BioPsychoSocial Medicine最新文献

Background: Disordered eating behaviors, emotional eating (EE), uncontrolled eating (UE), and cognitive restraint (CR) contribute to weight dysregulation and remain public health concerns in Japan. Body image distortion (BID), or the misperception of one's body size, has been linked to both being underweight and overweight. While health literacy (HL) and BID are individually associated with eating behaviors, the influence of higher-order HL domains-communicative and critical literacy-and their interactions with BID remain unclear. This study examined how HL and BID jointly influence multidimensional eating behaviors.

Methods: In this cross-sectional study of Japanese adults, HL was measured using the 14-item Health Literacy Scale. BID was defined as the discrepancy between the perceived (via the Figure Rating Scale) and actual body size (via BMI) and categorized as underestimation, no distortion, or overestimation. Eating behaviors (UE, EE, and CR) were assessed using the Japanese version of the 18-item Three-Factor Eating Questionnaire-R18V2. Multinomial logistic regression was used to examine the association between HL and BID, and general linear models were used to test whether BID moderated the effects of higher-order HL domains on eating behavior.

Results: Among the participants, 13.0% were underweight, 60.2% had a normal weight, 18.7% were overweight, and 8.0% were obese. BID was categorized as overestimation (36.7%), non-distortion (53.6%), or underestimation (9.7%). HL scores were not significantly associated with overestimation or underestimation; however, a higher BMI was inversely related to overestimation. Higher functional HL was associated with lower EE, UE, and CR across all BID subgroups. However, associations for communicative HL varied by BID (interaction P = 0.002 for EE, 0.070 for CR); it was positively associated with EE and CR in the underestimated group, but inversely associated with EE in the overestimated group. Critical HL was positively associated with CR in the overestimation group (interaction, P = 0.015).

Conclusion: Fostering functional HL may support healthier eating behaviors, regardless of BID. Communicative HL may be beneficial for individuals with overestimation-type BID, but potentially counterproductive for those with underestimation. Critical HL appears to encourage more restrictive eating, specifically among individuals with overestimated HL.

Objective: This study explores the level of frailty and the factors that influence elderly HF inpatients. It also examines the correlation between social frailty, perceived social support, and psychological resilience. It verifies psychological resilience and perceived social support as mediators between social frailty and frailty.

Method: This cross-sectional study collected four hundred fifty-six questionnaires from Northeast China, Northwest China and South China. The research assessment tools include the FRAIL scale (frailty), MSPSS scale (perceived social support), CD-RISC10 (psychological resilience), and HALFT scale (social frailty). Data analysis was performed using multiple regression analysis and the SPSS PROCESS Macro plug-in Model 6 and Model 4.

Results: Female (β = 0.085, p = 0.036), number of hospitalizations (β = 0.342, p < 0.001), and NYHA class (β = 0.325, p = 0.004) were risk factors for frailty in elderly HF inpatients. Frailty was found to be at a medium-high level, negatively correlated with perceived social support (ρ=-0.471, p < 0.01) and psychological resilience (ρ=-0.670, p < 0.01), and positively correlated with social frailty (ρ = 0.596, p < 0.01). Psychological resilience and perceived social support mediated the relation between social frailty and frailty, with an indirect effect of 27.18%, 10.49%, and 24.19%, respectively, all partial mediation.

Conclusion: NYHA class, number of hospitalizations, and female sex are indicators of the frailty level of elderly HF patients. Social frailty, psychological resilience, and perceived social support are interrelated. Psychological resilience and perceived social support are mediators in the relation between social frailty and frailty.

Background: Interoception refers to the multisensory integration and perception of the body's internal state within the central nervous system, which involves learning, memory, emotions, and experiences. Interoceptive dysfunction has been associated with alexithymia and alexisomia. Despite growing academic interest in interoception, standardized evaluation methods have yet to be established. The widely used Heartbeat Counting Task (HCT), a representative method for assessing interoceptive accuracy, has limitations owing to the potential influence of knowledge of heart rate, time perception, and tactile sensations. Therefore, more reliable assessment methods are needed. This study focused on the feasibility of the heaviness perception test as a method for assessing interoceptive accuracy and investigates its relationship with other interoceptive indices.

Methods: A total of 41 healthy volunteers (19 female; mean age 19.1 ± 0.8 years) participated in the study. The heaviness perception test was conducted using an approach similar to the method of adjustment applied to psychophysical measurements, and the absolute error scores were calculated. Other interoceptive indices investigated in this study include the HCT, Body Perception Questionnaire-Body Awareness Very Short Form (BPQ-VSF), the 20-item Toronto Alexithymia Scale (TAS-20), and Shitsu-Taikan-Sho-Scale (STSS) for alexisomia.

