Pub Date : 2024-08-06DOI: 10.1016/j.jpsychores.2024.111883
Objectives
This study sought to describe the 2-year evolution of the intensity and frequency of noncardiac chest pain (NCCP), NCCP-related disability and health-related quality of life in a cohort of emergency department (ED) patients. It also aimed to identify and characterize subgroups of patients who share similar NCCP trajectories.
Methods
672 consecutive patients with NCCP were prospectively recruited in two EDs. NCCP, physical and mental health-related quality of life and pain-related impairment were assessed at baseline and 6 months, 1 year and 2 years after the index ED visit.
Results
Significant reductions in the intensity and frequency of NCCP and in NCCP-related disability were observed over time, with 58.1% of patients being considered NCCP-free at the 2-year follow-up. Four trajectories of NCCP intensity were identified through latent class growth mixture modelling: Worsening Trajectory (6.8%), Persistence Trajectory (20.5%), Limited Improvement Trajectory (13.1%) and Remission Trajectory (59.5%). Physical quality of life was significantly higher in the latter two trajectories at all assessment points. Patients in the Remission Trajectory reported a better mental quality of life and a greater decrease in NCCP-related disability over time than those in the other trajectories.
Conclusions
Over 40% of ED patients with NCCP experienced persistent biopsychosocial morbidity that warrants further clinical attention.
{"title":"A prospective investigation of the prognosis of noncardiac chest pain in emergency department patients","authors":"","doi":"10.1016/j.jpsychores.2024.111883","DOIUrl":"10.1016/j.jpsychores.2024.111883","url":null,"abstract":"<div><h3>Objectives</h3><p>This study sought to describe the 2-year evolution of the intensity and frequency of noncardiac chest pain (NCCP), NCCP-related disability and health-related quality of life in a cohort of emergency department (ED) patients. It also aimed to identify and characterize subgroups of patients who share similar NCCP trajectories.</p></div><div><h3>Methods</h3><p>672 consecutive patients with NCCP were prospectively recruited in two EDs. NCCP, physical and mental health-related quality of life and pain-related impairment were assessed at baseline and 6 months, 1 year and 2 years after the index ED visit.</p></div><div><h3>Results</h3><p>Significant reductions in the intensity and frequency of NCCP and in NCCP-related disability were observed over time, with 58.1% of patients being considered NCCP-free at the 2-year follow-up. Four trajectories of NCCP intensity were identified through latent class growth mixture modelling: Worsening Trajectory (6.8%), Persistence Trajectory (20.5%), Limited Improvement Trajectory (13.1%) and Remission Trajectory (59.5%). Physical quality of life was significantly higher in the latter two trajectories at all assessment points. Patients in the Remission Trajectory reported a better mental quality of life and a greater decrease in NCCP-related disability over time than those in the other trajectories.</p></div><div><h3>Conclusions</h3><p>Over 40% of ED patients with NCCP experienced persistent biopsychosocial morbidity that warrants further clinical attention.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0022399924002952/pdfft?md5=25c09ebc6cdb315ca6bae1c2a51992b2&pid=1-s2.0-S0022399924002952-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-06DOI: 10.1016/j.jpsychores.2024.111880
Objective
Validations of brief delirium tools have not included analysis of psychiatric disorders comorbidities or control groups. We validated the Delirium Diagnostic Tool-Provisional (DDT-Pro) in 422 geriatric inpatients with high incidence of depression and/or dementia.
Methods
Cross-sectional study using two delirium reference standards, DSM-5-TR and Delirium Rating Scale-Revised-98 (DRS-R98). We assessed concurrent and construct DDT-Pro validity too.
Results
There were 117 (27.7%) delirium cases using DDT-Pro, 104 (24.6%) per DSM-5-TR and 93 (22.0%) per DRS-R98; 133 patients (31.5%) had depression and 105 (24.9%) dementia, some comorbid with delirium. DDT-Pro accuracy (AUC under ROC curve) ranges were 88.3–95.9% vs DSM-5-TR and 92.7–95.0% vs DRS-R98 for whole sample and four diagnostic groups, without statistical differences. DDT-Pro ≤6 had the most balanced sensitivity-specificity for delirium diagnosis against both DSM-5-TR and DRS-R98 with similar specificity but higher sensitivity for DRS-R98 than DSM-5-TR delirium, with the highest values in patients with depression and dementia (≥92% sensitivity, ≥81% specificity). Positive and negative likelihood ratios support diagnostic strength. Concurrent validity was high reflected by significant correlations (p < 0.001) of DDT-Pro total and item scores with DRS-R98 and Delirium Frontal Index scores, highest in groups with comorbid depression and/or dementia. The DDT-Pro represented a single construct for delirium demonstrated by one factor with high item loadings and high internal consistency reliability of its items.
