Journal of Psychosomatic Research最新文献_第8页

Navigating bio-psychosocial pathways in the relationship between food insecurity and mobility in the elderly 在老年人粮食不安全与流动性之间的关系中探索生物-心理-社会路径

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-23 DOI: 10.1016/j.jpsychores.2024.111891

Rizky Andana Pohan , Ririn Dwi Astuti , Putri Bunga Aisyah Pohan , Erfan Ramadhani , Rikas Saputra

引用次数: 0

Adverse childhood experiences and alexithymia intensity as predictors of temporal dynamics of functioning in individuals with irritable bowel syndrome: A three-wave latent transition analysis 预测肠易激综合征患者功能的时间动态的童年不良经历和亚历山大强度：三波潜转分析

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-23 DOI: 10.1016/j.jpsychores.2024.111904

Marcin Rzeszutek , Joanna Kowalkowska , Katarzyna Drabarek , Angelika Van Hoy , Katarzyna Schier , Maja Lis-Turlejska , Małgorzata Dragan , Paweł Holas , Dominika Maison , Elżbieta Litwin , Julia Wawrzyniak , Wiktoria Znamirowska , Szymon Szumiał , Małgorzata Desmond

Objective

Despite high prevalence of irritable bowel syndrome (IBS) and its significant negative impact on individuals' quality of life, its etiology remains poorly understood. This prospective study explored whether early life factors (adverse childhood experiences; ACEs) and alexithymia intensity, could explain IBS symptom severity and its effects on psychological functioning over time. We also compared the studied variables between an IBS sample and a healthy control group.

Method

Based on the Rome III Diagnostic Criteria for IBS, 245 individuals with a diagnosis of IBS were recruited from a national sample of Poles. The IBS sample completed the following psychometric questionaries in three waves, one month apart: Adverse Childhood Experiences Questionnaire, Toronto Alexithymia Scale, IBS Symptom Severity Score, Short Form Perceived Stress Scale, and Ultra-Brief Patient Health Questionnaire for Anxiety and Depression. Latent transition analysis was used to identify distinct profiles of IBS symptom dynamics.

Results

The IBS group reported a significantly higher number of ACEs, greater alexithymia severity, and more intense levels of stress, anxiety, and depressive symptoms compared to the healthy controls. Four profiles of IBS individuals with distinct dynamics of IBS symptoms, stress, anxiety, and depressive symptoms were extracted, which correlated with the baseline number of ACEs and alexithymia intensity among participants.

Conclusion

Childhood adversity and associated problems in emotional processing affect IBS symptom severity. ACEs should be included in IBS screening and considered in the design of individualized multidisciplinary treatment approaches for IBS patients.

尽管肠易激综合征（IBS）的发病率很高，而且对个人的生活质量产生了很大的负面影响，但人们对其病因仍然知之甚少。这项前瞻性研究探讨了早期生活因素（童年不良经历 ACE）和自闭症强度是否可以解释肠易激综合征症状的严重程度及其对心理功能的长期影响。我们还比较了肠易激综合征样本与健康对照组之间的研究变量。研究方法：根据罗马 III 肠易激综合征诊断标准，我们从全国波兰样本中招募了 245 名被诊断为肠易激综合征的患者。肠易激综合征样本分三次完成了以下心理测试问卷，每次间隔一个月：童年不良经历问卷、多伦多亚历山大症量表、肠易激综合征症状严重程度评分、简表感知压力量表以及超简表焦虑和抑郁患者健康问卷。结果与健康对照组相比，肠易激综合征组报告的 ACE 数量明显更多，自闭症严重程度更高，压力、焦虑和抑郁症状也更严重。研究提取了四种具有不同肠易激综合征症状、压力、焦虑和抑郁症状动态变化的肠易激综合征个体特征，这些特征与参与者的基线ACE数量和情感淡漠强度相关。ACE应纳入肠易激综合征筛查，并在设计针对肠易激综合征患者的个性化多学科治疗方法时加以考虑。

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引用次数: 0

Bilateral vestibulopathy – Loss of vestibular function and experience of emotions 双侧前庭病 - 丧失前庭功能和情感体验

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-22 DOI: 10.1016/j.jpsychores.2024.111894

C. Lahmann , M. Dieterich , S. Becker-Bense , G. Schmid-Mühlbauer

Objective

The vestibular system is closely connected to emotion-processing neuronal circuits. Patients with bilateral vestibulopathy (BVP), a chronic loss of vestibular function, show remarkably lower rates of psychiatric comorbidities and vertigo-related anxiety (VRA) than those with episodic vertigo/dizziness (v/d). This study aimed to evaluate whether patients with BVP differ from those with episodic v/d in terms of VRA, general anxiety, and cognitions about body and health.

