Journal of Psychosomatic Research最新文献_第8页

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 : 2026-02-01 Epub 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

Journal of Psychosomatic Research 2025 year in review 心身研究杂志2025年回顾。

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-02-01 Epub Date: 2025-12-23 DOI: 10.1016/j.jpsychores.2025.112506

Fiammetta Cosci

引用次数: 0

EAPM 2026 Florence EAPM 2026佛罗伦萨

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-02-01 Epub Date: 2026-01-09 DOI: 10.1016/S0022-3999(26)00010-3

引用次数: 0

Which cognitive-behavioural factors play a role in the reduction of post-COVID-19 fatigue following cognitive behavioural therapy and care as usual? A secondary analysis of the ReCOVer study 在常规认知行为治疗和护理后，哪些认知行为因素在减少covid -19后疲劳中发挥作用？对ReCOVer研究的二次分析

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-02-01 Epub Date: 2025-11-19 DOI: 10.1016/j.jpsychores.2025.112467

Tanja A. Kuut , Mathilde G.E. Verdam , Annemarie M.J. Braamse , Chantal P. Rovers , Hans Knoop , Fabiola Müller

Objective

A previous randomized controlled trial (RCT) showed the efficacy of cognitive behavioural therapy for fatigue (CBT-F) in relieving severe fatigue in a subgroup of post-COVID-19 patients as compared to care as usual (CAU). The aim of this study, a secondary analysis of the RCT, was to investigate which cognitive behavioural variables mediate the fatigue-reducing effect of CBT and which variables predict a reduction in fatigue independent of the intervention condition.

Methods

A total of 114 patients (CBT-F = 57, CAU = 57) were included. The primary outcome was fatigue severity assessed with the Checklist Individual Strength, subscale fatigue. Assessments were conducted at baseline and directly post-CBT-F or CAU. Mediation analyses and linear regression analyses were performed with purposeful selection of variables based on statistical significance and relevance.

Results

The final parallel mediation model included increased self-reported activity and self-efficacy regarding fatigue as well as a reduction in anticipated adverse consequences of activity as mechanisms explaining the reduction in fatigue in CBT-F as compared to CAU. Across conditions, the same three variables predicted a decrease in fatigue; problems with sleep and sleep-wake pattern was retained in the model based on purposeful selection principles.

Conclusion

Perceptions and beliefs regarding activity and the controllability of fatigue seem to mediate the effect of CBT-F on fatigue as compared to CAU. Changes in these variables might be generic mechanisms explaining reductions in fatigue as they also seem to be related to the reduction in fatigue across intervention conditions.

先前的一项随机对照试验（RCT）显示，与常规护理（CAU）相比，认知行为治疗疲劳（CBT-F）在缓解covid -19后亚组患者严重疲劳方面的疗效。本研究的目的是对随机对照试验进行二次分析，目的是调查哪些认知行为变量介导CBT减轻疲劳的效果，哪些变量预测与干预条件无关的疲劳减轻。方法共纳入114例患者，其中CBT-F = 57例，CAU = 57例。主要结果是疲劳严重程度评估与检查表个人力量，亚量表疲劳。在基线和cbt - f或CAU后直接进行评估。中介分析和线性回归分析，基于统计显著性和相关性有目的地选择变量。结果最终的平行中介模型包括自我报告的活动和疲劳自我效能的增加，以及活动预期不良后果的减少，作为解释CBT-F中疲劳减少的机制，与CAU相比。在不同的条件下，同样的三个变量预测了疲劳的减少；基于有目的选择原则的模型保留了睡眠和睡眠-觉醒模式的问题。结论与CAU相比，有关活动和疲劳可控性的认知和信念似乎介导了CBT-F对疲劳的影响。这些变量的变化可能是解释疲劳减少的一般机制，因为它们似乎也与干预条件下疲劳的减少有关。

