Search

Introduction: The early and rapid identification of psychosomatic symptoms is crucial to prevent harmful outcomes in patients with human papillomavirus (HPV) infection in busy comprehensive clinics. This study aimed to explore the prevalence and rapid screening method of the Diagnostic Criteria for Psychosomatic Research-revised (DCPR) syndromes in patients with HPV infection. Methods: A total of 504 participants underwent a clinical assessment that included DCPR, Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), the Social Support Rating Scale (SSRS), the Simplified Coping Style Questionnaire (SCSQ), fear of disease, sociodemographic and clinical characteristics. The prevalence of DCPR syndromes and DSM-5 diagnoses were compared between the HPV-positive and negative patients using χ2 tests. We explored the rapid screen indicator through multiple logistic regression analyses of the participants' psychosocial factors, sociodemographic and clinical characteristics. Results: The incidence of DCPR syndromes in HPV-positive patients (56.6%) was significantly greater than that in HPV-negative patients (17.3%) and DSM-5 diagnoses (8.5%) in the HPV-positive group. Health anxiety, irritable mood, type A behavior, and demoralization were the most common psychosomatic syndromes in HPV-positive patients. As the degree of fear increased from 0 to 5 to 10, the risk of DCPR increased from 1.27 (95% CI: 0.21–7.63) to 3.24 (score range: 1–5, 95% CI: 1.01–10.39) to 9.91 (score range: 6–10, 95% CI: 3.21–30.62) in the HPV-positive group. Conclusion: The degree of fear, as an independent risk factor, could be used to quickly screen outpatients with a high risk of DCPR syndrome among women with HPV infection. [ABSTRACT FROM AUTHOR]

Abstract Psychological characterization of patients affected by Inflammatory Bowel Disease (IBD) focuses on comorbidity with psychiatric disorders, somatization or alexithymia. Whereas IBD patients had higher risk of stable anxiety and depression for many years after the diagnosis of the disease, there is a lack of studies reporting a comprehensive psychosomatic assessment addressing factors of disease vulnerability, also in the long-term. The objective of this investigation is to fill this gap in the current literature. The aims were thus to assess: a) changes between baseline and a 4-year follow-up in psychiatric diagnoses (SCID), psychosomatic syndromes (DCPR), psychological well-being (PWB-I), lifestyle, gastrointestinal symptoms related to IBD and Irritable Bowel Syndrome (IBS)-like symptoms b) stability of psychiatric and psychosomatic syndromes at 4-year follow-up. A total of 111 IBD outpatients were enrolled; 59.5% of them participated at the follow-up. A comprehensive assessment, including both interviews and self-report questionnaires, was provided at baseline and follow-up. Results showed increased psychiatric diagnoses, physical activity, consumption of vegetables and IBS-like symptoms at follow-up. Additionally, whereas psychiatric diagnoses were no longer present and new psychopathological pictures ensued at follow-up, more than half of the sample maintained psychosomatic syndromes (particularly allostatic overload, type A behavior, demoralization) from baseline to follow-up. Long-term presence/persistence of such psychosocial burden indicates the need for integrating a comprehensive psychosomatic evaluation beyond traditional psychiatric nosography in IBD patients. Moreover, since psychosomatic syndromes represent vulnerability factors of diseases, further studies should target subgroups of patients presenting with persistent psychosomatic syndromes and worse course of the disease.

It has been noticed that more and more people struggle with chronic psychosomatic diseases from the gastrointestinal system, such as irritable bowel syndrome (IBS) and Crohn’s disease (CD). Chronic psychosomatic diseases of the gastrointestinal system are characterized by a long duration of symptoms, abdominal pain, lengthy diagnostic process, a lot of medical tests, an ambiguous etiology. Patients need support in coping with their ailments and their consequences. The study included 101 respondents; the majority of respondents were women (79.2%). The project addressed the following questions: What are the psychosomatic characteristics of subjects with IBS and CD? What are the differences in the severity of cognitive evaluation of the disease situation due to the presence of psychosomatic syndromes? What is the relationship between the number of psychosomatic syndromes and disease evaluation? The study was conducted mainly using the snowball method. The research had a two-stage: a semi-structured interview (DCPR-S-SSI) and a paper-and-pencil questionnaire (KOS version B). Data suggests that: group of respondents had characteristic psychosomatic syndromes, i.e. allostatic overload, type A behavior pattern, demoralization, irritable state; there are statistically significant differences in the assessment of disease significance due to the presence of psychosomatic syndromes and their number in sufferers; the more psychosomatic syndromes are present in patients with IBS and CD, the greater the intensity of disease significance as harm/loss and threat. Identified assessments of the meaning of illness in conjunction with psychosomatic syndromes are a challenge for psychological support. [ABSTRACT FROM AUTHOR]

