Journal of Psychosomatic Research最新文献_第3页

Fibromyalgia and its psychosocial determinants in mothers of children with attention-deficit/hyperactivity disorder: A controlled cross-sectional study 注意缺陷/多动障碍儿童母亲的纤维肌痛及其社会心理决定因素：一项对照横断面研究

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-04-01 Epub Date: 2026-01-31 DOI: 10.1016/j.jpsychores.2026.112561

Halenur Teke , Abdulbaki Artik , Bahar Oztelcan Gunduz , Cansel Azizagaoglu , Kazim Kutluturk , Nuran Erden , Erman Atas , Mehmet Ayhan Congologlu

Objective

To investigate the prevalence of fibromyalgia (FM) and its psychosocial correlates in mothers of children diagnosed with attention-deficit/hyperactivity disorder (ADHD), compared with mothers of healthy peers.

Methods

This controlled cross-sectional study included 81 mothers of children with ADHD and 80 mothers of typically developing peers. FM was evaluated according to the American College of Rheumatology 2016 criteria. Psychometric evaluations included the Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Autism-Spectrum Quotient (AQ), along with a structured sociodemographic form. Group comparisons and multivariable logistic regression analyses were conducted to identify independent predictors of FM.

Results

FM prevalence was significantly higher in mothers of children with ADHD compared with controls (38.3% vs. 7.5%, p < 0.001). Mothers in the ADHD group also reported markedly elevated anxiety and depressive symptoms. In univariate analyses, higher maternal anxiety, depressive symptoms, autistic traits, and a history of psychiatric disorder were associated with FM. In the fully adjusted model, however, only higher maternal anxiety and older child age remained independent predictors of FM in the ADHD group. When the full sample was analyzed, having a child with ADHD was also independently associated with maternal FM. FM severity demonstrated moderate positive correlations with anxiety and depression.

Conclusion

Mothers of children with ADHD constitute a high-risk group for FM, likely driven by chronic caregiving stress and associated psychological burden. Routine screening and early psychosocial support interventions targeting parental mental health may help prevent or mitigate FM-related disability in this vulnerable population.

目的：比较诊断为注意缺陷多动障碍（ADHD）儿童的母亲与健康同龄人的母亲的纤维肌痛（FM）患病率及其社会心理相关因素。方法：本对照横断面研究包括81名ADHD儿童的母亲和80名发育正常的母亲。根据美国风湿病学会2016年标准对FM进行评估。心理测量评估包括纤维肌痛影响问卷（FIQ）、贝克抑郁量表（BDI）、贝克焦虑量表（BAI）和自闭症谱系商（AQ），以及结构化的社会人口统计表格。通过分组比较和多变量逻辑回归分析来确定FM的独立预测因子。结果：ADHD患儿母亲的FM患病率明显高于对照组（38.3% vs. 7.5%）。结论：ADHD患儿的母亲是FM的高危人群，可能是由慢性照顾压力和相关的心理负担驱动的。针对父母心理健康的常规筛查和早期社会心理支持干预可能有助于预防或减轻这一弱势群体中与fm相关的残疾。

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引用次数: 0

Unravelling the role of brain-derived neurotrophic factor (BDNF) in anorexia, bulimia, and binge-eating disorder: A systematic review and meta-analysis 揭示脑源性神经营养因子（BDNF）在厌食症、贪食症和暴食症中的作用：一项系统综述和荟萃分析

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-04-01 Epub Date: 2026-02-09 DOI: 10.1016/j.jpsychores.2026.112580

Massimo Fioranelli , Pietro Sedati , Alessia Topa , Maria Grazia Roccia , Giancarlo Santoni , Maria Luisa Garo

Background

Brain-derived neurotrophic factor (BDNF) plays a role in neuroplasticity, appetite regulation, and reward processing. Its possible involvement in eating disorders (EDs) has been investigated; however, contradictory findings and substantial methodological heterogeneity have prevented definitive conclusions.

Objective

To systematically evaluate peripheral BDNF levels in individuals with EDs, healthy controls and recovered individuals.

Methods

A systematic review with meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement (CRD420250654199). Observational studies and randomized controlled trials comparing BDNF levels in individuals with and without EDs were included. The Newcastle-Ottawa Scale and risk-of-bias tool for randomized trials were used.

