Journal of Psychosomatic Research最新文献_第9页

Self-efficacy mediates social support and self-management behaviors in kidney transplant recipients: A systematic review and meta-analytic structural equation modeling analysis 自我效能感对肾移植受者社会支持和自我管理行为的影响：一项系统综述和荟萃分析结构方程模型分析

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-11-25 DOI: 10.1016/j.jpsychores.2025.112470

Jiaxin Fang , Liu Han , Xiaohong Lin , Keke Lin , Xiangru Li , Yingtian Jia , Xinran Yang , Hongxia Liu , Rongmei Zhang

Background

Self-management among kidney transplant recipients (KTRs) is crucial for preventing postoperative complications and improving health outcomes. However, challenges such as a lack of physical activity and the frequent consumption of high-calorie foods persist. Therefore, targeted interventions for enhancing post-transplant self-management behaviors are essential. Currently, scientific evidence on effective strategies to improve self-management among KTRs is lacking. Enhancing social support and promoting self-efficacy may be significant approaches.

Design and methods

This study employs a meta-analytic structural equation modeling (MASEM) approach to examine the mediating role of self-efficacy in the relationship between social support and self-management behaviors in KTRs. A comprehensive search was conducted across multiple databases, including PubMed, Embase, APA PsycInfo, Cochrane Library, CINAHL, Web of Science, ERIC, Springer, CNKI, VIP, and Wanfang, from the inception of each database until August 9, 2024. Statistical analyses were performed using Comprehensive Meta-Analysis software, Mplus for Mac, and R Studio for Mac.

Results

A total of 1990 titles and abstracts were screened in this study, resulting in the inclusion of 19 studies. The MASEM was constructed using a two-stage structural equation modeling approach. The analysis revealed that self-efficacy partially mediated the relationship between social support and self-management behaviors (direct effect: 0.140; indirect effect: 0.299; 95 % CI: 0.268, 0.331).

Conclusions

This study highlights the importance of clinical interventions aimed at enhancing social support and self-efficacy to improve self-management behaviors in KTRs.

Registration

https://doi.org/10.17605/OSF.IO/MXBZY(https://osf.io/).

背景肾移植受者的自我管理对于预防术后并发症和改善健康结果至关重要。然而，缺乏体育活动和频繁食用高热量食物等挑战依然存在。因此，加强移植后自我管理行为的针对性干预至关重要。目前，缺乏有效的策略来提高ktr自我管理的科学证据。加强社会支持和提高自我效能感可能是重要的途径。设计与方法本研究采用元分析结构方程模型（MASEM）方法，探讨自我效能感在社会支持与自我管理行为之间的中介作用。我们对PubMed、Embase、APA PsycInfo、Cochrane Library、CINAHL、Web of Science、ERIC、施普林格、CNKI、VIP、万方等多个数据库进行了全面检索，检索时间从每个数据库建立到2024年8月9日。采用综合meta分析软件Mplus for Mac和R Studio for Mac进行统计分析。结果本研究共筛选了1990篇论文和摘要，纳入了19篇研究。MASEM采用两阶段结构方程建模方法构建。分析发现，自我效能感在社会支持与自我管理行为的关系中起部分中介作用（直接效应：0.140；间接效应：0.299;95% CI: 0.268, 0.331）。结论加强社会支持和自我效能感的临床干预对改善ktrs患者的自我管理行为具有重要意义[j] . registrationhttp://doi.org/10.17605/OSF.IO/MXBZY(https://osf.io/。

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引用次数: 0

Frequency and correlates of non-adherence in a large sample of adult patients after kidney transplantation: A cross-sectional KTx360° substudy 肾移植后大样本成人患者不依从发生率及其相关因素：一项横断面KTx360°亚研究

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-11-25 DOI: 10.1016/j.jpsychores.2025.112474

Mariel Nöhre , Felix Klewitz , Maximilian Bauer-Hohmann , Eva Kyaw Tha Tun , Marietta Lieb , Yesim Erim , Uwe Tegtbur , Lena Schiffer , Lars Pape , Mario Schiffer , Martina de Zwaan

Objective

Non-adherence to immunosuppressive medication (ISM) is a common and preventable cause of graft loss after kidney transplantation (KTx). Adherence is a multifaceted construct influenced by various factors. Despite frequent reports linking non-adherence with multiple variables, results often seem contradictory. The lack of patient registers in Germany to encompass psychosocial aspects limits data to smaller, selective studies. The aim was to evaluate the frequency and correlates of non-adherence in a large sample of adult KTx patients.

