Journal of Psychosomatic Research最新文献_第6页

Psychiatric disorders and the burden of chronic gastrointestinal diseases: Evidence from a nationwide cross-sectional study 精神疾病和慢性胃肠道疾病的负担：来自全国横断面研究的证据

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-01-02 DOI: 10.1016/j.jpsychores.2025.112512

Tak Kyu Oh , In-Ae Song

Objectives

Psychiatric disorders are leading contributors to global morbidity. Chronic gastrointestinal (GI) diseases are also highly prevalent. Despite the gut–brain axis theory, large-scale evidence comparing the burden of functional versus organic GI diseases across diverse psychiatric conditions is scarce. We aimed to evaluate the prevalence odds of chronic GI disorders—categorized into functional, organic, and hepatobiliary–pancreatic (HBP) diseases—among adults with psychiatric disorders compared with matched controls.

Methods

We performed a nationwide cross-sectional study using South Korea's National Health Insurance Service database. Adults aged ≥18 years with at least one psychiatric diagnosis between 2021 and 2022 were included (n = 526,918). A control cohort without psychiatric diagnoses (n = 473,082) was selected. After 1:1 propensity score matching, 348,304 individuals remained in each group.

Results

In the matched cohort (n = 696,608), patients with psychiatric disorders had a significantly higher prevalence of total chronic GI disorders (69.8 % vs 52.1 %; odds ratio [OR] 2.13, 95 % confidence interval [CI] 2.11–2.15; P < 0.001). The magnitude of association was strongest for functional GI disorders (OR 2.12, 95 % CI 2.10–2.14; P < 0.001), followed by organic GI disorders (OR 1.60, 95 % CI 1.57–1.63; P < 0.001) and HBP diseases (OR 1.43, 95 % CI 1.41–1.46; P < 0.001).

Conclusion

Psychiatric disorders are associated with a substantial burden of chronic GI diseases. The association was markedly stronger for functional GI disorders than for organic conditions, supporting the clinical significance of the gut–brain axis in this population.

目的精神疾病是全球发病率的主要原因。慢性胃肠（GI）疾病也非常普遍。尽管存在肠-脑轴理论，但比较不同精神状况下功能性和器质性胃肠道疾病负担的大规模证据很少。我们的目的是评估慢性胃肠道疾病（分为功能性、器质性和肝胆胰（HBP）疾病）在患有精神疾病的成年人中与匹配对照组相比的患病率。方法我们使用韩国国民健康保险服务数据库进行了一项全国性的横断面研究。年龄≥18岁且在2021年至2022年间至少有一次精神诊断的成年人被纳入研究（n = 526,918）。选取无精神病诊断的对照队列（n = 473,082）。在1:1的倾向得分匹配后，每组仍有348,304人。结果在匹配的队列中（n = 696,608），精神障碍患者的总体慢性胃肠道疾病患病率明显更高（69.8% vs 52.1%；优势比[OR] 2.13, 95%可信区间[CI] 2.11-2.15; P < 0.001）。相关性最强的是功能性胃肠道疾病（OR 2.12, 95% CI 2.10-2.14; P < 0.001），其次是器质性胃肠道疾病（OR 1.60, 95% CI 1.57-1.63; P < 0.001）和高血压疾病（OR 1.43, 95% CI 1.41-1.46; P < 0.001）。结论精神疾病是慢性胃肠道疾病的重要负担。与器质性疾病相比，功能性GI疾病的相关性明显更强，这支持了肠脑轴在该人群中的临床意义。

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引用次数: 0

Network analysis of fear of progression, anxiety, and depression in parents of children with malignant solid tumors: A cross-sectional study 恶性实体瘤患儿父母对进展、焦虑和抑郁的恐惧网络分析：一项横断面研究。

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-01-02 DOI: 10.1016/j.jpsychores.2025.112516

Yiming Gao , Xiaohe Lin, Xiaona Shen, Xiangyu Zhao, Di Zhao, Ping Li

Objective

Fear of progression (FoP), anxiety, and depression are common emotional distresses for parents of children with cancer, but yet these concerns often lack attention. This study explored the network connections between FoP, anxiety, and depression in parents of children with malignant solid tumors.

Methods

This study that included 447 parents of children with malignant solid tumors. All participants completed the Fear of Progression Questionnaire-parent version (FoP-Q-SF/PR), the 2-item Generalize Anxiety Disorder Scale (GAD-2) and the 2-item Patient Health Questionnaire (PHQ-2). We estimated two network models: regularized partial correlation network and Bayesian Directed Acyclic Graph (DAG).