Results

Twenty-one studies were included. BDNF serum levels were significantly lower in acute anorexia (AN) compared with healthy controls (Standardized Mean Difference [SMD] = −0.49;p < 0.001,n = 17), with significance maintained after excluding outliers (SMD = –0.41; p < 0.001,n = 8). No significant difference was found between recovered AN and controls. Bulimia nervosa (BN) individuals showed significantly lower BDNF serum levels (SMD = –0.72;p < 0.001,n = 4). Longitudinal studies showed a significant increase in serum BDNF levels after recovery (SMD = 1.78;p = 0.003,n = 6).

Discussion

These findings support a predominantly state-related association between peripheral BDNF levels and illness stage in AN and BN, rather than a stable condition-specific. Evidence for binge-eating disorders is extremely limited, relying on a single eligible study. Interpretation is constrained by methodological heterogeneity, variability in recovery definitions, and the largely correlational nature of the evidence. Further standardized, high-quality longitudinal studies are needed to clarify whether peripheral BDNF alterations reflect state-related mechanisms, trait vulnerability, or dynamic biological changes across illness stages.

脑源性神经营养因子（BDNF）在神经可塑性、食欲调节和奖励加工中发挥重要作用。它与饮食失调（EDs）的可能关系已被调查；然而，相互矛盾的发现和大量的方法异质性阻碍了明确的结论。目的系统评价ed患者、健康对照者和康复者外周血BDNF水平。方法按照PRISMA （Preferred Reporting Items for systematic review and meta-analysis）声明（CRD420250654199）进行系统评价和meta分析。观察性研究和随机对照试验比较了有和没有ed的个体的BDNF水平。采用纽卡斯尔-渥太华量表和随机试验的偏倚风险工具。结果共纳入21项研究。急性厌食症（AN）患者血清BDNF水平显著低于健康对照组（标准化平均差[SMD] = - 0.49;p < 0.001,n = 17），排除异常值后仍具有显著性（SMD = -0.41;p < 0.001,n = 8）。恢复后的AN与对照组无显著差异。神经性贪食症（BN）患者血清BDNF水平显著降低（SMD = -0.72;p < 0.001,n = 4）。纵向研究显示，恢复后血清BDNF水平显著升高（SMD = 1.78;p = 0.003,n = 6）。这些发现支持AN和BN中外周BDNF水平与疾病阶段之间的主要状态相关关系，而不是稳定的特定条件。暴饮暴食障碍的证据极其有限，依赖于单一的合格研究。解释受到方法学的异质性、恢复定义的可变性和证据的相关性的限制。需要进一步标准化、高质量的纵向研究来澄清外周BDNF的改变是否反映了状态相关机制、特征易感性或疾病阶段的动态生物学变化。

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引用次数: 0

Illness perception profiles and psychological and subjective physical symptoms in atrial fibrillation 房颤患者的疾病感知特征、心理和主观生理症状。

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-04-01 Epub Date: 2026-01-26 DOI: 10.1016/j.jpsychores.2026.112540

Minjie Zheng, Xinxin Shi, Zhijuan Xie, Shiyu Zhang, Shan Qu

Background

Illness perceptions have been associated with outcomes in patients with atrial fibrillation (AF). This study aimed to identify distinct illness perception profiles in patients with AF and examine their associations with psychological and physical responses.

Method

A total of 150 patients with AF were enrolled in this study. Illness perception profiles were identified using latent profile analysis (LPA). Model fit indices were evaluated to determine the optimal class solution. Logistic regression analyses were conducted to examine the associations between illness perception profiles and psychological and physical outcomes, including Generalized anxiety disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), 12-Item Short Form Health Survey (SF-12) and University of Toronto atrial fibrillation severity scale (AFSS).

Result

A two-class model was identified as optimal, comprising a “Reactive–Minimizing” profile (Class 1, 49%) and a “Symptom-Helplessness” profile (Class 2, 51%). Univariate logistic analysis revealed significant differences between classes in age, AF type, work status, PHQ-9, AFSS-symptoms, and AFSS-burden. In the multivariable logistic regression adjusted for age and sex (logistic outcome: Class 2 vs. Class 1), higher AFSS-burden scores were independently associated with the “Symptom-Helplessness” profile (OR = 1.26, 95% CI: 1.09–1.45, p = 0.001). Conversely, higher PHQ-9 scores were associated with the “Reactive–Minimizing” profile (OR for Symptom-Helplessness = 0.92, 95% CI: 0.86–0.99, p = 0.018).