Results: Interoception accuracy assessed using the heaviness perception test showed a significant positive correlation with the BPQ-VSF score (r = .504, p < .01) and a negative correlation with the TAS-20 and STSS scores (TAS-20: r = -.342, p < .05; STSS: r = -.353, p < .05). However, there was no correlation between the heaviness perception test score and the absolute error score on the HCT.

Conclusions: The results suggest that the heaviness perception test is a feasible and useful method for assessing interoceptive accuracy and that it may be useful as an evaluation tool.

Background: Hwabyung is a psychiatric syndrome originally described in Korea that presents as chronic psychosomatic distress with emotional dysregulation and heightened somatic arousal. However, no objective analysis to clarify its progressive mechanism within a universal biopsychological framework has as yet been done that incorporates insights from traditional East Asian medical psychology.

Methods: We recruited 118 patients with Hwabyung and assessed their psychological and somatic symptoms using the Hwabyung Test (HB). Levels of depression, anxiety, and anger expression, as well as biopsychological features were evaluated with the Sasang Personality Questionnaire (SPQ). Psychological and somatic symptoms of Hwabyung were predicted through a regression analysis that used three SPQ subscales: behavioral activation (SPQ-B), cognitive flexibility (SPQ-C), and emotional responsiveness (SPQ-E). Hwabyung subgroups were identified by K-means analysis and their psychosomatic and biopsychological patterns were analyzed with HB and SPQ through ANCOVA and Profile Analysis to explore underlying biopsychological dimensions beyond culture-specific frameworks.

Results: The SPQ subscales explained 26.0% of the psychological and 14.3% of the somatic symptoms of Hwabyung. Three distinct Hwabyung subgroups (mild, moderate, and severe) were identified based on the severity of psychological and somatic symptoms. Patients with severe symptoms showed a unique SPQ subscale profile with high SPQ-B, low SPQ-C, and low SPQ-E scores, reflecting volatile, aggressive, rigid, pessimistic, repressed, and isolated biopsychological characteristics.

Discussion: This study suggests a representative SPQ subscale profile of Hwabyung and underlying mind-body interaction mechanisms within East-Asian biopsychological theory. It offers a more comprehensive and generalizable understanding of Hwabyung and other culture-bound psychosomatic syndromes, supporting improved diagnostic and intervention strategies across populations.

Background: Primary prevention of depressive symptoms among independent older adults is a critical public health challenge. Lifestyle factors and social support networks are increasingly recognized as pivotal determinants of mental health in this population. However, few longitudinal studies have examined these relationships, and little attention has been directed to gender-based differences. We investigated the associations between lifestyle factors and social support networks and the depressive symptoms of community-dwelling independent older adults in a sex-stratified 3-year longitudinal study.

Methods: This study used data from the Japan Gerontological Evaluation Study. Participants were functionally independent individuals aged 65 years and older. Our final analysis included data for 6,929 individuals collected between 2019 and 2022. A logistic regression analysis was conducted with depressive symptoms in 2022 as the dependent variable. Lifestyle factors and social support networks were treated as independent variables, with age, chronic diseases, and household income included as covariates. The effects of interactions between lifestyle factors and social support networks on depressive symptoms were also analyzed.

Results: The prevalence of depressive symptoms was 10.7% in men and 11.6% in women in the 3-year follow-up. The incidence rate of newly developed depressive symptoms (per 1,000 person-years) was 35.6 for men and 38.8 for women. Sex-based differences were found in lifestyle and social support network factors associated with depressive symptoms. In men, walking for more than 30 min per day, insomnia, and emotional support were significantly associated with the risk for depressive symptoms. In women, walking for more than 30 min per day, insomnia, and instrumental support were significantly associated with the risk for depressive symptoms. No interaction effects between lifestyle factors and social support networks on depressive symptoms were observed in either men or women.

Conclusion: These findings underscore the importance of preventing depressive symptoms among older adults, particularly through the lens of gender-specific differences in lifestyle factors and social support networks associated with depressive symptoms. This study highlights the potential for developing targeted and effective primary prevention strategies by identifying modifiable determinants of depressive symptoms.

Background: Although seated isometric yoga has been shown to reduce the fatigue and pain of patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), some patients who are for the most part bedridden have difficulty practicing it. Many patients with this disease also suffer from fibromyalgia (FM). We developed a recumbent isometric yoga program for patients who were for the most part bedridden, including patients with comorbid FM. The aim of this study was to investigate the effect of this recumbent isometric yoga intervention with such patients.