Conclusions
The DDT-Pro demonstrated strong performance metrics in general hospital elderly inpatients with preexisting depression and/or dementia, which is unique among brief delirium tools. Its optimized cutoff score was the same as in other populations.
{"title":"Validation of the delirium diagnostic tool-provisional (DDT-Pro) in geriatric medical inpatients with diagnostic permutations of the 3Ds with and without delirium","authors":"","doi":"10.1016/j.jpsychores.2024.111880","DOIUrl":"10.1016/j.jpsychores.2024.111880","url":null,"abstract":"<div><h3>Objective</h3><p>Validations of brief delirium tools have not included analysis of psychiatric disorders comorbidities or control groups. We validated the Delirium Diagnostic Tool-Provisional (DDT-Pro) in 422 geriatric inpatients with high incidence of depression and/or dementia.</p></div><div><h3>Methods</h3><p>Cross-sectional study using two delirium reference standards, DSM-5-TR and Delirium Rating Scale-Revised-98 (DRS-R98). We assessed concurrent and construct DDT-Pro validity too.</p></div><div><h3>Results</h3><p>There were 117 (27.7%) delirium cases using DDT-Pro, 104 (24.6%) per DSM-5-TR and 93 (22.0%) per DRS-R98; 133 patients (31.5%) had depression and 105 (24.9%) dementia, some comorbid with delirium. DDT-Pro accuracy (AUC under ROC curve) ranges were 88.3–95.9% vs DSM-5-TR and 92.7–95.0% vs DRS-R98 for whole sample and four diagnostic groups, without statistical differences. DDT-Pro ≤6 had the most balanced sensitivity-specificity for delirium diagnosis against both DSM-5-TR and DRS-R98 with similar specificity but higher sensitivity for DRS-R98 than DSM-5-TR delirium, with the highest values in patients with depression and dementia (≥92% sensitivity, ≥81% specificity). Positive and negative likelihood ratios support diagnostic strength. Concurrent validity was high reflected by significant correlations (<em>p</em> < 0.001) of DDT-Pro total and item scores with DRS-R98 and Delirium Frontal Index scores, highest in groups with comorbid depression and/or dementia. The DDT-Pro represented a single construct for delirium demonstrated by one factor with high item loadings and high internal consistency reliability of its items.</p></div><div><h3>Conclusions</h3><p>The DDT-Pro demonstrated strong performance metrics in general hospital elderly inpatients with preexisting depression and/or dementia, which is unique among brief delirium tools. Its optimized cutoff score was the same as in other populations.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914458","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}
Pub Date : 2024-08-06DOI: 10.1016/j.jpsychores.2024.111881
Objective
This cross-sectional research aimed to examine how reproductive factors influence depression and suicidal ideation among postmenopausal women.
Methods
Data from the 2007 to 2018 US National Health and Nutrition Examination Survey were analyzed for this study. The Patient Health Questionnaire (PHQ-9) was adopted to measure depression and suicidal ideation in the participants.
Results
Out of 3076 participants, 9.5% (348/3076) experienced depression, and 3.4% (128/3076) reported suicidal ideation. Following the adjustment for confounding factors, premature menopause (OR = 1.81, 95% CI: 1.03–3.15) was significantly associated with an increased risk of depression. Moreover, postmenopausal women with a higher number of pregnancies exhibited a greater risk of depression (OR = 1.29, 95% CI: 1.09–1.53; P < 0.001). Conversely, a longer reproductive lifespan (OR = 0.96, 95% CI: 0.93–0.99) and a higher number of livebirths (OR = 0.68, 95% CI: 0.54–0.86; P < 0.001) were linked to a decreased risk of depression. Furthermore, the use of oral contraceptives (OR = 0.52, 95% CI: 0.28–0.97; P = 0.021) was significantly associated with a decreased likelihood of experiencing suicidal ideation, while the number of livebirths (OR = 0.68, 95% CI: 0.48–0.97; P = 0.018) exhibited a negative correlation with suicidal ideation.
Conclusion
Our results indicate that reproductive factors are significantly associated with the risk of depression and suicidal ideation in postmenopausal women. Further longitudinal studies with repeated measures of depression are necessary to establish causal relationships.