Conclusion

Person-centered illness perception profiling revealed two distinct cognitive–emotional patterns in patients with AF that were associated with depressive symptoms and symptom burden, highlighting their potential value for individualized psychological and clinical management.

背景：疾病认知与房颤（AF）患者的预后相关。本研究旨在确定房颤患者不同的疾病感知特征，并检查其与心理和身体反应的关系。方法：本研究共纳入150例房颤患者。疾病知觉特征用潜在特征分析（LPA）确定。对模型拟合指标进行评价，确定最优类解。采用Logistic回归分析来检验疾病感知概况与心理和身体结果之间的关系，包括广泛性焦虑障碍-7 （GAD-7）、患者健康问卷-9 （PHQ-9）、12项简短健康调查（SF-12）和多伦多大学房颤严重程度量表（AFSS）。结果：两类模型被确定为最佳模型，包括“反应-最小化”模型（类1,49%）和“症状-无助”模型（类2,51%）。单因素logistic分析显示，不同班级在年龄、房颤类型、工作状态、PHQ-9、afss症状和afss负担方面存在显著差异。在调整了年龄和性别的多变量logistic回归中（logistic结局：2级vs. 1级），较高的afss负担得分与“症状-无助”特征独立相关（OR = 1.26, 95% CI: 1.09-1.45, p = 0.001）。相反，较高的PHQ-9分数与“反应最小化”特征相关（症状无助的OR = 0.92, 95% CI: 0.86-0.99, p = 0.018）。结论：以人为中心的疾病感知分析揭示了AF患者与抑郁症状和症状负担相关的两种截然不同的认知-情绪模式，强调了它们对个体化心理和临床管理的潜在价值。

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引用次数: 0

Preoperative anxiety is associated with postoperative cardiovascular events, extubation delay, and pain in patients undergoing cardiac surgery: A prospective observational study in Taiwan 术前焦虑与心脏手术患者术后心血管事件、拔管延迟和疼痛相关：台湾一项前瞻性观察研究。

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-04-01 Epub Date: 2026-02-04 DOI: 10.1016/j.jpsychores.2026.112576

Siao-Ya Su , Jiin-Ling Jiang , Jui-Chih Chang , Jen-Hung Wang , Malcolm Koo

Objective

Preoperative anxiety is common among patients undergoing cardiac surgery and may influence early postoperative recovery. Evidence linking anxiety to clinically relevant postoperative outcomes remains limited, particularly in non-Western populations. This study examined the association between preoperative anxiety and multiple postoperative outcomes in patients undergoing cardiac surgery in Taiwan.

Methods

In this prospective observational study, 113 adult patients scheduled for elective cardiac surgery were enrolled at a tertiary medical center in Eastern Taiwan. Preoperative anxiety was assessed using the Visual Analogue Scale for Anxiety (VAS-A; 0–10 scale). Outcomes included cardiovascular adverse events and non-arrhythmia-related cardiovascular events within 30 days postoperatively, delayed extubation (≥6 h), and mean 7-day postoperative pain, defined as a Critical-Care Pain Observation Tool score ≥ 2. Associations were evaluated using multivariable Firth's penalized logistic regression. Absolute risk estimates were derived at representative low and high anxiety levels.

Results

Higher preoperative VAS-A scores were independently associated with increased odds of cardiovascular adverse events (adjusted odds ratio [aOR], 1.34), non-arrhythmia-related cardiovascular events (aOR, 1.40), and delayed extubation (aOR, 1.40). The association with mean 7-day postoperative pain approached but did not reach conventional statistical significance after adjustment (aOR, 1.18). Absolute risk estimates demonstrated substantial differences across anxiety levels for all outcomes.

Conclusion

Preoperative anxiety is independently associated with several adverse postoperative outcomes after cardiac surgery. These findings support the potential value of brief preoperative anxiety screening as a pragmatic tool for perioperative risk identification. Further studies are needed to determine whether targeted anxiety management can improve postoperative clinical outcomes.

