Journal of Psychosomatic Research最新文献_第8页

A prospective investigation of the prognosis of noncardiac chest pain in emergency department patients 急诊科患者非心源性胸痛预后的前瞻性调查

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-06 DOI: 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.

本研究旨在描述一组急诊科（ED）患者两年来非心源性胸痛（NCCP）的强度和频率、NCCP 相关残疾以及健康相关生活质量的变化情况。该研究还旨在识别和描述具有相似 NCCP 轨迹的患者亚群。结果随着时间的推移，NCCP 的强度和频率以及与 NCCP 相关的致残率显著降低，58.1% 的患者在 2 年随访时无 NCCP。通过潜类增长混合建模，确定了 NCCP 强度的四种轨迹：恶化轨迹（6.8%）、持续轨迹（20.5%）、有限改善轨迹（13.1%）和缓解轨迹（59.5%）。后两种轨迹的患者在所有评估点的身体生活质量都明显较高。与其他轨迹的患者相比，缓解轨迹患者的精神生活质量更高，与 NCCP 相关的残疾程度随时间推移也有更大程度的下降。

{"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}

引用次数: 0

Validation of the delirium diagnostic tool-provisional (DDT-Pro) in geriatric medical inpatients with diagnostic permutations of the 3Ds with and without delirium 在老年内科住院病人中验证谵妄诊断工具临时版（DDT-Pro），对有谵妄和无谵妄的 3D 进行诊断排列。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-06 DOI: 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.

目的：简易谵妄工具的验证并不包括对精神疾病合并症或对照组的分析。我们在 422 名抑郁症和/或痴呆症发病率较高的老年住院患者中验证了谵妄诊断工具临时版（DDT-Pro）：方法：采用两种谵妄参考标准（DSM-5-TR 和谵妄评分量表-修订版-98（DRS-R98））进行横断面研究。我们还评估了 DDT-Pro 的并发有效性和结构有效性：使用 DDT-Pro 的谵妄病例为 117 例（27.7%），DSM-5-TR 为 104 例（24.6%），DRS-R98 为 93 例（22.0%）；133 名患者（31.5%）患有抑郁症，105 名患者（24.9%）患有痴呆症，其中一些患者合并有谵妄。整个样本和四个诊断组的 DDT-Pro 与 DSM-5-TR 和 DRS-R98 相比，准确率（ROC 曲线下的 AUC）范围分别为 88.3-95.9%和 92.7-95.0%，无统计学差异。与DSM-5-TR和DRS-R98相比，DDT-Pro ≤6对谵妄诊断的敏感性-特异性最为均衡，特异性相似，但DRS-R98的敏感性高于DSM-5-TR谵妄，其中抑郁症和痴呆症患者的敏感性和特异性值最高（敏感性≥92%，特异性≥81%）。正负似然比支持诊断强度。通过显著的相关性（p 结论）反映出并发有效性很高：DDT-Pro 在综合医院的老年住院患者中表现出了很强的性能指标，这在简短谵妄工具中是独一无二的。其优化截断分数与其他人群相同。

{"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}

引用次数: 0

Association of Female Reproductive Factors with depression and suicidal ideation in postmenopausal women: Evidence from NHANES 2007–2018 女性生殖因素与绝经后妇女抑郁和自杀意念的关系：来自 2007-2018 年国家健康调查（NHANES）的证据

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-06 DOI: 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.

目的本横断面研究旨在探讨生殖因素如何影响绝经后女性的抑郁和自杀意念。方法本研究分析了 2007 年至 2018 年美国国家健康与营养调查的数据。结果在3076名参与者中，9.5%（348/3076）的人有抑郁症，3.4%（128/3076）的人有自杀倾向。在对混杂因素进行调整后，过早绝经（OR = 1.81，95% CI：1.03-3.15）与抑郁风险增加有显著相关性。此外，怀孕次数越多的绝经后妇女患抑郁症的风险越高（OR = 1.29，95% CI：1.09-1.53；P < 0.001）。相反，生育期较长（OR = 0.96，95% CI：0.93-0.99）和活产次数较多（OR = 0.68，95% CI：0.54-0.86；P < 0.001）的女性患抑郁症的风险较低。此外，使用口服避孕药（OR = 0.52，95% CI：0.28-0.97；P = 0.021）与出现自杀意念的可能性降低显著相关，而活产数量（OR = 0.68，95% CI：0.48-0.97；P = 0.018）与自杀意念呈负相关。有必要进一步开展纵向研究，对抑郁症进行重复测量，以确定因果关系。

{"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}

引用次数: 0

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 患有饮食失调病症的女性在出现饮食失调行为之前和之后的负面情绪轨迹：对状态截觉作用的研究。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-05 DOI: 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.

