Journal of Psychosomatic Research最新文献_第6页

The role of self-efficacy and tangible support in managing depression in fibromyalgia: Expanding social support strategies 自我效能感和有形支持在控制纤维肌痛抑郁中的作用：扩展社会支持策略

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-21 DOI: 10.1016/j.jpsychores.2024.111964

Ajeng Ayu Widiastuti , Adi Atmoko , Nur Eva , Henni Anggraini , Aryudho Widyatno , Riza Amalia , Beny Dwi Pratama

引用次数: 0

Most people do not attribute their burnout symptoms to work 大多数人不会把自己的职业倦怠症状归咎于工作。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-21 DOI: 10.1016/j.jpsychores.2024.111962

Renzo Bianchi , Elin Lindsäter , Tonje Erevik Vollan , Rune Tesaker , Håkon Homme Mathisen , Sigrid Hovdal Øyangen , Benjamin Ek , Una Wen Bø , Emilie Sofie Eilertsen , Tonje Hauglie-Hanssen , Jenny Sofie Hunvik , Maja Hansen Rasul , Irvin Sam Schonfeld

A prevailing belief among researchers is that burnout is a work-specific syndrome induced by intractable job stress. The validity of this belief, however, remains unclear. This cross-sectional study compared burnout with two general conditions, nonspecific psychological distress (NSPD) and exhaustion, in terms of (a) causal attributions to work and (b) associations with 11 job variables (e.g., job satisfaction). The study involved 813 individuals employed in Norway (70.5 % female). Burnout was assessed with the Burnout Assessment Tool; NSPD, with the K6; and exhaustion, with the Karolinska Exhaustion Disorder Scale. Results showed that only 27.7 % of participants with burnout symptoms attributed these symptoms to work. The proportions of individuals ascribing their symptoms to work were similar for NSPD (26.9 %) and exhaustion (27.5 %). The higher one's burnout score, the higher the likelihood of attributing one's burnout, NSPD, and exhaustion symptoms to work. Overall, burnout shared more variance with job variables than did NSPD and exhaustion. Coworker support, job security, and job autonomy constituted notable exceptions. In multiple regression analyses, seven of the 11 job variables predicted NSPD; five predicted burnout and exhaustion. An a posteriori analysis of a nationally balanced quota sample of 591 U.S. employees (48.2 % female) replicated our main finding—only 35.9 % of participants attributed their burnout symptoms to work. This study invites stakeholders to exercise more caution when making etiological inferences about burnout. Assuming that symptoms experienced at work are necessarily caused by work may hinder our ability to mitigate these symptoms. Our findings further question work-centric views of burnout.

研究人员普遍认为，职业倦怠是一种由难以承受的工作压力诱发的工作综合症。然而，这种观点的正确性仍不明确。这项横断面研究比较了职业倦怠与非特异性心理困扰（NSPD）和精疲力竭这两种一般情况在（a）对工作的因果归因和（b）与 11 个工作变量（如工作满意度）之间的关联。这项研究涉及在挪威工作的813人（70.5%为女性）。倦怠感通过倦怠感评估工具进行评估；NSPD通过K6进行评估；精疲力竭则通过卡罗林斯卡精疲力竭障碍量表进行评估。结果显示，只有 27.7% 有职业倦怠症状的参与者将这些症状归咎于工作。将自己的症状归因于工作的人数比例，在 NSPD（26.9%）和精疲力竭（27.5%）方面相似。职业倦怠得分越高，将自己的职业倦怠、NSPD 和疲惫症状归因于工作的可能性就越大。总体而言，工作倦怠与工作变量之间的差异要大于 NSPD 和精疲力竭。同事支持、工作安全感和工作自主性是明显的例外。在多元回归分析中，11 个工作变量中有 7 个预测了 NSPD，5 个预测了职业倦怠和精疲力竭。对 591 名美国雇员（48.2% 为女性）的全国均衡配额样本进行的后验分析重复了我们的主要发现--只有 35.9% 的参与者将其职业倦怠症状归因于工作。这项研究提醒相关人员在对职业倦怠进行病因学推断时要更加谨慎。假设在工作中出现的症状一定是由工作引起的，可能会妨碍我们减轻这些症状的能力。我们的研究结果进一步质疑了以工作为中心的职业倦怠观点。

