BioPsychoSocial Medicine最新文献

Background: Premenstrual disorder (PMD), which includes premenstrual syndrome and premenstrual dysphoric disorder, has a complex pathogenesis and may be closely related to emotional cognition and memory. However, the mechanisms underlying these associations remain unclear. Therefore, this study used machine learning to explore the roles of various factors that are not typically considered risk-factors for PMD.

Methods: A predictive model for PMD was constructed using a dataset of questionnaire responses and heartrate variability data collected from 60 participants during their follicular and luteal phases. Based on the Japanese version of the Premenstrual Symptom Screening Tool, the binary objective variable (PMD status) was defined as "PMD" for moderate-to-severe premenstrual syndrome and premenstrual dysphoric disorder and other conditions as "non-PMD." The contribution of each feature to the predictive model was assessed using the Shapley Additive exPlanations (SHAP) model-interpretation framework.

Results: Of the 58 participants (providing 117 data points), 17 (34 data points) were in the PMD group and 41 (83 data points) were in the non-PMD group. The area under the receiver operating characteristic curve was 0.90 (95% confidence interval: 0.82-0.98). Among the top 20 features with the highest SHAP values, six were associated with maternal bonding. Four of the six mother-related characteristics were associated with overprotection.

Conclusions: Based on these findings, parental bonding experiences, including maternal overprotection, may be associated with the presence of PMD.

Background: Polycystic Ovary Syndrome (PCOS) is an endocrinal dysfunction characterized by androgen excess, irregular or absent menstruation, and polycystic ovarian morphology. While extensive research is conducted on the biochemical and medical ramifications of PCOS. However, there is not much research on cognitive mechanisms, especially attention. Attention is the fundamental cognitive ability that influences other cognitive and psychological phenomena. Therefore, the present study attempts to investigate the effect of PCOS on attention.

Methods: Flanker's task examining focussed attention and Posner's cueing task measuring divided attention was administered to 173 female participants, of which 101 constituted the PCOS group and the remaining were control. The Analysis of Variance was used to analyze the data.

Results: These findings demonstrated that the PCOS group took longer in focused attention, 557.21 milliseconds (SD = 169.70), compared to the reaction time of 462.88 milliseconds (SD = 120.80) in divided attention. Concerning accuracy, the PCOS group made more errors in the focused attention task at 0.98 (SD = 0.41), while for the divided attention task, it was 0.99 (SD = 0.27).

Conclusions: Women with PCOS showed more error and slower reaction time in focused attention.

Background: Individuals with type 2 diabetes and eating disorders must change their eating behaviors, which are often influenced by psychological factors like depression and anxiety. To efficiently assess daily psychological status, the present study aimed to develop computerized adaptive tests (CAT) based on item response theory (IRT).

Methods: Individuals with depression, anxiety disorders, eating disorders, type 2 diabetes, and healthy persons participated in the study. Participants completed six questionnaires, including momentary and most recent one-week depression, anxiety, and positive affect. We selected items meeting the IRT assumptions, applied a graded response model, and conducted CAT simulations.

Results: Across all six questionnaires, the CAT simulations used a smaller number of items and exhibited substantial Pearson's correlation coefficients exceeding 0.95 between simulated and full item-set mood status estimates. These estimated mood scores demonstrated satisfactory concurrent validity with the Hospital Anxiety and Depression Scale and sufficient discriminant validity between the clinical group and healthy controls.

Conclusion: These findings suggest that these scales offer efficient measurement of the mood status of individuals with an eating disorder or type 2 diabetes.

Background: Fibromyalgia (FM) is a disease characterized by chronic widespread pain concomitant with various symptoms such as fatigue and anxiety. Although chronic inflammation has been implicated in the immunological abnormalities of FM, there are few human studies on complement and immunoglobulins. In this study, we investigated the immunological characteristics of FM patients and the association between their clinical symptoms and immunological indices, including complement and immunoglobulins.

