Management of Functional Somatic Syndromes and Bodily Distress

Psychotherapy and Psychosomatics, Год журнала: 2018, Номер 87(1), С. 12 - 31

Опубликована: Янв. 1, 2018

Functional somatic syndromes (FSS), like irritable bowel syndrome or fibromyalgia and other symptoms reflecting bodily distress, are common in practically all areas of medicine worldwide. Diagnostic therapeutic approaches to these vary substantially across within medical specialties from biomedicine psychiatry. Patients may become frustrated with the lack effective treatment, doctors experience disorders as difficult treat, this type health problem forms an important component global burden disease. This review intends develop a unifying perspective on understanding management FSS distress. Firstly, we present clinical current concepts for classification. Secondly, propose integrated etiological model which encompasses wide range biopsychosocial vulnerability triggering factors considers consecutive aggravating maintaining factors. Thirdly, systematically scrutinize evidence base terms umbrella systematic reviews 2007 2017 give recommendations treatment levels care, concentrating developments over last 10 years. We conclude that activating, patient-involving, centrally acting therapies appear be more than passive ones primarily act peripheral physiology, recommend stepped care translate truly approach into actual patient.

Язык: Английский

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Management of somatic symptom disorder

Dialogues in Clinical Neuroscience, Год журнала: 2018, Номер 20(1), С. 23 - 31

Опубликована: Март 31, 2018

This review paper gives an overview of the management somatic symptom disorder. It starts with a description clinical problem patients persistent bodily distress, discusses classificatory, epidemiological, and etiological issues then describes evidence practical principles dealing these who are often seen as "difficult" to treat. is concluded that best-suited approach stepped care close cooperation primary care, specialist, mental health professionals operating on basis biopsychosocial model integrating well psychosocial determinants distress therapeutic factors.

Язык: Английский

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Somatic symptom disorder in patients with post-COVID-19 neurological symptoms: a preliminary report from the somatic study (Somatic Symptom Disorder Triggered by COVID-19)

Journal of Neurology Neurosurgery & Psychiatry, Год журнала: 2022, Номер 93(11), С. 1174 - 1180

Опубликована: Авг. 25, 2022

Objectives To assess the diagnosis of somatic symptom disorder (SSD) in patients with unexplained neurological symptoms occurring after SARS-CoV-2 infection, also referred to as long COVID. Design Single-centre observational study. Participants Adult experiencing long-lasting mild Of 58 consecutive our centre, 50 were included. Intervention Patients contacted for a standardised psychometric evaluation by phone, followed self-survey. Main outcome Positive SSD according criteria Diagnostic and Statistical Manual Mental Disorders-5 (DSM-5). Results Although did not meet DSM-5 functional specifically, based on was positive 32 (64%) patients. In remaining 18 patients, considered possible given high score diagnostic scales. Physical examination normal all. Brain MRI showed unspecific minor white matter hyperintensities 8/46 Neuropsychological assessment exclusively impairment attention 14 out 15 tested discrepancy their major subjective complaint. Forty-five (90%) met Chronic Fatigue Syndrome. Seventeen (32%) screened mood-anxiety disorders, 19 (38%) had history prior 27 (54%) reported past trauma. Additional self-survey highlighted post-traumatic stress 12/43 (28%), levels alexithymia traits perfectionism. Long-lasting impact rate insomnia (29/43, 67%), psychiatric follow-up (28/50, 56%) work or pay loss (25/50, 50%). Conclusion A majority COVID may require specific management. Trial registration number NCT04889313 .

Язык: Английский

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None

Springer eBooks, Год журнала: 2022, Номер unknown

Опубликована: Янв. 1, 2022

Язык: Английский

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Immune and Epigenetic Pathways Linking Childhood Adversity and Health Across the Lifespan

Frontiers in Psychology, Год журнала: 2021, Номер 12

Опубликована: Ноя. 26, 2021

Childhood adversity is associated with a host of mental and physical health problems across the lifespan. Individuals who have experienced childhood (e.g., child abuse neglect, family conflict, poor parent/child relationships, low socioeconomic status or extreme poverty) are at greater risk for morbidity premature mortality than those not exposed to adversity. Several mechanisms likely contribute relationship between lifespan behaviors, cardiovascular reactivity). In this paper, we review large body research within field psychoneuroimmunology, demonstrating early life stress alterations immune system. We first literature that dysregulation different indices, including proinflammatory cytokine production (and its impact on telomere length), illness infection susceptibility, latent herpesvirus reactivation, response tumor. then summarize growing how may alter epigenetic processes. Finally, propose future directions related work basic applied implications.