目的：术前焦虑在心脏手术患者中很常见，并可能影响术后早期恢复。将焦虑与临床相关的术后结果联系起来的证据仍然有限，特别是在非西方人群中。本研究探讨台湾心脏手术患者术前焦虑与术后多项预后的关系。方法：在本前瞻性观察研究中，选取台湾东部某三级医疗中心113例预定择期心脏手术的成人患者。术前焦虑采用视觉模拟焦虑量表（VAS-A； 0-10分）进行评估。结果包括术后30天内心血管不良事件和非心律失常相关心血管事件，延迟拔管（≥6小时），术后平均7天疼痛，定义为危重护理疼痛观察工具评分≥2。使用多变量Firth惩罚逻辑回归评估相关性。绝对风险估计是在具有代表性的低焦虑和高焦虑水平下得出的。结果：术前VAS-A评分较高与心血管不良事件（校正优势比[aOR]， 1.34）、非心律失常相关心血管事件（aOR, 1.40）和延迟拔管（aOR, 1.40）的发生率增加独立相关。调整后，与术后7天平均疼痛的相关性接近但未达到常规统计学意义（aOR, 1.18）。绝对风险评估表明，在所有结果中，焦虑水平之间存在实质性差异。结论：术前焦虑与心脏手术后几种不良预后独立相关。这些发现支持术前短暂焦虑筛查作为围手术期风险识别的实用工具的潜在价值。有针对性的焦虑管理是否能改善术后临床结果还需要进一步的研究。

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引用次数: 0

The association among social participation, loneliness and depression in stroke survivors: A longitudinal cross-lagged panel analysis 脑卒中幸存者社会参与、孤独和抑郁之间的关系：纵向交叉滞后面板分析

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-04-01 Epub Date: 2026-01-21 DOI: 10.1016/j.jpsychores.2026.112553

Liping Sun , Yuexia Liao , Zhi'e Gu , Xiaojuan Wan , Ningning Liu

Objective

To examine longitudinal associations among depressive symptoms, loneliness, and social participation in stroke survivors, and the temporal role of loneliness between social participation and depressive symptoms.

Methods

277 stroke survivors were conveniently sampled from two tertiary hospitals in Yangzhou, China. Depressive symptoms, loneliness, and social participation were assessed using the Patient Health Questionnaire-9, UCLA Loneliness Scale, and Utrecht Scale for Evaluation of Rehabilitation-Participation, respectively. Data were collected at baseline (T1), 3 months (T2), and 6 months (T3) post-stroke, with a cross-lagged panel model used to examine the reciprocal relationships among variables.

Results

Cross-lagged panel analysis revealed: T1 depressive symptoms positively predicted T2 loneliness (β = 0.133, P = 0.046)；T1 social participation negatively predicted T2 loneliness (β = −0.226, P < 0.001) and depressive symptoms (β = −0.256, P < 0.001)；T2 depressive symptoms negatively predicted T3 social participation (β = −0.098, P = 0.027)；T2 loneliness positively predicted T3 depressive symptoms (β = 0.171, P = 0.006)；T2 social participation negatively predicted T3 loneliness (β = −0.174, P = 0.001). Mediation analysis showed T2 loneliness mediated T1 social participation's effect on T3 depressive symptoms (indirect effect = −0.037, 95% CI [−0.082, −0.010]).

Conclusion

Alternating cross-lagged effects were observed among depressive symptoms, loneliness, and social participation in stroke survivors, with loneliness potentially acting as a mediator between social participation and subsequent depressive symptoms. These findings suggest hypotheses for phase-specific interventions, which should be tested in future studies.

目的探讨脑卒中幸存者抑郁症状、孤独感和社会参与之间的纵向关系，以及孤独感在社会参与和抑郁症状之间的时间作用。方法从扬州市两所三级医院抽取277例脑卒中幸存者。抑郁症状、孤独感和社会参与分别采用患者健康问卷-9、UCLA孤独感量表和乌得勒支康复参与评估量表进行评估。在脑卒中后基线（T1）、3个月（T2）和6个月（T3）收集数据，采用交叉滞后面板模型来检验变量之间的倒数关系。结果交叉滞后面板分析显示：T1抑郁症状正预测T2孤独（β = - 0.226, P < 0.001）和抑郁症状（β = - 0.256, P < 0.001）；T2抑郁症状负预测T3社会参与（β = - 0.098, P = 0.027）；T2孤独正预测T3抑郁症状（β = 0.171, P = 0.006）；T2社会参与负预测T3孤独（β = - 0.174, P = 0.001）。中介分析显示T2孤独感介导T1社会参与对T3抑郁症状的影响（间接效应= - 0.037,95% CI[- 0.082, - 0.010]）。结论脑卒中幸存者抑郁症状、孤独感和社会参与之间存在交变滞后效应，孤独感可能在社会参与与随后的抑郁症状之间起中介作用。这些发现提出了针对特定阶段干预措施的假设，这些假设应该在未来的研究中得到检验。