Methods

This cross-sectional study involved a subsample of 202 patients with episodic v/d (i.e., vestibular migraine, vestibular paroxysmia, or Menière's disease) and 43 patients with BVP. All patients underwent standardised neurological/neurotological examinations, structured clinical interviews (SCID-I), and self-report questionnaires, such as the Vertigo Handicap Questionnaire (VHQ), Beck Anxiety Inventory (BAI), Trait Anxiety from the State-Trait-Anxiety Inventory (STAI-T), and Cognitions About Body and Health questionnaire (CABAH). Non-parametric tests were used for analysis. Due to multiple testing, the significance level was set at p ≤ .008.

Results

Patients with episodic v/d exhibited higher VRA levels than those with BVP. However, this difference was not statistically significant (p = .04; r = 0.15, small effect). Additionally, patients with BVP reported more catastrophizing cognitions (p < .001; r = 0.25, small effect) and bodily weakness (p = .003; r = 0.22, small effect) compared to those with episodic v/d. There were no differences in general anxiety levels (BAI and STAI-T) between patients with v/d and those with BVP.

Conclusion

Patients with episodic v/d and BVP differed in their appraisal (cognition). The difference in VRA (subjective feeling) was not statistically significant. These preliminary results are discussed using a component approach to emotions.

前庭系统与情绪处理神经元回路密切相关。双侧前庭大腺病（BVP）是一种慢性前庭功能丧失，与发作性眩晕/头晕（v/d）患者相比，双侧前庭大腺病患者的精神疾病合并症和眩晕相关焦虑（VRA）发生率明显较低。本研究旨在评估在眩晕相关焦虑、一般焦虑以及对身体和健康的认知方面，BVP 患者与发作性眩晕/头晕患者是否存在差异。方法这项横断面研究涉及 202 名发作性眩晕/头晕（即前庭性偏头痛、前庭阵发性痛或梅尼埃病）患者和 43 名 BVP 患者。所有患者均接受了标准化的神经学/神经病学检查、结构化临床访谈（SCID-I）和自我报告问卷，如眩晕障碍问卷（VHQ）、贝克焦虑量表（BAI）、国家-特质-焦虑量表（STAI-T）中的特质焦虑以及身体与健康认知问卷（CABAH）。分析采用非参数检验。结果发作性 v/d 患者的 VRA 水平高于 BVP 患者。然而，这一差异并无统计学意义（p = 0.04；r = 0.15，影响较小）。此外，与发作性 v/d 患者相比，BVP 患者报告了更多的灾难化认知（p < .001; r = 0.25，小效应）和身体虚弱（p = .003; r = 0.22，小效应）。结论发作性 v/d 和 BVP 患者在评价（认知）方面存在差异。VRA（主观感觉）的差异在统计学上并不显著。本文采用情绪成分法对这些初步结果进行了讨论。

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引用次数: 0

Research priorities for medically not yet explained symptoms expressed by patients, carers, and healthcare professionals in the Netherlands following the James Lind Alliance priority setting partnership approach 根据詹姆斯-林德联盟确定优先事项的合作方法，荷兰患者、护理人员和医疗保健专业人员就医学上无法解释的症状提出的研究优先事项

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-22 DOI: 10.1016/j.jpsychores.2024.111890

Iman Elfeddali , Willem Johan Kop , Margot Metz , Linh Nguyen , Jennifer Sweetman , Jonathan Gower , Christina M. van der Feltz-Cornelis , Arjan C. Videler

Objective

Experiencing physical symptoms that are medically not yet explained (MNYES) is associated with considerable burden in daily life. Research priorities in this area have been primarily investigator-driven. The present study identifies the top 10 research priorities, incorporating the views of patients, carers and healthcare professionals.

Methods

This study used the Priority Setting Partnership approach in collaboration with the James Lind Alliance (JLA). The priority setting approach combines survey-based data from patients with a specific disorder/condition and relevant stakeholders (i.e., caregivers and healthcare professionals) with input from group meetings and a final priority setting consensus meeting. There were three consecutive phases: (1) online survey with an open-ended question to collect topics for future scientific research (N = 345 participants); (2) an online survey among stakeholders to prioritise the research questions generated in Phase 1 (N = 400); and (3) a final multi-stakeholder consensus meeting, held over two half-days to determine the final top 10 research priorities for the Netherlands (day 1 N = 25, day 2 N = 24).

Results

Phase 1 resulted in 572 topics, which were reduced to 37 summary research questions. Phase 2 resulted in 18 research priorities, that were ranked and the top 10 priorities were established during the final consensus meeting. The top 10 research priorities included three main themes: optimising efficient diagnosis and treatment, aetiology and prevention, and coping with MNYES.