Introduction: Among the elderly, the availability of tool assessing psychosomatic syndromes is limited. The present study aims at testing inter‐rater reliability and concurrent validity of the semi‐structured interview for the Diagnostic Criteria for Psychosomatic Research (DCPR‐R‐SSI) in the elderly of the general population. Method: One hundred eight subjects were recruited. Participants received a clinical assessment which included the DCPR‐R‐SSI, the Illness Attitude Scale (IAS), the Geriatric Depression Scale (GDS), the Psychosocial Index (PSI), the Toronto Alexithymia Scale‐20 (TAS‐20). Analyses of inter‐rater reliability of DCPR‐R‐SSI and concurrent validity between DCPR‐R‐SSI and self‐administered questionnaires were conducted. Results: DCPR‐R‐SSI showed excellent inter‐rater reliability with a percent of agreement of 90.7% (K Cohen: 0.856 [SE = 0.043], 95% CI: 0.77–0.94). DCPR‐R demoralization showed fair concurrent validity with GDS; concurrent validity was also fair between DCPR‐R Alexithymia and TAS‐20, and between DCPR‐R allostatic overload and PSI allostatic load, while the concurrent validity between DCPR‐R Disease Phobia and IAS was moderate. Conclusion: DCPR‐R‐SSI represents a reliable and valid tool to assess psychosomatic syndromes in the elderly. DCPR‐R is in need of being implemented in the elderly clinical evaluation. [ABSTRACT FROM AUTHOR]

It is fundamental for analytical psychology to understand images symbolically. However, Jung was aware of the non-symbolic and direct appearance of image in synchronistic visions and dreams. Therefore, there are two aspects of the non-symbolic: literal and synchronistic. Firstly, the pathology of the non-symbolic was explored in psychosomatic syndromes, trauma, borderline syndromes and autism spectrum disorder (ASD). Then the historical and cultural considerations show that dreams were shared and understood directly and non-symbolically in Japanese medieval times. Historically, the symbolic aspect emerged through the loss of this directness and is characteristic for the modern, western, and adult consciousness. However, the increasing prevalence of ASD and ambiguity between reality and virtual reality show that the contemporary world is again dominated by directness and the non-symbolic, which can be called 'postmodern consciousness'. [ABSTRACT FROM AUTHOR]

Background and Aim: Patients with the symptoms of gastrointestinal diseases and ulcers constitute a large number of patients referring to general and internal clinics. Furthermore, preliminary studies on gastric ulcers highlighted the role of psychological factors in the development of a susceptible gastric ulcer. The current study aimed to determine the effects of Cognitive-Behavioral Therapy (CBT) on pain intensity and stress coping styles in patients with gastric ulcers. Methods & Materials: This was an experimental study with a pretest-posttest-follow-up and a control group design. The statistical population included all patients with a gastric ulcer who were referred to public health centers in Tehran City, Iran, in the winter of 2018. Among the volunteers participating in the study, 30 patients with gastric ulcers were selected by the convenience sampling method. Next, they were randomly assigned to the experimental and control groups (n=15/group). Measurement tools included the McGill Pain Questionnaire (MPQ) and the Coping Inventory for Stressful Situations (CISS; Endler & Parker, 1990). The experimental group subjects participated in eight 90-minute sessions of CBT. However, the controls received no psychological treatment in this period. For data analysis, repeated-measures Analysis of Variance (ANOVA) and post-hoc tests were applied. Ethical Considerations: This study was approved by the Research Ethics Committee of the Islamic Azad University, Karaj Branch (Code: IR.IAU.K.REC.1397.85). Results: The present research results signified that CBT improved problem-oriented coping styles (P