{"title":"Association of Female Reproductive Factors with depression and suicidal ideation in postmenopausal women: Evidence from NHANES 2007–2018","authors":"","doi":"10.1016/j.jpsychores.2024.111881","DOIUrl":"10.1016/j.jpsychores.2024.111881","url":null,"abstract":"<div><h3>Objective</h3><p>This cross-sectional research aimed to examine how reproductive factors influence depression and suicidal ideation among postmenopausal women.</p></div><div><h3>Methods</h3><p>Data from the 2007 to 2018 US National Health and Nutrition Examination Survey were analyzed for this study. The Patient Health Questionnaire (PHQ-9) was adopted to measure depression and suicidal ideation in the participants.</p></div><div><h3>Results</h3><p>Out of 3076 participants, 9.5% (348/3076) experienced depression, and 3.4% (128/3076) reported suicidal ideation. Following the adjustment for confounding factors, premature menopause (OR = 1.81, 95% CI: 1.03–3.15) was significantly associated with an increased risk of depression. Moreover, postmenopausal women with a higher number of pregnancies exhibited a greater risk of depression (OR = 1.29, 95% CI: 1.09–1.53; <em>P</em> < 0.001). Conversely, a longer reproductive lifespan (OR = 0.96, 95% CI: 0.93–0.99) and a higher number of livebirths (OR = 0.68, 95% CI: 0.54–0.86; <em>P</em> < 0.001) were linked to a decreased risk of depression. Furthermore, the use of oral contraceptives (OR = 0.52, 95% CI: 0.28–0.97; <em>P</em> = 0.021) was significantly associated with a decreased likelihood of experiencing suicidal ideation, while the number of livebirths (OR = 0.68, 95% CI: 0.48–0.97; <em>P</em> = 0.018) exhibited a negative correlation with suicidal ideation.</p></div><div><h3>Conclusion</h3><p>Our results indicate that reproductive factors are significantly associated with the risk of depression and suicidal ideation in postmenopausal women. Further longitudinal studies with repeated measures of depression are necessary to establish causal relationships.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239215","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}
Pub Date : 2024-08-05DOI: 10.1016/j.jpsychores.2024.111878
Objective
Affect regulation theories of eating disorders (ED) posit that negative affect increases in the hours before and decreases following disordered eating behaviors (DEBs) in daily life, yet findings from studies assessing affective changes post-DEBs are mixed. This inconsistency may be due to the previously unassessed role of other transdiagnostic processes in these associations, such as interoception (the ability to sense and integrate information from bodily sensations). To address this research gap, the present study examined whether different interoception dimensions moderated negative affect trajectories surrounding DEBs in the natural environment.
Method
150 women with ED pathology (Mage = 21.0, SD = 4.1) completed 4 surveys targeting affect and DEBs each day for a 10-day ecological momentary assessment period. Polynomial multilevel models examined negative affect trajectories pre- and post-DEBs (dietary restriction, overeating, loss of control eating), and whether these trajectories varied based on daily interoception dimensions (not distracting, self-regulation, body listening and trust).
Results
Negative affect increased prior to loss of control eating—but not dietary restriction or overeating—and decreased following all DEBs. Further, the magnitude of the decrease in negative affect that emerged post-dietary restriction decreased in strength as daily “not distracting” interoception increased. The other interoception dimensions did not moderate negative affect trajectories surrounding DEBs.
Conclusions
Allowing oneself to experience (vs. distract from) uncomfortable bodily sensations may weaken affect dysregulation processes that follow dietary restriction in daily life and are theorized to maintain DEBs. These results provide insight that may strengthen EDs theories, research, and inform interoception-focused interventions.