Conclusion

The top 10 priorities provide insight into what is most important for future research into MNYES from the perspective of patients, carers and healthcare professionals.

目标出现医学上无法解释的身体症状（MNYES）会给日常生活带来相当大的负担。该领域的研究重点主要由研究人员决定。本研究结合患者、照护者和医疗保健专业人员的意见，确定了十大优先研究事项。优先事项设定方法将特定疾病/症状患者和相关利益方（即护理人员和医护人员）的调查数据与小组会议和最终优先事项设定共识会议的意见相结合。该方法分为三个连续的阶段：(1) 在线调查，以开放式问题的形式收集未来科学研究的主题（N = 345 名参与者）；(2) 在利益相关者中进行在线调查，对第 1 阶段产生的研究问题进行优先排序（N = 400）；(3) 举行为期两个半天的最终多方利益相关者共识会议，以确定荷兰的最终 10 大研究优先事项（第 1 天 N = 25，第 2 天 N = 24）。第 2 阶段产生了 18 个研究重点，并对其进行了排序，在最后的共识会议上确定了前 10 个研究重点。十大优先研究事项包括三大主题：优化有效诊断和治疗、病因和预防以及应对 MNYES。

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引用次数: 0

Sleep disturbance as a poor prognostic predictor in patients with advanced non-small-cell lung cancer treated with immune checkpoint inhibitors: A prospective study 睡眠障碍是接受免疫检查点抑制剂治疗的晚期非小细胞肺癌患者的不良预后预测因素：前瞻性研究

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-22 DOI: 10.1016/j.jpsychores.2024.111892

Ning Li , Dinglong Xue , Xu Zhao, Lijun Li, Kaiya Men, Jiaxin Yang, Hao Jiang, Qingwei Meng, Shuai Zhang

Background

Sleep disturbances are highly prevalent in oncology and often exacerbate symptoms, leading to reduced quality of life, which in turn may further affect the tolerability and efficacy of oncological treatments. Sleep disturbance and cancer have an intimate and complicated relationship, and may be a negative predictor of cancer treatment. The present study aimed to characterize the relationship between sleep disturbance and immune checkpoint inhibitor (ICI) therapy in patients with advanced non-small cell lung cancer (NSCLC).

Methods

Data from 171 patients with advanced NSCLC, who underwent ICI treatment between December 2020 and October 2022, were analysed in our prospective study. Sleep disturbances were evaluated according to the Pittsburgh Sleep Quality Index (PSQI), with a cut-off value of 5, to investigate the impact of sleep disturbance on the survival of patients with NSCLC and the efficacy of ICI treatment.

Results

The median progression-free survival (PFS) was10.4 months (9 5% confidence interval [CI]:9.84–10.97). Univariate and multivariate analyses revealed that sleep disturbance and depressive symptom predicted worse prognosis with shortened PFS. Patients who experienced sleep disturbance exhibited a significant reduction in PFS (9.2 vs. 11.8 months; HR: 1.83 [9 5% CI 1.27–2.6 5]; p = 0.001), as did those with depressive states (HR 1.5 5 [9 5% CI 1.06–2.28]; p = 0.02 5). Additionally, patients with sleep disturbance and depressive symptoms exhibited significantly lower objective response rates and disease control rates.

Conclusion

Sleep disturbance could be a factor for prognosis in patients with advanced NSCLC undergoing first- or second-line treatment with ICIs, including shorter PFS and reduced efficacy.

背景睡眠障碍在肿瘤学中非常普遍，它往往会加重症状，导致生活质量下降，反过来又会进一步影响肿瘤治疗的耐受性和疗效。睡眠障碍与癌症的关系密切而复杂，可能是癌症治疗的负面预测因素。本研究旨在描述晚期非小细胞肺癌（NSCLC）患者睡眠障碍与免疫检查点抑制剂（ICI）治疗之间的关系。方法我们的前瞻性研究分析了在2020年12月至2022年10月期间接受ICI治疗的171例晚期NSCLC患者的数据。结果中位无进展生存期（PFS）为10.4个月（9.5%置信区间[CI]：9.84-10.97）。单变量和多变量分析显示，睡眠障碍和抑郁症状预示着预后较差，PFS缩短。睡眠障碍患者的 PFS 明显缩短（9.2 个月 vs. 11.8 个月；HR：1.83 [9 5% CI 1.27-2.6 5]；p = 0.001），抑郁症状患者也是如此（HR 1.5 5 [9 5% CI 1.06-2.28]; p = 0.02 5）。此外，有睡眠障碍和抑郁症状的患者客观反应率和疾病控制率明显较低。