Diagnostic Criteria for Psychosomatic Research (DCPR), developed by a team of Italian and American researchers at the end of the 20th century, was elaborated and then revised based on observations and studies conducted by clinicians. In this paper, we present their current version known as DCPR-R. This classification system departs from the functional/organic dichotomy of disorders. The new criteria allow for the assessment of the role of multiple emotional/behavioural dimensions and responses in the functioning of an affected person. The revised version has four diagnostic modules, i.e., stress, illness behaviour, psychological manifestation, and personality. The authors introduced an additional factor to describe life experiences that contribute to stress (allostatic overload). Illness behaviours include health anxiety, disease phobia, hypochondriasis, thanatophobia, illness denial, persistent somatisation, conversion, and anniversary reaction. Irritable mood, somatic symptoms secondary to a psychiatric disorder and demoralisation are psychological manifestations. Type A behaviour pattern and alexithymia are considered personalityrelated factors. The authors of DCPR-R proposed a certain number of criteria to be met in order to diagnose each of these syndromes. The system makes it possible to clearly determine the presence of a given syndrome, but it does not allow to assess its severity. Psychosomatic syndromes play an important role in the development and/or course of somatic diseases. Inclusion of these syndromes in clinical diagnosis has made it possible to expand the spectrum of information about patient's functioning, and, once they are diagnosed, offer appropriate psychological assistance, which will translate into an improvement in the quality of life. [ABSTRACT FROM AUTHOR]

Background and Aim Patients with the symptoms of gastrointestinal diseases and ulcers constitute a large number of patients referring to general and internal clinics. Furthermore, preliminary studies on gastric ulcers highlighted the role of psychological factors in the development of a susceptible gastric ulcer. The current study aimed to determine the effects of Cognitive-Behavioral Therapy (CBT) on pain intensity and stress coping styles in patients with gastric ulcers. Methods & Materials This was an experimental study with a pretest-posttest-follow-up and a control group design. The statistical population included all patients with a gastric ulcer who were referred to public health centers in Tehran City, Iran, in the winter of 2018. Among the volunteers participating in the study, 30 patients with gastric ulcers were selected by the convenience sampling method. Next, they were randomly assigned to the experimental and control groups (n=15/group). Measurement tools included the McGill Pain Questionnaire (MPQ) and the Coping Inventory for Stressful Situations (CISS; Endler & Parker, 1990). The experimental group subjects participated in eight 90-minute sessions of CBT. However, the controls received no psychological treatment in this period. For data analysis, repeated-measures Analysis of Variance (ANOVA) and post-hoc tests were applied. Ethical Considerations This study was approved by the Research Ethics Committee of the Islamic Azad University, Karaj Branch (Code: IR.IAU.K.REC.1397.85). Results The present research results signified that CBT improved problem-oriented coping styles (P<0.01) and decreased emotion-focused coping styles (P<0.01) and avoidance (P<0.01) in the test group. Besides, the mean scores of pain intensity decreased in the experimental group, compared to the controls (P<0.01). Conclusion The provided CBT was effective on pain intensity and stress coping styles in patients with gastric ulcers. [ABSTRACT FROM AUTHOR]

Background The literature has outlined positive effects of cardiac rehabilitation ( CR) on clinical psychological distress ( DSM depression and anxiety) and quality of life (QoL). In cardiac settings, subclinical distress (subthreshold depressive and anxious symptomatology) and psychological well-being also showed relevant clinical implications. This research explored these psychological variables, their changes over time and cardiac course of CR patients. Methods Clinical and subclinical distress, QoL, and psychological well-being were assessed in 108 consecutive patients undergoing CR, at baseline and up to 12 months after the program's completion. Results Of all patients, 25.9 per cent showed high distress with a DSM diagnosis, 31.5 per cent high distress without a DSM diagnosis, and 42.6 per cent low distress. Comparing these subgroups, worse QoL and psychological well-being were significantly linked not only to clinical but also to subclinical distress. After CR completion, a significant reduction in DSM diagnoses was observed, whereas there were no positive effects on subclinical distress, QoL, and well-being, or when they initially occurred, they were not long lasting. Moreover, only the subgroup with high distress without a DSM diagnosis was at greater risk for adverse cardiac outcomes, showing worse scores on items of contentment. Conclusions These findings confirm data on clinical distress reduction after CR completion. However, a large amount of relevant subclinical distress remains and predicts adverse cardiac events. [ABSTRACT FROM AUTHOR]