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引用次数: 0

Childhood maltreatment, cognitive performance, and cognitive decline in middle-aged and older adults with chronic disease: A prospective study 患有慢性疾病的中老年人的童年虐待、认知表现和认知能力下降：一项前瞻性研究。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-21 DOI: 10.1016/j.jpsychores.2024.111965

Ann Xiuli Chicoine , Howard Chertkow , Jean-Claude Tardif , David Busseuil , Bianca D'Antono

Objectives

Childhood maltreatment (CM) may increase the risk for cognitive deficits and dementia later in life. However, most research has been cross-sectional in nature, has typically focused on specific types of CM, and rarely examined individual differences. The objectives are to evaluate 1) if CM predicts poorer cognitive performance and greater cognitive decline over a 5-year follow-up in older men and women with coronary artery disease (CAD) or other non-cardiovascular (non-CVD) chronic disease, and whether 2) sex and CAD status influence these relations.

Methods

Men and women (N = 1254; 39.6 % women; 65.6 ± 7.0 years old) with CAD or other non-CVD chronic diseases completed the Childhood Trauma Questionnaire Short Form (CTQ-SF). The Montreal Cognitive Assessment (MoCA) was administered twice at 5-year intervals. Main analyses included bivariate correlations, hierarchical analyses and moderation analyses controlling for sociodemographic and health parameters.

Results

CM was experienced by 32 % of the sample, while scores suggestive of cognitive deficits were obtained by 32.7 % and 40.2 % at study onset and follow-up, respectively. CM was associated with significantly lower MoCA scores at study onset (b = −0.013, p = 0.020), but not with change in MoCA over time (b = −0.002, p = 0.796). While MoCA scores did differ as a function of sex and CAD status, the latter did not influence the relations between maltreatment and MoCA.

Conclusions

CM predicted poorer cognitive functioning among older individuals with chronic diseases but did not play a role in any further cognitive decline over the follow-up period. Further research is needed to help understand the mechanisms implicated.

目的：童年虐待（CM）可能会增加日后出现认知障碍和痴呆症的风险。然而，大多数研究都是横断面研究，通常侧重于特定类型的儿童虐待，很少研究个体差异。本研究的目的是评估：1）冠状动脉疾病（CAD）或其他非心血管疾病（non-cardiovascular (non-CVD)）慢性疾病老年男性和女性患者在 5 年随访期间，CM 是否预示着较差的认知表现和较大的认知衰退；2）性别和 CAD 状态是否影响这些关系：患有冠状动脉疾病或其他非心血管疾病慢性病的男性和女性（N = 1254；39.6% 为女性；65.6 ± 7.0 岁）填写了儿童创伤问卷简表（CTQ-SF）。蒙特利尔认知评估（MoCA）每隔 5 年进行两次。主要分析包括双变量相关性分析、层次分析以及控制社会人口学和健康参数的调节分析：32%的样本患有CM，32.7%和40.2%的样本在研究开始和随访时分别获得了提示认知障碍的分数。在研究开始时，CM 与较低的 MoCA 分数明显相关（b = -0.013，p = 0.020），但与 MoCA 随时间的变化无关（b = -0.002，p = 0.796）。虽然MoCA得分因性别和CAD状态而异，但后者并不影响虐待与MoCA之间的关系：CM预示着患有慢性疾病的老年人认知功能较差，但在随访期间并没有导致认知功能进一步下降。需要进一步研究以帮助了解其中的机制。

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引用次数: 0

Unlike other medical conditions, type 2 diabetes is a risk factor for new-onset major depression after COVID-19 与其他疾病不同，2 型糖尿病是 COVID-19 后新发重度抑郁症的风险因素。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-21 DOI: 10.1016/j.jpsychores.2024.111963

Matthieu Gasnier , Anne-Lise Lecoq , Tài Pham , Luc Morin , François Radiguer , Eugénie Gosset-Grainville , Marie Quinque , Wassim Najib Alaoui , Eric Deflesselle , Walid Choucha , Samy Figueiredo , Mohamad Zaidan , Laurent Savale , David Montani , Xavier Monnet , Laurent Becquemont , Emmanuelle Corruble , Romain Colle

Objective

It is unclear whether pre-COVID medical conditions are risk factors for post-COVID major depressive episode (MDE). We aimed to determine which pre-COVID medical conditions are risk factors for post-COVID MDE after a hospitalization for COVID-19.