{"title":"Sleep disturbance as a poor prognostic predictor in patients with advanced non-small-cell lung cancer treated with immune checkpoint inhibitors: A prospective study","authors":"Ning Li , Dinglong Xue , Xu Zhao, Lijun Li, Kaiya Men, Jiaxin Yang, Hao Jiang, Qingwei Meng, Shuai Zhang","doi":"10.1016/j.jpsychores.2024.111892","DOIUrl":"10.1016/j.jpsychores.2024.111892","url":null,"abstract":"<div><h3>Background</h3><p>Sleep disturbances are highly prevalent in oncology and often exacerbate symptoms, leading to reduced quality of life, which in turn may further affect the tolerability and efficacy of oncological treatments. Sleep disturbance and cancer have an intimate and complicated relationship, and may be a negative predictor of cancer treatment. The present study aimed to characterize the relationship between sleep disturbance and immune checkpoint inhibitor (ICI) therapy in patients with advanced non-small cell lung cancer (NSCLC).</p></div><div><h3>Methods</h3><p>Data from 171 patients with advanced NSCLC, who underwent ICI treatment between December 2020 and October 2022, were analysed in our prospective study. Sleep disturbances were evaluated according to the Pittsburgh Sleep Quality Index (PSQI), with a cut-off value of 5, to investigate the impact of sleep disturbance on the survival of patients with NSCLC and the efficacy of ICI treatment.</p></div><div><h3>Results</h3><p>The median progression-free survival (PFS) was10.4 months (9 5% confidence interval [CI]:9.84–10.97). Univariate and multivariate analyses revealed that sleep disturbance and depressive symptom predicted worse prognosis with shortened PFS. Patients who experienced sleep disturbance exhibited a significant reduction in PFS (9.2 vs. 11.8 months; HR: 1.83 [9 5% CI 1.27–2.6 5]; <em>p</em> = 0.001), as did those with depressive states (HR 1.5 5 [9 5% CI 1.06–2.28]; <em>p</em> = 0.02 5). Additionally, patients with sleep disturbance and depressive symptoms exhibited significantly lower objective response rates and disease control rates.</p></div><div><h3>Conclusion</h3><p>Sleep disturbance could be a factor for prognosis in patients with advanced NSCLC undergoing first- or second-line treatment with ICIs, including shorter PFS and reduced efficacy.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"186 ","pages":"Article 111892"},"PeriodicalIF":3.5,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142083877","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

Halifax somatic symptom disorder trial: A pilot randomized controlled trial of intensive short-term dynamic psychotherapy in the emergency department 哈利法克斯躯体症状障碍试验：急诊科短期强化动态心理治疗试点随机对照试验。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-22 DOI: 10.1016/j.jpsychores.2024.111889

Joel M. Town , Allan Abbass , Samuel Campbell

Background

Patients commonly present at hospital Emergency Departments (ED) with distress that meet criteria for a Somatic Symptom and Related Disorder (SSRD). Without access to effective treatment, risk of ongoing patient disability and further ED visits is high.

Method

This pilot trial used a randomized parallel group design to test the efficacy of Intensive Short-Term Dynamic Psychotherapy (ISTDP). ED patients who met criteria for SSRD were recruited. The effects of ISTDP plus medical care as usual (MCAU) were judged through comparison against 8 weeks of MCAU plus wait-list symptom monitoring (WL-SM). The primary outcome was somatic symptom at 8 weeks. Patients allocated to WL-SM could cross-over to receive ISTDP and 6-month follow-up data was collected. Baseline measures of patient attachment style and alexithymia were collected to examine vulnerabilities to somatic symptoms. ClinicalTrials.gov: NCT02076867.

Results

Thirty-seven patients were randomized to 2 groups (ISTDP = 19 and WL-SM = 18). Multi-level modelling showed that change over time on somatic symptoms was significantly greater in the ISTDP group. Between-group differences were large at 8 weeks (Cohen's d = 0.94) and increased by end of treatment (Cohen's d = 1.54). Observed differences in symptoms of depression and illness anxiety were also large, favoring ISTDP, and effects were maintained at follow-up. Patients receiving ISTDP had reduced ED service utilization at 2-year follow-up.

Conclusions

ISTDP appears an efficacious treatment for SSRD and a larger randomized trial is justified.

