Somatic Symptoms Research Articles

Side-effect expectations are associated with disability, physical fitness, and somatic symptoms 3 months after post-COVID neurological inpatient rehabilitation

IntroductionThe COVID-19 pandemic, caused by SARS-CoV-2, has led to long-term health issues known as post-COVID-19 condition, including fatigue and cognitive disruptions. Despite its recognition as a public health concern, the efficacy of therapeutic interventions, especially in neurological rehabilitation, remains unclear. This study examines how treatment expectations are associated with psychological and physical outcomes in post-COVID-19 condition neurological rehabilitation. MethodsIn an observational cohort study 61 patients with confirmed post-COVID-19 condition were included. Baseline (T0) data on treatment and side effect expectations were collected, before participants underwent a 4–6 week multidisciplinary rehabilitation program. Primary outcome was illness-related disability (Pain Disability Index). Secondary outcomes included depressive symptoms (PHQ-9), anxiety levels (GAD-7), functional status (PCFS), fatigue (CFS), and physical fitness (6MWT). Regression models analyzed the associations of baseline expectations with outcomes at the end of rehabilitation (T1) and three months post-rehabilitation (T2). ResultsAfter adjusting for multiple testing, higher baseline side-effect expectations were associated with greater illness-related disability (β = 0.42, p = 0.007), reduced physical fitness (β = − 0.24, p = 0.04), and more somatic symptoms (β = 0.33, p = 0.006) at follow-up (T2). Positive treatment expectations were associated with poorer functional status (β = 0.35, p = 0.011) at T2. ConclusionThis study highlights the associations of side-effect expectations with post-COVID-19 condition rehabilitation outcomes. Higher side-effect expectations were associated to poorer outcomes, indicating a nocebo effect. Surprisingly, positive expectations were linked to worse outcomes, possibly due to unrealistic optimism. Managing patient expectations realistically and addressing side-effect concerns seems crucial for optimizing rehabilitation outcomes.

In perspective of specific symptoms of major depressive disorder: Functional connectivity analysis of electroencephalography and potential biomarkers of treatment response

BackgroundThe symptom variability in major depressive disorder (MDD) complicates treatment assessment, necessitating a thorough understanding of MDD symptoms and potential biomarkers. MethodsIn this prospective study, we enrolled 54 MDD patients and 39 controls. Over the course of weeks 1, 2, and 4 participants underwent evaluations, with electroencephalograms (EEG) recorded at baseline and week 1. Our investigation considered five previously identified syndromal factors derived from the 17-item Hamilton Depression Rating Scale (17-item HAMD) for assessing depression: core, insomnia, somatic anxiety, psychomotor-insight, and anorexia. We assessed treatment response and EEG characteristics across all syndromal factors and total scores, all of which are based on the 17-item HAMD. To analyze the topology of brain networks, we employed functional connectivity (FC) and a graph theory-based method across various frequency bands. ResultsThe healthy control group had notably higher values in delta band EEG FC compared to the MDD patient group. Similar distinctions were observed between the responder and non-responder patient groups. Further exploration of baseline FC values across distinct syndromal factors revealed significant variations among the core, psychomotor-insight, and anorexia subgroups when using a specific graph theory-based approach, focusing on global efficiency and average clustering coefficient. LimitationsDifferent antidepressants were included in this study. Therefore, the results should be interpreted with caution. ConclusionsOur findings suggest that delta band EEG FC holds promise as a valuable predictor of antidepressant efficacy. It demonstrates an ability to adapt to individual variations in depressive symptomatology, offering insights into personalized treatment for patients with depression.

Impact of somatic complaints on the mental health of bank sector employees: An empirical study

Somatic complaints refer to bodily symptoms that people encounter that don't have obvious biological origins, such as headaches, digestive issues, and musculoskeletal discomfort. There is a scarcity of research explicitly concentrating on the banking industry, despite prior studies looking at the connection between somatic symptoms and mental health in a variety of professional circumstances. This study explores somatic symptoms' impact on banking sector employees' mental health. The research initiative intends to collect quantitative data through questionnaires using a mixed methods approach to determine the incidence and severity of somatic symptoms experienced by bank personnel. Questionnaires (n=196) were distributed amongst different public and private banks of Southern Punjab. The data was analyzed using a reliability test, linear regression model, and correlation to find the relation between somatic complaints and mental health issues. The results show that there is a positive relationship between somatic complaints and mental health issues, i.e., a person having somatic complaints will also suffer from mental health issues, hence, satisfies the research hypothesis. Moreover, according to the study, greater levels of somatic complaints among workers in the banking industry are correlated with higher levels of stress, anxiety, and depression. The association between somatic symptoms and mental health was also examined with respect to potential moderating factors such as company culture, workload, and job satisfaction. In a nutshell, enhancing an employee's psychological health may benefit their work happiness, productivity, and overall organizational performance.