{"title":"Trajectories of negative affect prior to and following disordered eating behaviors among women with eating disorder pathology: An examination of the role of state-interoception","authors":"","doi":"10.1016/j.jpsychores.2024.111878","DOIUrl":"10.1016/j.jpsychores.2024.111878","url":null,"abstract":"<div><h3>Objective</h3><p>Affect regulation theories of eating disorders (ED) posit that negative affect increases in the hours before and decreases following disordered eating behaviors (DEBs) in daily life, yet findings from studies assessing affective changes post-DEBs are mixed. This inconsistency may be due to the previously unassessed role of other transdiagnostic processes in these associations, such as interoception (the ability to sense and integrate information from bodily sensations). To address this research gap, the present study examined whether different interoception dimensions moderated negative affect trajectories surrounding DEBs in the natural environment.</p></div><div><h3>Method</h3><p>150 women with ED pathology (<em>M</em>age = 21.0, <em>SD</em> = 4.1) completed 4 surveys targeting affect and DEBs each day for a 10-day ecological momentary assessment period. Polynomial multilevel models examined negative affect trajectories pre- and post-DEBs (dietary restriction, overeating, loss of control eating), and whether these trajectories varied based on daily interoception dimensions (not distracting, self-regulation, body listening and trust).</p></div><div><h3>Results</h3><p>Negative affect increased prior to loss of control eating—but not dietary restriction or overeating—and decreased following all DEBs. Further, the magnitude of the decrease in negative affect that emerged post-dietary restriction decreased in strength as daily “not distracting” interoception increased. The other interoception dimensions did not moderate negative affect trajectories surrounding DEBs.</p></div><div><h3>Conclusions</h3><p>Allowing oneself to experience (vs. distract from) uncomfortable bodily sensations may weaken affect dysregulation processes that follow dietary restriction in daily life and are theorized to maintain DEBs. These results provide insight that may strengthen EDs theories, research, and inform interoception-focused interventions.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917919","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}
Pub Date : 2024-07-31DOI: 10.1016/j.jpsychores.2024.111868
Objective
The dorsolateral prefrontal cortex (DLPFC) is implicated in pain modulation, suggesting its potential as a therapeutic target for pain relief. However, studies on transcranial electrical stimulation (tES) over the DLPFC yielded diverse results, likely due to differences in stimulation protocols or pain assessment methods. This study aims to evaluate the analgesic effects of DLPFC-tES using a meta-analytical approach.
Methods
A meta-analysis of 29 studies involving 785 participants was conducted. The effects of genuine and sham DLPFC-tES on pain perception were examined in healthy individuals and patients with clinical pain. Subgroup analyses explored the impact of stimulation parameters and pain modalities.
Results
DLPFC-tES did not significantly affect pain outcomes in healthy populations but showed promise in reducing pain-intensity ratings in patients with clinical pain (Hedges' g = −0.78, 95% CI = [−1.33, −0.24], p = 0.005). Electrode placement significantly influenced the analgesic effect, with better results observed when the anode was at F3 and the cathode at F4.
Conclusions
DLPFC-tES holds potential as a cost-effective pain management option, particularly for clinical populations. Optimizing electrode placement, especially with an symmetrical configuration, may enhance therapeutic efficacy. These findings underscore the promise of DLPFC-tES for alleviating perceived pain intensity in clinical settings, emphasizing the importance of electrode placement optimization.
目的 背外侧前额叶皮层(DLPFC)与疼痛调节有关,这表明它有可能成为缓解疼痛的治疗靶点。然而,有关经颅电刺激(tES)DLPFC的研究结果各不相同,这可能是由于刺激方案或疼痛评估方法的差异造成的。本研究旨在使用荟萃分析方法评估 DLPFC-tES 的镇痛效果。在健康人和临床疼痛患者中研究了真实和虚假DLPFC-tES对痛觉的影响。结果DLPFC-tES对健康人群的疼痛结果没有显著影响,但在降低临床疼痛患者的疼痛强度评级方面表现良好(Hedges' g = -0.78, 95% CI = [-1.33, -0.24],p = 0.005)。电极位置对镇痛效果有明显影响,当阳极位于 F3,阴极位于 F4 时,镇痛效果更好。优化电极位置,尤其是对称配置,可提高疗效。这些研究结果突显了 DLPFC-tES 在临床环境中减轻感知疼痛强度的前景,同时强调了电极位置优化的重要性。
{"title":"Analgesia of noninvasive electrical stimulation of the dorsolateral prefrontal cortex: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.jpsychores.2024.111868","DOIUrl":"10.1016/j.jpsychores.2024.111868","url":null,"abstract":"<div><h3>Objective</h3><p>The dorsolateral prefrontal cortex (DLPFC) is implicated in pain modulation, suggesting its potential as a therapeutic target for pain relief. However, studies on transcranial electrical stimulation (tES) over the DLPFC yielded diverse results, likely due to differences in stimulation protocols or pain assessment methods. This study aims to evaluate the analgesic effects of DLPFC-tES using a meta-analytical approach.</p></div><div><h3>Methods</h3><p>A meta-analysis of 29 studies involving 785 participants was conducted. The effects of genuine and sham DLPFC-tES on pain perception were examined in healthy individuals and patients with clinical pain. Subgroup analyses explored the impact of stimulation parameters and pain modalities.</p></div><div><h3>Results</h3><p>DLPFC-tES did not significantly affect pain outcomes in healthy populations but showed promise in reducing pain-intensity ratings in patients with clinical pain (Hedges' g = −0.78, 95% CI = [−1.33, −0.24], <em>p</em> = 0.005). Electrode placement significantly influenced the analgesic effect, with better results observed when the anode was at F3 and the cathode at F4.</p></div><div><h3>Conclusions</h3><p>DLPFC-tES holds potential as a cost-effective pain management option, particularly for clinical populations. Optimizing electrode placement, especially with an symmetrical configuration, may enhance therapeutic efficacy. These findings underscore the promise of DLPFC-tES for alleviating perceived pain intensity in clinical settings, emphasizing the importance of electrode placement optimization.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141978643","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}
Pub Date : 2024-07-30DOI: 10.1016/j.jpsychores.2024.111865
Objective
Dealing with cancer evokes not only physical and emotional distress, but may also promote resilience through spirituality. Patients with cancer are vulnerable to neuroendocrine dysregulation. This longitudinal observational study examined the degree to which spirituality was associated with neuroendocrine biomarkers and the moderating role of Hispanic ethnicity.