Results

The regularized partial correlation network demonstrated a correlation between FoP, anxiety, and depressive symptoms, with a stronger association observed between anxiety and depression. The results of the Network Centrality Indicator showed that the top three symptoms in terms of expected impact (EI) were “fear of major treatment”, “life anxiety”, and “feeling tense, anxious, or eager”. The DAG showed that the symptoms of FoP activated each other, which in turn activated anxiety and depressive symptoms. In particular, “fear of major treatment” was at the top of the DAG and therefore has the highest predictive priority in the network.

Conclusion: “Fear of major treatment” was a core symptom in the regularized partial correlation network and an upstream symptom in the DAG. The findings suggest that strengthening health education, building confidence in overcoming the disease, and reinforcing positive coping may help to improve negative emotions in parents of children with malignant solid tumors.

目的：恐惧进展（FoP）、焦虑和抑郁是癌症儿童父母常见的情绪困扰，但这些担忧往往缺乏关注。本研究探讨了恶性实体瘤患儿家长的FoP、焦虑和抑郁之间的网络联系。方法：本研究纳入447例恶性实体瘤患儿家长。所有参与者均完成了进展恐惧问卷-家长版（FoP-Q-SF/PR）、2项广泛性焦虑障碍量表（GAD-2）和2项患者健康问卷（PHQ-2）。我们估计了两种网络模型：正则化部分相关网络和贝叶斯有向无环图（DAG）。结果：正则化的部分相关网络显示了FoP、焦虑和抑郁症状之间的相关性，其中焦虑和抑郁之间的相关性更强。网络中心性指标（Network Centrality Indicator）结果显示，预期影响（EI）前三名的症状分别是“害怕重大治疗”、“生活焦虑”和“感到紧张、焦虑或渴望”。DAG显示，FoP的症状相互激活，进而激活焦虑和抑郁症状。特别是，“对重大治疗的恐惧”位于DAG的顶部，因此在网络中具有最高的预测优先级。结论：“对重大治疗的恐惧”是正则化部分相关网络的核心症状，是DAG的上游症状。研究结果提示，加强健康教育，树立战胜疾病的信心，加强积极应对，可能有助于改善恶性实体瘤患儿家长的负面情绪。

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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 : 2026-01-02 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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引用次数: 0

Family emotional climate, depressive symptoms, and pain prevalence: Testing mediation pathways among midlife and older Black Americans 家庭情绪气候、抑郁症状和疼痛患病率：在中年和老年美国黑人中测试调解途径

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-12-31 DOI: 10.1016/j.jpsychores.2025.112509

Sarah B. Woods , Bhaskar Thakur , Staja Booker , Beatrice Wood , Patricia N.E. Roberson

Objective

Family relationship quality has been linked to pain outcomes, recently for aging Black adults, yet possible mechanisms of effect remain heretofore untested. Guided by the Biobehavioral Family Model, this study tested whether depressive symptoms mediate prospective associations between family emotional climate and pain prevalence, and whether associations are moderated by baseline chronic pain status.

Methods

We tested hypothesized associations among Black American participants of the nationally representative Midlife in the United States study (second [2004–2006] and third [2013–2015] waves) who reported on pain prevalence (N = 471; 65.2 % women; μ[age] = 50.45), using mediation and moderated mediation models.

Results

Greater family strain was linked to a greater likelihood of chronic pain 10 years later via greater depressive symptoms. Greater family support was associated with a decreased likelihood of chronic pain via decreased depressive symptoms. Baseline chronic pain status moderated this indirect effect via its moderation of the direct link between family support and depressive symptoms, such that this effect was significantly stronger for individuals reporting baseline chronic pain.

Conclusion

Depression is well-supported as a chronic pain antecedent. This study provides initial evidence it may also serve as a mutable mechanism linking family emotional climate to pain for aging Black Americans. Primary care-based assessments of family emotional climate to intervene on family strain while mitigating depressive symptoms which reflect chronic strain may be pain-protective. Interventions may also benefit from enhancing family support especially for patients experiencing chronic pain. Additional within-group, longitudinal research is needed to further support the tested mechanism.