Halifax somatic symptom disorder trial: A pilot randomized controlled trial of intensive short-term dynamic psychotherapy in the emergency department

BackgroundPatients commonly present at hospital Emergency Departments (ED) with distress that meet criteria for a Somatic Symptom and Related Disorder (SSRD). Without access to effective treatment, risk of ongoing patient disability and further ED visits is high. MethodThis pilot trial used a randomized parallel group design to test the efficacy of Intensive Short-Term Dynamic Psychotherapy (ISTDP). ED patients who met criteria for SSRD were recruited. The effects of ISTDP plus medical care as usual (MCAU) were judged through comparison against 8 weeks of MCAU plus wait-list symptom monitoring (WL-SM). The primary outcome was somatic symptom at 8 weeks. Patients allocated to WL-SM could cross-over to receive ISTDP and 6-month follow-up data was collected. Baseline measures of patient attachment style and alexithymia were collected to examine vulnerabilities to somatic symptoms. ClinicalTrials.gov: NCT02076867. ResultsThirty-seven patients were randomized to 2 groups (ISTDP = 19 and WL-SM = 18). Multi-level modelling showed that change over time on somatic symptoms was significantly greater in the ISTDP group. Between-group differences were large at 8 weeks (Cohen's d = 0.94) and increased by end of treatment (Cohen's d = 1.54). Observed differences in symptoms of depression and illness anxiety were also large, favoring ISTDP, and effects were maintained at follow-up. Patients receiving ISTDP had reduced ED service utilization at 2-year follow-up. ConclusionsISTDP appears an efficacious treatment for SSRD and a larger randomized trial is justified.

Self-esteem mediates child abuse predicting adulthood anxiety, depression, and substance use symptoms 18 years later

According to biopsychosocial models, experiencing parental child abuse increases susceptibility to adulthood psychopathology. However, there is a paucity of studies examining potential mechanisms of the parental child abuse and adulthood psychopathology relationship. The purpose of the current study was to determine if Time 2 (T2) trait self-esteem mediated levels of Time 1 (T1) retrospectively recalled parental child abuse predicting (T3) past-year major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD), alcohol use disorder (AUD), and substance use disorder (SUD) symptoms. The 18-year Midlife Development in the United States (MIDUS) study included participants (N = 3294; T1 average age of 45.62 years) assessed at three different time points, each spaced about nine years apart. We performed structural equation mediation modeling analyses to determine how maternal and paternal child abuse at T1 would independently predict T3 MDD, GAD, PD, AUD, and SUD symptoms. We also examined whether T2 self-esteem mediated these relations while controlling for adulthood T1 psychopathology symptoms, demographics, socioeconomic status, somatic symptoms, and parental psychopathology. Consistent with our hypotheses, higher T1 maternal and paternal abuse predicted increased T3 GAD, PD, AUD, and SUD symptoms via diminished T2 self-esteem as the mediator (% proportion mediated = 33.0–100). However, childhood paternal, but not maternal, abuse predicted adulthood MDD symptoms via reduced self-esteem. Findings remained after adjusting for covariates. Our research highlights the importance of understanding retrospectively recalled parental child abuse–adulthood psychopathology relations, their potential mechanisms, and self-esteem as a malleable treatment target for adults with heightened child abuse.

Depression, anxiety, and posttraumatic stress in women with and without brain injuries due to intimate partner violence: Psychometric evaluation of measurement approaches and group comparisons.