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引用次数: 0

Prevalence of self-reported sensitivities to various environmental factors in Germany, Sweden, and Finland based on multiple classification criteria 基于多重分类标准的德国、瑞典和芬兰对各种环境因素自我报告敏感性的流行程度

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-02-01 Epub Date: 2025-12-10 DOI: 10.1016/j.jpsychores.2025.112495

Ferenc Köteles , Michael Witthöft , Anne-Kathrin Bräscher , Josef Bailer , Steven Nordin

Objective

Our knowledge on the prevalence of self-reported sensitivities to environmental factors is poor. The lack of accepted criteria/assessment makes findings of different studies difficult to compare; the way of assessment might play a role in the reported prevalence rates. The present study aimed to report the prevalence rates of five environmental sensitivities for the German general population, to compare three of them with Swedish and Finnish data, and to demonstrate the impact of strictness of criterion on the results.

Methods

Data from a German (n = 2515), a Swedish (n = 3253) and a Finnish (n = 1467) population-based survey was used. Sentitivities were rated on ordinal scales in all samples.

Results

In the German sample, about 25 % of participants reported mild reactions to sounds, chemicals, and buildings, and about 10 % to electromagnetic fields (EMFs) and wind turbines, with a similar pattern for strong reactions, but with proportions of 1–2 %. Data from the Nordic countries show consistent similarities between these two countries, with prevalences exceeding 34 % for mild reactions to chemicals and sounds and about 5 % to EMFs, with a similar pattern for strong reactions, but with proportions of 1–8 %. Prevalence of sensitivity to EMFs was higher, whereas prevalence of sensitivity to chemicals and sounds was lower in Germany. Classification criteria significantly impacted the reported prevalence rates.

Conclusion

Various environmental sensitivities affect a considerable proportion of the general populations of the three countries. To improve comparability, self-report assessment of sensitivities should be based on at least an ordinal scale instead of the widely used yes-or-no question.

目的：我们对自我报告的环境因素敏感性的患病率了解甚少。缺乏公认的标准/评估使得不同研究的结果难以比较；评估方法可能在报告的患病率中发挥作用。本研究旨在报告德国一般人口中五种环境敏感性的流行率，将其中三种与瑞典和芬兰的数据进行比较，并证明标准的严格程度对结果的影响。方法：采用来自德国（n = 2515）、瑞典（n = 3253）和芬兰（n = 1467）人群调查的数据。对所有样本的敏感性按顺序进行评分。结果：在德国的样本中，大约25%的参与者报告对声音、化学物质和建筑物有轻微反应，大约10%的参与者对电磁场（emf）和风力涡轮机有轻微反应，强烈反应的模式类似，但比例为1- 2%。来自北欧国家的数据显示，这两个国家之间存在一致的相似性，对化学品和声音的轻度反应的患病率超过34%，对电磁场的患病率约为5%，强烈反应的患病率也类似，但比例为1- 8%。在德国，对电磁辐射敏感的患病率较高，而对化学物质和声音敏感的患病率较低。分类标准显著影响报告的患病率。结论：各种环境敏感性影响了这三个国家相当大比例的普通人群。为了提高可比性，敏感性的自我报告评估应该至少基于一个顺序量表，而不是广泛使用的是或否问题。

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引用次数: 0

Age, sex and mental distress as predictors of rate and deterioration of persistent physical symptoms over three and six years in a general population 在一般人群中，年龄、性别和精神困扰作为3年和6年持续身体症状发生率和恶化的预测因素

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-02-01 Epub Date: 2025-12-18 DOI: 10.1016/j.jpsychores.2025.112505

Karl Fjellborg , Clara Cervin , Michael Witthöft , Ferenc Köteles , Steven Nordin

Background

Better understanding for persistent physical symptoms (PPS) may improve prevention of symptoms from becoming persistent and deteriorating over time. This study tested the hypotheses of age and level of mental distress symptoms of anxiety, depression, sleep disturbance and burnout statistically predicting rate of PPS and deterioration of PPS over three and six years in a general adult population. We also addressed whether sex is associated with these two aspects of PPS.

