Journal of Psychosomatic Research最新文献

英文中文

Long-term treatment outcomes of mindfulness-based cognitive therapy for fatigue in patients with inflammatory bowel disease: Results of a randomized controlled trial 基于正念的认知疗法对炎症性肠病患者疲劳的长期治疗效果：随机对照试验的结果

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-11 DOI: 10.1016/j.jpsychores.2024.111949

Quirine M. Bredero , Joke Fleer , Ans Smink , Greetje Kuiken , Joke Potjewijd , Marleen Laroy , Marijn C. Visschedijk , Maurice Russel , Mark van der Lugt , Maarten A.C. Meijssen , Egbert Jan van der Wouden , Gerard Dijkstra , Maya J. Schroevers

Objectives

Fatigue is prevalent in patients with inflammatory bowel disease (IBD) in remission. Previously, we showed that fatigued IBD patients experienced a significant decrease in fatigue after receiving mindfulness-based cognitive therapy (MBCT). The current study examined to what extent these short-term beneficial effects of MBCT on fatigue were maintained over nine months follow-up, and whether patient characteristics were associated with clinically relevant improvement in fatigue.

Methods

A randomized controlled trial, including an MBCT and waiting-list control condition, was performed in fatigued IBD patients in remission. For this study, we analysed long-term outcomes of 108 patients who received MBCT (either directly or after three months waiting). The primary outcome was fatigue, assessed with the Checklist Individual Strenght-20. Secondary outcomes included fatigue interference, depression, anxiety, and quality of life.

Results

The reduced level of fatigue post-treatment did not change significantly during follow-up (F(2,76) = 1.68, p = 0.19). In total, 29% of patients reported clinically relevant improvement from pre-treatment to nine months follow-up. We found few significant differences in baseline characteristics between those reporting clinically relevant improvement and those not, except that patients who improved were significantly more often unemployed (χ²(1, n = 73) = 4.40, p = 0.04). Secondary outcomes, which did not change significantly during MBCT, also remained stable during follow-up.

Conclusion

Findings suggest that reductions in IBD-related fatigue after receiving MBCT are sustained over nine months follow-up, with around one-third of patients reporting clinically relevant improvement from pre-treatment to follow-up. Employment status might be related to improvements in fatigue. Future research is needed to confirm these long-term outcomes.

Preregistration

ClinicalTrials.gov ID: NCT03162575.

目的缓解期炎症性肠病（IBD）患者普遍感到疲劳。此前，我们的研究表明，疲劳的 IBD 患者在接受正念认知疗法（MBCT）治疗后，疲劳感明显减轻。目前的研究考察了 MBCT 对疲劳的短期有益影响在九个月的随访中的维持程度，以及患者的特征是否与疲劳的临床相关改善有关。方法对缓解期的疲劳 IBD 患者进行了随机对照试验，包括 MBCT 和等待名单对照条件。在这项研究中，我们分析了 108 名接受 MBCT（直接或等待三个月后）治疗的患者的长期疗效。主要结果是疲劳，用《个人力量检查表-20》进行评估。次要结果包括疲劳干扰、抑郁、焦虑和生活质量。结果治疗后疲劳程度的降低在随访期间没有显著变化（F(2,76) = 1.68, p = 0.19）。从治疗前到九个月的随访期间，总共有 29% 的患者报告了临床相关的改善。我们发现，报告临床相关改善和未报告临床相关改善的患者在基线特征方面几乎没有明显差异，但改善的患者失业率明显更高（χ2(1, n = 73) = 4.40, p = 0.04）。结论研究结果表明，接受 MBCT 治疗后，与 IBD 相关的疲劳症状会在九个月的随访中持续减轻，约有三分之一的患者报告从治疗前到随访期间出现了临床相关的改善。就业状况可能与疲劳的改善有关。未来的研究需要证实这些长期结果：NCT03162575。

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引用次数: 0

Predictors of treatment response trajectories to cognitive behavioral therapy for chronic fatigue syndrome: A cohort study 慢性疲劳综合征认知行为疗法治疗反应轨迹的预测因素：一项队列研究

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-11 DOI: 10.1016/j.jpsychores.2024.111954

Lukas Van Oudenhove , Soetkin Debyser , Elfi Vergaelen , Stephan Claes , Maaike Van Den Houte

Background

The response to cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) varies greatly between patients, but predictors of treatment success remain to be elucidated. We aimed to identify patient subgroups based on fatigue trajectory during CBT, identify pre-treatment predictors of subgroup membership, and disentangle the direction of predictor – outcome relationships over time.