The current study examined the psychometric properties of common mental health questionnaires among women survivors of intimate partner violence (IPV) with and without brain injuries due to IPV and evaluated whether women with and without IPV-related brain injuries differed in depression, anxiety, and posttraumatic stress disorder (PTSD) symptom severity. Women survivors of IPV with and without IPV-related brain injuries were recruited online through Prolific (N = 205, M = 39.8 ± 11.9 years old, 83.9% non-Hispanic White, 42.4% college-educated). They completed the eight-item Patient Health Questionnaire (PHQ-8), seven-item Generalized Anxiety Disorder scale (GAD-7), and PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) (PCL-5). Model fit and internal consistency were estimated for each scale. Groups were compared on mental health symptom severity, with and without controlling for age, education, and IPV severity. Both one-factor and multifactor models showed excellent fit for all scales. PHQ-8 (ω = .91), GAD-7 (ω = .94), and PCL-5 total scores (ω = .95) had strong reliability, and all subscale scores had acceptable-to-strong reliability (ω range = .79-.94). Women with IPV-related brain injuries reported greater physical IPV severity, higher rates of depression, and higher somatic anxiety and PTSD symptom severity. No group differences in mental health symptoms were significant after controlling for IPV severity. The PHQ-8, GAD-7, and PCL-5 showed evidence for reliability and validity among women survivors of IPV. Women with IPV-related brain injuries had higher PTSD symptom severity, attributable to greater physical violence exposure in general. Brain injury screening among survivors appears warranted for women with extensive physical IPV experiences. Interventions addressing PTSD, violence prevention, and brain injury recovery may best serve this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Ehlers-Danlos Syndrome and Fibromyalgia: Beyond Pain and Fatigue

Introduction: Ehlers-Danlos syndrome (EDS) is a genetic disorder that affects the connective tissue. Hypermobile subtype (hEDS), which is the most common, is characterized by joint hyperlaxity, diffuse generalized pain, and chronic fatigue. Meanwhile, fibromyalgia is a pain regulation disorder of chronic, widespread musculoskeletal pain, fatigue, cognitive disturbance, psychiatric and multiple somatic symptoms. Objective: To examine the similarities and differences between hEDS, fibromyalgia and highlight the importance of their proper diagnosis and treatment. Methods: A systematic search of PubMed and Scopus databases was performed for all English - Spanish language studies published between 2013 and May 2023. Two reviewers independently selected studies, extracted data and applied quality criteria. Study quality was assessed using PRISMA and a synthesis of the best evidence was obtained. Results: A total of 20 studies met the criteria and were therefore analyzed. Conclusion: Diagnosing EDS and fibromyalgia can be challenging in medical practice as their clinical manifestations can overlap, and they may even coexist in the same patient.

Systemic inflammation and menopausal symptomatology: insights from postmenopausal women.

This study aims to investigate the association between systemic inflammation, measured by the systemic immune-inflammatory index (SII), and menopausal symptoms in postmenopausal women. A cross-sectional study was conducted with 702 postmenopausal women recruited from a tertiary hospital. Participants completed the Menopause Rating Scale (MRS) to assess somatic, psychological, and urogenital symptoms. Blood samples were collected to calculate SII. Statistical analyses included correlation, univariate regression, and multivariate regression to determine the association between SII and menopausal symptoms. The most commonly reported symptoms were muscle and joint problems (75.9%), hot flashes and sweating (72.5%), sleeping problems (71.2%), and depressive mood (69.9%). Women with higher total and somatic subscale scores had significantly elevated SII levels compared with those with lower scores. SII was the most associated variable for high total MRS (odds ratio, 4.77; 95% CI, 3.36-6.78; P < 0.001) and somatic subscale scores (odds ratio, 6.32; 95% CI, 4.45-8.99; P < 0.001). Exercise and gravidity were negatively associated with high total MRS and somatic subscale scores. Conversely, no significant associations were observed between SII and the urogenital or psychological subscale scores. Elevated SII levels were found associated with higher somatic subscale and total MRS scores, suggesting that inflammation may contribute to worsened somatic menopausal symptoms in this group. These findings suggest that exploring inflammatory pathways could be beneficial in managing menopausal symptoms and enhancing quality of life for postmenopausal women.