{"title":"The association among social participation, loneliness and depression in stroke survivors: A longitudinal cross-lagged panel analysis","authors":"Liping Sun , Yuexia Liao , Zhi'e Gu , Xiaojuan Wan , Ningning Liu","doi":"10.1016/j.jpsychores.2026.112553","DOIUrl":"10.1016/j.jpsychores.2026.112553","url":null,"abstract":"<div><h3>Objective</h3><div>To examine longitudinal associations among depressive symptoms, loneliness, and social participation in stroke survivors, and the temporal role of loneliness between social participation and depressive symptoms.</div></div><div><h3>Methods</h3><div>277 stroke survivors were conveniently sampled from two tertiary hospitals in Yangzhou, China. Depressive symptoms, loneliness, and social participation were assessed using the Patient Health Questionnaire-9, UCLA Loneliness Scale, and Utrecht Scale for Evaluation of Rehabilitation-Participation, respectively. Data were collected at baseline (T1), 3 months (T2), and 6 months (T3) post-stroke, with a cross-lagged panel model used to examine the reciprocal relationships among variables.</div></div><div><h3>Results</h3><div>Cross-lagged panel analysis revealed: T1 depressive symptoms positively predicted T2 loneliness (<em>β</em> = 0.133, <em>P</em> = 0.046)；T1 social participation negatively predicted T2 loneliness (<em>β</em> = −0.226, <em>P</em> < 0.001) and depressive symptoms (<em>β</em> = −0.256, <em>P</em> < 0.001)；T2 depressive symptoms negatively predicted T3 social participation (<em>β</em> = −0.098, <em>P</em> = 0.027)；T2 loneliness positively predicted T3 depressive symptoms (<em>β</em> = 0.171, <em>P</em> = 0.006)；T2 social participation negatively predicted T3 loneliness (<em>β</em> = −0.174, <em>P</em> = 0.001). Mediation analysis showed T2 loneliness mediated T1 social participation's effect on T3 depressive symptoms (indirect effect = −0.037, 95% <em>CI</em> [−0.082, −0.010]).</div></div><div><h3>Conclusion</h3><div>Alternating cross-lagged effects were observed among depressive symptoms, loneliness, and social participation in stroke survivors, with loneliness potentially acting as a mediator between social participation and subsequent depressive symptoms. These findings suggest hypotheses for phase-specific interventions, which should be tested in future studies.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"203 ","pages":"Article 112553"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015598","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}

引用次数: 0

Distress in postural orthostatic tachycardia syndrome (POTS) is largely driven by ineffective healthcare, not patients' attitudes 体位性心动过速综合征（POTS）的痛苦主要是由无效的医疗保健驱动的，而不是患者的态度

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-04-01 Epub Date: 2026-01-21 DOI: 10.1016/j.jpsychores.2026.112552

Svetlana Blitshteyn , Blair P. Grubb

引用次数: 0

Loneliness and somatic complaints: An experience sampling method study 孤独与躯体抱怨：经验抽样法研究

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-04-01 Epub Date: 2026-01-22 DOI: 10.1016/j.jpsychores.2026.112554

Martine Smeets , Elody Hutten , Peter Verboon , Yvonne Bol , Viviane Thewissen , Ellen M.M. Jongen

Objective

Previous studies have shown a positive relation between retrospectively measured loneliness and somatic complaints. This study investigated the relation between state loneliness and state somatic complaints as well as the direction of this relation in the context of daily life. It was hypothesized that there is a positive contemporaneous association between state loneliness and state somatic complaints as well as a positive bidirectional temporal association.

Methods

Using the Experience Sampling Method, 16 patients with somatic symptom disorder and 27 participants from the general population received a signal on their smartphones 10 times a day for 14 days to fill out an ESM-item on loneliness and two on somatic complaints. To test our hypotheses, multilevel linear regression models with random effects were estimated.