Method

A population-based sample (n = 1837) aged 18–79 years from Västerbotten in Sweden was used. Longitudinal data were collected based on the 15-item Patient Health Questionnaire for PPS assessment as well as other validated questionnaire instruments at baseline and 3- and 6-year follow-up. Deterioration was assessed with the reliable change index paradigm. Chi-square tests and analyses of covariance were applied.

Results

Old age was found to statistically predict deterioration, but not long-term rate, of PPS over three and six years, and female sex to predict rate, but not deterioration. Symptom levels of all four types of mental distress predicted both PPS rate (η² = 0.097–0.202) and deterioration (η² = 0.007–0.023) over both three and six years. When controlling for the other three types of mental distress, sleep disturbance, and in particular burnout, explained most unique variance in predicting rate and deterioration.

Conclusions

The findings encourage healthcare professionals to assess PPS at an early stage, especially in persons at old age, in women and in patients with mental distress.

背景：更好地了解持续性身体症状（PPS）可能有助于预防症状随着时间的推移变得持续和恶化。本研究检验了年龄和焦虑、抑郁、睡眠障碍和倦怠等精神困扰症状水平对普通成年人3年和6年PPS发病率和PPS恶化的统计学预测假设。我们还探讨了性是否与PPS的这两个方面有关。方法采用瑞典Västerbotten年龄在18-79岁的人群为基础的样本（n = 1837）。在基线和3年和6年随访期间，通过15项患者健康问卷以及其他有效的问卷工具收集纵向数据。用可靠变化指数范式评估恶化程度。采用卡方检验和协方差分析。结果年龄对3年和6年PPS的恶化有统计学意义，但对远期发病率无统计学意义；性别对PPS的恶化无统计学意义。在3年和6年期间，所有四种精神困扰的症状水平均可预测PPS发生率（η2 = 0.097 ~ 0.202）和病情恶化（η2 = 0.007 ~ 0.023）。当控制其他三种类型的精神困扰时，睡眠障碍，特别是倦怠，解释了预测率和恶化的最独特的方差。结论：研究结果鼓励医疗保健专业人员在早期阶段评估PPS，特别是在老年人、妇女和精神困扰患者中。

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引用次数: 0

Preoperative sleep quality and anxiety as predictors of postoperative pain and recovery in Gynecologic oncology surgery: A prospective observational study 术前睡眠质量和焦虑作为妇科肿瘤手术术后疼痛和恢复的预测因素：一项前瞻性观察研究

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-02-01 Epub Date: 2025-12-11 DOI: 10.1016/j.jpsychores.2025.112496

Celal Akdemir , Suna Aşkın Turan , Mücahit Furkan Balcı , Süleyman Özen , Nefise Şeker , Denizhan Bayramoğlu , Zeynep Bayramoğlu , Muzaffer Sancı

Purpose

This study evaluated associations between preoperative sleep quality, anxiety, and short-term postoperative outcomes in patients undergoing gynecologic oncology surgery.

Methods

This prospective observational study included 72 women undergoing open gynecologic cancer surgery. Preoperative sleep quality and anxiety were assessed 24–48 h before surgery using the Pittsburgh Sleep Quality Index (PSQI) and the Beck Anxiety Inventory (BAI). Postoperative pain was measured using the Numerical Rating Scale (NRS) at 0, 4, 8, 12, and 24 h. Complications, rescue analgesia use, and length of stay were recorded.