Psychosocial, pharmacological, and legal interventions for improving the psychosocial outcomes of children with substance misusing parents: A systematic review

AbstractBackgroundParental substance misuse is a pervasive risk factor for a range of detrimental outcomes for children across the life course. While a variety of interventions have been developed for this population, the existing evidence‐base requires consolidation and consideration of the comparative effectiveness of different interventions to facilitate evidence‐informed decisions between different intervention approaches.ObjectivesThis review aimed to use network meta‐analysis to synthesise the comparative effectiveness of psychosocial, legal, and pharmacological interventions for improving outcomes for children with substance misusing parents. Network meta‐analysis was not possible; however, we synthesised the effects of a broad range of interventions on child psychosocial outcomes. Another aim was to examine potential moderators of the effects, yet this was also not possible due to data limitations. A secondary objective was to qualitatively synthesise economic, treatment completion, and treatment acceptability information for included studies.Search MethodsSearches were performed in November 2020 and again in April 2021. Encompassing multiple disciplines, we searched 34 databases, 58 grey literature repositories, and 10 trial registers. Supplementary hand searches were conducted on 11 journals, along with harvesting the references of all included studies and existing reviews, and forward citation searching each report of all included studies. Study authors were contacted to obtain missing data.Selection CriteriaEligible studies included randomised and quasi‐experimental evaluations of psychosocial, pharmacological, and/or legal interventions using either a placebo, no treatment, waitlist control, treatment‐as‐usual, or alternative treatment as a comparison condition. Study participants needed to be comprised of families with children under the age of 18 with one or more currently substance‐misusing parents (or caregivers). Studies were required to evaluate the eligible intervention using a child‐focused psychosocial outcome. If reported in eligible studies, the following secondary outcomes were also synthesised in the review: cost‐effectiveness, treatment completion, length of time in treatment and acceptability of treatment (e.g., participant perspectives of the intervention). There were no restrictions placed on publication status or geographic location, however only research written in English was included.Data Collection and AnalysisStandard methodological procedures were followed across all stages of the review, as guided by the published protocol for the review (Eggins et al., 2020). Due to the inability to conduct network meta‐analyses, random effects pairwise meta‐analyses with inverse variance were used to synthesise effects when two or more studies with conceptually similar interventions and outcomes were available. Results of the meta‐analyses are displayed in forest plots, and separate analyses are provided for conceptually distinct outcomes and time‐points of measurement. Sensitivity analyses are used to explore possible sources of heterogeneity in the absence of sufficient studies to conduct subgroup analyses.Main Results99 studies (reported in 231 documents) met review inclusion criteria, encompassing 22,213 participants. Most studies were conducted in the United States (k = 76), almost half were randomised controlled trials (k = 46), and the most common comparator was treatment‐as‐usual (k = 50). Interventions were evaluated using a large range of child psychosocial outcomes which broadly fell under: (a) child welfare; (b) child development; (c) child emotional and behavioural; and (d) educational domains. Intervention models were rarely only legal or pharmacological in nature, with most studies evaluating integrated psychosocial treatments with either pharmacology, coordinated health care, case‐management, and/or judicial or child welfare oversight and coordination. Thirty‐six meta‐analyses and 227 single effect sizes were used to appraise the effectiveness of included interventions, based on 68 studies with sufficient data for effect size calculation. The size and direction of the effects varied across interventions, type of outcomes, and time‐point of measurement. Twenty‐seven meta‐analyses and 186 single effect sizes suggested null effects. Only five single effect size estimates based on three studies indicated negative effects including: higher depressive and somatisation symptoms (parent‐report), hopelessness (child‐report), educational achievement difficulties (parent‐report), and substantiated child protection reports for those engaged with interventions versus treatment‐as‐usual or no treatment. Nine meta‐analyses and 36 single study effect estimates suggest that psychosocial, pharmacological and/or legal interventions have a positive effect on a range of specific child welfare, developmental, and emotional/behavioural outcomes for children. The risk of bias varied across domains and studies, which further lowers confidence in the results. Based on a subset of included studies, treatment completion tends to vary, yet cost‐benefits can be achieved when intervening with children whose parents misuse substances.Authors' ConclusionsDespite a large body of evaluation evidence, disparate outcomes, and missing data precluded analyses to formally examine the comparative effectiveness of psychosocial, legal, and pharmacological interventions for improving outcomes for children with substance misusing parents. The large amount of unreported (missing) data meant that many effect estimates were underpowered due to single studies and small sample sizes. The review findings suggest that interventions for families affected by parental substance misuse can be effective when they holistically address multiple domains such as parent wellbeing/mental health, parenting, children's wellbeing, and/or other factors impacting family wellbeing (e.g., housing).

