psycho-emotional state of the patient and dying out of frequent psychosomatic complaints.

Association of the meaning of life with satisfaction, the occurrence of subjective complaints and the family’s economic status in the population of lower secondary school students

IntroductionFeeling of meaning in life is extremely crucial factor of mental health. The lack of it can result in various disorders. Many authors, especially those connected with current of humanistic psychology underline the teenagers’ life sense.The aimThe aim of the paper was to examine the level of satisfaction with life, the frequency of psychosomatic complaints by junior high school students as well as the estimation of economical status of family and the analysis of meaning in life with above mentioned factors.Material and methodsThe research was carried out in 2015 at 70 schools from all over the country, in group of 3695 lower secondary school students of I-III classes at the age of 13-17 (M=14,9; SD=0,87). The analysis connected with meaning in life using the shorten version of Purpose in Life Test (PIL) as well as analysis of life satisfaction using Cantril scale were taken up. What is more, the subjective physical complaints using single-factor shorten scale and economic status of family with the usage of material resources FAS scale (Family Affluence Scale) were examined. The statistical analysis included a one-way analysis of variance (ANOVA), t-student test post-hoc test as well as multivariate logistic regression model.ResultsThe average level of meaning in life among the examined students was 24,7 points (the summary scale 0-36 points), the boys achieved higher score than girls. The students satisfied with life (t=28,0; p<0,001), with rare physical complaints (F=124,8; p<0,001) and from affluent families (F=15,4; p<0,001) were significantly characterized by higher average level of meaning in life than students who were dissatisfied with their life, often or fairly suffer from health complaints and live in families of at most average level of affluence.ConclusionThe meaning in life is positively connected with satisfaction with life, lack of subjective complaints and family affluence. Because there is a lack of analysis linked with school teenagers’ meaning in life in Polish literature, another research involved not only shorten but also full version of this tool should be conducted.

Physical effects of Anma therapy (Japanese massage) for gynecologic cancer survivors: A randomized controlled trial

ObjectivesCancer survivors often have physical and psychological complaints after standard cancer treatment. We conducted a randomized control trial to evaluate the physical and psychological/emotional effects of Anma therapy (Japanese massage, AMT) in gynecologic cancer survivors. The primary objective was to verify the effects of 8 consecutive weeks of weekly AMT. The secondary objective was to confirm the immediate effects of single-session AMT. We report here results of the physical effects of AMT. MethodsForty participants were randomly allocated to an AMT group that received one 40-min AMT session per week for 8weeks and a no-AMT group. The primary endpoint was severity of subjective physical complaints assessed using a visual analogue scale (VAS). Secondary endpoints were urine and saliva analyses and psychological/emotional questionnaire scores. ResultsIn the primary analysis, least-squares means (LSM) estimates of VAS score improvement over the 8weeks were −21.5 (95% confidence interval [CI], −30.1 to −12.8, P=0.0017) in the AMT group (n=20) and 0.8 (95%CI, −7.7 to 9.2, P=0.89) in the no-AMT group (n=20). The difference in the LSM estimates between the groups was −22.2 (95%CI, −34.4 to −10.1, P=0.0007). There were significant differences in VAS score and urinary epinephrine between before and after the intervention session, demonstrating the superiority of AMT. ConclusionsA single AMT session reduces the severity of subjective physical complaints and might inhibit the sympathetic nervous system in gynecologic cancer survivors. Receiving weekly AMT sessions for eight weeks effectively continues to reduce the severity of subjective physical complaints.

