Journal of Psychosomatic Research最新文献

Objectives

To investigate the associations between stress resilience in late adolescence and later risk of severe COVID-19 and other lower respiratory infections. A secondary aim was to examine potential confounding between low cardiorespiratory fitness (CRF) and stress resilience in relation to respiratory infection.

Methods

We conducted a registry-based cohort study of 1.4 million Swedish men, undergoing military conscription between 1968 and 2005. All were assessed by a psychologist for stress resilience, receiving a score between 1 and 9. The outcomes were hospitalization or death due to COVID-19 from March 2020 to September 2021 and hospitalization due to bacterial or viral pneumonia from conscription until January 2020. A secondary aim was to examine potential confounding between low cardiorespiratory fitness (CRF) and stress resilience in relation to respiratory infection.

Results

Poor stress resilience in late adolescence is associated with later risk of severe lower respiratory infections. Using a high resilience score as the reference, the hazard ratio (95 % CI) for death due to COVID-19 for the lowest scores was 1.49 (1.01–2.18) adjusted for CRF and other confounders. The corresponding adjusted hazard ratios for hospitalization due to bacterial pneumonia were 2.28 (2.03–2.57) and for viral pneumonia 1.92 (1.33–2.79). No significant interaction was seen between stress resilience and CRF in the analysis.

Conclusions

Poor stress resilience is a prospective factor for severe COVID-19 as well as for bacterial and viral respiratory pneumonia endpoints, independent of CRF. These findings imply an effect of late adolescent stress resilience on the immune system later in life.

Objective

Comorbidities between internalizing disorders (IDs) and functional disorders (FDs) are well-documented, indicating shared pathways. However, their symptom-level relationships have been largely unexplored. This exploratory study employs a network approach to investigate symptoms of major depressive disorder (MDD), generalized anxiety disorder (GAD), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), and irritable bowel syndrome (IBS) to identify bridge symptoms explaining comorbidity between the two domains.

Methods

We used cross-sectional data on 72,919 adult subjects from the Lifelines Cohort Study, a Dutch general population sample. A total of 38 symptoms representing diagnostic criteria of IDs and FDs were assessed with validated questionnaires. Network models were estimated using eLasso, based on the Ising model, to identify bridge symptoms. The Network Comparison Test (NCT) was used to test whether there were differences in network structure and strength across sex and age.

Results

Symptoms were moderately connected, with a network density of 52.7%. ID and FD symptoms clustered in their respective domains, but were connected through the bridge symptoms, fatigue, difficulty concentrating, trouble sleeping, and unrefreshing sleep. Fatigue and difficulty concentrating had the most connections, associated with 86.6% and 78.9% of the other symptoms, respectively. NCTs indicated no differences in network connectivity between females versus males or younger versus older adults (>50 years).

Conclusions

ID and FD symptoms are moderately interconnected. Bridge symptoms displaying strong connections to multiple disorders may play a central role in the mechanisms underpinning the comorbidity between IDs and FDs.

Objective

This study aimed to investigate the effectiveness of an adapted ACT intervention (BrainACT) in people who experience anxiety and/or depressive symptoms following acquired brain injury.

Methods

The study is a multicentre randomized controlled two-arm parallel trial. In total, 72 people who survived a stroke or traumatic brain injury were randomized into an eight-session ACT or control (i.e. psycho-education and relaxation) intervention. The primary outcome measures were the Hospital Anxiety and Depression Scale (HADS) and the Depression Anxiety and Stress Scale (DASS). Secondary outcomes were ACT process measures, participation, and quality of life. Outcome assessments were performed by trained assessors, blinded to treatment condition, pre-treatment, during treatment, post-treatment, and at 7 and 12 months follow-up.

Results

There were no differences between groups on any outcome measure. Participants in both groups significantly improved on all outcome measures, except for participation frequency. More clinically relevant long-term improvements (i.e. recovered or reliable changes on the HADS) were found in favour of ACT for depressive and anxiety symptoms.

Conclusion

The study was negative on the primary outcome measures. On an individual level, this study showed that especially on the long term ACT seems to show a more clinically relevant decrease in anxiety and depressive symptoms compared to an active control intervention. However, ACT was not superior in improving ACT-related processes such as psychological flexibility, cognitive defusion, and valued living nor in increasing participation or quality of life. Further large-scale group studies are warranted.

Trial registration

The study was originally registered in the Dutch Trial Register (now Clinical Trial Registry Platform), NL-OMON50203. Registered on 18/07/2018 and now to be found under https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON50203.

In this cross-sectional study, a German translation of the subscale “Purpose in Life” (PLQ) from the Scales of Psychological Well-being (SPWB) was validated in a representative sample of participants from healthy and cardiovascular populations. The main objectives were to assess the reliability, convergent, and discriminant validity using a large and representative sample (N = 466 healthy sample, N = 247 patients with an implanted cardioverter-defibrillator (ICD), N = 70 patients with a cardiovascular disease (CVD)).