Methods

This cross-sectional substudy was embedded within the structured follow-up program KTx360°. It took place at the transplant centers of Hannover Medical School, Hann. Münden and Erlangen in Germany between May 2017 and October 2020. 838 adult KTx patients participated in this substudy. Adherence was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS) alongside other sociodemographic, psychosocial, and medical variables.

Results

Participants had an average age of 52.3 years (SD = 13.5), with 58.7 % male. According to the BAASIS interview, 22.1 % reported non-adherence, mainly due to timing (13.0 %) and taking (11.7 %) non-adherence, with only 0.5 % ceasing at least one ISM. Factors linked to non-adherence in regression analysis included younger age, male gender, longer post-transplant time, and perceived medication overuse. The effect sizes were small. The informative value is limited by the design and the sample size.

Conclusion

In our cross-sectional analysis, nearly a quarter of the participants reported suboptimal adherence, mainly associated with primarily non-modifiable risk factors. Routine adherence assessments and targeted interventions are essential to improving long-term outcomes.

目的：免疫抑制药物不依从性（ISM）是肾移植术后移植物丧失的一个常见且可预防的原因。依从性是一个受多种因素影响的多方面结构。尽管经常有报告将不遵医嘱与多个变量联系起来，但结果似乎往往是相互矛盾的。德国缺乏包括心理社会方面的患者登记，限制了数据规模较小的选择性研究。目的是评估大量成年KTx患者不依从性的频率和相关因素。方法本横断面亚研究纳入结构化随访计划KTx360°。实验在汉诺威医学院的移植中心进行。2017年5月至2020年10月期间在德国的梅恩登和埃尔兰根。838名成年KTx患者参与了本亚研究。使用巴塞尔免疫抑制药物依从性评估量表（basasis）以及其他社会人口统计学、社会心理和医学变量来评估依从性。结果参与者平均年龄52.3岁（SD = 13.5），男性占58.7%。根据basasis的访谈，22.1%的患者报告未依从性，主要是由于时间（13.0%）和服用（11.7%）未依从性，只有0.5%的患者至少停止了一次ISM。在回归分析中，与不依从性相关的因素包括年龄较小、男性、移植后时间较长和感知到的药物过度使用。效应量很小。信息价值受到设计和样本量的限制。在我们的横断面分析中，近四分之一的参与者报告了不理想的依从性，主要与主要不可改变的风险因素有关。常规依从性评估和有针对性的干预措施对于改善长期结果至关重要。

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引用次数: 0

Psychological heterogeneity in functional neurological disorders: A systematic review of studies exploring psychopathological sub-types 功能性神经疾病的心理异质性：对精神病理亚型研究的系统回顾

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-11-24 DOI: 10.1016/j.jpsychores.2025.112473

Anna Mammì , Kathryn Harper , Cordelia Gray , Markus Reuber , Richard J. Brown

Background

Functional Neurological Disorders (FND) are characterised by distressing neurological symptoms arising from altered brain network functioning rather than structural damage. FND were traditionally conceptualised as homogeneous (conversion) disorders despite the apparent heterogeneity of the condition.

Objective

In order to aid our understanding of the clinical spectrum of FND, this systematic review explores empirical evidence for psychological patient sub-groups.

Methods

OVID Medline/Embase/PsycINFO, Scopus and WoS were searched from 1980 to September 2025. We used the SURE quality appraisal process and an analytic process involving four steps of narrative synthesis.

Results

Of 10,414 articles screened, 13 papers met our inclusion criteria. Six non-exclusive and potentially interacting psychological themes were identified: “emotional dysregulation associated with high distress”, “constricted affect with low overt distress”, “presence of comorbid mental disorders”, “overt traumatisation”, “dissociation” and “lower intellectual abilities”.

Conclusions

This review confirms that there is an empirical basis for the perception of FND as aetiologically heterogeneous disorders. Six recurring psychological themes, often overlapping and interconnected, were identified. These findings emphasize the necessity of adopting a multidimensional framework for understanding FND. Further empirical validation may allow for FND treatment to be tailored to the specific psychological needs of this diverse patient group.

