Journal of Psychosomatic Research最新文献

{"title":"Biopsychosocial factors associated with distress in people with suspected postural orthostatic tachycardia syndrome (POTS): A longitudinal regression and correlation study","authors":"Iris Knoop ,&nbsp;Annie S.K. Jones ,&nbsp;Sam Norton ,&nbsp;Nicholas Gall ,&nbsp;Rona Moss-Morris","doi":"10.1016/j.jpsychores.2025.112499","DOIUrl":"10.1016/j.jpsychores.2025.112499","url":null,"abstract":"<div><h3>Purpose</h3><div>Postural Orthostatic Tachycardia Syndrome (POTS) is a debilitating condition of the autonomic nervous system with no clear referral, diagnosis, and treatment pathways. Patients experience high levels of symptoms and moderate levels of distress. The purpose of this study was to explore biopsychosocial factors associated with distress in those under investigation for POTS, to identify potential targets for intervention.</div></div><div><h3>Methods</h3><div>A longitudinal, quantitative survey. Participants (<em>n</em> = 149) completed demographic, psychosocial, and symptom questionnaires prior to a diagnostic POTS clinic visit and 6 months follow-up (<em>n</em> = 98). Correlation and regression analyses were used to identify factors associated with distress at baseline (within one month before diagnostic hospital visit) and at 6 months follow up.</div></div><div><h3>Results</h3><div>At baseline, distress levels were moderate and greater symptom focusing, all-or-nothing and avoidance behaviours, threatening views of the illness, emotional reactivity, cardiac anxiety, POTS symptoms, number of specialists seen, lower social support, and younger age were significantly associated with higher levels of baseline distress. The baseline regression model including all demographic, clinical, and psychosocial factors explained 61.2 % of the variance in distress, with the psychosocial variables collectively explaining 55.6 % of this variance (F = 11.06, <em>p</em> &lt; .001). There was no significant difference between distress levels at baseline and follow-up. Psychosocial variables explained 4.7 % of the variance (F = 0.76, <em>p</em> = .665) in changes in distress scores over 6 months. Baseline distress scores accounted for the vast majority of variance in distress at follow-up.</div></div><div><h3>Conclusions</h3><div>This study identified key novel psychosocial factors that were significantly associated with distress which could be potential targets for intervention. Additional factors such as younger age and a higher number of specialists seen were also associated with higher levels of distress, which merits attention when assessing patients' psychological wellbeing this patient group. Distress levels did not significantly change following the specialist consultation and investigation.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"201 ","pages":"Article 112499"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do we still need Engel's biopsychosocial model?","authors":"Fiammetta Cosci","doi":"10.1016/j.jpsychores.2025.112451","DOIUrl":"10.1016/j.jpsychores.2025.112451","url":null,"abstract":"","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"200 ","pages":"Article 112451"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between fear of disease progression and social isolation in stroke patients: The mediating role of self-perceived burden and self-disclosure","authors":"Yujing Gu ,&nbsp;Honggan Wang ,&nbsp;Yun Zhao ,&nbsp;Zhaodi Liao ,&nbsp;Jun Xie","doi":"10.1016/j.jpsychores.2025.112455","DOIUrl":"10.1016/j.jpsychores.2025.112455","url":null,"abstract":"<div><h3>Aim</h3><div>Post-stroke sequelae, such as motor dysfunction, may reduce patients' participation in social activities, thereby increasing their risk of social isolation. Previous studies have linked fear of disease progression with social isolation, yet the underlying mechanisms of this association remain unclear. To develop effective intervention strategies, it is essential to explore the contributing factors related to social isolation in depth.