Methods

297 individuals with CFS were enrolled in a standardized CBT program consisting of 17 sessions, with session timing variable between participants. Self-reported levels of fatigue, depressive, anxiety, and somatic symptoms, perceived stress, and positive affect were collected pre-treatment, and after 3, 10, and 15 sessions. Latent Class Growth Analysis (LCGA) was used to identify subgroups based on fatigue trajectories and baseline predictors of group membership. Cross-lagged structural equation models were used to disentangle predictor-outcome relationships.

Results

LCGA identified four fatigue trajectory subgroups, which were labelled as “no improvement” (23 %), “weak improvement” (45 %), “moderate improvement” (23 %), and “strong improvement” (9 %) classes. Higher pre-treatment levels of depressive, anxiety, and somatic symptoms, stress, and lower levels of positive affect predicted membership of the “no improvement” subgroup. Reductions in anxiety preceded reductions in fatigue, while the depressive symptoms – fatigue relationship was bidirectional.

Conclusions

On a group level, there were statistically significant reductions in fatigue after 15 sessions of CBT, with important individual differences in treatment response. Higher pre-treatment levels of anxious, depressive, and somatic symptoms and perceived stress are predictors of lack of response, with reductions in anxiety and stress preceding improvements in fatigue.

背景慢性疲劳综合征（CFS）患者对认知行为疗法（CBT）的反应差异很大，但治疗成功的预测因素仍有待阐明。我们的目的是根据患者在 CBT 治疗过程中的疲劳轨迹确定患者亚组，确定亚组成员的治疗前预测因素，并厘清预测因素与治疗结果之间随时间变化的关系。在治疗前、3 次、10 次和 15 次治疗后，收集他们对疲劳、抑郁、焦虑和躯体症状、感知压力和积极情绪的自我报告水平。采用潜类增长分析法（LCGA）根据疲劳轨迹和群体成员的基线预测因素确定亚组。结果LCGA确定了四个疲劳轨迹亚组，分别为 "无改善"（23%）、"弱改善"（45%）、"中度改善"（23%）和 "强改善"（9%）。治疗前抑郁、焦虑和躯体症状水平较高，压力较大，积极情绪水平较低，这些都预示着患者属于 "无改善 "亚组。焦虑的减轻先于疲劳的减轻，而抑郁症状与疲劳之间的关系是双向的。治疗前较高的焦虑、抑郁和躯体症状水平以及感知到的压力是缺乏反应的预测因素，而焦虑和压力的减轻先于疲劳的改善。

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引用次数: 0

Can the Whiteley Index be used to assess health anxiety in adolescents from the general population? 怀特利指数能否用于评估普通人群中青少年的健康焦虑？

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-11 DOI: 10.1016/j.jpsychores.2024.111946

Charlotte Steen Duholm , Davíð R.M.A. Højgaard , Eva Ørnbøl , Kaare Bro Wellnitz , Per Hove Thomsen , Martin Køster Rimvall , Charlotte Ulrikka Rask