The findings indicated that the German PLQ is a reliable and valid measure of positive psychological well-being, showing a positive correlation with health-related quality of life, optimism, and positive affect. In turn, the PLQ score was significantly and negatively correlated with depressive symptom severity, anxiety, pessimism, and negative affect, while being distinct from these constructs. The comparability of the measurement properties of the German PLQ with the original English version further supports the validity of the translation. Additionally, the unidimensional structure of the German version mirrored that of the English PLQ.

As this study used a large and representative sample, it provides the most up-to-date normative population value for the subscale of the SPWB. Moreover, this study represents the first known exploration of the questionnaire in a cardiovascular sample, revealing relationships between health-related quality of life, optimism, positive affect, and the German PLQ. However, in patients with ICD, the positive correlation between the PLQ and the physical component of the SF-12 did not reach significance. Despite these valuable findings, future research to enhance the understanding of the PLQ and its implications is warranted.

Background

Research is increasingly highlighting the intricate relationship between mental and physical health. However, longitudinal studies investigating the interplay between chronic diseases (CDs), depression and anxiety are still relatively scarce. This study aimed to delve into the longitudinal connections among these variables.

Methods

This study conducted a 4-year prospective survey involving 486 participants from rural communities in Shandong Province, China. The relationships among these variables were analyzed using multiple linear regression, cross-lagged path analysis, and multiple-group analysis.

Results

Our analysis revealed that the number of CDs reported at wave 1 significantly predicted anxiety levels (β = 0.126, p < .01) at wave 2, while depression symptoms also predicted anxiety (β = 0.220, p < .01) at wave 2. Furthermore, anxiety levels at wave 1 significantly predicted both the number of CDs (β = 0.219, p < .01) and depression symptoms (β = 0.160, p < .05) at wave 2. However, the study did not find support for a relationship between CDs and depression.

Conclusion

The study uncovered a bidirectional association between CDs and anxiety, depression and anxiety, but found no direct longitudinal relationship between CDs and depression. Research has indicated that CDs indirectly affect depression through anxiety.

Objectives

This study explores the mental health situation in Kosova and the impact of the COVID-19 pandemic.

Methods

Marketed quantities of antidepressants (N06A) and anxiolytics (N05B) from 2017 to 2022 were analyzed using the Anatomical Therapeutic Chemical/Defined Daily Doses (ATC/DDD) methodology. Caution is advised as these quantities may not directly reflect patient usage and could include uses for conditions outside their primary indications.

Results

Prior to the pandemic, antidepressant quantities remained relatively stable, but rose from 6.8 DDD/1000 inhabitants/day in 2019 to 9.7 in 2020 and 12.4 in 2021, before returning to pre-pandemic levels of 6.8 DDD in 2022. Over 80 % of these were selective serotonin reuptake inhibitors. Meanwhile, anxiolytic quantities initially decreased from 17.4 DDD in 2017 to 9.9 in 2019, then rebounded to 17.9 DDD in 2020. Notably, alprazolam usage surged from 2.9 in 2017 to 6.9 in 2021, subsequently dropping to 2.0 in 2022.

Conclusions

The volatile trends in medication quantities during the pandemic suggest a fragile mental health landscape in Kosova—a developing, post-conflict country with a youthful population—underscoring the need for proactive interventions in similar contexts globally.

Objective

This study aimed to explore the mediating roles of mindfulness and illness perception in the effects of a social media-based Mindfulness psyCho-behAvioRal intErvention (MCARE) on depressive and anxiety symptoms among patients with ACS.

Methods

This study conducted a secondary longitudinal mediation analysis using data from a randomized controlled trial of the MCARE grogram in patients with ACS. Participants were recruited at two tertiary hospitals in Jinan, China. The MCARE program consisted of six weekly sessions addressing mindfulness training and disease management to facilitate understanding and management of emotions and illness. The analytical sample included participants who completed measures of the primary outcomes, i.e., depression (PHQ-9) and anxiety (GAD-7) and potential mediators, i.e., mindfulness (CAMS-R) and illness perception (Brief-IPQ) at baseline (T0), immediate post-intervention (T1), and 12-week after the commencement of the intervention (T2).

Results

This study included 146 participants (mean age 58.9 years (SD = 8.9), 69.2 % male), including both intervention and control groups. The mediation analysis revealed a significant mediating effect of T1 mindfulness in the relationship between the group and T2 depression symptoms (indirect effect: -0.109, 95 % CI: −0.191, −0.041; P = 0.004), accounting for 26 % of the effect. For T2 anxiety symptoms, T1 illness perception exhibited a significant mediating effect (indirect effect: -0.055, 95 % CI: −0.110, −0.005; P = 0.035), accounting for 22 % of the effect.

Conclusions

This study found that mindfulness and illness perception played a mediating role in the effects of the MCARE program on depressive and anxiety symptoms among patients with ACS.