功能性神经系统疾病（FND）的特征是由大脑网络功能改变而非结构损伤引起的令人痛苦的神经系统症状。FND传统上被定义为同质（转化）障碍，尽管情况明显存在异质性。目的探讨心理病人亚群的经验证据，以帮助我们了解FND的临床谱。方法检索1980 ~ 2025年9月的Medline/Embase/PsycINFO、Scopus和WoS数据库。我们使用了SURE质量评估过程和包含四个叙事综合步骤的分析过程。结果10414篇文献中，13篇符合纳入标准。确定了六个非排他和潜在相互作用的心理主题：“与高痛苦相关的情绪失调”，“与低明显痛苦相关的狭窄情感”，“共病精神障碍的存在”，“明显的创伤”，“分离”和“低智力”。结论本综述证实了FND作为病因异质性疾病的认知有经验基础。六个反复出现的心理学主题，经常重叠和相互关联，被确定。这些发现强调了采用多维框架来理解FND的必要性。进一步的经验验证可能会使FND治疗适合于这一不同患者群体的特定心理需求。

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引用次数: 0

The impact of age on prevalence of anxiety, depression and stress in patients with chronic obstructive pulmonary disease 年龄对慢性阻塞性肺疾病患者焦虑、抑郁和压力患病率的影响

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-11-24 DOI: 10.1016/j.jpsychores.2025.112472

Abebaw Mengistu Yohannes , Mark T. Dransfield , Richard Casaburi , Nicola A. Hanania

Background

Over 40 % of patients with chronic obstructive pulmonary disease (COPD) suffer from mood and anxiety disorders. However, little is known about the impact of age on the prevalence of anxiety, depression and stress in patients with COPD. We examined the prevalence of depression, anxiety and stress in patients with COPD aged 65 years and older compared to less than 65 years old and their relation to quality of life (QoL), dyspnea, lung function and exercise capacity.

Methods

From our research database, we examined 993 clinically stable COPD patients recruited from 2013 to 2019, before entering pulmonary rehabilitation (PR). At baseline, COPD patients completed: dyspnea measured by modified Medical Research Council (mMRC) scale, exercise capacity by incremental shuttle walk test (ISWT), QoL by St. George's Respiratory Questionnaire (SGRQ), and psychological distress by Depression Anxiety Stress Scale (DASS).

Results

Seven-hundred-sixty-seven patients with COPD ≥65 years with mean age (SD) 75 (6) years were compared to 226 patients with COPD <65 years with mean age 58 (6) years. Patients <65 years compared to patients ≥65 years with COPD had higher scores for DASS-depression ≥10, (61 % vs. 38 %), DASS-anxiety ≥8 (73 % vs 51 %) and DASS-stress ≥15 (45 % vs. 25 %) all (p < 0.001). Younger patients with COPD had poorer QoL, elevated dyspnea, and lower FEV₁ percentage predicted, (all p < 0.001). No significant difference in exercise capacity was seen between the two groups (p = 0.58).

Conclusion

Younger COPD patients exhibited higher levels of depression, anxiety and stress, with poorer QoL and elevated symptoms of dyspnea compared to older patients.

背景：40%的慢性阻塞性肺疾病（COPD）患者患有情绪和焦虑障碍。然而，年龄对慢性阻塞性肺病患者焦虑、抑郁和压力患病率的影响知之甚少。我们研究了65岁及以上COPD患者与65岁以下COPD患者的抑郁、焦虑和压力患病率，以及它们与生活质量（QoL）、呼吸困难、肺功能和运动能力的关系。方法从我们的研究数据库中，我们研究了2013年至2019年在进入肺康复（PR）之前招募的993名临床稳定的COPD患者。在基线时，COPD患者完成：用改良的医学研究委员会（mMRC）量表测量呼吸困难，用增量穿梭步行测试（ISWT）测量运动能力，用圣乔治呼吸问卷（SGRQ）测量生活质量，用抑郁焦虑压力量表（DASS）测量心理困扰。结果767例COPD≥65岁患者，平均年龄（SD） 75(6)岁；226例COPD≥65岁患者，平均年龄58(6)岁。65岁COPD患者与≥65岁COPD患者相比，dass -抑郁≥10分（61%比38%）、dass -焦虑≥8分（73%比51%）和dass -应激≥15分（45%比25%）得分均较高（p < 0.001）。较年轻的COPD患者生活质量较差，呼吸困难加重，预测FEV1百分比较低（均p <； 0.001）。两组的运动能力差异无统计学意义（p = 0.58）。结论与老年患者相比，年轻COPD患者表现出更高的抑郁、焦虑和压力水平，生活质量较差，呼吸困难症状增加。