Health anxiety (HA) is characterized by worry about being or becoming ill. The Whiteley Index (WI) is a valid and frequently used measure for HA in adults. We examined item response distribution, floor and ceiling effects, and construct validity of four different one-factor models of the WI (an 8-item model, the widely used WI-7, a revised 7-item version (WI-7-R), and a 6-item version (WI-6-R)) in a population-based sample of adolescents, using data from the 16–17-year follow-up of the Copenhagen Child Cohort 2000 (N = 2521, 16–17 years old). Females generally scored higher on all eight WI items compared to males. Construct validity was examined by confirmatory factor analysis and hypothesis testing. The WI-7-R and WI-6-R both showed acceptable fits. All four models showed good internal consistency. Hypothesis testing showed good discriminant validity, as the hypotheses on positive correlations with anxiety, depression, and physical symptoms, as well as a negative correlation with health-related quality of life, were met for both the WI-7-R and WI-6-R. We advocate for the use of the WI-6-R, which focuses on core HA symptoms and excludes items concerning physical symptoms. The overall testing supports that the WI-6-R possesses valid psychometric properties for use with adolescents in the general population.

健康焦虑（HA）的特点是担心自己生病或成为病人。怀特利指数（WI）是一种有效且常用的成人健康焦虑测量方法。我们利用哥本哈根儿童队列 2000（N = 2521，16-17 岁）16-17 年的随访数据，在以人口为基础的青少年样本中研究了 WI 的项目反应分布、下限效应和上限效应以及四种不同单因素模型（8 个项目模型、广泛使用的 WI-7、修订的 7 个项目版本（WI-7-R）和 6 个项目版本（WI-6-R））的结构效度。与男性相比，女性在所有八个 WI 项目上的得分普遍较高。结构效度通过确认性因子分析和假设检验进行检验。WI-7-R和WI-6-R均显示出可接受的拟合度。所有四个模型都显示出良好的内部一致性。假设检验显示，WI-7-R 和 WI-6-R 均符合与焦虑、抑郁和身体症状呈正相关以及与健康相关生活质量呈负相关的假设，因此具有良好的判别效度。我们主张使用 WI-6-R，因为它侧重于核心的医管局症状，而不包括有关躯体症状的项目。总体测试结果表明，WI-6-R 具有有效的心理测量特性，适用于普通人群中的青少年。

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引用次数: 0

Major depressive disorder, neuroticism, suicidal behaviors, and depression severity are associated with cytokine networks and their intricate interactions with metabolic syndrome 重度抑郁症、神经质、自杀行为和抑郁症严重程度与细胞因子网络及其与代谢综合征之间错综复杂的相互作用有关

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-10 DOI: 10.1016/j.jpsychores.2024.111951

Michael Maes , Ketsupar Jirakran , Asara Vasupanrajit , Bo Zhou , Chavit Tunvirachaisakul , Abbas F. Almulla

Objectives

To identify alterations in the immune profiles in outpatients with major depression (MDD), and its associations with key features, such as suicidal ideation, neuroticism, cognitive symptoms, and the depression phenome while accounting for metabolic syndrome (MetS).

Methods

In this case-control study, we assayed 48 serum cytokines, chemokines, and growth factors in 67 healthy controls and 66 MDD outpatients. Around 50 % of the outpatient MDD and control participants had a diagnosis of MetS.

Results

Ten differentially expressed proteins (DEPs) were upregulated in outpatient MDD (i.e., CXCL12, tumor necrosis factor [TNF]β, platelet-derived growth factor [PDGF], CCL11, interleukins [IL]9, IL4, CCL5, CCL2, CCL4, IL1 receptor antagonist [IL1RN]), indicating an immune and defense response. Six DEPs were downregulated (vascular endothelial growth factor A [VEGFA], IL12, CCL3, colony stimulating factor [CSF]1, IL1B, nerve growth factor [NGF]), indicating lowered neurogenesis and neuron death regulation. Significant interactions between outpatient MDD and MetS caused a) substantial increases in IL4, IL17, TNF, TNFB, CCL2, CCL5, PDGF, IL1RN; and b) downregulation of VEGFA and FGF. A large part of the variance in neuroticism (26 %), suicidal behaviors (23 %), and the MDD phenome (31 %) was predicted by immunological data and interactions between MetS and CCL5, TNFB or VEGFA.