Methods
Participants were adults who were recently diagnosed with colorectal cancer (n = 81, 55 years old, 66% male, 63% Hispanic, 72% advanced cancer, 7 months post-diagnosis). The domains of spirituality (faith, meaning, and peace) and ethnicity (Hispanic vs. non-Hispanic) were self-reported. Cortisol and alpha amylase (sAA) were assayed from saliva samples collected at waking and bedtime on seven consecutive days. Mean levels at waking and bedtime, and diurnal slopes over seven days were calculated. Age and cancer stage were covariates. Results: Overall, patients reported moderate to high levels of spirituality. General linear modeling revealed that greater faith was associated with higher levels of sAA at waking and bedtime as well as more blunted diurnal pattern of sAA only among Hispanic patients (p ≤ .045). Greater peace was associated with steeper diurnal pattern of sAA, regardless of ethnicity (B = 0.021, p = .005). Meaning and cortisol were not significantly associated with study variables.
Conclusions
Findings indicate that presence of peace facing a cancer diagnosis associated with neuroendocrine regulation, whereas drawing on one's faith, particularly among Hispanic patients, associated with neuroendocrine dysregulation during the first months after the diagnosis. Further investigations of psychobiobehavioral moderators and mediators for healthy neuroendocrine functioning among patients with cancer are warranted.
目的应对癌症不仅会引起身体和精神上的痛苦,还可能通过精神疗法提高复原力。癌症患者容易出现神经内分泌失调。这项纵向观察研究探讨了灵性与神经内分泌生物标志物的关联程度以及西班牙裔的调节作用:参与者为最近被诊断出患有结直肠癌的成年人(n = 81,55 岁,66% 为男性,63% 为西班牙裔,72% 为晚期癌症,诊断后 7 个月)。精神领域(信仰、意义与和平)和种族(西班牙裔与非西班牙裔)均为自我报告。连续七天在起床和就寝时采集唾液样本,化验皮质醇和α-淀粉酶(sAA)。计算出醒时和睡前的平均水平以及七天内的昼夜斜率。年龄和癌症分期是协变量:结果:总体而言,患者报告的精神信仰程度为中度到高度。一般线性建模显示,只有在西班牙裔患者中,较高的信仰与较高的醒时和睡前 sAA 水平以及较钝化的 sAA 日间模式有关(p ≤ .045)。无论种族如何,更平和的情绪与更陡峭的 sAA 日间模式相关(B = 0.021,p = .005)。意义和皮质醇与研究变量无明显关联:研究结果表明,面对癌症诊断时的平和心态与神经内分泌调节有关,而在诊断后的头几个月中,依靠自己的信仰(尤其是在西班牙裔患者中)与神经内分泌失调有关。有必要进一步研究癌症患者神经内分泌功能健康的心理生物行为调节因素和中介因素。
{"title":"The associations of spirituality and Hispanic ethnicity with neuroendocrine biomarkers among patients with colorectal cancer","authors":"","doi":"10.1016/j.jpsychores.2024.111865","DOIUrl":"10.1016/j.jpsychores.2024.111865","url":null,"abstract":"<div><h3>Objective</h3><p>Dealing with cancer evokes not only physical and emotional distress, but may also promote resilience through spirituality. Patients with cancer are vulnerable to neuroendocrine dysregulation. This longitudinal observational study examined the degree to which spirituality was associated with neuroendocrine biomarkers and the moderating role of Hispanic ethnicity.</p></div><div><h3>Methods</h3><p>Participants were adults who were recently diagnosed with colorectal cancer (<em>n</em> = 81, 55 years old, 66% male, 63% Hispanic, 72% advanced cancer, 7 months post-diagnosis). The domains of spirituality (faith, meaning, and peace) and ethnicity (Hispanic vs. non-Hispanic) were self-reported. Cortisol and alpha amylase (sAA) were assayed from saliva samples collected at waking and bedtime on seven consecutive days. Mean levels at waking and bedtime, and diurnal slopes over seven days were calculated. Age and cancer stage were covariates. <strong>Results:</strong> Overall, patients reported moderate to high levels of spirituality. General linear modeling revealed that greater faith was associated with higher levels of sAA at waking and bedtime as well as more blunted diurnal pattern of sAA only among Hispanic patients (<em>p</em> ≤ .045). Greater peace was associated with steeper diurnal pattern of sAA, regardless of ethnicity (<em>B</em> = 0.021, <em>p</em> = .005). Meaning and cortisol were not significantly associated with study variables.</p></div><div><h3>Conclusions</h3><p>Findings indicate that presence of peace facing a cancer diagnosis associated with neuroendocrine regulation, whereas drawing on one's faith, particularly among Hispanic patients, associated with neuroendocrine dysregulation during the first months after the diagnosis. Further investigations of psychobiobehavioral moderators and mediators for healthy neuroendocrine functioning among patients with cancer are warranted.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908172","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}
Pub Date : 2024-07-27DOI: 10.1016/j.jpsychores.2024.111861
Background