Results

Associations between state loneliness and state somatic complaints in the context of daily life were demonstrated (B = 0.12, SE = 0.01, p < .001). Temporal analyses revealed, however, that state loneliness (t-1) did not predict somatic complaints (t) in daily life (90-min window; B = 0.01, SE = 0.01, p = .573). Neither did state somatic complaints predict state loneliness (B = 0.02, SE = 0.03, p = .534).

Conclusions

This study demonstrated contemporaneous associations between state loneliness and state somatic complaints in the context of daily life. However, state loneliness did not predict subsequent state somatic complaints, nor did state somatic complaints predict subsequent state loneliness. Future studies are necessary to further disentangle the complex relationship between loneliness and somatic complaints.

目的以往的研究表明，回顾性测量的孤独感与躯体抱怨之间存在正相关关系。本研究探讨了状态孤独与状态躯体抱怨的关系，以及这种关系在日常生活中的走向。假设状态孤独与状态躯体抱怨之间存在正相关，同时存在正相关的双向时间关系。方法采用体验抽样法，选取16例躯体症状障碍患者和27例普通人群，在14天内每天10次通过智能手机接收信号，填写一份关于孤独感的esm项目和两份关于躯体抱怨的esm项目。为了检验我们的假设，我们估计了具有随机效应的多水平线性回归模型。结果在日常生活情境下，状态孤独与状态躯体抱怨之间存在相关性（B = 0.12, SE = 0.01, p < 0.001）。然而，时间分析显示，状态孤独（t-1）不能预测日常生活中的躯体抱怨(t)（90分钟窗口；B = 0.01, SE = 0.01, p = .573）。状态躯体抱怨也不能预测状态孤独（B = 0.02, SE = 0.03, p = .534）。结论：本研究证明了日常生活中状态孤独和状态躯体抱怨之间的同步关联。然而，状态孤独并不能预测随后的状态躯体抱怨，状态躯体抱怨也不能预测随后的状态孤独。未来的研究有必要进一步理清孤独与躯体抱怨之间的复杂关系。

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引用次数: 0

Stigma in functional neurological disorder; a longitudinal study 功能性神经障碍的病耻感；纵向研究

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-04-01 Epub Date: 2026-01-20 DOI: 10.1016/j.jpsychores.2026.112550

Caoimhe Mcloughlin , Neil Ramsay , Lineke Tak , Alan Carson , Jon Stone

Background

Stigma in Functional Neurological Disorder has been consistently reported by patient organisations as one of their biggest challenges. We aimed to longitudinally evaluate different components of stigma, namely perceived, internalised (self) and anticipated stigma experienced by patients with FND, and to explore associated factors.

Methods

Participants were mainly recruited prospectively via outpatient clinics at two centres, shortly after communicating the diagnosis. Measures included: perceived, internalised and anticipated stigma, somatic symptom burden, quality of life, depression, anxiety, illness attribution, and experience of care.

Results

Ninety-six respondents completed the baseline survey, of which 80 completed the follow-up (mean duration 7 months). Perceived stigma (Stigma Scale for Chronic Illness-8, mean 21.2) scores were in the moderate range. Regarding internalised stigma, 32% agreed they had considered that FND was their fault. Anticipated stigma was experienced most from work, followed by healthcare, then friends and family. Participants held a balanced view of their condition as physical and psychological in contrast to their perception of others' understanding of FND as psychological – which in turn significantly related to higher stigma scores. Identifying as a man, being in a relationship, higher age and level of education were statistically significantly protective against stigma. At follow up, perceived, self, and anticipated stigma, somatic symptom burden, quality of life, anxiety and depression scores did not change significantly.

Conclusion

People with FND experience high levels of perceived, self and anticipated stigma, and have high rates of physical and psychological comorbidity, which, in this cohort, did not improve over time. Counter-stigma approaches need to consider these different sources of stigma, outside just healthcare professionals.