目的：饮食失调症（ED）的情感调节理论认为，在日常生活中，饮食失调行为（DEB）发生前的数小时内，负面情感会增加，而在发生后则会减少，但评估饮食失调行为发生后情感变化的研究结果却不尽相同。这种不一致性可能是由于之前未评估过其他跨诊断过程在这些关联中的作用，例如内感知（感知和整合来自身体感觉的信息的能力）。为了填补这一研究空白，本研究考察了不同的内感知维度是否会调节自然环境中围绕 DEBs 的负面情绪轨迹：150名患有ED病症的女性（Mage = 21.0, SD = 4.1）在为期10天的生态瞬间评估期间，每天完成4项针对情感和DEBs的调查。多项式多层次模型研究了DEBs（饮食限制、暴饮暴食、饮食失控）前后的消极情绪轨迹，以及这些轨迹是否会因每日的内感知维度（不分心、自我调节、身体倾听和信任）而有所不同：结果：消极情绪在失控进食前有所增加，但在限制饮食或暴饮暴食后却有所减少。此外，随着每日 "不分散注意力 "内感知的增加，饮食限制后出现的负面情绪下降幅度也在减小。其他内感知维度并不能调节围绕饮食限制的负面情绪轨迹：结论：允许自己体验（而不是分散注意力）不舒服的身体感觉可能会削弱日常生活中饮食限制后的情感失调过程，而这种过程被认为会维持 DEBs。这些结果提供的洞察力可能会加强EDs理论和研究，并为以知觉为重点的干预措施提供信息。

{"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}

引用次数: 0

Analgesia of noninvasive electrical stimulation of the dorsolateral prefrontal cortex: A systematic review and meta-analysis 对背外侧前额叶皮层进行非侵入性电刺激的镇痛效果：系统回顾与荟萃分析

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-07-31 DOI: 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}

引用次数: 0

The associations of spirituality and Hispanic ethnicity with neuroendocrine biomarkers among patients with colorectal cancer 精神信仰和西班牙裔与结直肠癌患者神经内分泌生物标志物的关系。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-07-30 DOI: 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}

引用次数: 0

Changes in illness perception, pain catastrophizing, and psychological distress following hand surgeon consultation: A prospective study 手外科医生会诊后疾病感知、疼痛灾难化和心理困扰的变化：前瞻性研究。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-07-27 DOI: 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.

背景：基线心态因素是影响治疗决策和结果的重要因素。从理论上讲，改善治疗前的心态可能会改善治疗决策和治疗效果。这项前瞻性队列研究评估了手外科医生会诊后患者心态的变化。此外，我们还评估了手术和非手术患者在疾病认知方面的变化是否存在差异：主要结果是疾病感知，使用简明疾病感知问卷（B-IPQ，范围 0-80）的总分进行测量。次要结果为 B-IPQ 分量表、疼痛灾难化（使用疼痛灾难化量表 (PCS) 测量）和心理困扰（使用患者健康问卷-4 测量）：共有 276 名患有各种手部和腕部疾病的患者在手外科医生会诊前后（中位时间间隔：15 天）填写了心态问卷。B-IPQ总分从就诊前的39.7（±10.6）分提高到就诊后的35.8（±11.3）分（p 结论：就诊前和就诊后患者的心态均有所改善：手外科医生会诊后，患者的疾病感知和疼痛灾难化程度均有所改善，这表明临床医生在会诊过程中可能会积极影响患者的心态，他们可以尝试加强这种影响，以改善治疗效果。此外，手术患者在疾病感知方面的改善更大，这表明非手术患者可能会受益于更有针对性的改变心态策略。

{"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}

引用次数: 0

Depression, anxiety, and development of obesity from childhood to young adulthood in China 抑郁、焦虑与中国儿童至青年期肥胖症的发展

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-07-25 DOI: 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.

目标研究从儿童期到青年期不同年龄段的儿童和青少年中，抑郁和焦虑症状与肥胖发展之间的横向和纵向双向关系。方法这是一项三波纵向研究，共纳入了>20万名5至18岁的学龄儿童。分别在基线、6 个月和 12 个月时对参与者进行评估。每次评估都会收集抑郁和焦虑症状以及参与者的体重和身高。肥胖与抑郁或焦虑之间的横断面关联通过方差分析和卡方检验进行检验。结果12至14岁年龄组的肥胖率达到高峰。同时，在每个年龄组中，较高的平均体重指数和肥胖率与较严重的抑郁和焦虑症状有关（PS < 0.001）。纵向来看，随着时间的推移，抑郁和焦虑会显著增加肥胖症的发病风险（几率比 [ORs] = 1.08 至 1.77）。此外，随着时间的推移，肥胖会明显增加抑郁（ORs = 1.17 至 1.68）和焦虑（ORs = 1.25 至 1.71）的发病风险，并阻碍抑郁症状（ORs = 0.68 至 0.79）和焦虑症状（ORs = 0.73 至 0.74）的缓解。研究结果表明，肥胖与心理困扰之间存在双向关联，因此，长期持续跟踪儿童和青少年的体重指数和心理状况，以避免两者之间的负向相互作用得到强化，可能具有重要意义。

{"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}

引用次数: 0

Tara Petzke, 2024 EAPM Elsevier young investigator award recipient, on symptom reporting 2024 年 EAPM Elsevier 青年研究员奖获得者 Tara Petzke 谈症状报告

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-07-25 DOI: 10.1016/j.jpsychores.2024.111866

引用次数: 0

P factor in children with chronic physical illness 患有慢性身体疾病儿童的 P 因子。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-07-23 DOI: 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}

引用次数: 0