Baseline mindset factors are important factors that influence treatment decisions and outcomes. Theoretically, improving the mindset prior to treatment may improve treatment decisions and outcomes. This prospective cohort study evaluated changes in patients' mindset following hand surgeon consultation. Additionally, we assessed if the change in illness perception differed between surgical and nonsurgical patients.
Methods
The primary outcome was illness perception, measured using the total score of the Brief Illness Perception Questionnaire (B-IPQ, range 0–80). Secondary outcomes were the B-IPQ subscales, pain catastrophizing (measured using the Pain Catastrophizing Scale (PCS)), and psychological distress (measured using the Patient Health Questionnaire-4).
Results
A total of 276 patients with various hand and wrist conditions completed the mindset questionnaires before and after hand surgeon consultation (median time interval: 15 days). The B-IPQ total score improved from 39.7 (±10.6) before to 35.8 (±11.3) after consultation (p < 0.0001, Cohen's d = 0.36); scores also improved for the B-IPQ subscales Coherence, Concern, Emotional Response, Timeline, Treatment Control, and Identity and the PCS. There were no changes in the other outcomes. Surgical patients improved on the B-IPQ subscales Treatment Control and Timeline, while nonsurgical patients did not.
Conclusions
Illness perception and pain catastrophizing improved following hand surgeon consultation, suggesting that clinicians may actively influence the patients' mindset during consultations, and that they may try to enhance this effect to improve outcomes. Furthermore, surgical patients improved more in illness perceptions, indicating that nonsurgical patients may benefit from a more targeted strategy for changing mindset.
{"title":"Changes in illness perception, pain catastrophizing, and psychological distress following hand surgeon consultation: A prospective study","authors":"","doi":"10.1016/j.jpsychores.2024.111861","DOIUrl":"10.1016/j.jpsychores.2024.111861","url":null,"abstract":"<div><h3>Background</h3><p>Baseline mindset factors are important factors that influence treatment decisions and outcomes. Theoretically, improving the mindset prior to treatment may improve treatment decisions and outcomes. This prospective cohort study evaluated changes in patients' mindset following hand surgeon consultation. Additionally, we assessed if the change in illness perception differed between surgical and nonsurgical patients.</p></div><div><h3>Methods</h3><p>The primary outcome was illness perception, measured using the total score of the Brief Illness Perception Questionnaire (B-IPQ, range 0–80). Secondary outcomes were the B-IPQ subscales, pain catastrophizing (measured using the Pain Catastrophizing Scale (PCS)), and psychological distress (measured using the Patient Health Questionnaire-4).</p></div><div><h3>Results</h3><p>A total of 276 patients with various hand and wrist conditions completed the mindset questionnaires before and after hand surgeon consultation (median time interval: 15 days). The B-IPQ total score improved from 39.7 (±10.6) before to 35.8 (±11.3) after consultation (<em>p</em> < 0.0001, Cohen's d = 0.36); scores also improved for the B-IPQ subscales Coherence, Concern, Emotional Response, Timeline, Treatment Control, and Identity and the PCS. There were no changes in the other outcomes. Surgical patients improved on the B-IPQ subscales Treatment Control and Timeline, while nonsurgical patients did not.</p></div><div><h3>Conclusions</h3><p>Illness perception and pain catastrophizing improved following hand surgeon consultation, suggesting that clinicians may actively influence the patients' mindset during consultations, and that they may try to enhance this effect to improve outcomes. Furthermore, surgical patients improved more in illness perceptions, indicating that nonsurgical patients may benefit from a more targeted strategy for changing mindset.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0022399924002733/pdfft?md5=c09473545e9b8a7eb475ae89aea30f60&pid=1-s2.0-S0022399924002733-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.1016/j.jpsychores.2024.111867
Objective
To examine the cross-sectional and longitudinal bidirectional associations of depression and anxiety symptoms with the development of obesity over time among children and adolescents in different age groups from childhood to young adulthood.