</div></div><div><h3>Methods</h3><div>This study aimed to investigate the mediating roles of self-perceived burden and self-disclosure in the relationship between fear of disease progression and social isolation among stroke patients. A total of 342 inpatients from neurology departments were surveyed using a self-designed demographic questionnaire, the Generalized Alienation Scale (GAS), Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Self-Perceived Burden Scale (SPBS), and Distress Disclosure Index (DDI). A parallel mediation model was constructed, and descriptive statistics, difference tests, Spearman correlation analysis, hierarchical multiple regression, and mediation effect analysis were conducted.</div></div><div><h3>Results</h3><div>Fear of disease progression was positively associated with social isolation (c = 0.275). It was positively related to self-perceived burden (a1 = 0.598) and negatively related to self-disclosure (a2 = −0.412). Both mediators were significantly associated with social isolation (b1 = 0.188; b2 = −0.099). Significant indirect effects were found through self-perceived burden (a1b1 = 0.113) and self-disclosure (a2b2 = 0.041). The direct effect remained significant (c' = 0.121), indicating partial mediation.</div></div><div><h3>Conclusion</h3><div>Self-perceived burden and self-disclosure simultaneously mediate the impact of fear of disease progression on social isolation, offering new insights for healthcare professionals aiming to prevent social isolation among stroke survivors.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"200 ","pages":"Article 112455"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitivities and specificities of questionnaires and clinical signs and symptoms to predict daily life impairment after SARS-CoV-2 infection varied across different health sectors","authors":"Antonius Schneider ,&nbsp;Nele Kornder ,&nbsp;Klaus Linde ,&nbsp;Alexander Hapfelmeier","doi":"10.1016/j.jpsychores.2025.112439","DOIUrl":"10.1016/j.jpsychores.2025.112439","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the impact of patient selection in different health sectors on sensitivities and specificities of psychosomatic questionnaires and clinical signs and symptoms (CSS) for predicting daily life impairment (DLI) in individuals after SARS-CoV-2 infection.</div></div><div><h3>Methods</h3><div>Secondary data analysis of three independent cross-sectional surveys in general population (<em>n</em> = 2828), fourteen primary care practices (<em>n</em> = 204), and rehabilitation hospital (<em>n</em> = 161). DLI and symptoms were captured using questionnaires. PHQ-15 (Patient Health Questionnaire-15) and SSD-12 (Somatic Symptom Disorder-12), PHQ-2 (Patient Health Questionnaire-2), GAD-2 (Generalized Anxiety Disorder-2), and FAS (Fatigue Assessment Scale) were used to assess somatic symptom disorder (SSD), depression, anxiety and fatigue. Diagnostic indices were calculated to predict DLI.</div></div><div><h3>Results</h3><div>The sensitivities of questionnaires and CSS increased, and specificities decreased from general population to practices and hospital. SSD-12 had a higher diagnostic odds ratio (dOR; 95 % confidence interval) (17.4; 12.6–24.0) in population than in practices (8.4; 3.6–19.7) or hospital (8.1; 1.7–31.7). FAS &gt; 22 had higher dOR (15.0; 11.8–19.1) in population than in practices (5.3; 2.8–9.8) or hospital (4.8; 1.4–16.3). The pattern (population / practice / hospital) was similar in depression (9.2; 7.0–12.0 / 8.0; 3.6–18.1 / 12.2; 1.5–96.2) and anxiety (8.0; 6.0–10.8 / 2.4; 1.0–5.6 / 3.0; 0.6–14.1). Areas under the curves of questionnaires were highest in population, followed by hospital, and consistently lower for practices.</div></div><div><h3>Conclusion</h3><div>There is a large variation in sensitivities and specificities to predict DLI. The extent to which SSD or psychosomatic comorbidity contributes to DLI varied across the health sectors in which patients are diagnosed and treated.