目的家庭关系质量与疼痛结果有关，最近对老年黑人成年人来说，但可能的影响机制迄今尚未得到检验。在生物行为家庭模型的指导下，本研究测试了抑郁症状是否介导家庭情绪气候与疼痛患病率之间的前瞻性关联，以及这种关联是否被基线慢性疼痛状态所调节。方法采用中介和调节中介模型，对美国具有全国代表性的中年研究（第二波[2004-2006]和第三波[2013-2015]）中报告疼痛患病率的美国黑人参与者（N = 471, 65.2%为女性，年龄= 50.45）的假设关联进行检验。结果：家庭压力越大，10年后抑郁症状越严重，患慢性疼痛的可能性越大。更多的家庭支持通过减少抑郁症状而降低慢性疼痛的可能性。基线慢性疼痛状态通过调节家庭支持和抑郁症状之间的直接联系来调节这种间接影响，因此这种影响对报告基线慢性疼痛的个体显着更强。结论抑郁是慢性疼痛的前因。这项研究提供了初步证据，它也可能作为一种可变机制，将家庭情感气候与老年美国黑人的痛苦联系起来。以初级保健为基础的家庭情绪气候评估，干预家庭紧张，同时减轻反映慢性紧张的抑郁症状，可能具有疼痛保护作用。干预措施也可能受益于加强家庭支持，特别是对患有慢性疼痛的患者。需要进一步的组内纵向研究来进一步支持已测试的机制。

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引用次数: 0

Risk factors for fatigue symptoms in the general population over 7 years: Findings from the Cooperative Health Research in the Region of Augsburg F4 and FF4 studies 7岁以上普通人群疲劳症状的危险因素：来自奥格斯堡地区合作卫生研究F4和FF4研究的结果

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-12-31 DOI: 10.1016/j.jpsychores.2025.112511

Seryan Atasoy , Heribert Sattel , Constanze Hausteiner-Wiehle , Ina-Maria Rückert-Eheberg , Birgit Linkohr , Margit Heier , Karl-Heinz Ladwig , Annette Peters , Peter Henningsen

Background

To examine sex-specific risk factors of elevated fatigue symptoms over 7 years in a large community cohort.

Methods

Data were drawn from 1700 adults (52.3 % women; mean age = 49.6 ± 9.4 years) participating in the KORA F4 study and its 7-year follow-up (FF4) in Augsburg, Germany. Fatigue symptoms (0−12) were assessed at both time points using four items from the Depression and Exhaustion Scale. Sex-stratified generalized estimating equation (GEE) models examined associations with sociodemographic, behavioural, medical (BMI, medical illness, hemoglobin, C-reactive protein, thyroid-stimulating hormone [TSH], Epstein–Barr virus), psychological (depression, anxiety, childhood trauma), and bodily distress factors (somatization, self-rated health, pain, sleep complaints).

Results

Women reported significantly higher fatigue levels than men at both assessments. Cross-sectionally, higher baseline fatigue was associated with physical inactivity, medical illness, and multiple psychological and bodily distress factors. Several associations differed descriptively by sex: psychological distress and medical utilization showed stronger links in women, whereas sociodemographic factors and selected biomarkers were more relevant in men. Longitudinally, fatigue levels were stable over the follow-up, with baseline fatigue emerging as the main predictor of subsequent fatigue (men: OR = 1.65[1.55–1.77]; women: OR = 1.72 [1.59–1.86]). Physical inactivity and somatization predicted fatigue in both sexes. Depression symptoms, childhood trauma, and lower TSH predicted fatigue only in women, whereas sleep complaints were uniquely predictive in men. Medical measures showed limited value.

Conclusion

Baseline fatigue was linked to behavioural, medical, and psychosocial risk profiles, while longitudinal analyses revealed distress and prior fatigue as the key predictors of elevated fatigue symptoms over time.

背景：在一个大型社区队列中研究7年来疲劳症状升高的性别特异性危险因素。方法数据来自德国奥格斯堡参加KORA F4研究及其7年随访（FF4）的1700名成年人（52.3%为女性，平均年龄= 49.6±9.4岁）。使用抑郁和疲惫量表中的四个项目在两个时间点评估疲劳症状（0 - 12）。性别分层广义估计方程（GEE）模型研究了与社会人口学、行为、医学（BMI、医学疾病、血红蛋白、c反应蛋白、促甲状腺激素[TSH]、eb病毒）、心理（抑郁、焦虑、童年创伤）和身体困扰因素（躯体化、自评健康、疼痛、睡眠抱怨）的关联。结果在两项评估中，女性报告的疲劳程度明显高于男性。横断面上，较高的基线疲劳与缺乏身体活动、医疗疾病以及多种心理和身体痛苦因素有关。一些关联在描述上因性别而异：心理困扰和医疗利用在女性中表现出更强的联系，而社会人口因素和选定的生物标志物在男性中更为相关。纵向上，疲劳水平在随访期间保持稳定，基线疲劳成为后续疲劳的主要预测因子（男性：OR = 1.65[1.55-1.77]；女性：OR = 1.72[1.59-1.86]）。缺乏运动和躯体化预示着男女都会感到疲劳。抑郁症状、童年创伤和较低的TSH仅在女性中预测疲劳，而睡眠抱怨在男性中是唯一的预测因素。医疗措施的作用有限。结论：基线疲劳与行为、医学和社会心理风险概况有关，而纵向分析显示，随着时间的推移，痛苦和先前的疲劳是疲劳症状加剧的关键预测因素。