Methods
This is a three-wave longitudinal study that included >200,000 school-aged children between 5 and 18 years. Participants were assessed at baseline, 6 months, and 12 months. Depression and anxiety symptoms, as well as participants' weight and height, were collected at each assessment. The cross-sectional associations between obesity and depression or anxiety were examined through ANOVA and Chi-square tests. Multivariable logistic regression analyses were performed to investigate their longitudinal bidirectional associations.
Results
The prevalence of obesity reached a peak in the age group between 12 and 14 years. Concurrently, higher mean BMI and obesity prevalence were associated with more severe symptoms of depression and anxiety in each age group (ps < 0.001). Longitudinally, depression and anxiety significantly increased the risk of development of obesity over time (odds ratios [ORs] = 1.08 to 1.77). Moreover, obesity significantly aggravated the risk of development of depression (ORs = 1.17 to 1.68) and anxiety (ORs = 1.25 to 1.71) over time and hindered the alleviation of depressive (ORs = 0.68 to 0.79) and anxiety symptoms (ORs = 0.73 to 0.74).
Conclusion
Findings suggest that there were bidirectional associations between obesity and psychological distress. It may be important to continuously track BMI and psychological conditions for children and adolescents over time to avoid the reinforcement of their negative reciprocal interactions.
{"title":"Depression, anxiety, and development of obesity from childhood to young adulthood in China","authors":"","doi":"10.1016/j.jpsychores.2024.111867","DOIUrl":"10.1016/j.jpsychores.2024.111867","url":null,"abstract":"<div><h3>Objective</h3><p>To examine the cross-sectional and longitudinal bidirectional associations of depression and anxiety symptoms with the development of obesity over time among children and adolescents in different age groups from childhood to young adulthood.</p></div><div><h3>Methods</h3><p>This is a three-wave longitudinal study that included >200,000 school-aged children between 5 and 18 years. Participants were assessed at baseline, 6 months, and 12 months. Depression and anxiety symptoms, as well as participants' weight and height, were collected at each assessment. The cross-sectional associations between obesity and depression or anxiety were examined through ANOVA and Chi-square tests. Multivariable logistic regression analyses were performed to investigate their longitudinal bidirectional associations.</p></div><div><h3>Results</h3><p>The prevalence of obesity reached a peak in the age group between 12 and 14 years. Concurrently, higher mean BMI and obesity prevalence were associated with more severe symptoms of depression and anxiety in each age group (<em>p</em>s < 0.001). Longitudinally, depression and anxiety significantly increased the risk of development of obesity over time (odds ratios [ORs] = 1.08 to 1.77). Moreover, obesity significantly aggravated the risk of development of depression (ORs = 1.17 to 1.68) and anxiety (ORs = 1.25 to 1.71) over time and hindered the alleviation of depressive (ORs = 0.68 to 0.79) and anxiety symptoms (ORs = 0.73 to 0.74).</p></div><div><h3>Conclusion</h3><p>Findings suggest that there were bidirectional associations between obesity and psychological distress. It may be important to continuously track BMI and psychological conditions for children and adolescents over time to avoid the reinforcement of their negative reciprocal interactions.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840587","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}
Pub Date : 2024-07-25DOI: 10.1016/j.jpsychores.2024.111866
{"title":"Tara Petzke, 2024 EAPM Elsevier young investigator award recipient, on symptom reporting","authors":"","doi":"10.1016/j.jpsychores.2024.111866","DOIUrl":"10.1016/j.jpsychores.2024.111866","url":null,"abstract":"","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848851","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}
Pub Date : 2024-07-23DOI: 10.1016/j.jpsychores.2024.111863
Background
The p factor represents the overall liability for the development of mental illness. While evidence supporting the p factor in adults has been reported, studies in children are fewer, and none have examined the p factor in children with chronic physical illness (CPI).