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"200 ","pages":"Article 112439"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What role does social activity play in the relationship between hearing loss and cognitive decline or mental health in older adults: A systematic review and meta-analysis","authors":"Jing Li,&nbsp;Liu Sun,&nbsp;Yuan-Yuan Zhao,&nbsp;Han-Ting Wang,&nbsp;Jun-E Liu","doi":"10.1016/j.jpsychores.2025.112449","DOIUrl":"10.1016/j.jpsychores.2025.112449","url":null,"abstract":"<div><h3>Objective</h3><div>Hearing loss is a global public health concern among older adults, associated with cognitive decline and other mental health disorders. Social activity has been proposed as a potential pathway linking hearing loss and mental outcomes. This systematic review aimed to clarify the dual mediating and moderating roles of social activity in the links between hearing loss and mental health outcomes.</div></div><div><h3>Methods</h3><div>We searched five databases up to April 23, 2025, for empirical studies examining the role of social activity in the relationship between hearing loss and mental health. Data were synthesized using random-effects meta-analysis or best-evidence synthesis.</div></div><div><h3>Results</h3><div>Nineteen studies (11 longitudinal, 8 cross-sectional) were included, covering cognitive function (<em>n</em> = 12), depressive symptoms (<em>n</em> = 4), and positive emotional outcomes (<em>n</em> = 3). Meta-analysis showed a small but significant mediating effect of social activity on the hearing loss–cognitive decline link (estimate = −0.004, 95 % CI: −0.007 to −0.001), and a significant moderating effect (estimate = 0.087, 95 % CI: 0.050 to 0.124), with stronger negative effects among those with lower social activity. Best-evidence synthesis provided moderate support for mediation with depressive symptoms and positive emotional outcomes, and limited evidence for a moderating effect on depressive symptoms.</div></div><div><h3>Conclusion</h3><div>This review highlights the dual role of social activity in mediating and moderating the association between hearing loss and mental health in older adults. These findings underscore the importance of promoting social activity as a potential target for interventions. Further research is needed to validate these findings and identify effective strategies to enhance social activity.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"200 ","pages":"Article 112449"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalised and standardised wafer-based open-label placebos reduce perceived stress among university students: A three-arm randomised controlled trial","authors":"Johannes C. Fendel ,&nbsp;Corinna Ketter ,&nbsp;Paulina Liese ,&nbsp;Dimitri Nalezinski ,&nbsp;Magdalena Schiele ,&nbsp;Frederic Linßen ,&nbsp;Stefan Schmidt","doi":"10.1016/j.jpsychores.2025.112450","DOIUrl":"10.1016/j.jpsychores.2025.112450","url":null,"abstract":"<div><h3>Background</h3><div>Open-label placebos (OLPs) are placebos administered transparently, without deception that can nonetheless yield beneficial effects. We tested a novel OLP delivery format—printed edible wafers, with or without individualised coaching-based personalisation, in highly stressed university students.</div></div><div><h3>Methods</h3><div>In this superiority randomised controlled trial, <em>N</em> = 137 highly stressed university students were randomly assigned for three weeks to a personalised OLP (personalised printed image, label, desired effects) a standardised OLP (standardised for stress reduction), or a waitlist control. The primary objective was to test whether the personalised OLP reduces perceived stress compared to waitlist. Secondary objectives included examining whether the standardised OLP also improves outcomes relative to control and whether personalisation yields incremental benefits. Assessments were conducted at baseline, post-intervention, and at a three-month follow-up. The primary outcome was perceived stress; secondary outcomes included anxiety, depression, sleep, well-being, and life satisfaction; moderators were treatment expectancy (TE) and general self-efficacy (GSE).</div></div><div><h3>Results</h3><div>Both OLP arms reduced perceived stress vs. waitlist; these effects were maintained at follow-up. Anxiety decreased only in the personalised arm. The OLP arms did not differ significantly. In the standardised arm, lower GSE predicted larger depressive-symptom reductions and higher TE predicted greater well-being gains (vs. waitlist).