Path to Suicidality in Korean Adolescents: Mediating Role of Self-Esteem, Somatic Symptoms, and Self-Harm Amid Depressive Symptoms

This study explored the relationship between depressive symptoms and suicidality among community-dwelling adolescents aged 10–18 years, examining whether self-esteem, somatic symptoms, and self-harm mediate this relationship. Utilizing a pre-existing dataset from a nationwide adolescent mental health survey conducted in Korea in 2021, data were collected using several standardized self-administered instruments: the Korean version of Rosenberg’s self-esteem scale, Korean Children’s Somatization Inventory, Korean version of the Self-Harm Inventory, Mental Health Screening for Depressive Disorders, and Mental Health Screening for Suicide Risk. A path model was constructed and validated, followed by path analysis to assess the effects. Data from 6689 adolescents, including 5937 students and 752 out-of-school adolescents, revealed that 18.7% were in the suicidality group, 11.8% experienced depressive symptoms, 57.9% exhibited somatic symptoms, and 27.4% engaged in self-harm. Depressive symptoms had a positive direct effect on suicidality (β = 0.166, p &lt; 0.001, 95% confidence interval = 0.159–0.172). Bootstrapping tests showed a statistically significant indirect effect of self-esteem, somatic symptoms, and self-harm on the relationship between depressive symptoms and suicidality (β = 0.021, 95% confidence interval = 0.013–0.029). Our findings suggest that self-esteem, somatic symptoms, and self-harm mediate the relationship between depressive symptoms and suicidality, and comprehensive mental health management strategies addressing these factors are recommended.

Physical symptoms in prolonged grief disorder: a case report.

Prolonged grief disorder (PGD) was added as a new disorder to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) in 2022. PGD is defined as an intense yearning or longing for the deceased and preoccupation with thoughts or memories of the deceased. The official diagnostic criteria for PGD do not include physical symptoms, but it is sometimes associated with somatic symptoms. We present the case of a patient suffering from facsimile illness who lost her husband due to the deterioration of a brain tumor. She suffers from similar physical symptoms (severe headache reminiscent of a brain tumor, and hypertension) as her deceased husband. We focused on the dual process model in which grief exposure and behavioral activation began, ensuring an oscillation between loss-oriented grief (e.g., crying, feeling a continuing bond) and restoration-oriented grief (e.g., attending to life changes, new roles/identities/relationships). Outpatient psychotherapy based on the dual-process model of grief improved her physical symptoms. This case report highlights the physical symptoms experienced by those bereaved by a deceased loved one. Exposure therapy and behavioral activation approaches based on the dual-process model of grief response were effective in reducing the physical symptoms of facsimile illness. Physical symptoms in deceased family members triggered by bereavement are often overlooked and need to be recognized.

Psychological factors and health-related quality of life in fibromyalgia patients

BackgroundFibromyalgia (FM) has been associated with decreased health-related quality of life (HRQoL), which has been linked to psychological variables such as anxiety, depression, coping, and social support. This study aimed to simultaneously analyse the association of these variables with HRQoL in FM patients and explore their mediating role in the relationship between somatic symptoms and HRQoL.Participants and procedureA cross-sectional sample of 134 FM patients (97% women) with no other rheumatologic diseases followed in specialized healthcare services completed self-report questionnaires to evaluate pain, fatigue, sleep, anxiety, depression, coping, social support, and HRQoL.ResultsThe results indicated that FM patients experienced a negative impact on all dimensions of HRQoL, with anxiety primarily affecting the mental dimensions, and depression and social support affecting both physical and mental dimensions. Anxiety, depression, dysfunctional coping, and low social support were independent predictors of HRQoL and mediated the effect of somatic symptoms in the mental component of HRQoL.ConclusionsFM patients experience a negative impact on HRQoL, and anxiety, depression, coping and social support play an important role as independent predictors of this decrease, and as mediators of the effect of somatic symptoms in the mental dimen-sions of HRQoL. This underscores the importance of considering these psychological variables in the therapeutic approach to FM and suggests the need for interventions targeting anxiety, depression, dysfunctional coping, and low social support to improve HRQoL in FM patients.