Quality of life in patients treated with lipoprotein apheresis

Elevated levels of low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) [Lp(a)] are known risk factors for atherosclerosis and cardiovascular events. Although lipoprotein apheresis (LA) yields optimal outcomes for patients suffering from progressive cardiovascular disease (CVD; coronary, peripheral, and cerebrovascular arterial disease) in the presence of hyperlipoproteinemia (LDL-C > 100 mg/dL or Lp(a) > 60 mg/dL), LA primarily serves as a "last-resort therapy". Extant findings show that the incidence of new cardiovascular events can be reduced by regular LA. However, it remains unclear whether improvements to the quality of life (QOL) improvement produced by the positive impact on the course of cardiovascular disease outweighs the therapy's time consuming and invasive character. We surveyed 36 patients (32 men and 4 women; age 53 ± 13 years [mean + standard deviation]) undergoing regular LA therapy to assess the effects of apheresis on QOL. QOL was evaluated in 29 patients on regular lipoprotein apheresis treatment using the Medical Outcomes Study 36-item Short Form Health Survey (SF-36), the Beck Depression Inventory (BDI), and a newly developed questionnaire for assessing QOL in patients undergoing LA. Patients treated with LA showed lower QOL scores regarding mental aspects and equal scores regarding physical aspects compared to the general population, analogue to the results of patients on hemodialysis (SF-36). Analysis of BDI scores showed apheresis patients did not meet criteria for depression diagnosis, although their depression scores were higher than the general population. Compared to the pre-apheresis period, patients described an improvement of their physical and mental fitness, less angina pectoris and no treatment related pain were reported (apheresis questionnaire). Apheresis treatment appears to reduce the subjective physical complaints of patients. The partly impaired mental health in patients undergoing apheresis may be attributed to the underlying severe cardiovascular disease. The procedure itself is generally tolerated without major complaints, suggesting the benefits of apheresis exceed any negative effects on patient QOL.

A Sex- and Gender-Based Analysis of Allostatic Load and Physical Complaints

Biological sex and sociocultural gender influence stress-related diseases. Our goal was to explore whether sex and gender roles would predict both allostatic load and physical complaints. This study investigated whether sex- and gender-based factors would correspond to objective and subjective health outcomes. Thirty Montreal workers (mean [SE] age, 45.4 [2.1] years) participated. The 30-item Bem Sex Role Inventory was administered to assess scores for masculinity and femininity, which were then transformed into an androgyny index representing gender roles along a continuum. Fifteen biomarkers representing neuroendocrine, immune, metabolic, and cardiovascular systems were aggregated into an allostatic load index measuring physiological dysregulations. The 42-item Wahler Physical Symptoms Inventory was used to measure self-rated physical complaints. Results using logistic and linear regressions controlling for age revealed that increased masculinity predicted inclusion in the high allostatic load group (P = 0.010; odds ratio = 0.715), and sex did not; increased masculinity and female sex together predicted increased physical complaints (P = 0.008; adjusted r(2)= 0.30); and high allostatic load group membership corresponded to increased physical complaints adjusted (P = 0.001; adjusted r(2) = 0.301). That higher masculinity was related to increased objective physiological dysregulations and subjective physical complaints suggests an increased vulnerability to hyperarousal pathologies, such as cardiovascular disease, among masculine-typed individuals.

The allostatic load: How stress makes us sick

Biological sex and sociocultural gender influence stress-related diseases. Our goal was to explore whether sex and gender roles would predict both allostatic load and physical complaints.This study investigated whether sex- and gender-based factors would correspond to objective and subjective health outcomes.Thirty Montreal workers (mean [SE] age, 45.4 [2.1] years) participated. The 30-item Bem Sex Role Inventory was administered to assess scores for masculinity and femininity, which were then transformed into an androgyny index representing gender roles along a continuum. Fifteen biomarkers representing neuroendocrine, immune, metabolic, and cardiovascular systems were aggregated into an allostatic load index measuring physiological dysregulations. The 42-item Wahler Physical Symptoms Inventory was used to measure self-rated physical complaints.Results using logistic and linear regressions controlling for age revealed that increased masculinity predicted inclusion in the high allostatic load group (P = 0.010; odds ratio = 0.715), and sex did not; increased masculinity and female sex together predicted increased physical complaints (P = 0.008; adjusted r2= 0.30); and high allostatic load group membership corresponded to increased physical complaints adjusted (P = 0.001; adjusted r2 = 0.301).That higher masculinity was related to increased objective physiological dysregulations and subjective physical complaints suggests an increased vulnerability to hyperarousal pathologies, such as cardiovascular disease, among masculine-typed individuals.