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引用次数: 0

Functional movement and gait disorders: A matter of age? 功能性运动和步态障碍：年龄问题？

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-11-22 DOI: 10.1016/j.jpsychores.2025.112471

Gilbert Kanyinda Kayombo , Tatiana Witjas , Camille Comet , Valentin Mira , Eve Benchetrit , Nelson Monteiro-Dias , Etienne Fortanier , Adil Maarouf , Alexandre Eusebio , Jean-Philippe Azulay , Frédérique Fluchère , Stephan Grimaldi

Background

Functional neurological disorders (FND) represent a significant public health challenge due to their prevalence and impact on quality of life. Functional movement disorders (FMD) and functional gait disorders (FGD) represent a large part of the broad phenotype spectrum of FND.

Objective

This study aimed to describe the clinical profiles and associated characteristics of FMD and FGD, with particular attention to age-related symptoms.

Methods

A retrospective review of medical records with standardized collection of data of FND and FMD patients from three Neurological Referral Centers was conducted from 2016 to 2024. Data collected included demographic information and clinical outcomes.

Results

Sixty-eight patients were included with a female predominance (75.53 %). Thirty-seven had FMD (mean age 47.19 ± 18.66 years), 14 had FGD (63.0 ± 11.50), and 17 had both (49.53 ± 20.90 years). FGD were more frequent in older patients compared with FMD patients (p = 0.0046) and with patients with the mixed phenotype (p = 0.043). Tremors were the most common FMD subtype (70.3 %), while astasia-abasia was the predominant FGD phenotype (57.1 %). Fifty-three percent of patients were lost to follow-up, 20.6 % improved, and 26.5 % remained stable. Lack of physical and psychological rehabilitation was predominant in lost-to-follow-up subjects.

Conclusion

FND age of onset was significantly associated with phenotype, with older patients being more affected by FGD. This association may be partially influenced by societal perceptions of aging and mobility.

功能性神经障碍（FND）由于其患病率和对生活质量的影响而成为一个重大的公共卫生挑战。功能性运动障碍（FMD）和功能性步态障碍（FGD）代表了FND广泛表型谱的很大一部分。目的本研究旨在描述口蹄疫和FGD的临床特征和相关特征，特别关注与年龄相关的症状。方法回顾性分析2016 - 2024年3家神经系统转诊中心收治的FND和FMD患者的病历资料。收集的数据包括人口统计信息和临床结果。结果共纳入68例患者，女性占75.53%。FMD 37例（平均年龄47.19±18.66岁），FGD 14例（63.0±11.50岁），两者均有17例（49.53±20.90岁）。与FMD患者（p = 0.0046）和混合表型患者（p = 0.043）相比，FGD在老年患者中更常见。震颤是最常见的FMD亚型（70.3%），而失稳-失稳是主要的FGD表型（57.1%）。53%的患者失去随访，20.6%好转，26.5%保持稳定。在失访者中，缺乏身体和心理康复是主要的。结论FGD发病年龄与表型有显著相关性，年龄较大的患者更易发生FGD。这种联系可能部分受到社会对老龄化和流动性的看法的影响。