Correlation between psychological traits and the use of smart medical services in young and middle-aged adults: An observational study

BACKGROUND Psychological problems affect economic development. However, there is a huge gap between mental health service resources and mental health service needs. Existing mental health service technology and platforms cannot meet all the diverse mental health needs of people. Smart medicine is a new medical system based online that can effectively improve the quality and efficiency of medical services and make mental health services accessible. AIM To explore the level of intelligent medical use among young and middle-aged people and its correlation with psychological factors. METHODS Convenience sampling was used to select 200 young and middle-aged patients with medical experience at the Third People's Hospital of Chengdu between January 2022 and January 2023 as the research subjects. The general condition Questionnaire, Eysenck Personality Questionnaire, Symptom Checklist-90, General Health Questionnaire, and Smart Medical Service Use Intention Questionnaire were used to collect data. Pearson’s correlation was used to analyze the correlation between the participants’ willingness to use smart medical services and their personality characteristics, psychological symptoms, and mental health. RESULTS The results revealed that the mental health of young and middle-aged people was poor, and some had psychological problems such as anxiety, depression, and physical discomfort. Familiarity, acceptance, and usage of smart healthcare in this population are at a medium level, and these levels correlate with psychological characteristics. Acceptance was positively correlated with E, and negatively correlated with P, anxiety, fear, anxiety/insomnia, and social dysfunction. The degree of use was negatively correlated with P, obsessive-compulsive symptoms, depression, anxiety, hostility, paranoia, and somatic symptoms. CONCLUSION The familiarity, acceptance, and usage of smart medical services among the middle-aged and young groups are related to various psychological characteristics.

Validation of the Persistent Somatic Symptom Stigma Scale for Healthcare Professionals

ObjectivePersistent somatic symptoms (PSS) describe recurrent or continuously occurring symptoms such as fatigue, dizziness, or pain that have persisted for at least several months. These include single symptoms such as chronic pain, combinations of symptoms, or functional disorders such as fibromyalgia or irritable bowel syndrome. While many studies have explored stigmatisation by healthcare professionals towards people with PSS, there is a lack of validated measurement instruments. We recently developed a stigma scale, the Persistent Somatic Symptom Stigma scale for Healthcare Professionals (PSSS-HCP). The aim of this study is to evaluate the measurement properties (validity and reliability) and factor structure of the PSSS-HCP. Study Design and SettingThe PSSS-HCP was tested with 121 healthcare professionals across the United Kingdom to evaluate its measurement properties. Analysis of the factor structure was conducted using principal component analysis. We calculated Cronbach’s alpha to determine the internal consistency of each (sub)scale. Test re-test reliability was conducted with a sub-sample of participants with a two-week interval. We evaluated convergent validity by testing the association between the PSSS-HCP and the Medical Condition Regard Scale (MCRS) and the influence of social desirability using the short form of the Marlowe Crowne Social Desirability Scale (MCSDS). ResultsThe PSSS-HCP showed sufficient internal consistency (Cronbach’s alpha = 0.84) and sufficient test-retest reliability, intraclass correlation = 0.97 (95% CI 0.94 to 0.99, p<0.001). Convergent validity was sufficient between the PSSS-HCP and the MCRS, and no relationship was found between the PSSS-HCP and the MCSDS. A three factor structure was identified (othering, uneasiness in interaction, non-disclosure) which accounted for 60.5% of the variance using 13 of the 19 tested items. ConclusionThe PSSS-HCP can be used to measure PSS stigmatisation by healthcare professionals. The PSSS-HCP has demonstrated sufficient internal consistency, test-retest reliability, convergent validity and minimal influence of social desirability bias. The PSSS-HCP has demonstrated potential to measure important aspects of stigma and provide a foundation for stigma reduction intervention evaluation.

Eye Movement Desensitization and Reprocessing of Maleficium: Case Study of a “Cursed” Woman Suffering From Unexplained Pain

The present case study describes the application of the eye movement desensitization and reprocessing (EMDR) approach to a patient experiencing the distressing memory of an act of apparent ‘maleficium.’ The patient was in treatment due to somatic symptom disorder. Transcripts from the EMDR desensitization session were used to qualitatively describe both the dysfunctional stored memories associated with the apparent sorcery and the healing associations contributing to the zeroing of the alleged subjective unit of disturbance. Changes in psychometric measures of symptoms showed that the patient experienced a relevant and unexpected reduction of different clinical outcomes, with a specific notable effect on the subjective evaluation of pain. An explanation based on adaptive information processing is offered to explain this last unexpected finding.