背景：在医院急诊科（ED）就诊的患者通常都有符合躯体症状及相关障碍（SSRD）标准的困扰。如果得不到有效治疗，患者持续致残和进一步到急诊科就诊的风险很高：这项试点试验采用随机平行分组设计，以测试短期强化动态心理疗法（ISTDP）的疗效。试验招募了符合 SSRD 标准的急诊室患者。通过与为期8周的常规医疗护理（MCAU）和候补症状监测（WL-SM）进行比较，判断ISTDP和常规医疗护理（MCAU）的效果。主要结果是 8 周后的躯体症状。接受 WL-SM 治疗的患者可交叉接受 ISTDP 治疗，并收集 6 个月的随访数据。此外，还收集了患者依恋风格和情感障碍的基线测量数据，以检查患者对躯体症状的易感性：NCT02076867.结果：37名患者被随机分为两组（ISTDP=19和WL-SM=18）。多层次建模显示，ISTDP组躯体症状随时间的变化明显更大。8 周时，组间差异较大（Cohen's d = 0.94），治疗结束时，组间差异有所扩大（Cohen's d = 1.54）。抑郁症状和疾病焦虑的观察差异也很大，有利于 ISTDP，而且效果在随访中保持不变。接受ISTDP治疗的患者在2年的随访中减少了对急诊室服务的使用：ISTDP似乎是一种治疗SSRD的有效方法，有理由进行更大规模的随机试验。

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引用次数: 0

Facilitating and hindering factors in the treatment of persistent somatic symptoms in migrants: A scoping review 治疗移民持续性躯体症状的促进因素和阻碍因素：范围界定审查

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-15 DOI: 10.1016/j.jpsychores.2024.111887

Erik van Twillert , Mirjam M.C. Hulsman , Lineke M. Tak

Objective

To identify facilitating and hindering factors in the treatment of persistent somatic symptoms (PSS) in migrants in psychiatry and other health care settings in Western countries.

Methods

A scoping literature review was conducted by searching PubMed and Embase, using combinations of search terms related to the treatment of PSS in migrants. Studies outside of the scope of current guidelines or limited to specific underlying diseases such as post-traumatic stress disorder (PTSD) or consequences of torture were excluded. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies, and identified and categorized facilitating and hindering treatment factors.

Results

Of the 347 unique citations identified in the initial the search, 18 studies met the inclusion criteria. These studies showed a wide variety in study design, interventions used, measurement instruments, and study quality. Common treatment adaptations related to: (a) translation and interpretation, (b) adaptation to lower educational levels, (c) culture-sensitive therapists and materials, (d) gender roles, (e) removal of practical barriers, (f) supportive treatment, and (g) nonverbal therapy forms. The most commonly mentioned influencing factors of treatment success related to: (a) body and experience-oriented treatment elements, (b) translation and communication, (c) cultural sensitivity, (d) group interaction, and (e) caring for one's own health.

Conclusion

This review provides an overview of available research on treatment adaptations for PSS in migratory background patients. Potential facilitating and hindering factors for treatment success that may be useful for healthcare providers treating PSS in patients with a migratory background were identified.

方法通过检索 PubMed 和 Embase，使用与移民持续性躯体症状（PSS）治疗相关的检索词组合，进行范围性文献综述。不属于现行指南范围或仅限于创伤后应激障碍（PTSD）或酷刑后果等特定潜在疾病的研究被排除在外。两名独立审稿人核实了这些研究是否符合纳入标准，评估了研究质量，并对促进和阻碍治疗的因素进行了识别和分类。这些研究在研究设计、所使用的干预措施、测量工具和研究质量方面存在很大差异。常见的治疗调整涉及(a) 翻译和口译，(b) 适应较低的教育水平，(c) 文化敏感的治疗师和材料，(d) 性别角色，(e) 消除实际障碍，(f) 支持性治疗，(g) 非语言治疗形式。最常被提及的影响治疗成功的因素包括(结语：本综述概述了现有的关于移民背景患者 PSS 治疗适应性的研究。综述指出了治疗成功的潜在促进和阻碍因素，这些因素可能对医护人员治疗具有移民背景的患者的 PSS 有所帮助。

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引用次数: 0

Biomarkers as predictors of CBT responsiveness in major depressive disorder: The role of heart rate variability and inflammation 生物标志物是重度抑郁障碍患者对 CBT 反应性的预测因子：心率变异性和炎症的作用

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-13 DOI: 10.1016/j.jpsychores.2024.111885

Frank Euteneuer , Marie Neubert , Stefan Salzmann , Susanne Fischer , Ulrike Ehlert , Winfried Rief

Objective

Biological risk factors for cardiovascular disease may relate to poor treatment responsiveness in major depressive disorder (MDD). These factors encompass low-grade inflammation and autonomic dysregulation, as indexed by decreased heart rate variability (HRV) and increased heart rate (HR). This secondary analysis examined whether higher levels of inflammatory markers or autonomic alterations relate to lower responsiveness to cognitive behavioral therapy (CBT) among individuals with MDD.

Methods

Eighty antidepressant-free patients with MDD were randomly assigned to 14 weeks of CBT or waitlist (WL). Potential biological moderators at study entry included HR and HRV (24-h, daytime, nighttime) and inflammatory markers such as C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-α. Forty non-clinical controls were involved to verify biological alterations in MDD at study entry. Depressive symptoms were assessed at baseline and at the end of treatment.