Methods

We conducted a nested retrospective case-cohort study within a cohort of 650 patients evaluated six months after hospitalization for COVID-19 at Bicêtre hospital, France. Nine medical conditions present before COVID-19 (High blood pressure, obesity, type 2 diabetes, cardiac, respiratory and renal disease, immune deficiency, neoplasia and liver disease) were extracted from medical records. MDE was assessed using the Structured Clinical Interview for DSM-5 Disorders-Clinician Version (SCID-5-CV). Bivariate and multivariable analyses were performed to determine which pre-COVID medical conditions are independent risk factors for post-COVID new-onset MDE.

Results

Patients mean age was 62.8 (15.8), 258 (39.7 %) were women; 301 (46.3 %) had high blood pressure, 205 (32.4 %) had obesity, and 186 (28.6 %) had type 2 diabetes. Thirty-six (5.5 %) patients were diagnosed with a new-onset MDE. In contrast to other medical conditions, type 2 diabetes was significantly associated with new-onset MDE (OR = 2.51 [1.19–5.29]).

Conclusion

Unlike other pre-COVID medical conditions, type 2 diabetes is a risk factor for post-COVID MDE. Patients with type 2 diabetes should be screened for MDE after a hospitalization for COVID-19.

目的：目前尚不清楚COVID前的医疗状况是否是COVID后重度抑郁发作（MDE）的风险因素。我们旨在确定哪些 COVID 前的医疗状况是 COVID-19 住院后重度抑郁发作的风险因素：我们在法国 Bicêtre 医院对 COVID-19 住院 6 个月后进行评估的 650 名患者队列中开展了一项巢式回顾性病例队列研究。研究人员从病历中提取了 COVID-19 前的九种疾病（高血压、肥胖、2 型糖尿病、心脏病、呼吸系统疾病、肾病、免疫缺陷、肿瘤和肝病）。MDE 采用 DSM-5 疾病结构化临床访谈-医师版（SCID-5-CV）进行评估。进行了二元和多元分析，以确定哪些COVID前的疾病是COVID后新发MDE的独立风险因素：患者平均年龄为 62.8（15.8）岁，258（39.7%）人为女性；301（46.3%）人患有高血压，205（32.4%）人患有肥胖症，186（28.6%）人患有 2 型糖尿病。有 36 名患者（5.5%）被诊断为新发 MDE。与其他病症相比，2 型糖尿病与新发 MDE 显著相关（OR = 2.51 [1.19-5.29]）：结论：与COVID前的其他病症不同，2型糖尿病是COVID后MDE的风险因素。2型糖尿病患者在因COVID-19住院后应进行MDE筛查。

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引用次数: 0

Weekend sleep duration, weekday sleep characteristics and the risk of prediabetes and diabetes 周末睡眠时间、平日睡眠特征与糖尿病前期和糖尿病风险。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-18 DOI: 10.1016/j.jpsychores.2024.111959

Tomoyuki Kawada

引用次数: 0

Association between fluctuations in blood cholesterol levels and the risk of suicide death in the general population 血液中胆固醇水平的波动与普通人群自杀死亡风险之间的关系

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-18 DOI: 10.1016/j.jpsychores.2024.111956

Chaiho Jeong , Jin-Hyung Jung , Dae Jong Oh , Kyungdo Han , Mee Kyoung Kim

Objective

Suicide is a pressing global public health issue. While recent studies have explored the association between serum cholesterol levels and suicide risk, the association between cholesterol variability and suicide risk is not well characterized.

Methods

This was a nationwide population-based cohort study using data from the Korean National Health Insurance Service database. A total of 1,983,701 patients with at least three measurements of TC between 2004 and 2009 were included. Participants were followed until death by suicide or the study's end in December 2021. Participants were categorized based on baseline TC or TC variability. TC variability was assessed using coefficient of variation (CV), variability independent of the mean (VIM), and average successive variability (ASV).

Results

Over a median follow-up of 11 years, 5883 (0.3 %) patients died by suicide. Compared to subjects with TC <200 mg/dL, those with TC ≥240 mg/dL had a lower risk of suicide death (hazard ratio [HR]: 0.85, 95 % confidence interval [95 % CI]: 0.78–0.93). In the unadjusted model, the HR for suicide death in the highest quartile (Q4) compared to the lowest quartile (Q1) of TC variability was 1.36 (95 % CI: 1.26–1.46). After adjusting for potential confounders, high variability in TC levels was associated with a higher risk of suicide death (HR 1.27, 95 % CI: 1.18–1.37). When analyzed based on the combination of TC baseline and variability, the highest quartile of TC variability showed a higher rate of suicide death compared to the lowest quartile, regardless of baseline TC level.