{"title":"Functional movement and gait disorders: A matter of age?","authors":"Gilbert Kanyinda Kayombo , Tatiana Witjas , Camille Comet , Valentin Mira , Eve Benchetrit , Nelson Monteiro-Dias , Etienne Fortanier , Adil Maarouf , Alexandre Eusebio , Jean-Philippe Azulay , Frédérique Fluchère , Stephan Grimaldi","doi":"10.1016/j.jpsychores.2025.112471","DOIUrl":"10.1016/j.jpsychores.2025.112471","url":null,"abstract":"<div><h3>Background</h3><div>Functional neurological disorders (FND) represent a significant public health challenge due to their prevalence and impact on quality of life. Functional movement disorders (FMD) and functional gait disorders (FGD) represent a large part of the broad phenotype spectrum of FND.</div></div><div><h3>Objective</h3><div>This study aimed to describe the clinical profiles and associated characteristics of FMD and FGD, with particular attention to age-related symptoms.</div></div><div><h3>Methods</h3><div>A retrospective review of medical records with standardized collection of data of FND and FMD patients from three Neurological Referral Centers was conducted from 2016 to 2024. Data collected included demographic information and clinical outcomes.</div></div><div><h3>Results</h3><div>Sixty-eight patients were included with a female predominance (75.53 %). Thirty-seven had FMD (mean age 47.19 ± 18.66 years), 14 had FGD (63.0 ± 11.50), and 17 had both (49.53 ± 20.90 years). FGD were more frequent in older patients compared with FMD patients (<em>p</em> = 0.0046) and with patients with the mixed phenotype (<em>p</em> = 0.043). Tremors were the most common FMD subtype (70.3 %), while astasia-abasia was the predominant FGD phenotype (57.1 %). Fifty-three percent of patients were lost to follow-up, 20.6 % improved, and 26.5 % remained stable. Lack of physical and psychological rehabilitation was predominant in lost-to-follow-up subjects.</div></div><div><h3>Conclusion</h3><div>FND age of onset was significantly associated with phenotype, with older patients being more affected by FGD. This association may be partially influenced by societal perceptions of aging and mobility.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"200 ","pages":"Article 112471"},"PeriodicalIF":3.3,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624418","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 depressive symptoms and incident diabetes risk among middle-aged and older adults: A longitudinal cohort study 中老年人抑郁症状与糖尿病发病风险的轨迹：一项纵向队列研究

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-11-21 DOI: 10.1016/j.jpsychores.2025.112469

Le Zhao , Yan Lou , Yun Zou

Objectives

Accumulating evidence links depressive symptoms to later diabetes risk, yet most studies assess depression at a single time point. This study examined the association between long-term depressive symptom trajectories and incident diabetes among middle-aged and older adults in the United States and the United Kingdom.

Methods

Data were derived from two nationally representative cohorts: the Health and Retirement Study (HRS, waves 4–7 for exposure, 8–12 for outcome; 1998–2014) and the English Longitudinal Study of Aging (ELSA, waves 1–4 for exposure, 5–9 for outcome; 2002–2018). Participants aged ≥50 years and free of diabetes at baseline were included. Depressive symptoms were measured using the 8-item Center for Epidemiologic Studies Depression Scale (CESD). Total, somatic, and cognitive-affective symptom domains were classified into five trajectories: consistently low, decreasing, fluctuating, increasing, and consistently high. Incident diabetes was identified via self-reported physician diagnosis. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs).

Results

This study included 8741 adults to examine the association between depressive symptom trajectories and diabetes risk over 10 years. Compared with the consistently low group, participants in the increasing trajectory showed a significantly higher risk of diabetes across the overall (HR = 1.48, 95 % CI: 1.01–2.17), somatic (HR = 1.56, 95 % CI: 1.01–2.50), and cognitive-affective domains (HR = 2.15, 95 % CI: 1.39–3.32).

Conclusions

Rising depressive symptom trajectories, particularly in the cognitive-affective domain, were associated with increased diabetes risk. Sustained depression monitoring and early interventions targeting evolving depressive patterns may help prevent diabetes onset.

越来越多的证据表明抑郁症状与后来患糖尿病的风险有关，但大多数研究只在一个时间点评估抑郁。本研究调查了美国和英国中老年人群长期抑郁症状轨迹与糖尿病发病率之间的关系。方法数据来自两个具有全国代表性的队列：健康与退休研究（HRS，波4-7为暴露，波8-12为结果；1998-2014）和英国老龄化纵向研究（ELSA，波1-4为暴露，波5-9为结果；2002-2018）。受试者年龄≥50岁，基线时无糖尿病。采用8项流行病学研究中心抑郁量表（CESD）测量抑郁症状。总体、躯体和认知-情感症状域被分为五个轨迹：持续低、下降、波动、增加和持续高。偶发性糖尿病是通过自我报告的医生诊断来确定的。Cox比例风险模型用于估计风险比（hr）和95%置信区间（ci）。结果本研究纳入8741名成年人，研究10年来抑郁症状轨迹与糖尿病风险之间的关系。与持续较低的组相比，增加轨迹的参与者在整体（HR = 1.48, 95% CI: 1.01-2.17），躯体（HR = 1.56, 95% CI: 1.01-2.50）和认知-情感领域（HR = 2.15, 95% CI: 1.39-3.32）显示出显著更高的糖尿病风险。结论抑郁症状轨迹的增加，特别是在认知-情感领域，与糖尿病风险增加有关。持续的抑郁监测和针对不断发展的抑郁模式的早期干预可能有助于预防糖尿病的发生。