Conclusion

Outpatient MDD is characterized by a cytokine profile with neurotoxic potential which partly explains neuroticism, suicidal behaviors, and the phenome's severity. Lowered IL-10 and activated cytokine profiles with neurotoxic potential are characteristics of outpatient MDD and other depression phenotypes, including severe first-episode inpatient MDD. The presence of MetS in outpatient MDD considerably activates immune profiles with neurotoxic potential. Consequently, immune studies in MDD should always be performed in subjects with and without MetS.

方法在这项病例对照研究中，我们检测了 67 名健康对照者和 66 名重度抑郁症门诊患者的 48 种血清细胞因子、趋化因子和生长因子。结果10种差异表达蛋白（DEPs）在MDD门诊患者中上调（即CXCL12、肿瘤坏死因子[TNF]β、血小板衍生生长因子[PDGF]、CCL11、白细胞介素[IL]9、IL4、CCL5、CCL2、CCL4、IL1受体拮抗剂[IL1RN]），表明存在免疫和防御反应。六种 DEPs 下调（血管内皮生长因子 A [VEGFA]、IL12、CCL3、集落刺激因子 [CSF]1、IL1B、神经生长因子 [NGF]），表明神经发生和神经元死亡调节功能降低。门诊 MDD 和 MetS 之间的显著交互作用导致：a）IL4、IL17、TNF、TNFB、CCL2、CCL5、PDGF、IL1RN 大量增加；b）VEGFA 和 FGF 下调。免疫学数据以及 MetS 与 CCL5、TNFB 或 VEGFA 之间的相互作用预测了神经质（26%）、自杀行为（23%）和 MDD 表型（31%）的大部分差异。IL-10降低和具有神经毒性的细胞因子激活是门诊MDD和其他抑郁症表型的特征，包括严重的首发住院MDD。门诊 MDD 中 MetS 的存在大大激活了具有神经毒性潜能的免疫特征。因此，对 MDD 的免疫研究应始终在有 MetS 和无 MetS 的受试者中进行。

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引用次数: 0

Comment on “A meta-analysis of the prevalence and risk of mental health problems in allergic rhinitis patients” 关于 "过敏性鼻炎患者精神健康问题发生率和风险的荟萃分析 "的评论

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-09 DOI: 10.1016/j.jpsychores.2024.111950

Haifei Xiang, Hao Wu

引用次数: 0

Strength-based surgical consultation to navigate patient's unhelpful thoughts 以力量为基础的手术咨询，引导患者的无益想法

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-09 DOI: 10.1016/j.jpsychores.2024.111947

Rudi Haryadi , Muhammad Harwansyah Putra Sinaga , Ashari Mahfud , Jarkawi , Thrisia Febrianti

引用次数: 0

Poor stress resilience as an independent risk factor for severe COVID-19 and respiratory infections 抗压能力差是严重 COVID-19 和呼吸道感染的独立风险因素。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-09 DOI: 10.1016/j.jpsychores.2024.111953

Khairiyah Khadijah , Rizky Andana Pohan , Ririn Dwi Astuti , Putri Bunga Aisyah Pohan , Muhammad Yasir Arafat Pohan , Maria Oktasari , Riza Amalia

引用次数: 0

Bridging cultures: Expanding the MCARE intervention to diverse global Populations 架设文化桥梁：将 MCARE 干预措施扩展至全球不同人群

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-09 DOI: 10.1016/j.jpsychores.2024.111948

Tamama Rofiqah , Ahmad Yanizon , Riza Amalia , Muhammad Taufiqurrahman , Ramtia Darma Putri , Hanik Mufaridah , Lutfatulatifah

引用次数: 0

Response to comments on ‘Mechanisms of psycho-behavioural mindfulness intervention (MCARE) on depressive and anxiety symptoms in patients with acute coronary syndrome: A longitudinal mediation analysis’ 对 "心理行为正念干预（MCARE）对急性冠状动脉综合征患者抑郁和焦虑症状的影响机制：纵向中介分析

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-09 DOI: 10.1016/j.jpsychores.2024.111952