Results

Individuals with MDD exhibited reduced total 24-h HRV (i.e., triangular index) and daytime HRV (i.e., triangular index, HF-HRV, LF-HRV, RMSSD), as well as increased levels of inflammatory markers. Patients who received CBT exhibited stronger reductions in self- and clinician-rated depressive symptoms, compared to WL. False discovery rate-adjusted moderation analyses did not show overall moderating effects of biological measures on treatment responsiveness. However, higher CRP levels were specifically associated with poorer improvement in somatic depressive symptoms.

Conclusions

There was no overall evidence for a moderating role of inflammation or autonomic features in CBT responsiveness in MDD. Higher levels of CRP might, however, specifically be associated with less improvement in somatic depressive symptoms during CBT.

目的心血管疾病的生物风险因素可能与重度抑郁症（MDD）治疗反应不佳有关。这些因素包括低度炎症和自律神经失调，表现为心率变异性（HRV）降低和心率（HR）升高。这项二次分析研究了较高水平的炎症标志物或自律神经改变是否与MDD患者对认知行为疗法（CBT）的较低反应性有关。方法将八名未服用抗抑郁药的MDD患者随机分配到为期14周的CBT或候补名单（WL）中。研究开始时的潜在生物调节因子包括心率和心率变异（24 小时、白天、夜间）以及炎症指标，如 C 反应蛋白 (CRP)、白细胞介素 (IL)-6 和肿瘤坏死因子 (TNF)-α。40名非临床对照者参与了研究，以验证研究开始时多发性硬化症的生物学改变。结果MDD患者的24小时总心率变异（即三角形指数）和日间心率变异（即三角形指数、HF-HRV、LF-HRV、RMSSD）均有所降低，炎症标志物水平也有所升高。与 WL 相比，接受 CBT 治疗的患者自我和临床医生评定的抑郁症状减少更明显。假发现率调整调节分析并未显示生物指标对治疗反应性的总体调节作用。结论没有总体证据表明炎症或自律神经特征对 MDD 的 CBT 反应性有调节作用。然而，CRP水平较高可能与CBT期间躯体抑郁症状改善较差特别相关。

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引用次数: 0

Effectiveness of psychological interventions to decrease cognitive fusion in patients with chronic pain: A systematic review and meta-analysis 心理干预对减少慢性疼痛患者认知融合的效果：系统回顾与荟萃分析

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-13 DOI: 10.1016/j.jpsychores.2024.111888

Susana Sanduvete-Chaves , Salvador Chacón-Moscoso , Francisco J. Cano-García

Objective

While there is sufficient evidence of Acceptance and Commitment Therapy's effectiveness in allowing patients to deal with chronic pain, the effectiveness in cognitive fusion, one of the six core components of the Psychology Flexibility Model, has yet to be established. The aim of this article is to assess whether psychological interventions decrease cognitive fusion.

Methods

The Web of Science, SCOPUS, Medline, and PsycINFO databases were searched for primary studies up to June 2024. Studies with a cognitive fusion measure in which chronic pain patients received a psychological intervention were included. A methodological quality scale was applied to the selected studies and the average effect sizes (Hedges g) were calculated.

Results

This review included 18 articles with 24 studies (19 pre-post/follow-up studies and five randomized control trials). Cognitive fusion decreased significantly after the intervention. The effect sizes were small/medium at post-test, g = -0.39, p < .001, 95% CI [-0.52, -0.26]; and medium at long-term follow-up, g = -0.55, p < .001, 95% CI [−0.74, -0.36]. A similar tendency was found for studies with RCTs at post-test, g = -0.61, p = .006, 95% CI [−1.05, -0.17], short-term follow-up, g = -0.79, p < .001, 95% CI [−1.18, -0.40] and long-term follow-up, g = -0.58, p = .003, 95% CI [-0.95, -0.20]). Moderator variables such as unemployment, gender, pain intensity, level of depression before the intervention, and duration and intervention modality were identified.

Conclusion

Psychological interventions tended to decrease cognitive fusion in chronic pain patients. Nonetheless, more clinical trials are needed to establish the role of cognitive fusion in psychological flexibility.