</div></div><div><h3>Conclusions</h3><div>Wafers may be a versatile OLP delivery method with potential for mechanism-guided refinement and targeted personalisation in preventive and clinical contexts.</div></div><div><h3>Trial registration</h3><div><span><span>https://osf.io/8afdz</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"200 ","pages":"Article 112450"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of psychosocial and behavioural determinants on allostatic load in early pregnant women: A cross-sectional study","authors":"Dehui Yuan ,&nbsp;Minghuan Wang ,&nbsp;Sisi Bu ,&nbsp;Min Xiong ,&nbsp;Liang Lu ,&nbsp;Liu Zhang ,&nbsp;Yuhong Li","doi":"10.1016/j.jpsychores.2025.112436","DOIUrl":"10.1016/j.jpsychores.2025.112436","url":null,"abstract":"<div><h3>Objective</h3><div>Allostatic load (AL) reflects the cumulative wear and tear from chronic environmental challenges to the body and has an impact on adverse pregnancy outcomes. This study explored the influence of psychosocial and behavioural factors on AL among pregnant women.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 455 Chinese women in early pregnancy from January to May 2022. AL was assessed by waist-to-hip ratio, body mass index, glucose, high-density lipoprotein, total cholesterol, systolic blood pressure, diastolic blood pressure, and high-sensitivity C-reactive protein. Depression was assessed using the Edinburgh Postpartum Depression Scale. Physical activity was assessed using the short version of the International Physical Activity Questionnaire. Life purpose was assessed using the Ryff Scale of Psychological Well-Being. Pregnancy-related anxiety was assessed by the Chinese Pregnancy Related Anxiety Scale. Odds ratios (OR) and 95 % confidence intervals (CIs) were estimated using logistic regression analysis.</div></div><div><h3>Results</h3><div>36.7 % of pregnant women had high AL (AL ≥ 3). Multivariate analysis showed university degree or above (OR = 0.47, 95 % CI 0.25–0.88), moderate physical activity level (OR = 0.38, 95 % CI 0.21–0.69), life purpose (OR = 1.17, 95 % CI 1.05–1.32), and depression (OR = 0.08, 95 % CI 0.07–0.94) were independently associated with AL.</div></div><div><h3>Conclusions</h3><div>Healthcare providers should consider the impact of education, life purpose, depression and physical activity on physiological wear in early pregnancy to detect high AL and promote maternal and child health.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"200 ","pages":"Article 112436"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-based prediction of delirium in older patients with chronic kidney disease requiring intensive care: A hospital-based retrospective cohort study","authors":"Chia-Rung Wu ,&nbsp;Yung-Chun Chang ,&nbsp;Victoria Tranyor ,&nbsp;Shu-Tai Shen Hsiao ,&nbsp;Shu-Liu Guo ,&nbsp;Shu-Chuan Lin ,&nbsp;Sen-Kuang Hou ,&nbsp;Hsiao-Yean Chiu","doi":"10.1016/j.jpsychores.2025.112454","DOIUrl":"10.1016/j.jpsychores.2025.112454","url":null,"abstract":"<div><h3>Objectives</h3><div>Delirium is a common complication in intensive care units (ICUs), especially among older adults with chronic kidney disease (CKD). It is associated with increased mortality and prolonged hospitalization. Machine learning (ML)-based models can help predict delirium. In this study, we developed an ML-based delirium prediction model for critically ill older patients with CKD.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients aged ≥65 years admitted to the ICU between January 2021 and November 2023. Delirium was assessed every 8 h throughout the ICU stay using the Intensive Care Delirium Screening Checklist (ICDSC) and defined as a score of ≥4. Eight ML models were compared in terms of the area under the receiver operating characteristic curve (AUROC), accuracy, F1-score, specificity, and recall.</div></div><div><h3>Results</h3><div>This study included 895 patients, of whom 55.3 % developed delirium. The random forest model outperformed others (F1-score: 0.891; specificity: 0.911; recall: 0.864; accuracy: 0.885; precision: 0.923; AUROC: 0.950). Backward feature selection achieved an F1-score of 0.892 and an AUROC of 0.953, identifying 14 key predictors of delirium: physical restraint use, low Glasgow Coma Scale score, high white blood cell count, hypernatremia, fever, advanced age, hypoalbuminemia, hypercalcemia, low hemoglobin, high Acute Physiology and Chronic Health Evaluation II (APACHE II) score, hyperkalemia, mechanical ventilation, sedation, and elevated C-reactive protein.