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引用次数: 0

Impact of somatic comorbidities on mortality rates and clinical progression of unipolar depression: A 10-year prospective study with depressed inpatients 躯体合并症对单极抑郁症死亡率和临床进展的影响：一项针对住院抑郁症患者的10年前瞻性研究

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-12-30 DOI: 10.1016/j.jpsychores.2025.112510

Bruno Perosa Carniel , Luísa Monteiro Burin , Giulio Bertollo Alexandrino , Pedro Henrico Grazziotin Portal , Marina Ribeiro de Matos , Graziella Nunes Peixoto , Neusa Sica da Rocha

Introduction

Somatic comorbidities and unipolar depression (UD) are frequent comorbidities and can lead to some diseases being overlooked, complicating treatment and recovery. Patients with UD die on average more than 10 years younger than those in the overall population. No study has evaluated the association between somatic comorbidities and mortality in the progression of UD using a clinical staging model. We assessed the prevalence of somatic comorbidities in a sample of inpatients with UD at different stages of progression and the mortality rates after a 10-year follow-up, identifying the underlying causes and predictors of mortality.

Methods

Longitudinal study with 151 inpatients with UD, evaluated at hospital admission and 10 years after discharge. The UD progression was assessed using the clinical staging model of UD. The t-test and chi-square test were used to compare the groups' survival and mortality rates. A multivariable Poisson regression model with robust variance estimation was used to evaluate mortality risk and predictors.

Results

Of the 151 patients, 28 (19 %) died after 10 years of follow-up. The most frequent underlying cause of death was cardiovascular diseases (32 %). Somatic comorbidities were more prevalent in the residual (67 %) and recurrent (71 %) stages of UD. Age (p = 0.000) and the number of somatic comorbidities (p = 0.000) were predictors of mortality.

Conclusions

The majority of patients exhibited somatic comorbidities, which were more prevalent in the residual and recurrent stages of UD. Somatic diseases, especially cardiovascular diseases, were the leading causes of underlying mortality. Moreover, the number of comorbidities significantly predicted mortality among inpatients with UD.

躯体合并症和单极抑郁症（UD）是常见的合并症，可导致一些疾病被忽视，使治疗和康复复杂化。UD患者的平均死亡年龄比总体人群的平均死亡年龄小10岁以上。没有研究使用临床分期模型评估UD进展中躯体合并症与死亡率之间的关系。我们评估了处于不同进展阶段的UD住院患者样本中躯体合并症的患病率，以及10年随访后的死亡率，确定了潜在的原因和死亡率的预测因素。方法对151例住院UD患者进行纵向研究，在入院时和出院后10年进行评估。采用UD临床分期模型评估UD的进展情况。采用t检验和卡方检验比较各组的生存率和死亡率。采用稳健方差估计的多变量泊松回归模型评估死亡风险和预测因素。结果151例患者中，28例（19%）在随访10年后死亡。最常见的潜在死亡原因是心血管疾病（32%）。躯体合并症在UD的残留期（67%）和复发期（71%）更为普遍。年龄（p = 0.000）和躯体合并症数量（p = 0.000）是死亡率的预测因子。结论大多数患者存在躯体合并症，在UD的残余期和复发期更为普遍。躯体疾病，特别是心血管疾病，是潜在死亡的主要原因。此外，合并症的数量显著预测住院UD患者的死亡率。

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引用次数: 0

The protective role of resilience in mitigating psychological distress in inflammatory bowel diseases: A critical review 恢复力在减轻炎症性肠病心理困扰中的保护作用：一项重要综述。

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-12-26 DOI: 10.1016/j.jpsychores.2025.112507

Khairiyah Khadijah , Rizky Andana Pohan , Ririn Dwi Astuti

引用次数: 0

A cross sectional study of post-concussion symptoms following mild traumatic brain injury in an Asian population: Influence of negative mental states and somatic features 亚洲人群轻度外伤性脑损伤后脑震荡症状的横断面研究：消极精神状态和躯体特征的影响