Objective
We aimed to model the p factor in a longitudinal sample of children with CPI using a parent-reported checklist and examine its construct validity against a structured diagnostic interview.
Methods
We used data from 263 children aged 2–16 years diagnosed with a CPI who were enrolled in the Multimorbidity in Children and Youth across the Life-course (MY LIFE) study. The p factor was modelled using the Emotional Behavioural Scales over 24 months using confirmatory factor analysis. Validation of the p factor was set against the Mini International Neuropsychiatric Interview for Children and Adolescents.
Results
Factorial evidence supported the p factor, modelled using a bi-factor structure, compared to a standard correlated-factors (i.e., two-factor) structure [Δχ2 = 9.66(4), p = 0.047]. p factor scores were correlated with the number of different mental illness diagnoses (r = 0.71) and total number of diagnoses (r = 0.72). Dose-response relationships were shown for the number of different diagnoses (p < 0.001) and total number of diagnoses (p < 0.001).
Conclusion
In this first study of the p factor in children with CPI, we showed evidence of its bi-factor structure and associations with mental illness diagnoses. Mental comorbidity in children with CPI is pervasive and warrants transdiagnostic approaches to integrated pediatric care.
背景:p 因子代表了精神疾病发展的总体责任。尽管有证据显示成人存在 p 因素,但针对儿童的研究却较少,而且没有一项研究对患有慢性躯体疾病(CPI)的儿童进行了 p 因素研究:我们的目的是使用家长报告的核对表,在慢性躯体疾病儿童的纵向样本中建立 p 因子模型,并根据结构化诊断访谈检验其构建有效性:我们使用了263名被诊断患有CPI的2-16岁儿童的数据,这些儿童参加了儿童和青少年一生中的多病症(MY LIFE)研究。通过确认性因子分析,使用情绪行为量表对 p 因子进行了 24 个月的建模。根据儿童和青少年迷你国际神经精神访谈对 p 因子进行了验证:与标准的相关因子(即双因子)结构相比,使用双因子结构建模的因子支持 p 因子[Δχ2 = 9.66(4),p = 0.047]。不同诊断数(p 结论:p因子得分与诊断数之间存在剂量-反应关系:在这项首次针对 CPI 儿童的 p 因子研究中,我们发现了其双因子结构及其与精神疾病诊断相关性的证据。CPI患儿的精神疾病合并症非常普遍,需要采用跨诊断方法进行综合儿科护理。
{"title":"P factor in children with chronic physical illness","authors":"","doi":"10.1016/j.jpsychores.2024.111863","DOIUrl":"10.1016/j.jpsychores.2024.111863","url":null,"abstract":"<div><h3>Background</h3><p>The <em>p</em> factor represents the overall liability for the development of mental illness. While evidence supporting the <em>p</em> factor in adults has been reported, studies in children are fewer, and none have examined the <em>p</em> factor in children with chronic physical illness (CPI).</p></div><div><h3>Objective</h3><p>We aimed to model the <em>p</em> factor in a longitudinal sample of children with CPI using a parent-reported checklist and examine its construct validity against a structured diagnostic interview.</p></div><div><h3>Methods</h3><p>We used data from 263 children aged 2–16 years diagnosed with a CPI who were enrolled in the Multimorbidity in Children and Youth across the Life-course (MY LIFE) study. The <em>p</em> factor was modelled using the Emotional Behavioural Scales over 24 months using confirmatory factor analysis. Validation of the <em>p</em> factor was set against the Mini International Neuropsychiatric Interview for Children and Adolescents.</p></div><div><h3>Results</h3><p>Factorial evidence supported the <em>p</em> factor, modelled using a bi-factor structure, compared to a standard correlated-factors (i.e., two-factor) structure [Δχ<sup>2</sup> = 9.66(4), <em>p</em> = 0.047]. <em>p</em> factor scores were correlated with the number of different mental illness diagnoses (<em>r</em> = 0.71) and total number of diagnoses (<em>r</em> = 0.72). Dose-response relationships were shown for the number of different diagnoses (<em>p</em> < 0.001) and total number of diagnoses (p < 0.001).</p></div><div><h3>Conclusion</h3><p>In this first study of the <em>p</em> factor in children with CPI, we showed evidence of its bi-factor structure and associations with mental illness diagnoses. Mental comorbidity in children with CPI is pervasive and warrants transdiagnostic approaches to integrated pediatric care.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0022399924002757/pdfft?md5=383ac8f3a77de95464f815b2e4efddbe&pid=1-s2.0-S0022399924002757-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}