Three-Month Follow-Up of the Post-COVID Syndrome after Admission to a Specialised Post-COVID Centre-A Prospective Study Focusing on Mental Health with Patient Reported Outcome Measures (PROMs).

The impairments and duration of PASC (post-acute sequelae of COVID-19) symptoms in mental health have, to date, not been comprehensively examined. Our objective is to provide longitudinal data on the mental health of Post-COVID patients and to identify risk and protective factors associated with a severe or prolonged course. The mental health of 265 Post-COVID patients of the outpatient Post-COVID centre of the University Hospital Erlangen was assessed 17.1 (T0) and 22.5 months after infection (T1). An online survey with validated questionnaires for Post-COVID symptoms (Post-COVID Syndrome Score), depression (Patient Health Questionnaire-9), somatic symptoms (Patient Health Questionnaire-15), anxiety (Generalized Anxiety Disorder-7), fatigue (Fatigue Severity Scale) and Post-Exertional Malaise (PEM) (DePaul Post-Exertional Malaise Screening) was conducted in the home environment. In total, 80% of patients experienced severe PASC at follow-up. Clinically relevant symptoms of depression, persistent somatic symptoms, anxiety and fatigue were reported by 55.8%, 72.5%, 18.9% and 89.4% of patients, respectively. Depressive, anxiety and somatic symptom severity decreased significantly over time; fatigue and PEM remained at an unchanged high level. The risk factor for higher depression scores was older age; prior psychiatric illness treated with psychotherapy was associated with more severe depressive, somatic, anxiety and PASC symptoms. PEM symptoms were significantly associated with longer duration between acute infection and initial presentation in the Post-COVID centre. Our findings align with previous research, claiming severe mental health symptoms in PASC syndrome, lasting for months after infection. In-depth assessment of risk and protective factors for the mental health implications of PASC is needed for the planning of health services and disease prevention.

Facilitating and hindering factors in the treatment of persistent somatic symptoms in migrants: A scoping review

ObjectiveTo identify facilitating and hindering factors in the treatment of persistent somatic symptoms (PSS) in migrants in psychiatry and other health care settings in Western countries. MethodsA scoping literature review was conducted by searching PubMed and Embase, using combinations of search terms related to the treatment of PSS in migrants. Studies outside of the scope of current guidelines or limited to specific underlying diseases such as post-traumatic stress disorder (PTSD) or consequences of torture were excluded. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies, and identified and categorized facilitating and hindering treatment factors. ResultsOf the 347 unique citations identified in the initial the search, 18 studies met the inclusion criteria. These studies showed a wide variety in study design, interventions used, measurement instruments, and study quality. Common treatment adaptations related to: (a) translation and interpretation, (b) adaptation to lower educational levels, (c) culture-sensitive therapists and materials, (d) gender roles, (e) removal of practical barriers, (f) supportive treatment, and (g) nonverbal therapy forms. The most commonly mentioned influencing factors of treatment success related to: (a) body and experience-oriented treatment elements, (b) translation and communication, (c) cultural sensitivity, (d) group interaction, and (e) caring for one's own health. ConclusionThis review provides an overview of available research on treatment adaptations for PSS in migratory background patients. Potential facilitating and hindering factors for treatment success that may be useful for healthcare providers treating PSS in patients with a migratory background were identified.

Fear of cancer recurrence experienced by pediatric survivors of childhood cancer: a scoping review.