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-12-26 DOI: 10.1016/j.jpsychores.2025.112492

Simon L. Collinson , Nicole Chen , Kathryn Ponniah , Ray Chua , Annette Chen , Ang Beng Ti

Objective

Persistent post-concussion symptoms resulting from a mild traumatic brain injury that typically last longer than three months may stem from a complex interaction of neurological and psychological factors, particularly negative mental states. Negative mental states including pessimism and depression are associated with post-concussion phenomena may be highly pertinent to Asian societies. The objective of this study was to examine the respective influences of culture specific psychological factors in the presentation of post-concussion symptoms.

Method

We examined the relationship between somatisation, depression and pessimism in 83 Asian mild traumatic brain injury (mTBI) outpatients and found depression levels, including cognitive/affective depression and somatic depression sub-factors, were significantly greater in patients with moderate or severe symptoms.

Results

Somatic depression was the best predictor of the severity of post-concussion symptoms especially in individuals who were more pessimistic.

Conclusion

The findings highlight negative mental states and cultural differences in the manifestation of post-concussion symptoms that should inform both clinical assessment and intervention for persistent PCS.

目的：轻度外伤性脑损伤引起的持续性脑震荡后症状通常持续3个月以上，可能是神经和心理因素复杂相互作用的结果，尤其是消极的精神状态。包括悲观和抑郁在内的消极精神状态与脑震荡后的现象有关，这可能与亚洲社会高度相关。本研究的目的是探讨文化特定心理因素在脑震荡后症状表现中的各自影响。方法：我们对83例亚洲轻度创伤性脑损伤（mTBI）门诊患者的躯体化、抑郁和悲观情绪之间的关系进行了研究，发现抑郁水平，包括认知/情感抑郁和躯体抑郁亚因素，在中度或重度症状患者中显著更高。结果：躯体抑郁是脑震荡后症状严重程度的最佳预测因子，特别是在悲观的个体中。结论：研究结果强调了消极的精神状态和文化差异在脑震荡后症状的表现，应为持续性PCS的临床评估和干预提供信息。

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引用次数: 0

Does symptom perception after negative affect induction differ between physically ill and healthy individuals? An experimental study within SOMA.CK 负性情绪诱导后的症状知觉在身体疾病和健康个体之间是否有差异？SOMA.CK的实验研究。

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-12-24 DOI: 10.1016/j.jpsychores.2025.112508

Birte Jessen , Christian Schmidt-Lauber , Tobias B. Huber , Bernd Löwe , Omer Van den Bergh , Michael Witthöft , Meike Shedden-Mora

Introduction

Symptom perception is highly subjective and shaped by complex biopsychosocial factors. This study examined whether negative affect induction using the Affect and Symptoms Paradigm (ASP) influences symptom perception in patients with non-dialysis chronic kidney disease (ND-CKD) and healthy controls.

Methods

Participants watched three picture series (positive, negative, neutral) from the International Affective Picture System (IAPS). After each series, participants rated symptom levels (10-item-symptom-checklist), affective state (Positive and Negative Affect Schedule) and arousal (Self-Assessment-Manikin-System). Associations of the ASP effect with symptom burden at 6 and 12 months was analysed in the CKD group.

Results

In N = 115 individuals with ND-CKD from the SOMA.CK study (mean age = 62.95, SD = 12.60) and 100 age- and sex-matched healthy controls (mean age = 60.00, SD = 12.80) negative pictures significantly increased negative affectivity and arousal. Symptom levels were higher after viewing negative versus positive/neutral pictures in both groups, but no significant interaction emerged, indicating a comparable response in both groups. Habitual symptoms did not moderate symptom levels after affect induction, although high habitual symptom reporters showed higher symptom levels across all picture categories. In the CKD group difficulties in identifying feelings moderated symptom levels after affect induction. The ASP effect predicted CKD-specific symptom burden at 6 months.

Conclusion

Negative affect induction increases symptom levels in a chronic illness such as CKD. These results align with the predictive processing model which suggests that symptom perception develops from a complex inferential process of somatosensory input in light of pre-existing symptom representations in memory.