Results

Poor sleep quality (%31.9) and clinically significant anxiety (%19.4) were both associated with higher mean postoperative pain scores (PSQI ≥5: 6.3 ± 1.2 vs 5.1 ± 1.3, p = 0.002; BAI ≥16: 6.5 ± 1.1 vs 5.2 ± 1.4, p = 0.001). In adjusted analyses, higher PSQI (β = 0.112, 95 % CI 0.039–0.185, p = 0.003) and higher BAI scores (β = 0.044, 95 % CI 0.023–0.065, p < 0.001) remained significantly associated with increased mean pain. Poor sleep quality was also linked to longer hospitalization (4 vs 3 days, p < 0.001) and higher complication rates (%52.2 vs %12.2, p < 0.001). Elevated anxiety was similarly associated with higher complication rates (%57.1 vs %17.2, p = 0.004) and more frequent rescue analgesia use (%64.3 vs %29.3, p = 0.014).

Conclusion

Preoperative sleep disturbances and anxiety are significantly associated with worse postoperative pain, higher complication rates, and prolonged recovery; routine screening and targeted interventions may therefore improve surgical outcomes.

Trial registration

The study was retrospectively registered at ClinicalTrials.gov (Identifier: NCT07036549) on June 24, 2025.

目的：本研究评估妇科肿瘤手术患者术前睡眠质量、焦虑和术后短期预后之间的关系。方法本前瞻性观察研究纳入72例接受开放性妇科肿瘤手术的妇女。术前24-48 h采用匹兹堡睡眠质量指数（PSQI）和贝克焦虑量表（BAI）评估睡眠质量和焦虑。术后0、4、8、12和24 h采用数值评定量表（NRS）测量疼痛。记录并发症、抢救镇痛使用情况和住院时间。结果spoor睡眠质量（%31.9）和临床显著焦虑（%19.4）均与较高的术后平均疼痛评分相关（PSQI≥5:6.3±1.2 vs 5.1±1.3,p = 0.002; BAI≥16:6.5±1.1 vs 5.2±1.4,p = 0.001）。在校正分析中，较高的PSQI （β = 0.112, 95% CI 0.039-0.185, p = 0.003）和较高的BAI评分（β = 0.044, 95% CI 0.023-0.065, p < 0.001）仍然与平均疼痛增加显著相关。睡眠质量差还与住院时间较长（4天对3天，p < 0.001）和并发症发生率较高（% 52.2%对% 12.2%,p < 0.001）有关。焦虑升高同样与更高的并发症发生率（%57.1 vs %17.2, p = 0.004）和更频繁的急救镇痛使用相关（%64.3 vs %29.3, p = 0.014）。结论术前睡眠障碍和焦虑与术后疼痛加重、并发症发生率高、恢复时间长有显著关系；因此，常规筛查和有针对性的干预可以改善手术结果。试验注册该研究于2025年6月24日在ClinicalTrials.gov（标识符：NCT07036549）上回顾性注册。