In contrast to the extensive literature on fear of cancer recurrence (FCR) experienced by adults, literature evaluating pediatric FCR has just begun to emerge. Given the rapidly expanding body of work assessing FCR in childhood and adolescence, a scoping review was conducted to synthesize existing findings. We aimed to assess (1) the characteristics and methods of this literature, (2) how pediatric FCR has been measured, and (3) the extant knowledge of FCR experienced by pediatric survivors of cancer. Inclusion criteria were: (1) original reports, (2) participants diagnosed with cancer before age 18, (3) current mean age under 18, (4) FCR was explicitly measured (quantitatively) or captured (qualitatively) via survivor self-report, and (6) published in English. Exclusion criteria were: (1) case studies, and (2) grey literature. Three databases (Embase, MEDLINE, PsycINFO) and reference lists from included studies were searched. All studies were screened for inclusion by two authors and all data were extracted by a single author. Of 3906 identified studies, 19 were included. Studies (published 1991 - 2023) encompassed diverse geographical locations, study designs, and measurement methods. Few assessed FCR as a primary aim (n = 6, 32%). FCR was experienced by 43 - 90% of pediatric survivors. FCR was often positively associated with somatic symptoms and negatively associated with quality of life and emotional functioning. FCR is a prevalent issue for children and adolescents. Additional evidence is needed to explore and confirm preliminary findings. Future pediatric FCR studies should aim to align with published priority research areas.

Biomarkers as predictors of CBT responsiveness in major depressive disorder: The role of heart rate variability and inflammation

ObjectiveBiological risk factors for cardiovascular disease may relate to poor treatment responsiveness in major depressive disorder (MDD). These factors encompass low-grade inflammation and autonomic dysregulation, as indexed by decreased heart rate variability (HRV) and increased heart rate (HR). This secondary analysis examined whether higher levels of inflammatory markers or autonomic alterations relate to lower responsiveness to cognitive behavioral therapy (CBT) among individuals with MDD. MethodsEighty antidepressant-free patients with MDD were randomly assigned to 14 weeks of CBT or waitlist (WL). Potential biological moderators at study entry included HR and HRV (24-h, daytime, nighttime) and inflammatory markers such as C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-α. Forty non-clinical controls were involved to verify biological alterations in MDD at study entry. Depressive symptoms were assessed at baseline and at the end of treatment. ResultsIndividuals with MDD exhibited reduced total 24-h HRV (i.e., triangular index) and daytime HRV (i.e., triangular index, HF-HRV, LF-HRV, RMSSD), as well as increased levels of inflammatory markers. Patients who received CBT exhibited stronger reductions in self- and clinician-rated depressive symptoms, compared to WL. False discovery rate-adjusted moderation analyses did not show overall moderating effects of biological measures on treatment responsiveness. However, higher CRP levels were specifically associated with poorer improvement in somatic depressive symptoms. ConclusionsThere was no overall evidence for a moderating role of inflammation or autonomic features in CBT responsiveness in MDD. Higher levels of CRP might, however, specifically be associated with less improvement in somatic depressive symptoms during CBT.

Different patterns of persistent somatic symptoms after COVID-19 reported by the Dutch media and the general population

ObjectivePost COVID-19 condition is characterized by persistent symptoms after COVID-19 with yet unknown etiology. To explore whether media-related nocebo effects potentially contribute to post COVID-19 condition, we studied in an observational cohort whether frequencies of media coverage of symptoms after COVID-19 corresponded with prevalence rates of these symptoms in participants from a general population cohort diagnosed with COVID-19. MethodsPrevalence rates and typology of symptoms after COVID-19 in the general population (N = 4231), adjusted for prevalence rates in a matched non-infected control population (n = 8462) were calculated by using data on 23 symptoms from the Lifelines COVID-19 Cohort collected between March 2020 and August 2021. Media coverage of post COVID-19 condition was assessed by coding 1266 Dutch post COVID-19-related news articles (inter-rater-κ ≥ 0.75), published during the corresponding timeframe. Herein, we assessed whether the same 23 symptoms were mentioned as being related to post COVID-19 condition. ResultsCore post COVID-19 condition symptoms were mentioned in 390 (30.8%) articles. Five of the ten core symptoms were mentioned by 10 or fewer articles. Ageusia/anosmia was most often persistently increased in COVID-19-positive participants (7.6%), yet was mentioned in 80 (6.3%) articles. General tiredness and breathing difficulties were frequently mentioned, in 23.9% and 17.1% of the articles respectively, while these were not the most frequently increased symptoms reported by participants (4.9% and 2.4%). ConclusionIf post COVID-19 condition was predominantly attributable to nocebo effects, its symptom profile would be expected to reflect levels of media coverage for symptoms after COVID-19. However, our findings do not support this.