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引用次数: 0

Clarifying the role of somatic and depressive symptoms in suicide risk: Evidence from a cross-sectional analysis 澄清躯体和抑郁症状在自杀风险中的作用：来自横断面分析的证据

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-11-20 DOI: 10.1016/j.jpsychores.2025.112468

Ronja Volz , Robert Philipp Kosilek , Carolin Haas , Patricia Dolp , Caroline Jung-Sievers , Tobias Teismann , Peter Henningsen , Peter Falkai , Jochen Gensichen , Karoline Lukaschek , for the POKAL Study Group

Background

Somatic symptoms are common in psychiatric and primary care populations, and their relationship with depression and suicidal ideation is complex. This study investigates the association between somatic symptoms and suicidal ideation, accounting for comorbid depressive symptoms.

Methods

This cross-sectional study included 521 in- and outpatient with PHQ-9 ≥ 6 or a positive response to item 9, indicative of suicidal thoughts. Somatic and depressive symptoms were assessed using the PHQ-15 and PHQ-2 or PHQ-9, respectively. Suicidal ideation was measured using the risk subscale of the SuPr-10; the protective subscale was included as a covariate. Associations were examined using correlation matrices and regression models.

Results

The sample was 68 % female with a mean age of 41 years; 52 % screened positive for suicidal ideation. PHQ-9 (mean = 14.8, SD = 5.0) and PHQ-15 scores (mean = 12.4, SD = 5.0) were moderately elevated. In a two-part regression model, higher depressive symptoms were associated with a reduced likelihood of reporting no suicidal ideation (OR = 0.50, 95 % CI: 0.41–0.62) and increased severity of suicidal ideation (IRR = 1.17, 95 % CI: 1.09–1.27). Somatic symptoms showed no meaningful direct effects but were indirectly associated with suicidal ideation via depressive symptoms (indirect effect OR = 1.05, 95 % CI: 1.03–1.07).

Conclusions

In individuals with somatic complaints, co-occurring depressive symptoms are strongly associated with suicidal ideation. Systematic depression screening is essential in somatically presenting patients.

背景：躯体症状在精神科和初级保健人群中很常见，它们与抑郁和自杀意念的关系很复杂。本研究调查了躯体症状和自杀意念之间的关系，并解释了共病抑郁症状。方法本横断面研究纳入521名PHQ-9≥6或对第9项有积极反应的住院和门诊患者，表明他们有自杀念头。躯体症状和抑郁症状分别用PHQ-15和PHQ-2或PHQ-9进行评估。自杀意念采用super -10风险子量表进行测量；保护分量表被纳入协变量。使用相关矩阵和回归模型检验相关性。结果患者中女性占68%，平均年龄41岁；52%的人有自杀意念。PHQ-9评分（平均14.8分，SD = 5.0）、PHQ-15评分（平均12.4分，SD = 5.0）中度升高。在两部分回归模型中，较高的抑郁症状与报告无自杀意念的可能性降低（OR = 0.50, 95% CI: 0.41-0.62）和自杀意念严重程度增加（IRR = 1.17, 95% CI: 1.09-1.27）相关。躯体症状没有直接影响，但通过抑郁症状与自杀意念间接相关（间接影响OR = 1.05, 95% CI: 1.03-1.07）。结论在躯体主诉个体中，共发抑郁症状与自杀意念密切相关。系统的抑郁症筛查对躯体症状患者至关重要。

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引用次数: 0

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

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-11-19 DOI: 10.1016/j.jpsychores.2025.112467

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

Objective

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

Methods

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

Results

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

Conclusion

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

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

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引用次数: 0

The relationship between fear of disease progression and social isolation in stroke patients: The mediating role of self-perceived burden and self-disclosure 脑卒中患者疾病进展恐惧与社会孤立的关系：自我感知负担和自我表露的中介作用。

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-11-17 DOI: 10.1016/j.jpsychores.2025.112455

Yujing Gu , Honggan Wang , Yun Zhao , Zhaodi Liao , Jun Xie

Aim

Post-stroke sequelae, such as motor dysfunction, may reduce patients' participation in social activities, thereby increasing their risk of social isolation. Previous studies have linked fear of disease progression with social isolation, yet the underlying mechanisms of this association remain unclear. To develop effective intervention strategies, it is essential to explore the contributing factors related to social isolation in depth.

