BioPsychoSocial Medicine最新文献

Background: Weight restoration is a crucial factor in the treatment of anorexia nervosa (AN); however, there is currently no consensus on the amount of energy required to achieve weight gain in patients with AN.

Methods: Forty-one patients with AN in a Japanese medical prison were included in the study. All the data were collected from their medical charts. Body weight and composition were measured using the multifrequency bioelectrical impedance device InBody 770®. Daily caloric intake was determined by subtracting the amount of calories in leftover food from that provided, and resting energy expenditure was calculated using Scalfi's formulation. These were then used to calculate daily amount of energy and energy necessary for a 1-kg weight gain (EE1). In addition, we investigated the relation between EE1 and the initial body composition values, body mass index, and AN subtype.

Results: Of the 41 patients, two had EE1s that we considered outliers. Excluding these, the mean EE1 was 12,776.8 kcal/kg, with large individual differences observed (range: 6,636-22,064 kcal/kg). Significant associations were noted between EE1 and body fat mass, body fat percentage, soft lean percentage, and body water ratio. Moreover, patients with body fat mass (BFM) ≤ 3 kg (p = 0.003), body fat percentage (BFP) ≤ 8% (p = 0.008), soft lean percentage (SLP) > 85% (p = 0.011), and body water ratio (BWR) > 0.665 (p = 0.011) had higher mean EE1s.

Conclusions: To gain weight, patients with AN may require a higher caloric intake than that reported in the literature for healthy women, particularly patients with less fat and more muscle. (242/350words).

Background: Over the past decade, mobile health (mHealth) technologies have been increasingly utilised to address eating behaviours and diet-related chronic diseases. Nevertheless, research assessing the momentary clinical characteristics of these conditions remains limited in Japan. This study provides an up-to-date overview of research using Ecological Momentary Assessment (EMA) technologies in Japanese clinical and non-clinical samples through a systematic review.

Methods: We reviewed studies extracted from MEDLINE via PubMed, Web of Science Core Collection and Scopus databases, spanning the period from 2004 to 2024. Our systematic review followed the "gold standard" Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additionally, the Checklist for Reporting EMA Studies (CREMAS) was used to evaluate the quality of included studies.

Results: From an initial pool of 32 potential articles, 4 studies met the inclusion criteria. A total of 75% of the studies were identified as using Personal Digital Assistants (PDAs) as the primary mHealth technology for EMA data collection.

Conclusion: Available evidence suggests that the use of a PDA-based approach may help improve the management of eating behaviour and monitoring diet-related chronic conditions in the Japanese population. Furthermore, integrating EMA into clinical practice could enhance the effectiveness of existing treatments and support ongoing health monitoring.

Background: Chronic pain, particularly pain secondary to trauma, is often accompanied by a feeling of perceived injustice. A prevalent feeling of injustice often goes along with a prolonged rehabilitation and problematic development of chronic pain. This feeling also correlates to catastrophizing. To date, too little is known about how the perception of injustice in chronic pain patients is interwoven with a variety of psychological, social and somatic factors. The present study sought to examine whether perceived injustice is correlated with pain level, pain diagnosis, depression, anxiety, stress, quality of life, pain related disability, occupation status and ongoing workers compensation litigation.

Material and methods: During the three month period, all patients undergoing an interdisciplinary assessment of their chronic pain at our institution (n = 191) were asked to take part in the study. 164 patients (86%) completed the injustice experience questionnaire (IEQ). Data regarding pain level, pain diagnosis, gender, age, depression, anxiety, stress, quality of life, pain related disability, occupation status and ongoing workers compensation litigation were extracted from the patient's charts. Correlations of these data to IEQ scores and differences between distinct subgroups of patients were analysed.

Results: Median total IEQ scores were 36.0 (IQR: 29.0-42.75). Median IEQ scores for the subscale blame and severity were 14.0 (IQR: 10.0-19.5) and 21.0 (IQR: 18.0-24.0) respectively. The IEQ correlated statistically significant with anxiety, depression and stress. No statistically significant differences were found in the IEQ scores between men and women. There was no statistically significant correlation of the IEQ scores with age, neither were statistically significant correlations with pain localizations found. No statistically significant correlation between IEQ scores and the different pain scores were found. IEQ values were higher in patients with pension application and with current sick leave. The presence of biographical factors (i.e. childhood trauma or experiences of emotional neglect) was related with higher IEQ values.

Conclusion: The IEQ appears to be more closely related to psychological and social determinants of pain than to somatic factors.

Background: This study aimed to investigate whether psychological flexibility moderates the relationship between premenstrual dysphoric disorder (PMDD) symptoms and depression, anxiety, positive parenting, and negative parenting.

Methods: For this study, a sample of 1,538 menstruating mothers with children aged 0 to 3 years (227 with 0-year-olds, 428 with 1-year-olds, 409 with 2-year-olds, and 424 with 3-year-olds) was assessed utilizing the Premenstrual Dysphoric Disorder Scale (PMDDS), Parental Acceptance and Action Questionnaire (PAAQ), and Hospital Anxiety and Depression Scale (HADS).

Results: The interaction effects between PMDDS and PAAQ scores were found to be significantly associated with anxiety and positive parenting, after controlling for other variables. Notably, higher PAAQ scores were associated with increased positive parenting, even in the presence of worsened PMDD symptoms. Furthermore, psychological flexibility, as measured by the PAAQ, had an independent effect on both depression and anxiety, though no moderating effect was observed.

Conclusions: Interventions aimed at enhancing psychological flexibility may be beneficial for mothers with premenstrual dysphoric disorder who are raising infants and toddlers.

Background: The prevailing paradigm for the etiology of irritable bowel syndrome is that transient noxious events lead to long-lasting sensitization of the neural pain circuit, despite complete resolution of the initiating event. In this study, we tested the hypotheses that (1) the combination of maternal separation (MS) and previous colorectal inflammation induces extensive visceral hypersensitivity in rats and (2) visceral hypersensitivity induced by maternal separation and previous colorectal inflammation in rats is mediated via the corticotropin-releasing hormone receptor-1 (CRH-R1) pathway.

Methods: Male rat pups were separated from their dams from postnatal day 2 to postnatal day 21. Acute colitis was induced by colorectal administration of trinitrobenzene sulfonic acid (TNBS) or vehicle on postnatal day 8. On postnatal day 50, the visceromotor response was evaluated by electromyography of the abdominal muscle in response to graded (10-80 mmHg) and phasic colorectal distention (CRD) one time. The same experiments were repeated after administration of the selective CRH-R1 antagonist CP-154,526 (20 mg/kg) or vehicle at 45 min before CRD.

Results: Compared with control rats, visceral perception was increased in MS + TNBS rats. MS + TNBS rats showed a significantly larger visceromotor response to phasic CRD with 40 mmHg, 60 mmHg, and 80 mmHg. Compared with vehicle administration in MS + TNBS rats, administration of CP-154,526 significantly attenuated this visceromotor response to CRD with 40 mmHg, 60 mmHg, and 80 mmHg.

Conclusions: These findings suggest that the combination of previous colitis and early life stress induce visceral hypersensitivity, and that the CRH-R1 pathway may play a role in this sensitization.

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.