Conclusion

High TC variability and low TC levels were associated with an increased risk of suicide.

目的自杀是一个紧迫的全球性公共卫生问题。尽管最近的研究探讨了血清胆固醇水平与自杀风险之间的关系，但胆固醇变异性与自杀风险之间的关系还没有得到很好的描述。方法这是一项基于全国人口的队列研究，使用的数据来自韩国国民健康保险服务数据库。共纳入了 1,983,701 名在 2004 年至 2009 年期间至少测量过三次胆固醇的患者。研究人员对参与者进行了随访，直至其自杀身亡或研究于 2021 年 12 月结束。根据基线 TC 或 TC 变异性对参与者进行分类。采用变异系数（CV）、不依赖于平均值的变异性（VIM）和平均连续变异性（ASV）对TC变异性进行评估。结果在11年的中位随访中，有5883名（0.3%）患者死于自杀。与血清总胆固醇<200毫克/分升的受试者相比，血清总胆固醇≥240毫克/分升的受试者自杀死亡的风险较低（危险比[HR]：0.85，95%置信区间[95% CI]：0.78-0.93）。在未经调整的模型中，与血 TC 变异性最低的四分位数（Q1）相比，血 TC 变异性最高的四分位数（Q4）的自杀死亡风险为 1.36（95 % 置信区间：1.26-1.46）。在对潜在的混杂因素进行调整后，TC 水平的高变异性与自杀死亡的高风险相关（HR 1.27，95 % CI：1.18-1.37）。根据血 TC 基线和变异性组合进行分析时，无论血 TC 基线水平如何，血 TC 变异性最高的四分位数与最低的四分位数相比，自杀死亡率更高。

{"title":"Association between fluctuations in blood cholesterol levels and the risk of suicide death in the general population","authors":"Chaiho Jeong , Jin-Hyung Jung , Dae Jong Oh , Kyungdo Han , Mee Kyoung Kim","doi":"10.1016/j.jpsychores.2024.111956","DOIUrl":"10.1016/j.jpsychores.2024.111956","url":null,"abstract":"<div><h3>Objective</h3><div>Suicide is a pressing global public health issue. While recent studies have explored the association between serum cholesterol levels and suicide risk<strong>,</strong> the association between cholesterol variability and suicide risk is not well characterized.</div></div><div><h3>Methods</h3><div>This was a nationwide population-based cohort study using data from the Korean National Health Insurance Service database. A total of 1,983,701 patients with at least three measurements of TC between 2004 and 2009 were included. Participants were followed until death by suicide or the study's end in December 2021. Participants were categorized based on baseline TC or TC variability. TC variability was assessed using coefficient of variation (CV), variability independent of the mean (VIM), and average successive variability (ASV).</div></div><div><h3>Results</h3><div>Over a median follow-up of 11 years, 5883 (0.3 %) patients died by suicide. Compared to subjects with TC <200 mg/dL, those with TC ≥240 mg/dL had a lower risk of suicide death (hazard ratio [HR]: 0.85, 95 % confidence interval [95 % CI]: 0.78–0.93). In the unadjusted model, the HR for suicide death in the highest quartile (Q4) compared to the lowest quartile (Q1) of TC variability was 1.36 (95 % CI: 1.26–1.46). After adjusting for potential confounders, high variability in TC levels was associated with a higher risk of suicide death (HR 1.27, 95 % CI: 1.18–1.37). When analyzed based on the combination of TC baseline and variability, the highest quartile of TC variability showed a higher rate of suicide death compared to the lowest quartile, regardless of baseline TC level.</div></div><div><h3>Conclusion</h3><div>High TC variability and low TC levels were associated with an increased risk of suicide.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"187 ","pages":"Article 111956"},"PeriodicalIF":3.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531887","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

Dissecting the association between long COVID and depressive symptoms in a nationally representative population from France 在法国具有全国代表性的人群中剖析长 COVID 与抑郁症状之间的关联。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-18 DOI: 10.1016/j.jpsychores.2024.111961

Sarah Tebeka , Joël Coste , Tatjana T. Makovski , Caroline Alleaume , Cyrille Delpierre , Anne Gallay , Baptiste Pignon , Clément Gouraud , Charles Ouazana Vedrines , Victor Pitron , Olivier Robineau , Olivier Steichen , Cédric Lemogne

Objective

Depressive symptoms may overlap with those of long COVID. This cross-sectional study aims to compare the prevalence of depressive symptoms among individuals infected with SARS-CoV-2 with versus without long COVID and to explore specific associations with each of the nine core symptoms of major depression.