Objective: Cardiac rehabilitation (CR) is considered the recommended secondary prevention treatment for cardiovascular diseases (CVD), in terms of health behaviours and, secondarily, better cardiac outcomes promotion. However, the role of psychiatric and psychosomatic distress on the efficacy of CR is unclear. This research aimed to evaluate the impact of CR on unhealthy behaviour modification and cardiac course, considering the moderating role of depression, anxiety, and psychosomatic syndromes.Design: A longitudinal design between and within groups was employed. The assessment was repeated four times: at admission to CR (T1), at discharge (T2), 6 (T3) and 12 months following CR completion (T4).Method: One hundred and eight patients undergoing CR versus 85 patients with CVD not referred to CR, underwent psychiatric, psychosomatic, and health behaviour assessment. The assessment included the Structured Clinical Interview for DSM-IV (depression and anxiety), the interview based on Diagnostic Criteria for Psychosomatic Research, GOSPEL Study questionnaire (health behaviours), Pittsburgh Sleep Quality Index, and 8-item Morisky Medication Adherence Scale.Results: Cardiac rehabilitation was associated with maintenance of physical activity, improvement of behavioural aspects related to food consumption, stress management, and sleep quality. On the contrary, CR was not associated with weight loss, healthy diet, and medication adherence. Depression and psychosomatic syndromes seem to moderate the modification of specific health-related behaviours (physical activity, behavioural aspects of food consumption, stress management, and pharmacological adherence).Conclusion: In CR settings, an integrated assessment including both psychiatric and psychosomatic syndromes is needed to address psychological factors associated with unhealthy behaviour modification. Statement of contribution What is already known on this subject? Cardiac rehabilitation (CR) is considered a class 1A treatment recommendation and the most cost-effective model of secondary prevention to reduce cardiovascular events. There is evidence about the association between psychological distress and both unhealthy behaviour and cardiac course. Depression and psychosomatic distress, such as type A behaviour and demoralization, are frequently associated with CVD course. However, the role of psychiatric and psychosomatic distress in CR is not well known. What does this study add? CR exerted a protective effect on physical activity and a positive effect on eating behaviour, stress management, and quality of sleep. CR did not show any particular effect on smoking, overweight/obesity, dietary habits, medication adherence, and patients' 1-year survival. Findings from this study suggest the importance to consider specific psychological and psychosomatic aspects in affecting lifestyle. [ABSTRACT FROM AUTHOR]

Background: In spite of the role of some psychosomatic factors as alexithymia, mood intolerance, and somatization in both pathogenesis and maintenance of anorexia nervosa (AN), few studies have investigated the prevalence of psychosomatic syndromes in AN. The aim of this study was to use the Diagnostic Criteria for Psychosomatic Research (DCPR) to assess psychosomatic syndromes in AN and to evaluate if psychosomatic syndromes could identify subgroups of AN patients. Methods: 108 AN inpatients (76 AN restricting subtype, AN-R, and 32 AN binge-purging subtype, AN-BP) were consecutively recruited and psychosomatic syndromes were diagnosed with the Structured Interview for DCPR. Participants were asked to complete psychometric tests: Body Shape Questionnaire, Beck Depression Inventory, Eating Disorder Inventory-2, and Temperament and Character Inventory. Data were submitted to cluster analysis. Results: Illness denial (63%) and alexithymia (54.6%) resulted to be the most common syndromes in our sample. Cluster analysis identified three groups: moderate psychosomatic group (49%), somatization group (26%), and severe psychosomatic group (25%). The first group was mainly represented by AN-R patients reporting often only illness denial and alexithymia as DCPR syndromes. The second group showed more severe eating and depressive symptomatology and frequently DCPR syndromes of the somatization cluster. Thanatophobia DCPR syndrome was also represented in this group. The third group reported longer duration of illness and DCPR syndromes were highly represented; in particular, all patients were found to show the alexithymia DCPR syndrome. Conclusions: These results highlight the need of a deep assessment of psychosomatic syndromes in AN. Psychosomatic syndromes correlated differently with both severity of eating symptomatology and duration of illness: therefore, DCPR could be effective to achieve tailored treatments. [ABSTRACT FROM AUTHOR]

Pediatric obstructive sleep apnea (OSA) has been shown to not only affect the quality of sleep, but also overall health in general. Untreated or inadequately treated OSA can lead to long-term sequelae involving cardiovascular, endothelial, metabolic, endocrine, neurocognitive, and psychological consequences. The physiological effects of pediatric OSA eventually become pathological. As the complex effects of pediatric OSA are discovered, they must be identified early so that healthcare providers can be better equipped to treat and even prevent them. Ultimately, adequate management of OSA improves overall quality of life. [ABSTRACT FROM AUTHOR]