</div></div><div><h3>Conclusion</h3><div>Our ML model demonstrated good performance in predicting delirium in critically ill older adults with CKD, suggesting potential value for early identification. Future studies may explore integration into hospital systems to support delirium prevention strategies.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"200 ","pages":"Article 112454"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"bodysymptoms.org: Postlaunch evaluation and update","authors":"Chloe Saunders ,&nbsp;Heidi Frølund Pedersen ,&nbsp;Charlotte Ulrikka Rask ,&nbsp;Lisbeth Frostholm","doi":"10.1016/j.jpsychores.2025.112445","DOIUrl":"10.1016/j.jpsychores.2025.112445","url":null,"abstract":"<div><div>Persistent physical symptoms (PPS) and functional somatic disorders present significant challenges to clinical communication. There is a lack of resources easily accessible in digital contexts that can support the development of therapeutic explanations and shared understandings. To address this problem <span><span>bodysymptoms.org</span><svg><path></path></svg></span> was launched in January 2024 as a multilingual, publicly accessible educational website designed to provide evidence-based, integrative explanations of PPS using a transdiagnostic, biopsychosocial framework. This report summarises the post-launch evaluation of <span><span>bodysymptoms.org</span><svg><path></path></svg></span> and outlines updates made in 2025.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"200 ","pages":"Article 112445"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145529194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional movement and gait disorders: A matter of age?","authors":"Gilbert Kanyinda Kayombo ,&nbsp;Tatiana Witjas ,&nbsp;Camille Comet ,&nbsp;Valentin Mira ,&nbsp;Eve Benchetrit ,&nbsp;Nelson Monteiro-Dias ,&nbsp;Etienne Fortanier ,&nbsp;Adil Maarouf ,&nbsp;Alexandre Eusebio ,&nbsp;Jean-Philippe Azulay ,&nbsp;Frédérique Fluchère ,&nbsp;Stephan Grimaldi","doi":"10.1016/j.jpsychores.2025.112471","DOIUrl":"10.1016/j.jpsychores.2025.112471","url":null,"abstract":"<div><h3>Background</h3><div>Functional neurological disorders (FND) represent a significant public health challenge due to their prevalence and impact on quality of life. Functional movement disorders (FMD) and functional gait disorders (FGD) represent a large part of the broad phenotype spectrum of FND.</div></div><div><h3>Objective</h3><div>This study aimed to describe the clinical profiles and associated characteristics of FMD and FGD, with particular attention to age-related symptoms.</div></div><div><h3>Methods</h3><div>A retrospective review of medical records with standardized collection of data of FND and FMD patients from three Neurological Referral Centers was conducted from 2016 to 2024. Data collected included demographic information and clinical outcomes.</div></div><div><h3>Results</h3><div>Sixty-eight patients were included with a female predominance (75.53 %). Thirty-seven had FMD (mean age 47.19 ± 18.66 years), 14 had FGD (63.0 ± 11.50), and 17 had both (49.53 ± 20.90 years). FGD were more frequent in older patients compared with FMD patients (<em>p</em> = 0.0046) and with patients with the mixed phenotype (<em>p</em> = 0.043). Tremors were the most common FMD subtype (70.3 %), while astasia-abasia was the predominant FGD phenotype (57.1 %). Fifty-three percent of patients were lost to follow-up, 20.6 % improved, and 26.5 % remained stable. Lack of physical and psychological rehabilitation was predominant in lost-to-follow-up subjects.</div></div><div><h3>Conclusion</h3><div>FND age of onset was significantly associated with phenotype, with older patients being more affected by FGD. This association may be partially influenced by societal perceptions of aging and mobility.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"200 ","pages":"Article 112471"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}