Anxiety and depression in primary care patients: Predictors of symptom severity and developmental correlates

Objective A study in a German general practice used the Hospital Anxiety and Depression Scale (HADS) to determine the prevalence of anxiety and depression in 242 consecutive patients. The study had two additional goals: (1) to identify indicators of symptom severity and (2) to validate the HADS by relating it to measures of developmental psychopathology. Methods In addition to the HADS, clinical/sociodemographic data were collected. Patients filled up additional questionnaires measuring attachment characteristics, recalled parental rearing behavior, resilience, adverse childhood experiences, and physical complaints. Results Using HADS cutoff scores of ≥11 in total, we found that 21.1% of the patients showed clinically relevant anxiety levels; the rate for depression was 12.0%, that for anxiety or depression was 26.1%, and that for anxiety and depression combined was 7%. With the exception of psychiatric disorders, the HADS did not differentiate between subgroups with different somatic diseases. HADS scores were shown to be predicted by the patients' sex, family status, number of consultations, and subjective physical complaints. Patients with higher HADS scores also indicated lower resilience, more insecure attachment, and negative recalled parental rearing behavior. Resilience, attachment security, and specific parental behavior (control/warmth) independently predicted anxiety, depression, and physical complaints. Conclusion This study provides further support for the usefulness of the HADS as a measure for routine screening for anxiety and depression and its relationship with constructs from developmental psychopathology. We recommend the use of the HADS in combination with potential indicators of symptom severity (fatigue, cardiovascular symptoms, high number of consultations) to identify patients needing psychosocial support.

Anxiety and depression in chronic hemodialysis: some somatopsychic determinants

Depression and anxiety are so common in hemodialysis (HD) patients that we found it useful to study the respective contributions of the subjective somatic sensations and of the objective medical comorbidity to psychological distress. We also hypothesized that denial has a protective effect against anxiety and depression, and that alexithymia is, on the contrary, a risk factor. In a cross-sectional design, we investigated relationships between psychological distress and somatic complaints, Charlson comorbidity index, denial and alexithymia, in a group of 54 patients on incenter HD. They filled psychometric self-rated questionnaires in (State Anxiety Inventory, Hospital Anxiety and Depression Scale, 13-item Short Beck Depression Inventory, Kidney Disease Quality of Life Short Form, 20-item Toronto Alexithymia Scale). A principal component analysis allowed us to focus on HADS-total score, which was confirmed to be representative of anxio-depression. Then, correlational analyses and a stepwise regression analysis were performed. HADS-total score is inversely associated with the use of denial as a psychological defence mechanism (p < 0.001), and positively correlated with difficulties in identifying emotions (p < 0.001), with difficulties in expressing feelings (p < 0.05), and with the intensity of subjective somatic complaints (p < 0.001). On the contrary, it is not related to the somatic comorbidity. In the stepwise regression, the somatic complaints, the denial and the difficulties in recognizing emotions emerge as the three main variables related to the HADS-total score (p < 0.001). Subjective physical complaints are here associated with psychological distress in chronic HD patients, while objective organic comorbidity does not seem to influence their mood and anxiety status. Denial is an efficient coping style against negative emotions, but it can diminish compliance. So, the subjective perception of the disease seems to have an important impact on the anxiety and mood levels, which can also be influenced by the emotional regulation abilities.

What influences self-perception of health in the elderly? The role of objective health condition, subjective well-being and sense of coherence

The study examines in what way objective health-related variables interfere with psychic health and personality factors in explaining self-perception of health in the elderly. Two hundred and sixty-one patients aged 60 and older of an internal medicine hospital previously examined between 1994 and 1997 were once more contacted five years later. One hundred and sixty-four patients could not be included in the present investigation because of death, dementia, or severe physical illness. Of the 97 patients eligible for this second investigation, 74 agreed to participate. They were investigated extensively by means of psychometric scales and diagnostic interviews. A positive selection effect could be found for the sample of the present investigation with regard to age and health-related variables. Subjective evaluation of health correlated highly with the self-evaluation scales that recorded subjective well-being (life satisfaction, anxiety, and depression), and with the sense of coherence, but not substantially with objective health-related variables. A backward regression resulted in a adjusted R 2=0.33 for the three retained variables “subjective physical complaints”, “sense of coherence” and “self-evaluated depression” which rendered the same variance clarification of subjective health as did the model including all variables. Since the elderly represent the majority of patients treated in general hospitals and as subjective health and subjective physical complaints influence frequency of medical consultations and health care utilization, this is an important issue for consultation-liaison-psychiatry and health policy.