Jiatong Cui , Guiqin Zhang , Yunyan Xianyu , Xiaohong Zhang , Yu Xin Cheng , Yu Jia Liu , Wei Xiong , Wei Liu , Qian Liu , Bing Xiang Yang , Huijing Zou

引用次数: 0

The association between anxiety and depression symptoms and pain and function in adolescents and young adults with chronic pain: A meta-analysis 患有慢性疼痛的青少年中焦虑和抑郁症状与疼痛和功能之间的关系：荟萃分析

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-01 DOI: 10.1016/j.jpsychores.2024.111945

Nicole Harte , Rachel V. Aaron , Kavya Bhattiprolu , Madelyne A. Bisby , Milena Gandy , Taylor Hathway , Blake F. Dear , Joanne Dudeney

Objective

Chronic pain in adolescents and young adults (AYAs) is associated with adverse functional and psychological outcomes; however, inconsistent findings across studies necessitate a comprehensive synthesis. This meta-analysis aimed to quantify associations between anxiety, depression, and pain/functional outcomes, and explore study and sample moderators, such as age, sex, pain duration, recruitment setting, and measurement tools.

Methods

We searched MEDLINE, PsycINFO, CENTRAL, and Embase through May 2024. included 57 studies (N = 12,603) of AYAs aged 12–25 years with chronic pain. Risk of bias and GRADE assessments were conducted. Pearson r correlations were meta-analyzed using a random-effects model.

Results

Small associations were found between anxiety, depression, and heightened pain intensity (r = 0.20, 0.24). Moderate-to-large associations were observed between anxiety, depression, and disability (r = 0.32, 0.34), pain interference (r = 0.47, 0.51), pain catastrophizing (both r = 0.50), and poorer quality of life (r = −0.56, −0.61). Anxiety had stronger correlations with pain intensity and catastrophizing in samples with more males. Anxiety measure moderated the anxiety-pain intensity relationship. Depression had stronger correlations with pain intensity for shorter pain duration, and catastrophizing and pain interference for longer pain durations. The depression-catastrophizing association was stronger in older samples.

Conclusion

Anxiety and depression significantly impact the chronic pain experience in AYAs, with stronger effects on functional outcomes and quality of life than pain intensity. Tailored interventions that consider age, sex, and pain duration may enhance treatment outcomes in this population.

目的：青少年和年轻成人（AYAs）的慢性疼痛与不良的功能和心理结果有关；然而，由于各项研究的结果不一致，因此有必要进行综合分析。本荟萃分析旨在量化焦虑、抑郁和疼痛/功能性结果之间的关联，并探讨研究和样本调节因素，如年龄、性别、疼痛持续时间、招募环境和测量工具等：我们检索了截至 2024 年 5 月的 MEDLINE、PsycINFO、CENTRAL 和 Embase，共纳入 57 项研究（N = 12603），研究对象为 12-25 岁患有慢性疼痛的青少年。进行了偏倚风险和 GRADE 评估。采用随机效应模型对 Pearson r 相关性进行了元分析：焦虑、抑郁和疼痛强度增加之间存在微小关联（r = 0.20、0.24）。焦虑、抑郁与残疾（r = 0.32，0.34）、疼痛干扰（r = 0.47，0.51）、疼痛灾难化（均为 r = 0.50）和较差的生活质量（r = -0.56，-0.61）之间存在中度至高度关联。在男性较多的样本中，焦虑与疼痛强度和灾难化的相关性更强。焦虑测量调节了焦虑与疼痛强度之间的关系。在疼痛持续时间较短的样本中，抑郁与疼痛强度的相关性更强；在疼痛持续时间较长的样本中，灾难化与疼痛干扰的相关性更强。在年龄较大的样本中，抑郁与灾难化的相关性更强：结论：焦虑和抑郁会严重影响亚健康人群的慢性疼痛体验，与疼痛强度相比，焦虑和抑郁对功能结果和生活质量的影响更大。考虑年龄、性别和疼痛持续时间的定制干预措施可提高该人群的治疗效果。

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