症状感知是高度主观的，受复杂的生物、心理和社会因素的影响。本研究利用情绪与症状范式（ASP）研究了负面情绪诱导是否会影响非透析慢性肾病（ND-CKD）患者和健康对照者的症状感知。方法：被试观看国际情感图片系统（IAPS）中的三组图片（积极、消极、中性）。每个系列结束后，参与者对症状水平（10项症状检查表）、情感状态（积极和消极影响表）和觉醒（自我评估-曼尼金系统）进行评分。分析慢性肾病组6个月和12个月时ASP效应与症状负担的关系。结果：N = 115例来自SOMA的ND-CKD患者。CK研究（平均年龄= 62.95,SD = 12.60）和100名年龄和性别匹配的健康对照（平均年龄= 60.00,SD = 12.80）的负面图片显著增加了负面情绪和唤醒。两组在观看消极图片后的症状水平均高于观看积极/中性图片后的症状水平，但没有出现显著的相互作用，表明两组的反应具有可比性。虽然高习惯症状报告者在所有图片类别中表现出更高的症状水平，但在影响诱导后，习惯症状没有调节症状水平。在CKD组中，情感识别的困难缓和了情感诱导后的症状水平。ASP效应预测6个月时ckd特异性症状负担。结论：负面情绪诱导增加慢性疾病如慢性肾病的症状水平。这些结果与预测加工模型一致，该模型表明，症状知觉是根据记忆中预先存在的症状表征，从躯体感觉输入的复杂推理过程发展而来的。

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引用次数: 0

Factors influencing excessive daytime sleepiness in obstructive sleep apnea: A retrospective cohort analysis integrating psychological assessment with polysomnography 影响阻塞性睡眠呼吸暂停患者日间过度嗜睡的因素：一项综合心理评估和多导睡眠图的回顾性队列分析。

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-12-24 DOI: 10.1016/j.jpsychores.2025.112502

Tuzhi Wang, Guoliang Peng, Kaiqi Huang, Hongyao Li, Yushan Chen, Xiaotao Zhang, Jiyang Pan

Objective

This study aimed to systematically evaluate psychological and polysomnographic parameters to analyze factors influencing excessive daytime sleepiness (EDS) in patients with obstructive sleep apnea (OSA).

Methods

We conducted a retrospective study of 318 adult OSA patients from a tertiary hospital sleep center. Participants underwent overnight polysomnography and completed questionnaires including the Epworth Sleepiness Scale (ESS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Mood Disorder Questionnaire (MDQ). Statistical analyses involved univariate and multivariable logistic regression, with dose-response relationships assessed using restricted cubic splines.

Results

Among 318 OSA patients, 95 (29.9 %) had EDS (ESS >10). The EDS group showed significantly higher PHQ-9, GAD-7, and MDQ scores (all p < 0.05). Polysomnography revealed that EDS patients exhibited longer total sleep time, shorter wake after sleep onset, higher apnea-hypopnea index (AHI), elevated AHI during rapid eye movement sleep, and reduced lowest oxygen saturation. After adjusting for confounders, multivariable analysis identified PHQ-9 scores (OR = 1.12, 95 %CI:1.06–1.18), MDQ scores (OR = 1.16, 95 %CI:1.06–1.27), and respiratory arousal index (OR = 1.03, 95 %CI:1.01–1.05) as independent risk factors for EDS, all demonstrating significant positive linear dose-response relationships.

Conclusion

Our findings indicate that depressive symptoms, subclinical affective instability, and respiratory arousals are independently associated with EDS in OSA patients, with clear dose-response relationships. These results suggest that a multifactorial framework encompassing both psychological and physiological domains may be a valuable direction for understanding EDS, and warrant future investigation into the clinical value of integrated assessments.

目的：本研究旨在系统评价阻塞性睡眠呼吸暂停（OSA）患者的心理及多导睡眠图参数，分析影响患者日间过度嗜睡（EDS）的因素。方法：对某三级医院睡眠中心318例OSA患者进行回顾性研究。参与者接受了夜间多导睡眠检查，并完成了包括Epworth嗜睡量表（ESS）、患者健康问卷-9 （PHQ-9）、广泛性焦虑障碍问卷-7 （GAD-7）和情绪障碍问卷（MDQ）在内的调查问卷。统计分析包括单变量和多变量逻辑回归，使用限制三次样条评估剂量-反应关系。结果：318例OSA患者中，95例（29.9%）发生EDS （ESS 2010）。结论：我们的研究结果表明，抑郁症状、亚临床情感不稳定和呼吸觉醒与OSA患者的EDS独立相关，且存在明显的剂量-反应关系。这些结果表明，一个包括心理和生理领域的多因素框架可能是理解EDS的一个有价值的方向，并保证未来对综合评估的临床价值进行研究。

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