Ageing Styles: Subjective Well-Being and Somatic Complaints in Inpatients Aged ≥60 Years

Background: Recent gerontological research shows a high variability in the elderly population. The aim of the present study is to investigate by means of cluster analysis, as to whether different ‘ageing styles’ can be identified in a sample of cognitively not impaired older persons, and to assess discrepancies between self-rated and expert-rated psychological and physical health. Method: 243 patients aged 60 years and older in a general hospital were investigated using a clinical psychiatric interview, expert ratings, and self-report scales after extensive internal medical diagnostic evaluation. Results: Five clusters, representing significantly different ‘ageing styles’ with regard to subjective well-being and subjective physical complaints, could be identified. Two clusters, which together constituted 57% of the sample, represented quite positive and desirable ageing styles. In two clusters (altogether 23% of the sample), there was a discrepancy between medical findings and subjective physical complaints. Conclusions: These findings support the notion of high variability in the elderly and the existence of subgroups, which show a discrepancy between subjective assessment of well-being and expert assessment of psychological and physical health and impairment. The recording of subjectively perceived physical complaints should, therefore, be part of the evaluation of older peoples’ subjective well-being.

Subjective physical complaints and hypochondriacal features from an attachment theoretical perspective.

The main goal of the present study was to examine the association between physical complaints, hypochondriacal features and attachment characteristics in a representative German general population sample. A total of 1997 German adults, 883 males and 1114 females, completed the Revised Adult Attachment Scale (RAAS), the short form of the Giessen Subjective Complaints List (GSCL) to investigate gender-related bodily complaints and the Whiteley Index for assessing hypochondriacal concerns. Item response theoretical methods, i.e. mixed Rasch analysis, were used in order to identify the best model for the attachment items. Findings suggested that five latent classes yielded the best model fit. The findings provided evidence that attachment styles displayed different profiles of subjective physical complaints. The highest amount of physical symptoms and hypochondriacal features was identified in anxiously attached individuals with two subsets displaying functionally different subjective symptoms. Secure attachment was, in contrast, not related to a higher amount of specific symptoms. Results are discussed in terms of a developmental approach to symptom experience and somatization.

Somatization disorder

Somatization disorder (SD) is a syndromatic classification that allows a physician to identify more easily patients with a lifelong history of chronic subjective physical complaints that are unverified by objective examinations either at the time of initial presentation or during the subsequent five years. The somaticizing process is believed to be an expression of emotional distress. The most common complaints of SD patients include recurrent pain (site and quality vary), conversion (pseudoneurologic) symptoms, nervousness or depression (or both), sexual and marital discord, and, often, menstrual difficulties. Such patients will generally have a history of repeated hospitalization or surgery. These symptoms are not perceived as mild or unimportant but lead to physician consultation, prescription drug use, and modification of life-style. Such patients are prone to "doctor-shopping" and self-medication and are at risk for many iatrogenic illnesses. Because they generally are resistant to psychologic explanations for their condition, management aimed at protecting them from the consequences of their behavior is important. A heightened threshold for instituting aggressive diagnostic and treatment procedures is necessary.

Structures of couple relations and body image in former patients with malignant cancers and their partners

49 couples where the female partner had formerly been suffering from carcinoma of the genitals, were examined with regard to the structure of their mutual relationship as partners and the extent of their subjective physical complaints and symptoms. Both the former cancer patients and their partners displayed very marked physical complaints. This can be interpreted as a sign of exaggerated attention being paid to the subject's own body. The highly developed sense of mutual empathy ceased when sexuality was involved; this can point to the existence of conflicts. Mutual relations within a couple were predominantly symmetrical. Unsatisfactory types of relationship were also identified. Results are interpreted with regard to possibilities of psychotherapeutic consultation by the treating physician.