Methods

This study aimed to investigate the mediating roles of self-perceived burden and self-disclosure in the relationship between fear of disease progression and social isolation among stroke patients. A total of 342 inpatients from neurology departments were surveyed using a self-designed demographic questionnaire, the Generalized Alienation Scale (GAS), Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Self-Perceived Burden Scale (SPBS), and Distress Disclosure Index (DDI). A parallel mediation model was constructed, and descriptive statistics, difference tests, Spearman correlation analysis, hierarchical multiple regression, and mediation effect analysis were conducted.

Results

Fear of disease progression was positively associated with social isolation (c = 0.275). It was positively related to self-perceived burden (a1 = 0.598) and negatively related to self-disclosure (a2 = −0.412). Both mediators were significantly associated with social isolation (b1 = 0.188; b2 = −0.099). Significant indirect effects were found through self-perceived burden (a1b1 = 0.113) and self-disclosure (a2b2 = 0.041). The direct effect remained significant (c' = 0.121), indicating partial mediation.

Conclusion

Self-perceived burden and self-disclosure simultaneously mediate the impact of fear of disease progression on social isolation, offering new insights for healthcare professionals aiming to prevent social isolation among stroke survivors.

目的：脑卒中后的后遗症，如运动功能障碍，可能会减少患者参与社会活动，从而增加其社会孤立的风险。先前的研究将对疾病进展的恐惧与社会孤立联系起来，但这种联系的潜在机制尚不清楚。为了制定有效的干预战略，必须深入探讨与社会孤立有关的促成因素。方法：本研究旨在探讨脑卒中患者疾病进展恐惧与社会孤立的关系中自我知觉负担和自我表露的中介作用。采用自行设计的人口统计问卷、广义疏离感量表（GAS）、进展恐惧简易问卷（FoP-Q-SF）、自我感知负担量表（SPBS）和痛苦披露指数（DDI）对342例神经内科住院患者进行调查。构建平行中介模型，进行描述性统计、差异检验、Spearman相关分析、层次多元回归和中介效应分析。结果：对疾病进展的恐惧与社会孤立呈正相关（c = 0.275）。与自我感知负担呈正相关（a1 = 0.598），与自我表露呈负相关（a2 = -0.412）。两种中介因子均与社会隔离显著相关（b1 = 0.188; b2 = -0.099）。自我感知负担（a1b1 = 0.113）和自我表露（a2b2 = 0.041）间接影响显著。直接影响仍然显著（c' = 0.121），表明部分中介作用。结论：自我认知负担和自我披露同时介导疾病进展恐惧对社会隔离的影响，为医疗保健专业人员预防脑卒中幸存者的社会隔离提供了新的见解。

{"title":"The relationship between fear of disease progression and social isolation in stroke patients: The mediating role of self-perceived burden and self-disclosure","authors":"Yujing Gu , Honggan Wang , Yun Zhao , Zhaodi Liao , Jun Xie","doi":"10.1016/j.jpsychores.2025.112455","DOIUrl":"10.1016/j.jpsychores.2025.112455","url":null,"abstract":"<div><h3>Aim</h3><div>Post-stroke sequelae, such as motor dysfunction, may reduce patients' participation in social activities, thereby increasing their risk of social isolation. Previous studies have linked fear of disease progression with social isolation, yet the underlying mechanisms of this association remain unclear. To develop effective intervention strategies, it is essential to explore the contributing factors related to social isolation in depth.</div></div><div><h3>Methods</h3><div>This study aimed to investigate the mediating roles of self-perceived burden and self-disclosure in the relationship between fear of disease progression and social isolation among stroke patients. A total of 342 inpatients from neurology departments were surveyed using a self-designed demographic questionnaire, the Generalized Alienation Scale (GAS), Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Self-Perceived Burden Scale (SPBS), and Distress Disclosure Index (DDI). A parallel mediation model was constructed, and descriptive statistics, difference tests, Spearman correlation analysis, hierarchical multiple regression, and mediation effect analysis were conducted.</div></div><div><h3>Results</h3><div>Fear of disease progression was positively associated with social isolation (c = 0.275). It was positively related to self-perceived burden (a1 = 0.598) and negatively related to self-disclosure (a2 = −0.412). Both mediators were significantly associated with social isolation (b1 = 0.188; b2 = −0.099). Significant indirect effects were found through self-perceived burden (a1b1 = 0.113) and self-disclosure (a2b2 = 0.041). The direct effect remained significant (c' = 0.121), indicating partial mediation.</div></div><div><h3>Conclusion</h3><div>Self-perceived burden and self-disclosure simultaneously mediate the impact of fear of disease progression on social isolation, offering new insights for healthcare professionals aiming to prevent social isolation among stroke survivors.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"200 ","pages":"Article 112455"},"PeriodicalIF":3.3,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566087","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