Methods

Data regarding age, gender, SARS-CoV-2 infections, current symptoms, their date of onset, impact on daily functioning, and consideration of alternative diagnoses were collected through phone interviews between September and December 2022 in a nationally representative sample of adults aged ≥18. Data on chronic health conditions and depressive symptoms (PHQ-9) were collected online in infected participants with or without long COVID, according to the WHO definition of the post-COVID-19 condition.

Results

Among 1247 participants (mean age (SD): 48.3 (14.3) years, 53.3 % of women), 12.8 % had long COVID and 87.2 % experienced SARS-CoV-2 infection at least 3 months prior to the survey without long COVID. Participant with long COVID were four-fold more likely to have a PHQ-9 score ≥ 10 than those without (44.0 % versus 11.1 %). Three symptoms out of nine were independently associated with long COVID: little interest or pleasure (aOR [95 % CI]: 2.01 [1.03–3.92]), feeling tired or having little energy (1.92 [1.10–3.33]), and poor attention/concentration (2.02 [1.03–3.96]).

Conclusion

Clinicians should screen patients with long COVID for major depression but associations with specific depressive symptoms suggest some clinical overlap. Future studies should consider the course of each depressive symptom separately and focus on those less prone to overlap with symptoms of long COVID.

目的抑郁症状可能与长COVID的症状重叠。本横断面研究旨在比较感染 SARS-CoV-2 并伴有和未伴有长 COVID 的人群中抑郁症状的发生率，并探讨与重度抑郁症九种核心症状中每种症状的具体关联：在 2022 年 9 月至 12 月期间，通过电话访问具有全国代表性的年龄≥18 岁的成年人样本，收集了有关年龄、性别、SARS-CoV-2 感染情况、当前症状、发病日期、对日常功能的影响以及是否考虑过其他诊断的数据。根据世界卫生组织对COVID-19后病情的定义，在线收集了有或无长期COVID的感染者的慢性健康状况和抑郁症状（PHQ-9）数据：在 1247 名参与者（平均年龄（SD）：48.3（14.3）岁，53.3% 为女性）中，12.8% 的人有长期 COVID，87.2% 的人在调查前至少 3 个月感染过 SARS-CoV-2，但没有长期 COVID。PHQ-9 评分≥10分的参与者中，患有长COVID的比例是未患有长COVID的比例的四倍（44.0%对11.1%）。在九种症状中，有三种症状与长期COVID独立相关：缺乏兴趣或乐趣（aOR [95 % CI]：2.01 [1.03-3.92]）、感到疲倦或精力不足（1.92 [1.10-3.33]）以及注意力/集中力差（2.02 [1.03-3.96]）：临床医生应筛查长 COVID 患者是否患有重度抑郁症，但与特定抑郁症状的关联表明存在一些临床重叠。未来的研究应分别考虑每种抑郁症状的病程，并重点关注不易与长 COVID 症状重叠的患者。

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引用次数: 0

Cost-utility analysis of transdiagnostic cognitive behavioural therapy for people with persistent physical symptoms in contact with specialist services evaluated in the PRINCE secondary trial 在 PRINCE 二次试验中评估了针对与专科服务机构接触的持续性躯体症状患者的跨诊断认知行为疗法的成本效益分析。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-17 DOI: 10.1016/j.jpsychores.2024.111960

Paul McCrone , Meenal Patel , Matthew Hotopf , Rona Moss-Morris , Mark Ashworth , Anthony S. David , Mujtaba Husain , Kirsty James , Sabine Landau , Trudie Chalder

Objective

To compare the cost-utility of transdiagnostic cognitive behavioural therapy (TDT-CBT) plus standardised medical care (SMC) to SMC alone to support people with persistent physical symptoms in contact with specialist services.

Methods

This study compared the cost-utility of TDT-CBT. A two-arm randomised controlled trial was conducted in secondary care settings. Participants received either TDT-CBT + SMC or SMC alone. Measures were taken at baseline and at 9-, 20-, 40-, and 52-week follow-up. Service use was measured, and costs calculated. Costs were combined with quality-adjusted life years (QALYs) based on the EQ-5D-5L using incremental cost-utility ratios with uncertainty addressed using cost-effectiveness planes and acceptability curves.