{"title":"Preoperative sleep quality and anxiety as predictors of postoperative pain and recovery in Gynecologic oncology surgery: A prospective observational study","authors":"Celal Akdemir , Suna Aşkın Turan , Mücahit Furkan Balcı , Süleyman Özen , Nefise Şeker , Denizhan Bayramoğlu , Zeynep Bayramoğlu , Muzaffer Sancı","doi":"10.1016/j.jpsychores.2025.112496","DOIUrl":"10.1016/j.jpsychores.2025.112496","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluated associations between preoperative sleep quality, anxiety, and short-term postoperative outcomes in patients undergoing gynecologic oncology surgery.</div></div><div><h3>Methods</h3><div>This prospective observational study included 72 women undergoing open gynecologic cancer surgery. Preoperative sleep quality and anxiety were assessed 24–48 h before surgery using the Pittsburgh Sleep Quality Index (PSQI) and the Beck Anxiety Inventory (BAI). Postoperative pain was measured using the Numerical Rating Scale (NRS) at 0, 4, 8, 12, and 24 h. Complications, rescue analgesia use, and length of stay were recorded.</div></div><div><h3>Results</h3><div>Poor sleep quality (%31.9) and clinically significant anxiety (%19.4) were both associated with higher mean postoperative pain scores (PSQI ≥5: 6.3 ± 1.2 vs 5.1 ± 1.3, <em>p</em> = 0.002; BAI ≥16: 6.5 ± 1.1 vs 5.2 ± 1.4, <em>p</em> = 0.001). In adjusted analyses, higher PSQI (β = 0.112, 95 % CI 0.039–0.185, <em>p</em> = 0.003) and higher BAI scores (β = 0.044, 95 % CI 0.023–0.065, <em>p</em> < 0.001) remained significantly associated with increased mean pain. Poor sleep quality was also linked to longer hospitalization (4 vs 3 days, <em>p</em> < 0.001) and higher complication rates (%52.2 vs %12.2, p < 0.001). Elevated anxiety was similarly associated with higher complication rates (%57.1 vs %17.2, <em>p</em> = 0.004) and more frequent rescue analgesia use (%64.3 vs %29.3, <em>p</em> = 0.014).</div></div><div><h3>Conclusion</h3><div>Preoperative sleep disturbances and anxiety are significantly associated with worse postoperative pain, higher complication rates, and prolonged recovery; routine screening and targeted interventions may therefore improve surgical outcomes.</div></div><div><h3>Trial registration</h3><div>The study was retrospectively registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (Identifier: <span><span>NCT07036549</span><svg><path></path></svg></span>) on June 24, 2025.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"201 ","pages":"Article 112496"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748514","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

Corrigendum to “Functional neuroimaging in patients with catatonia: A systematic review”. [Journal of Psychosomatic Research. 179 (2024) 111640] “紧张症患者的功能性神经影像学：系统回顾”的勘误表。心身研究，179(2024)111640。

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-02-01 Epub Date: 2025-12-15 DOI: 10.1016/j.jpsychores.2025.112497

Laura Duque , Mohammad Ghafouri , Nicolas A. Nunez , Juan Pablo Ospina , Kemuel L. Philbrick , John D. Port , Rodolfo Savica , Larry J. Prokop , Teresa A. Rummans , Balwinder Singh

引用次数: 0

Depressed or delirious? Overdiagnosis of depression in medically hospitalized patients 抑郁还是精神错乱？住院患者抑郁症的过度诊断

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-02-01 Epub Date: 2025-12-05 DOI: 10.1016/j.jpsychores.2025.112493

Molly Howland , Nicolas Thompson , Arushi Mahajan , Nona Nichols , Marielle Collins , Jack H. Owens Jr , Adele Viguera

Objective

Misdiagnosis of depression and delirium by non-psychiatric clinicians is common. Depression over-diagnosis can cause stigmatization of normal emotional reactions and delays in addressing delirium. We performed a multisite retrospective chart review to examine diagnostic agreement between non-psychiatric services and the consultation-liaison psychiatry (CLP) service.

Methods

We reviewed inpatient depression and delirium referrals across two Cleveland Clinic sites. Agreement between referral reason and CLP service diagnosis was assessed. We fit multivariable logistic regression models for the dependent variables of depression overdiagnosis and delirium masquerading as depression, with independent variables that included the primary team discipline and demographic and clinical variables.

Results

Diagnostic agreement for delirium, strict depression diagnosis, and broad depression diagnosis were 88 %, 67 %, and 80 %, respectively. Of patients referred for depression who did not receive a CL psychiatry diagnosis of depression, 49 % were diagnosed with adjustment disorder, 18 % with anxiety/OCD, 16 % with delirium, and 4 % with neurocognitive disorders. Older age and prior psychiatric diagnoses decreased the likelihood of depression overdiagnosis. Psychotropic medication use increased the likelihood of delirium misdiagnosed as depression.

Conclusion

Primary services overidentify depression and more accurately identify delirium. However, given that most alternative diagnoses were anxiety disorders or adjustment disorders, primary services seem adept at identifying psychological distress, which may be related to destigmatization and education efforts by psychiatrists. Primary services recognize prior psychiatric diagnoses as a depression risk factor and demonstrate awareness of geriatric presentations. However, prior psychotropic use may introduce bias. Further research, including direct knowledge and attitude assessments, is needed.