目的虽然有足够的证据表明接纳与承诺疗法能有效帮助患者应对慢性疼痛，但其对认知融合（心理学灵活性模型的六个核心组成部分之一）的有效性尚未得到证实。本文旨在评估心理干预是否会降低认知融合度。方法在 Web of Science、SCOPUS、Medline 和 PsycINFO 数据库中检索了截至 2024 年 6 月的主要研究。方法在 Web Science、SCOPUS、Medline 和 PsycINFO 数据库中搜索了截至 2024 年 6 月的主要研究，并纳入了慢性疼痛患者接受心理干预的认知融合测量研究。对所选研究采用了方法学质量量表，并计算了平均效应大小（Hedges g）。结果本综述共纳入18篇文章，24项研究（19项前后/随访研究和5项随机对照试验）。干预后，认知融合度明显下降。后测的效应大小为小/中，g = -0.39，p < .001，95% CI [-0.52，-0.26]；长期随访的效应大小为中，g = -0.55，p < .001，95% CI [-0.74，-0.36]。在后测（g = -0.61，p = .006，95% CI [-1.05，-0.17]；短期随访（g = -0.79，p <.001，95% CI [-1.18，-0.40]；长期随访（g = -0.58，p = .003，95% CI [-0.95，-0.20]）中，有 RCT 的研究也发现了类似的趋势。研究还发现了一些调节变量，如失业率、性别、疼痛强度、干预前的抑郁程度、干预持续时间和干预方式等。尽管如此，还需要更多的临床试验来确定认知融合在心理灵活性中的作用。

{"title":"Effectiveness of psychological interventions to decrease cognitive fusion in patients with chronic pain: A systematic review and meta-analysis","authors":"Susana Sanduvete-Chaves , Salvador Chacón-Moscoso , Francisco J. Cano-García","doi":"10.1016/j.jpsychores.2024.111888","DOIUrl":"10.1016/j.jpsychores.2024.111888","url":null,"abstract":"<div><h3>Objective</h3><p>While there is sufficient evidence of Acceptance and Commitment Therapy's effectiveness in allowing patients to deal with chronic pain, the effectiveness in cognitive fusion, one of the six core components of the Psychology Flexibility Model, has yet to be established. The aim of this article is to assess whether psychological interventions decrease cognitive fusion.</p></div><div><h3>Methods</h3><p>The Web of Science, SCOPUS, Medline, and PsycINFO databases were searched for primary studies up to June 2024. Studies with a cognitive fusion measure in which chronic pain patients received a psychological intervention were included. A methodological quality scale was applied to the selected studies and the average effect sizes (Hedges g) were calculated.</p></div><div><h3>Results</h3><p>This review included 18 articles with 24 studies (19 pre-post/follow-up studies and five randomized control trials). Cognitive fusion decreased significantly after the intervention. The effect sizes were small/medium at post-test, <em>g</em> = -0.39, <em>p</em> < .001, 95% CI [-0.52, -0.26]; and medium at long-term follow-up, <em>g</em> = -0.55, <em>p</em> < .001, 95% CI [−0.74, -0.36]. A similar tendency was found for studies with RCTs at post-test, <em>g</em> = -0.61, <em>p</em> = .006, 95% CI [−1.05, -0.17], short-term follow-up, <em>g</em> = -0.79, <em>p</em> < .001, 95% CI [−1.18, -0.40] and long-term follow-up, <em>g</em> = -0.58, <em>p</em> = .003, 95% CI [-0.95, -0.20]). Moderator variables such as unemployment, gender, pain intensity, level of depression before the intervention, and duration and intervention modality were identified.</p></div><div><h3>Conclusion</h3><p>Psychological interventions tended to decrease cognitive fusion in chronic pain patients. Nonetheless, more clinical trials are needed to establish the role of cognitive fusion in psychological flexibility.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"186 ","pages":"Article 111888"},"PeriodicalIF":3.5,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0022399924003003/pdfft?md5=dcb6716fb42a7bbdedfebdb12fa27495&pid=1-s2.0-S0022399924003003-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142088050","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

Different patterns of persistent somatic symptoms after COVID-19 reported by the Dutch media and the general population 荷兰媒体和普通民众报道的 COVID-19 后持续性躯体症状的不同模式

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-13 DOI: 10.1016/j.jpsychores.2024.111886

Aranka Vivienne Ballering , Ilona Plug , Sander K.R. van Zon , Tim Olde Hartman , Enny Das , Judith Rosmalen

Objective

Post COVID-19 condition is characterized by persistent symptoms after COVID-19 with yet unknown etiology. To explore whether media-related nocebo effects potentially contribute to post COVID-19 condition, we studied in an observational cohort whether frequencies of media coverage of symptoms after COVID-19 corresponded with prevalence rates of these symptoms in participants from a general population cohort diagnosed with COVID-19.

Methods

Prevalence rates and typology of symptoms after COVID-19 in the general population (N = 4231), adjusted for prevalence rates in a matched non-infected control population (n = 8462) were calculated by using data on 23 symptoms from the Lifelines COVID-19 Cohort collected between March 2020 and August 2021. Media coverage of post COVID-19 condition was assessed by coding 1266 Dutch post COVID-19-related news articles (inter-rater-κ ≥ 0.75), published during the corresponding timeframe. Herein, we assessed whether the same 23 symptoms were mentioned as being related to post COVID-19 condition.