Methods: 1) The serum 50% hemolytic complement activity (CH50), C3, C4, IgG, IgM, and hsCRP of 36 FM patients and 30 healthy sex- and age-matched controls (HC) were measured and compared. 2) Data from the Brief Pain Inventory (pain intention and pain interference subscales), the visual analog scale (VAS) (low back pain, knee pain, and fatigue), the State-Trait Anxiety Inventory and the Center for Epidemiologic Studies Depression Scale (anxiety and depression), and CH50, IgG, and hsCRP as immunological indices were acquired for 41 FM patients. Correlation analysis was done of the clinical symptom and immunological indices.

Results: 1) The FM group had significantly higher CH50 and lower IgG and IgM than the HC group after adjusting for body mass index (BMI). 2) Correlation analysis of immunological indices and clinical symptoms showed a positive, partial correlation between CH50 and fatigue and trait anxiety after adjusting for sex, age, and BMI.

Conclusions: FM patients had higher CH50 and lower immunoglobulin levels than HCs. CH50 was also associated with the fatigue and trait anxiety of FM patients. Further studies are needed to determine whether changes in these immunological indices can be used as biomarkers and/or therapeutic targets for FM.

Background: Recent studies have identified premenstrual disorders (PMDs) as a risk factor for postpartum depression. However, routine screening for preconception PMDs is not yet common in Japan. This study investigated the association between preconception PMDs and perinatal depression in a single tertiary care setting.

Methods: We analyzed data from pregnant women who gave birth at Kyoto University Hospital between April 2020 and October 2023. The Premenstrual Symptoms Screening Tool was administered at the first postconception visit to retrospectively assess PMD status before the current pregnancy. The Edinburgh Postnatal Depression Scale (EPDS) was administered during pregnancy and one month postpartum as a prospective measure of perinatal depression. EPDS cutoff values were set at 12/13 during pregnancy and 8/9 at one month postpartum.

Results: Of the 781 women analyzed, 53 had preconception PMD. Univariate and multivariate logistic regression analyses revealed that preconception PMD was associated with an EPDS score of ≥ 13 during pregnancy, with a crude odds ratio (OR) of 5.78 (95% confidence interval [CI]: 2.70-11.75) and an adjusted OR of 3.71 (95% CI: 1.54-8.35). For an EPDS score of ≥ 9 at 1 month postpartum, the crude OR was 3.36 (95% CI: 1.79-6.12) and the adjusted OR was 2.16 (95% CI: 1.04-4.35).

Conclusions: Our findings indicate that preconception PMDs are a significant risk factor for both depression during pregnancy and postpartum depression. These results support the implementation of preconception PMD screening during antenatal checkups as a preventive measure and to identify women in need of early mental health care.

Background: Psychosocial stress can induce various physical symptoms, including fever, which is a commonly seen symptom in pediatric practice. In cases of unexplained fever, psychogenic fever should be considered as a potential cause. Children with neurodevelopmental disorders may be more vulnerable to stress and therefore more prone to developing somatic symptoms than their peers. This study aimed to elucidate the characteristics of children with psychogenic fever and comorbidity.

Methods: This study included 21 patients with psychogenic fever who visited the Department of Pediatric Psychosomatic Medicine, Okayama University Hospital. Information on age, sex, disease onset, final estimated diagnosis, comorbidities, treatment course, and outcome was obtained from the patients' medical records.

Results: Of the 21 patients included, 7 were boys and 14 were girls, and their median age was 13.0 (range: 8.6-14.6) years. A total of 19 patients had no attendance at school, and all patients showed signs of maladjustment in school. The comorbidities included orthostatic dysregulation (n = 4) and migraine (n = 3). Neurodevelopmental disorders were observed in nine patients, eight of whom were diagnosed after the initial visit. The mean treatment duration was 37.2 months. The outcomes were complete remission (n = 9), improvement (n = 4), discontinuation (n = 1), and referral to another physician (n = 7).

