Journal of Psychosomatic Research最新文献

Persistent somatic symptoms (PSS) are common in primary care and often associated with functional impairment, dissatisfaction with medical care, and high societal costs. In the Netherlands, a strong primary care system has provided fertile ground for the development of a comprehensive approach to PSS, including evidence-based guidelines, stepped care pathways, and national patient information resources. This Editorial describes how PSS care is organized in the Dutch health system, the evolution of terminology and clinical concepts, the role of coordinators of PSS care in primary, secondary, and tertiary care, and the integration of psychosomatic interventions within this care. We highlight system innovations such as Thuisarts.nl (i.e. GPinfo.nl), a national, evidence-based patient information platform aligned with Dutch general practice guidelines, national care standards and regional collaborative care networks, reflect on implementation challenges, and describe the Dutch approach. The Dutch experience illustrates that PSS care can be coherently organized when anchored in general practice and supported by national guidance, patient information, psychosomatic and allied interventions, and collaborative networks. Remaining challenges include embedding consultation skills in training, ensuring equitable access, measuring patient-valued outcomes, and aligning system incentives to sustain implementation.

Background: Depressive disorders and asthma frequently co-occur in adolescence, but global co-patterning and shared population-level risk signals remain unclear.

Methods: Using Global Burden of Disease (GBD) 2021 estimates for ages 10-19 years (1990-2021), we characterized global and China-specific trends and sex disparities in incidence, prevalence, and disability-adjusted life years (DALYs) using joinpoint regression. We constructed a 2021 incidence-quartile co-occurrence typology, estimated typology-stratified coupling (Spearman rank correlation coefficient, ρ) using pooled country-year observations (1990/2000/2011/2021), prioritized shared summary exposure value (SEV) correlates using Shapley additive explanations (SHAP)-informed multiclass random forests and negative binomial models, and evaluated bidirectional genetic directionality using two-sample Mendelian randomization (MR).

Results: The burden of depressive disorders remained broadly stable but started to increase from 2019 onward, with persistent female excess. Asthma DALY rates declined overall, whereas incidence and prevalence were largely stable globally, with modest recent increases in North America. In 2021, typology membership showed marked income gradients and positive within-typology coupling (ρ = 0.408-0.925). Ambient particulate matter ≤2.5 μm (PM2.5) and household air pollution from solid fuels were consistently prioritized as shared ecological correlates and showed marked socioeconomic gradients. Two-sample MR supported a modest depressive disorders-to-asthma signal (inverse-variance weighted (IVW) odds ratio (OR) = 1.18, 95% confidence interval (CI) 1.02-1.36), whereas reverse-direction estimates were weaker and more heterogeneous.

Conclusions: Adolescent depressive disorders and asthma exhibit divergent long-term trajectories but cluster into income-patterned co-occurrence typologies with shared ecological risk signals. These findings reflect population-level correlates and do not directly estimate intervention or policy effects.

Objective: Inflammation contributes to the bidirectional relationship between depression and coronary artery disease (CAD). However, the impact of group psychotherapy on inflammatory levels in CAD patients with comorbid depression has not been elucidated.

Methods: A total of 337 patients (average age 59.2 years ±9.4, 80.4% male) from the SPIRR-CAD trial provided results of questionnaires and inflammatory data at baseline (T₀) and the 18-month follow-up (T₃) of a group psychotherapy program, with a maximum of 25 sessions vs. usual care.

Results: At baseline, inflammatory parameters were elevated for high-sensitivity C-reactive protein (hsCRP) in 41.2%, tumor necrosis factor-α (TNF-α) in 33.2% and interleukin-6 (IL-6) in 21.1% of all patients. From T₀ to T₃, prevalences of elevated hsCRP (p = .027), TNF-α (p = .013) and depression scores (measured with the Hamilton Depression Rating-Scale; (p = .002) significantly decreased in all patients. Additionally, an inflammatory factors score (IFS), calculated from the inflammatory parameters showed a significant decrease between T₀ and T₃ (p = .046) in all patients. A blockwise multivariate logistic regression analysis revealed a 4.59-fold higher chance of IFS reduction (or stable low values) for patients with a higher number (10-25) of group psychotherapy sessions (OR = 4.59, 95% CI: 1.39-15.1, p = .012) compared to patients with 1-9 sessions, even after adjusting for comorbidities or pharmacological antidepressant treatment.

Conclusion: This analysis demonstrates a significant impact of group psychotherapy sessions on IFS changes in CAD patients with persistently elevated depression scores. Beyond the influence of the absence of diabetes mellitus, a higher number of group psychotherapy sessions reduces the risk of inflammatory burden.