背景：功能性神经障碍的病耻感一直被患者组织报道为他们最大的挑战之一。我们的目的是纵向评估耻辱感的不同组成部分，即FND患者所经历的感知、内化（自我）和预期的耻辱感，并探讨相关因素。方法研究对象主要是在确诊后不久通过两个中心的门诊进行前瞻性招募。测量包括：感知的、内化的和预期的病耻感、躯体症状负担、生活质量、抑郁、焦虑、疾病归因和护理经历。结果96人完成基线调查，其中80人完成随访（平均随访时间7个月）。感知耻感（慢性疾病耻感量表-8，平均21.2）得分处于中等范围。至于内在化的污名，32%的人认为他们认为FND是他们的错。预期的耻辱最多来自工作，其次是医疗保健，然后是朋友和家人。参与者对自己的身体和心理状况持有平衡的看法，而不是他们认为其他人对FND的理解是心理上的——这反过来又与更高的污名得分显著相关。从统计数据来看，男性身份、恋爱关系、较高的年龄和教育水平都能显著地保护女性免受耻辱感的侵害。在随访中，感知、自我和预期的病耻感、躯体症状负担、生活质量、焦虑和抑郁评分无显著变化。结论FND患者经历了高水平的感知、自我和预期的耻辱感，并且有很高的身体和心理合并症发生率，在本队列中，这些并没有随着时间的推移而改善。反污名方法需要考虑这些不同的污名来源，而不仅仅是医疗保健专业人员。

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引用次数: 0

Change in self-esteem after weight-loss treatment. Alexithymia as a psychological mechanism 减肥治疗后自尊的改变。述情障碍是一种心理机制。

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-04-01 Epub Date: 2026-02-02 DOI: 10.1016/j.jpsychores.2026.112564

Chiara Conti , Martina Camelio , Martina Di Perna , Andrea Carapellotti , Maria Teresa Guagnano , Olivier Luminet , Piero Porcelli

Background

Self-esteem often changes during weight-loss treatment, and these fluctuations play a crucial role in shaping patients' adherence and clinical outcomes. Understanding the psychological factors that predict self-esteem trajectories during treatment-as-usual programs is therefore essential.

Aim

This longitudinal study investigated whether weight change, alexithymia and its facets, psychological distress, and binge-eating disorder predicted self-esteem after a 9-month clinical weight-loss program.

Methods

A consecutive sample of 155 adults with overweight or obesity completed assessments at baseline (T0) and at 9-month follow-up (T1) during standard non-pharmacological weight-loss treatment. Baseline measures included self-esteem (RSES), alexithymia (TAS-20), perceived stress (PSS), depressive symptoms (SDS), and binge-eating symptoms (BES). Percentage of total weight loss (%TWL) was calculated at T1. Hierarchical multiple regression models examined longitudinal predictors of self-esteem at follow-up, controlling for baseline self-esteem.

Results

Difficulty Describing Feelings (DDF) was the only one among the three TAS-20 facets that significantly predicted self-esteem at the 9-month follow-up, showing a negative association independent of weight change and other psychological factors. Percentage of total weight loss (%TWL) and diagnosis of binge eating disorder (BED) were also associated with self-esteem, whereas psychological distress did not show independent effects.

Discussion

DDF emerged as the main factor shaping the changes in self-esteem during weight-loss treatment. This suggests that the ability to articulate emotional experiences plays a central role in supporting positive self-evaluations over time. Enhancing patients' ability to describe emotions could help to consolidate gains in self-esteem.

背景：在减肥治疗过程中，自尊经常发生变化，这些波动在塑造患者的依从性和临床结果中起着至关重要的作用。因此，了解在常规治疗项目中预测自尊轨迹的心理因素是至关重要的。目的：这项纵向研究调查了体重变化、述情障碍及其方面、心理困扰和暴饮暴食症是否预测了9个月临床减肥计划后的自尊。方法：在标准非药物减肥治疗期间，155名超重或肥胖的成人连续样本在基线（T0）和9个月随访（T1）完成评估。基线测量包括自尊（RSES）、述情障碍（TAS-20）、感知压力（PSS）、抑郁症状（SDS）和暴食症状（BES）。计算T1时总减重百分比（%TWL）。层次多元回归模型在随访中检验自尊的纵向预测因子，控制基线自尊。结果：在9个月的随访中，感受描述困难（DDF）是TAS-20三个方面中唯一一个显著预测自尊的方面，表现出独立于体重变化等心理因素的负相关。总体重减轻的百分比（%TWL）和暴食症的诊断（BED）也与自尊有关，而心理困扰没有显示出独立的影响。讨论：DDF成为影响减肥治疗期间自尊变化的主要因素。这表明，随着时间的推移，表达情感体验的能力在支持积极的自我评价方面起着核心作用。增强病人描述情绪的能力有助于巩固自尊。

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引用次数: 0

Cross-sectional survey: Characteristics and associated factors of cancer-related fatigue in patients after glioma surgery 横断面调查：胶质瘤手术后患者癌症相关性疲劳的特征及相关因素

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-04-01 Epub Date: 2026-01-02 DOI: 10.1016/j.jpsychores.2025.112513

Jianfei Han, Jun Wei, Na Li, Yanan Jing, Haizhen Zhang, Hongchao Li

Objective

cancer-related fatigue (CRF) is a common symptom in patients following glioma surgery. This cross-sectional study aimed to determine the prevalence and severity of CRF in this population and to identify its independent associated factors. A pre-specified objective was to compare CRF characteristics between patients with high-grade gliomas (HGG) and low-grade gliomas (LGG).