Results

The costs during the follow-up period were £3473 for TDT-CBT + SMC and £3104 for SMC alone. The incremental cost for TDT-CBT + SMC adjusting for baseline was £482 (95 % CI, −£399 to £1233). QALYs over the follow-up were 0.578 for TDT-CBT + SMC and 0.542 for SMC alone. The incremental QALY was 0.038 (95 % CI, −0.005 to 0.080). The incremental cost per QALY was £12,684 for TDT-CBT + SMC. There was a 68.3 % likelihood that TDT-CBT + SMC was the most cost-effective option at a threshold of £20,000 per QALY.

Conclusion

Adding TDT-CTB to SMC results in slightly increased costs and slightly better outcomes in terms of QALYs. This represents a cost-effective option based on the conventional QALY threshold value.

目的：比较比较跨诊断认知行为疗法（TDT-CBT）加标准化医疗护理（SMC）与单纯标准化医疗护理的成本效益，以支持有持续性躯体症状的患者与专科服务机构联系：本研究比较了 TDT-CBT 的成本效益。这项研究比较了 TDT-CBT 的成本效益，并在二级医疗机构开展了一项双臂随机对照试验。参与者要么接受 TDT-CBT + SMC 治疗，要么只接受 SMC 治疗。在基线、9 周、20 周、40 周和 52 周的随访中进行了测量。对服务使用情况进行测量，并计算成本。根据 EQ-5D-5L 使用增量成本效用比将成本与质量调整生命年（QALYs）相结合，并使用成本效益平面和可接受性曲线解决不确定性问题：随访期间，TDT-CBT + SMC 的成本为 3473 英镑，单用 SMC 的成本为 3104 英镑。调整基线后，TDT-CBT + SMC 的增量成本为 482 英镑（95 % CI，-399 至 1233 英镑）。在随访期间，TDT-CBT + SMC 的 QALY 为 0.578，单用 SMC 的 QALY 为 0.542。增量 QALY 为 0.038（95 % CI，-0.005 至 0.080）。TDT-CBT+SMC的每QALY增量成本为12,684英镑。在每 QALY 20,000 英镑的临界值下，TDT-CBT + SMC 最具成本效益的可能性为 68.3%：结论：在 SMC 的基础上增加 TDT-CTB 会导致成本略有增加，但从 QALYs 的角度来看，效果略好。根据传统的 QALY 临界值，这是一种具有成本效益的方案。

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引用次数: 0

Persian version of the Short Health Anxiety Inventory (SHAI) for patients with cancer: Evaluation of psychometric properties, factor structure, and association with related constructs 针对癌症患者的短式健康焦虑量表（SHAI）波斯语版本：心理测量特性、因子结构以及与相关结构的关联评估

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-16 DOI: 10.1016/j.jpsychores.2024.111958

M. Mojtaba Poshtan , Abdulaziz Aflakseir , Michael Witthöft , Mary Gemma Cherry , Mani Ramzi

Objective

This study aims to evaluate the psychometric properties of the Short Health Anxiety Inventory (SHAI=short health anxiety inventory) in a sample of patients diagnosed with cancer. Factor structure, internal consistency, convergent validity, and gender differences in SHAI scores were assessed.

Methods

202 patients diagnosed with cancer participated, with 18 questionnaires excluded for incomplete data. Confirmatory Factor Analysis was conducted to confirm the factor structure. Internal consistency was also assessed using Cronbach's alpha.

Results

A two-factor model (thought intrusion and fear of illness) provided the best fit for the data (SBχ² (64) = 114.346, p < 0.001, CFI = 0.944, GFI = 0.908, RMSEA = 0.065). Internal consistency was high for the SHAI total score (α = 0.864) and its subscales (thought intrusion: α = 0.753; fear of illness: α = 0.825). Female patients also scored significantly higher than male patients on the SHAI total score (U = 5232.500, p = 0.012), thought intrusion subscale (U = 5189.00, p = 0.008) and fear of illness subscale (U = 5069.500, p = 0.018).

Conclusion

The SHAI demonstrates adequate psychometric properties for assessing health anxiety in cancer patients.