目的：非精神科临床医生对抑郁症和谵妄的误诊是常见的。抑郁症的过度诊断会导致对正常情绪反应的污名化和对谵妄治疗的延迟。我们进行了多地点回顾性图表回顾，以检查非精神科服务和咨询联络精神病学（CLP）服务之间的诊断一致性。方法：我们回顾了两个克利夫兰诊所的住院抑郁症和谵妄转诊病例。评估转诊原因与CLP服务诊断的一致性。我们拟合了抑郁症过度诊断和谵妄伪装成抑郁症的因变量的多变量逻辑回归模型，自变量包括主要团队纪律和人口统计学和临床变量。结果：谵妄的诊断符合率为88%，抑郁症的诊断符合率为67%，抑郁症的诊断符合率为80%。在未接受CL精神病学诊断的抑郁症患者中，49%被诊断为适应障碍，18%被诊断为焦虑/强迫症，16%被诊断为谵妄，4%被诊断为神经认知障碍。年龄较大和先前的精神病诊断降低了抑郁症过度诊断的可能性。精神药物的使用增加了谵妄被误诊为抑郁症的可能性。结论：基层医疗机构对抑郁症的鉴别过高，对谵妄的鉴别更准确。然而，考虑到大多数替代诊断是焦虑障碍或适应障碍，初级服务似乎善于识别心理困扰，这可能与精神科医生的去污名化和教育努力有关。初级服务承认先前的精神病诊断是抑郁症的危险因素，并表现出对老年表现的认识。然而，先前的精神药物使用可能会引入偏见。需要进一步的研究，包括直接的知识和态度评估。

{"title":"Depressed or delirious? Overdiagnosis of depression in medically hospitalized patients","authors":"Molly Howland , Nicolas Thompson , Arushi Mahajan , Nona Nichols , Marielle Collins , Jack H. Owens Jr , Adele Viguera","doi":"10.1016/j.jpsychores.2025.112493","DOIUrl":"10.1016/j.jpsychores.2025.112493","url":null,"abstract":"<div><h3>Objective</h3><div>Misdiagnosis of depression and delirium by non-psychiatric clinicians is common. Depression over-diagnosis can cause stigmatization of normal emotional reactions and delays in addressing delirium. We performed a multisite retrospective chart review to examine diagnostic agreement between non-psychiatric services and the consultation-liaison psychiatry (CLP) service.</div></div><div><h3>Methods</h3><div>We reviewed inpatient depression and delirium referrals across two Cleveland Clinic sites. Agreement between referral reason and CLP service diagnosis was assessed. We fit multivariable logistic regression models for the dependent variables of depression overdiagnosis and delirium masquerading as depression, with independent variables that included the primary team discipline and demographic and clinical variables.</div></div><div><h3>Results</h3><div>Diagnostic agreement for delirium, strict depression diagnosis, and broad depression diagnosis were 88 %, 67 %, and 80 %, respectively. Of patients referred for depression who did not receive a CL psychiatry diagnosis of depression, 49 % were diagnosed with adjustment disorder, 18 % with anxiety/OCD, 16 % with delirium, and 4 % with neurocognitive disorders. Older age and prior psychiatric diagnoses decreased the likelihood of depression overdiagnosis. Psychotropic medication use increased the likelihood of delirium misdiagnosed as depression.</div></div><div><h3>Conclusion</h3><div>Primary services overidentify depression and more accurately identify delirium. However, given that most alternative diagnoses were anxiety disorders or adjustment disorders, primary services seem adept at identifying psychological distress, which may be related to destigmatization and education efforts by psychiatrists. Primary services recognize prior psychiatric diagnoses as a depression risk factor and demonstrate awareness of geriatric presentations. However, prior psychotropic use may introduce bias. Further research, including direct knowledge and attitude assessments, is needed.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"201 ","pages":"Article 112493"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710299","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