Conclusion: Various comorbidities were observed in the patients of this study with psychogenic fever, including the coexistence of neurodevelopmental disorders, such as autistic spectrum disorder. Children with neurodevelopmental disorders are prone to psychological stress resulting from difficulties in social adjustment. It is crucial to understand the developmental characteristics and environmental adaptation of patients to facilitate accurate diagnosis and treatment.

Background: Low-grade systemic inflammation may be a key player in the immune activation that has been reported for mental health deterioration. We hypothesised that elevated serum levels of inflammatory cytokines increase neuroinflammation and exacerbate depressive symptoms.

Methods: The participants were part of a cohort study for whom data was available for both 2015 and 2019. In 2015, blood samples were collected from 232 participants. Their depressive symptoms were assessed both 2015 and 2019 using the Centre for Epidemiologic Studies Depression Scale (CES-D) (n = 33). The multiplex immunoassay system (Luminex® 200) was used to measure the serum concentrations of IL-6, IL-10, IL-12, IL-17A and TNFα. Data were analysed using linear models with the level of significance considered to be p < 0.05.

Results: After controlling for age, BMI, smoking and alcohol consumption, in 2015 the serum concentrations of IL-17A and TNFα in 2015 were significantly positively associated with the CES-D scores of women (standardised β (B) = .027, p < 0.01 and B = 0.26, p < 0.01, respectively). The serum concentrations of IL-17A and TNFα of men were significantly positively associated with the CES-D scores of 2019 (B = 0.62, p = 0.02 and B = 0.59, p = 0.02, respectively).

Conclusions: In this cross-sectional study, we found a significant positive correlation between the depressive symptoms and serum TNFα and IL-17A levels of women. In addition, our longitudinal findings suggest the possibility that TNFα and IL-17A could elevate the depressive symptoms of men.

Background: A decreased glomerular filtration rate (GFR), estimated using creatinine (Cr- eGFR), is often found at the initial presentation of anorexia nervosa (AN). Its pathophysiology has been explained mainly by dehydration, and chronic hypokalemia is also thought to be a cause. However, because we have often experienced cases of AN with decreased Cr-eGFR without these conditions, we must consider different etiologies. The focus of this paper is on low free triiodothyronine (FT3) syndrome. We also discuss the utility of eGFR, estimated using cystatin-C (CysC-eGFR), for these patients.

Methods: The data of 39 patients diagnosed with AN between January 2005 and December 2023 was available for study. The characteristics of patients at the lowest and highest body mass index standard deviation score (BMI-SDS) were examined. Data on the parameters Cr-eGFR, CysC-eGFR, dehydration markers, potassium (K), and hormonal data and BMI-SDS were assessed during the treatment course to evaluate the correlations in these parameters. Blood hematocrit, uric acid (UA), blood urine nitrogen (BUN) level, and urine specific gravity were adopted as dehydration markers; FT3, free thyroxine, thyroid stimulating hormone, and insulin-like growth factor were adopted as hormonal data. Cr-eGFR and simultaneously evaluated dehydration markers, K, or hormonal data were extracted and correlations associated with the changes in BMI-SDS were examined. Furthermore, Cr-eGFR and simultaneously assessed CysC-eGFR were compared.

Results: When the BMI-SDS was at the lowest value, low-FT3 syndrome was shown. Severe hypokalemia was not found in our study. A linear relation was not found between Cr-eGFR and BMI-SDS. A statistically significant correlation was found between Cr-eGFR and FT3 (p = 0.0025). Among the dehydration markers, statistically significant correlations were found between Cr-eGFR and BUN or UA. The difference between Cr-eGFR and CysC-eGFR was prominent, and CysC-eGFR showed much higher values.

Conclusions: Our data indicates that low-FT3 syndrome and dehydration were related to the renal function of our patients with AN. Furthermore, our data suggest that caution is needed in the interpretation of kidney function evaluation when using CysC-eGFR in cases of AN.