目的本研究旨在评估短式健康焦虑量表（SHAI=Short Health Anxiety Inventory）在癌症确诊患者样本中的心理测量特性。方法202名确诊为癌症的患者参与了研究，其中18份问卷因数据不完整而被排除。为确认因子结构，进行了确认性因子分析。结果双因素模型（思想入侵和对疾病的恐惧）对数据的拟合效果最好（SBχ2 (64) = 114.346, p < 0.001, CFI = 0.944, GFI = 0.908, RMSEA = 0.065）。SHAI总分（α = 0.864）及其分量表（思想入侵：α = 0.753；疾病恐惧：α = 0.825）的内部一致性很高。女性患者在SHAI总分（U = 5232.500，p = 0.012）、思维入侵分量表（U = 5189.00，p = 0.008）和疾病恐惧分量表（U = 5069.500，p = 0.018）上的得分也明显高于男性患者。

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引用次数: 0

The psychosocial anti-inflammatories: Sense of control, purpose in life, and social support in relation to inflammation, functional health and chronic conditions in adulthood 社会心理抗炎药：控制感、生活目标和社会支持与成年期炎症、功能性健康和慢性疾病的关系。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-15 DOI: 10.1016/j.jpsychores.2024.111957

Margie E. Lachman, Kylie A. Schiloski

Objective

Three psychosocial variables were examined as predictors of chronic inflammation, functional health, and number of chronic conditions.

Methods

This cohort study used the Midlife in the United States biomarker sample. Data were collected in 2004–2009 (M2) and 2013–17 (M3). The sample included 1244 adults ages 34 to 82 (M = 54.50, SD = 11.7), with 57 % women, 79 % white, and education from 6 to 20 years (M = 14.47, SD = 2.65). Sense of control, purpose in life, and social support were included as indicators of a psychosocial latent factor. Inflammation was measured with Interleukin-6, C-reactive Protein, E-Selectin, Fibrinogen, and Intracellular Adhesion Molecule-1. Covariates included age, sex, education, race, and household income. Functional health and chronic conditions were assessed M = 9.27 (SD = 0.78) years after the psychosocial variables and M = 7.06, (SD = 1.47) years after inflammation.

Results

Using a structural equation model and controlling for covariates, higher levels on the psychosocial variables predicted lower inflammation (β = −0.12, 95 % CI -0.22 to −0.02; p = .016), better functional health (β = 0.25, 95 % CI 0.18 to 0.32; p < .001), and fewer chronic conditions (β = −0.22, 95 % CI −0.30 to −0.15; p < .001), with inflammation a mediator (indirect effects: functional health, β = 0.03, 95 % CI 0.00 to 0.05, p = .020 and chronic conditions, β = −0.02, 95 % CI -0.03 to −0.00, p = .036).

Conclusions

Adaptive psychosocial beliefs and supportive relationships are important as they can provide motivation for engaging in health-promoting behaviors and can reduce stress that can lead to chronic inflammation and poor health. The results can inform a psychosocial prescription for health.

目的：研究三个社会心理变量对慢性炎症、功能性健康和慢性病数量的预测作用：将三个社会心理变量作为慢性炎症、功能性健康和慢性病数量的预测因素进行研究：这项队列研究使用了美国中年生物标志物样本。数据收集时间为 2004-2009 年（M2）和 2013-17 年（M3）。样本包括 1244 名 34 至 82 岁的成年人（中位数 = 54.50，标准差 = 11.7），其中女性占 57%，白人占 79%，受教育年限为 6 至 20 年（中位数 = 14.47，标准差 = 2.65）。控制感、生活目标和社会支持被列为社会心理潜在因素的指标。炎症用白细胞介素-6、C-反应蛋白、E-选择素、纤维蛋白原和细胞内粘附分子-1进行测量。协变量包括年龄、性别、教育程度、种族和家庭收入。对功能性健康和慢性疾病的评估是在心理社会变量评估后 M = 9.27（SD = 0.78）年和炎症评估后 M = 7.06（SD = 1.47）年进行的：使用结构方程模型并控制协变量，较高的心理社会变量水平可预测较低的炎症（β = -0.12，95 % CI -0.22 至 -0.02；p = .016）、较好的功能性健康（β = 0.25，95 % CI 0.18 至 0.32；p 结论：心理社会变量可预测较高的炎症水平：适应性心理社会信念和支持性人际关系非常重要，因为它们能为参与促进健康的行为提供动力，并能减轻可能导致慢性炎症和健康不良的压力。研究结果可为心理社会健康处方提供参考。

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