Reduced distress tolerance and elevated depression in functional tremor: A comparative cross-sectional observational study of tremor disorders 功能性震颤的痛苦耐受性降低和抑郁升高：震颤障碍的比较横断面观察研究

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2026-02-01 Epub Date: 2025-11-29 DOI: 10.1016/j.jpsychores.2025.112479

Patrick Sheehan , Yongjia Deng , Holly E. Phelps , Nicholas Jasinski , Kierstan Pyle , Michelle M. Coleman , Danielle Sblendorio , Delanie Talkington , Ann Murray , Adeel A. Memon , Maria C. Moreno-Escobar , Jessica Frey

Background

Patients with Parkinson's Disease (PD) frequently experience depression and anxiety, while those with Essential Tremor (ET) report anxiety and embarrassment related to their tremor. The emotional burden of functional tremor (FT) is less well understood.

Objective

To examine distress tolerance and related psychological symptoms across tremor subtypes.

Methods

Patients with FT (n = 20), ET (n = 21), and PD (n = 20) completed the Distress Tolerance Scale, Beck's Depression Inventory, and Essential Tremor Embarrassment Assessment. Adverse childhood experiences (ACEs), tremor-related disability, and tremor severity were also assessed.

Results

Patients with FT reported significantly higher depression than both PD and ET groups (overall: F(2,54) = 6.85, p = .002; FT vs. PD: p = .005; FT vs. ET: p = .005), and lower distress tolerance than the PD group (F(2,54) = 3.54, p = .036). No significant differences were found between groups in embarrassment, ACEs, nor disability.

Conclusion

This distinct psychological profile in patients with FT highlights the need for integrated biopsychosocial care, and the development of targeted, comprehensive interventions.

Tremor is the most common symptom in movement disorder clinics (Sharma and Pandey, 2016 [1]). Essential Tremor (ET) affects ∼5.8 % of people over 65 (Louis and McCreary, 2021 [2]), while Parkinson's Disease (PD) affects ∼1 % of people over 60 (Tysnes and Storstein, 2017 [3]). Functional tremors (FT), the most common functional movement disorder (FMD), comprise 55 % of FMD diagnoses (Bhatia and Schneider, 2007 [4]).

帕金森氏病（PD）患者经常经历抑郁和焦虑，而原发性震颤（ET）患者则报告与震颤相关的焦虑和尴尬。功能性震颤（FT）的情绪负担尚不清楚。目的探讨不同震颤亚型患者的痛苦耐受性及相关心理症状。方法FT （n = 20）、ET （n = 21）、PD （n = 20）患者分别完成痛苦耐受量表、贝克抑郁量表和特发性震颤困窘评定。不良童年经历（ace）、震颤相关残疾和震颤严重程度也被评估。结果FT患者的抑郁程度明显高于PD组和ET组(总体：F(2,54) = 6.85, p = 0.002；FT vs. PD: p = 0.005；FT组与ET组：p = 0.005)，且痛苦耐受力低于PD组（F(2,54) = 3.54, p = 0.036）。在尴尬、ace和残疾方面，两组之间没有发现显著差异。结论：FT患者的这种独特的心理特征强调了综合生物心理社会护理的必要性，以及有针对性的综合干预措施的发展。震颤是运动障碍诊所中最常见的症状（Sharma and Pandey, 2016[1]）。特发性震颤（ET）影响约5.8%的65岁以上人群（Louis and McCreary, 2021[3]），而帕金森病（PD）影响约1%的60岁以上人群（Tysnes and Storstein, 2017[3]）。功能性震颤（FT）是最常见的功能性运动障碍（FMD），占FMD诊断的55% （Bhatia和Schneider， 2007[4]）。

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引用次数: 0