Methods

Data were collected from 124 postoperative glioma patients using a battery of standardized scales, including the Piper Fatigue Scale (PFS), Memorial Symptom Assessment Scale-Short Form (MSAS-SF), Hospital Anxiety and Depression Scale (HADS), Perceived Social Support Scale (PSSS), and General Self-Efficacy Scale (GSES). CRF was assessed using the 22-item PFS, with a score ≥ 4 defining moderate-to-severe fatigue. Univariate analyses, multivariate logistic regression, and multiple linear regression analyses were employed to identify influencing factors for both the dichotomous and continuous CRF outcomes. A pre-specified subgroup analysis was conducted comparing patients with HGGs (WHO III-IV) and LGGs (WHO I-II). with additional exploratory analysis by IDH mutation status.

Results

HGG patients had a significantly higher incidence of moderate/severe CRF (79.69 % vs. 65.00 %). Multivariate analysis identified independent risk factors: lower education (OR = 2.44, 95 % CI: 1.05–5.68), high tumor grade (OR = 3.69, 95 % CI: 1.26–10.79), preoperative epilepsy (OR = 6.99, 95 % CI: 1.36–35.91), higher symptom distress (OR = 1.27, 95 % CI: 1.12–1.44), lower social support (OR = 0.90, 95 % CI: 0.84–0.97), depression (OR = 1.19, 95 % CI: 1.03–1.38), and lower self-efficacy (OR = 0.87, 95 % CI: 0.78–0.96).

Conclusion

CRF is highly prevalent and severe among postoperative glioma patients, especially in those with HGG. The management of CRF should be a priority in clinical practice, emphasizing early screening and multifaceted interventions targeting psychological state and social support, particularly for high-risk populations such as HGG patients, those with lower socioeconomic status, and tumors in critical functional lobes.

目的肿瘤相关性疲劳（CRF）是胶质瘤手术后患者的常见症状。本横断面研究旨在确定该人群中CRF的患病率和严重程度，并确定其独立的相关因素。预先指定的目的是比较高级别胶质瘤（HGG）和低级别胶质瘤（LGG）患者的CRF特征。方法采用Piper疲劳量表（PFS）、记忆症状评估简易量表（MSAS-SF）、医院焦虑抑郁量表（HADS）、感知社会支持量表（PSSS）和一般自我效能量表（GSES）等标准化量表收集124例胶质瘤术后患者的数据。CRF采用22项PFS进行评估，评分≥4分定义为中度至重度疲劳。采用单因素分析、多因素逻辑回归和多元线性回归分析来确定二分类和连续CRF结果的影响因素。对HGGs （WHO III-IV）和LGGs （WHO I-II）患者进行预先指定的亚组分析。并对IDH突变状态进行探索性分析。结果shgg患者中重度CRF发生率显著高于对照组（79.69% vs. 65.00%）。多因素分析确定独立危险因素：低学历（OR = 2.44, 95% CI: 1.05-5.68）、高肿瘤分级（OR = 3.69, 95% CI: 1.26-10.79）、术前癫痫（OR = 6.99, 95% CI: 1.36-35.91）、较高的症状困扰（OR = 1.27, 95% CI: 1.12-1.44）、较低的社会支持（OR = 0.90, 95% CI: 0.84-0.97）、抑郁（OR = 1.19, 95% CI: 1.03-1.38）、较低的自我效能（OR = 0.87, 95% CI: 0.78-0.96）。结论crf在胶质瘤术后患者中高发且严重，特别是在HGG患者中。CRF的管理应成为临床实践的重点，强调早期筛查和针对心理状态和社会支持的多方面干预，特别是对高危人群，如HGG患者、社会经济地位较低的患者和关键功能叶的肿瘤。

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