Results

Core post COVID-19 condition symptoms were mentioned in 390 (30.8%) articles. Five of the ten core symptoms were mentioned by 10 or fewer articles. Ageusia/anosmia was most often persistently increased in COVID-19-positive participants (7.6%), yet was mentioned in 80 (6.3%) articles. General tiredness and breathing difficulties were frequently mentioned, in 23.9% and 17.1% of the articles respectively, while these were not the most frequently increased symptoms reported by participants (4.9% and 2.4%).

Conclusion

If post COVID-19 condition was predominantly attributable to nocebo effects, its symptom profile would be expected to reflect levels of media coverage for symptoms after COVID-19. However, our findings do not support this.

目标 COVID-19 后症状的特点是 COVID-19 后症状持续存在，但病因不明。为了探究媒体相关的安慰效应是否可能导致 COVID-19 后遗症，我们在一个观察性队列中研究了媒体对 COVID-19 后遗症的报道频率是否与被诊断为 COVID-19 的普通人群中这些症状的流行率相对应。方法利用 2020 年 3 月至 2021 年 8 月期间收集的生命线 COVID-19 队列中 23 种症状的数据，计算出 COVID-19 后症状在普通人群（N = 4231）中的流行率和类型，并根据匹配的非感染对照人群（N = 8462）的流行率进行调整。通过对相应时间段内发表的 1266 篇与 COVID-19 后相关的荷兰新闻报道进行编码，评估了媒体对 COVID-19 后症状的报道情况（评分间κ≥ 0.75）。结果在 390 篇（30.8%）文章中提到了 COVID-19 后的核心症状。在 10 个核心症状中，有 5 个症状在 10 篇或更少的文章中被提及。在 COVID-19 阳性参与者（7.6%）中，老年躁狂症/嗅觉障碍最常持续加重，但有 80 篇文章（6.3%）提到了这一症状。一般疲倦和呼吸困难也经常被提及，分别在 23.9% 和 17.1% 的文章中被提及，而这些症状并不是参与者报告的最常见的加重症状（4.9% 和 2.4%）。然而，我们的研究结果并不支持这一观点。

{"title":"Different patterns of persistent somatic symptoms after COVID-19 reported by the Dutch media and the general population","authors":"Aranka Vivienne Ballering , Ilona Plug , Sander K.R. van Zon , Tim Olde Hartman , Enny Das , Judith Rosmalen","doi":"10.1016/j.jpsychores.2024.111886","DOIUrl":"10.1016/j.jpsychores.2024.111886","url":null,"abstract":"<div><h3>Objective</h3><p>Post COVID-19 condition is characterized by persistent symptoms after COVID-19 with yet unknown etiology. To explore whether media-related nocebo effects potentially contribute to post COVID-19 condition, we studied in an observational cohort whether frequencies of media coverage of symptoms after COVID-19 corresponded with prevalence rates of these symptoms in participants from a general population cohort diagnosed with COVID-19.</p></div><div><h3>Methods</h3><p>Prevalence rates and typology of symptoms after COVID-19 in the general population (<em>N</em> = 4231), adjusted for prevalence rates in a matched non-infected control population (<em>n</em> = 8462) were calculated by using data on 23 symptoms from the Lifelines COVID-19 Cohort collected between March 2020 and August 2021. Media coverage of post COVID-19 condition was assessed by coding 1266 Dutch post COVID-19-related news articles (inter-rater-κ ≥ 0.75), published during the corresponding timeframe. Herein, we assessed whether the same 23 symptoms were mentioned as being related to post COVID-19 condition.</p></div><div><h3>Results</h3><p>Core post COVID-19 condition symptoms were mentioned in 390 (30.8%) articles. Five of the ten core symptoms were mentioned by 10 or fewer articles. Ageusia/anosmia was most often persistently increased in COVID-19-positive participants (7.6%), yet was mentioned in 80 (6.3%) articles. General tiredness and breathing difficulties were frequently mentioned, in 23.9% and 17.1% of the articles respectively, while these were not the most frequently increased symptoms reported by participants (4.9% and 2.4%).</p></div><div><h3>Conclusion</h3><p>If post COVID-19 condition was predominantly attributable to nocebo effects, its symptom profile would be expected to reflect levels of media coverage for symptoms after COVID-19. However, our findings do not support this.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"186 ","pages":"Article 111886"},"PeriodicalIF":3.5,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0022399924002988/pdfft?md5=642dd4527155e2ac2c0fd59e79bbe2bc&pid=1-s2.0-S0022399924002988-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142012178","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