Methods: This was a randomized, controlled trial of 48 adult patients (7 male, 41 female, age 20-70 years) with ME/CFS without satisfactory improvement after ≥ 3 months of conventional therapy. They were divided randomly into a yoga group (n = 24) and a control group (n = 24). The yoga group received conventional therapy with recumbent isometric yoga practice for ~ 12 weeks (25-min sessions with a yoga instructor at hospital visits and daily in-home sessions). The control group received conventional therapy alone. The effect of recumbent isometric yoga on the level of functioning was assessed by measuring Performance Status (PS). Fatigue was assessed with self-rated questionnaires, including the Chalder Fatigue Scale (FS) and Profile of Mood States (POMS). Adverse events and benefits were recorded for the yoga group.

Results: After the intervention period, the PS score of the yoga group was significantly lower than that of the control group (P < 0.001), suggesting an improvement in functioning level. The Chalder FS score decreased in both groups, but the decrease was greater in the yoga group than in the control group (P < 0.01). Subgroup analysis showed that the Chalder FS score was reduced significantly only in the yoga group in patients with severe disease (P < 0.001) and those with comorbid FM (P < 0.01), although the PS scores did not differ significantly. In the yoga group, a single practice session with a yoga instructor significantly reduced fatigue and increased vigor in patients with severe disease and patients with comorbid FM. Patients reported no serious adverse effects and many benefits of recumbent isometric yoga, including improvements in physical symptoms and brain fog, enhanced awareness of their limits to activities that cause post-exertional malaise, and promotion of behavioral changes to live better within their limits.

Conclusions: Recumbent isometric yoga is an effective adjunctive therapy for patients with ME/CFS, including those for the most part bedridden and those who have FM.

Trial registration: University Hospital Medical Information Network (UMIN CTR) UMIN000023472 (Registered Aug. 4, 2016) and UMIN000030051 (Registered Nov. 20, 2017).

Objective: Screening tools such as the Patient Healthcare Questionnaire (PHQ) and Hospital Anxiety and Depression Scale (HADS) are useful for detecting poststroke depression (PSD). However, validation of these tools has yet to be conducted in the Singapore stroke population.

Method: A total of 138 adults were administered the HADS and both two- and nine-item versions of the PHQ. Receiver operating characteristic (ROC) analyses were utilized to validate these scales against the gold standard diagnosis of PSD through the Structured Clinical Interview for DSM-IV (SCID-IV).

Results: All the tools examined in this study had good convergent validity (rs = 0.55-0.89) and discriminative power (Area Under Curve: 0.849-0.887). The optimal cut-off scores were ≥ 7 for the HADS depression and anxiety subscales, ≥ 10 for the total score, ≥ 2 for the PHQ-2 and ≥ 8 for the PHQ-9. Additional analyses suggest that the use of both the PHQ and the HADS in specific combinations further improved diagnostic performance.

Conclusion: Both the PHQ and the HADS are acceptable tools for screening for poststroke depression in Singaporean inpatient rehabilitation care settings. Furthermore, our findings lead us to recommend using PHQ-9 with HADS-A for superior screening performance at sensitivity = 83.33%, specificity = 88.33%, positive predictive value = 51.72%, and negative predictive value = 97.25%.

Background: In Japan, approximately 20% of young women are underweight, a rate higher than that of other developed countries. For women, being underweight at a young age has been associated with amenorrhea, eating disorders, osteoporosis, and adverse pregnancy outcomes. We investigated young women's knowledge of these risks and associated factors.

Methods: A web-based survey was conducted among 984 Japanese women aged 18-29 years. The survey included questions about actual body weight, perceived healthy weight, body image, eating disorder tendency, knowledge of various risks and factors associated with being underweight, and sources of this knowledge. Participants were divided into underweight (< 18.5 kg/m²), normal weight (18.5-25 kg/m²), and obese (≥ 25 kg/m²) groups based on their body mass index (BMI). The body image and knowledge of health risks associated with being underweight were compared across the three groups and with women with and without an eating disorder tendency.

Results: Among the participants, 31.5% were underweight (BMI < 18.5 kg/m²). Of these, 87.4% considered their subjective ideal weight to be underweight, and 66.1% viewed their subjective healthy weight similarly. Underweight women reported greater body satisfaction than did those in other body shape groups. While 73.2% recognized amenorrhea as a risk of being underweight, only approximately half identified infertility, eating disorders, and osteoporosis as risks and associated factors, and few were aware of adverse pregnancy outcomes. Knowledge levels did not differ between underweight and normal-weight women. Conversely, women with a tendency toward an eating disorder were more aware of the risks of osteoporosis (58.6% vs. 49.0%) and eating disorders (66.8% vs. 55.2%) than were women without a tendency toward an eating disorder.

Conclusions: Young Japanese women had insufficient knowledge about the adverse pregnancy outcomes associated with being underweight. Underweight women are not less aware of the health risks and associated factors associated with underweight than normal-weight women. The body shape of young women may not be influenced by their knowledge of health issues associated with being underweight.