Acute and chronic fatigue after COVID-19: The impact of depression and somatic distress COVID-19后急性和慢性疲劳：抑郁和躯体窘迫的影响

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2025-11-17 DOI: 10.1016/j.jpsychores.2025.112456

Kamiar K. Rückert , Julia Petersen , Philipp S. Wild , Thomas Münzel , Jochem König , Karl J. Lackner , Isabel Heinrich , Julia Weinmann-Menke , Christian Dresel , Marc Bodenstein , Michael Kreuter , Felix Rausch , Manfred E. Beutel , Jasmin Ghaemi Kerahrodi

Objective

Fatigue is the most frequent and burdensome symptom following COVID-19. The contribution of biopsychosocial factors remains unclear, particularly with respect to symptom duration. This exploratory study investigated the prevalence of acute and chronic fatigue after COVID-19 and examined biopsychosocial correlations.

Methods

Cross-sectional data from 452 participants of the Gutenberg Post-COVID Study were analyzed. All individuals had a previous Sars-CoV-2 infection. Participants were categorized into three groups (1) no fatigue during assessment, (2) fatigue lasting 1–<6 months at assessment, and (3) fatigue lasting 6 months or more at assessment. Fatigue was assessed using the Chalder Fatigue Questionnaire (CFQ) and classified as acute (<6 months) or chronic (≥ 6 months). The modified PHQ-9 (mPHQ-9, excluding the fatigue item) measured depressivity. SSD-12 measured the somatic symptom burden. Associations were examined using multivariable regression analyses.

Results

51.6 % reported no fatigue, 13.9 % showed acute fatigue, 34.5 % displayed chronic fatigue. Vaccination status was not associated with fatigue. The severity of the infection was associated with acute fatigue. No significant associations were observed with chronic fatigue. When psychological variables (mPHQ-9, SSD-12) were introduced, associations with somatic pre-morbid conditions disappeared, except for body mass index. Higher levels of depressiveness and somatic distress increased the likelihood of both forms of fatigue, while lower social status was associated specifically with chronic fatigue.

Conclusion

Depressiveness and somatic distress are strongly linked to post-COVID fatigue, particularly its chronic form. These findings underscore the importance of a biopsychosocial framework and the need for interdisciplinary treatment approaches in post-COVID care.

目的：疲劳是新冠肺炎患者最常见和最繁重的症状。生物心理社会因素的作用尚不清楚，特别是在症状持续时间方面。本探索性研究调查了COVID-19后急性和慢性疲劳的患病率，并检查了生物心理社会相关性。方法对452名古腾堡后研究参与者的横断面数据进行分析。所有人以前都感染过Sars-CoV-2。参与者被分为三组(1)在评估时没有疲劳，(2)在评估时持续1 - 6个月的疲劳，(3)在评估时持续6个月或更长时间的疲劳。使用Chalder疲劳问卷（CFQ）评估疲劳，并将其分为急性（≤6个月）和慢性（≥6个月）。改进后的PHQ-9 （mPHQ-9，不包括疲劳项）测量了压抑度。SSD-12测量躯体症状负担。结果51.6%的患者无疲劳，13.9%表现为急性疲劳，34.5%表现为慢性疲劳。接种疫苗状态与疲劳无关。感染的严重程度与急性疲劳有关。与慢性疲劳无显著关联。当引入心理变量（mPHQ-9, SSD-12）时，除了体重指数外，与躯体病前状况的关联消失了。较高水平的抑郁和躯体压力增加了两种形式疲劳的可能性，而较低的社会地位与慢性疲劳特别相关。结论抑郁和躯体窘迫与covid - 19后疲劳密切相关，尤其是慢性疲劳。这些发现强调了生物心理社会框架的重要性以及在covid - 19后护理中采用跨学科治疗方法的必要性。

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引用次数: 0