Язык: Английский

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Biased Competition Favoring Physical Over Emotional Pain: A Possible Explanation for the Link Between Early Adversity and Chronic Pain

Psychosomatic Medicine, Год журнала: 2018, Номер 80(9), С. 880 - 890

Опубликована: Окт. 3, 2018

ABSTRACT Background Early adversity predisposes to chronic pain, but a mechanistic explanation is lacking. Survivors of early with pain often seem impaired in their ability be aware of, understand, and express distressing emotions such as anger fear social contexts. In this context, it has been proposed that may at times serve “psychic regulator” by preventing awareness more intolerable emotions. Method This narrative review builds on the premise physical emotional are conscious experiences can compete for selective attention. We highlight mechanisms whereby consequences put competitive disadvantage. A case history, supportive research findings, an evidence-based neurobiological model presented. Results Arising from abuse or neglect childhood, impairments adult capacity attend and/or conceptualize meaning felt distress associated engagement default network top-down modulation affective response generation processes. Persistent poorly conceptualized reduced emotion regulation ability, vagal tone, increased inflammation, amplified nociceptive signals. Attention reinforced temporary reduction negative causes. Conclusions These processes jointly promote biased competition favoring attention away one's own They constitute unintentional analog phenomenon self-injury patients borderline personality disorder whom intentional infliction serves downregulate intense distress. Attending to, expressing, understanding previously unacknowledged psychological unrelated facilitate recovery after adversity. Mechanistic studies validate clinically derived hypothesis urgently needed.

Язык: Английский

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Alexithymia in Gastroenterology and Hepatology: A Systematic Review

Frontiers in Psychology, Год журнала: 2018, Номер 9

Опубликована: Апрель 6, 2018

Background: Alexithymia is a multifaceted personality construct that represents deficit in the cognitive processing of emotions and currently understood to be related variety medical psychiatric conditions. The present review aims investigate relationship alexithymia with gastrointestinal (GI) disorders as functional (FGID, irritable bowel syndrome dyspepsia) inflammatory disease (IBD) (ulcerative colitis Crohn's disease) liver diseases chronic hepatitis C, cirrhosis, transplantation. Methods: articles were selected from main electronic databases (PsycInfo, Medline, Pubmed, Web Science, Scopus, Cochrane, ScienceDirect) using multiple combinations relevant search terms (defined GI diseases, English, use Toronto scales [TAS] for alexithymia). TAS was inclusion criterion because it most widely used measure, thus allowing comparisons across studies. Results: Forty-eight studies met criteria, which 38 focused on (27 FGID 11 IBD) 10 diseases. Most (n=30, 62%) cross-sectional. prevalence higher (two third or more) than IBD (from one 50% patients, consistent other non-GI diseases) general population (10-15%). In disorders, may viewed primary driver visceral perception, symptom reporting, health care use, persistence, negative treatment outcomes. Also, has been found associated psychological distress specific GI-related forms anxiety predicting severity well post-treatment outcomes several factors increasing burden impairing levels quality life. A number critical issues (small sample sizes, patients referred secondary tertiary centers, cross-sectional study design, single scale alexithymia) constitutes limitation generalization findings. Conclusions: showed play different roles gastroenterology according clinical characteristics various relevance subjective perception affecting negatively

Язык: Английский

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Health anxiety and associated constructs in children and adolescents with congenital heart disease: A CHAMPS cohort study

Journal of Health Psychology, Год журнала: 2018, Номер 25(10-11), С. 1355 - 1365

Опубликована: Фев. 5, 2018

This study explored health anxiety and associated constructs in children adolescents with congenital heart disease typically developing adolescents. A total of 84 participants (7–16 years) completed measures anxiety, intolerance uncertainty, sensitivity, DSM-IV disorder symptom categories. Results demonstrated that experienced significantly higher levels compared to Our findings highlight a specific chronic physical population who may be at risk clinical related psychopathology require appropriate intervention.

Язык: Английский

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Alexithymia and Physical Illness: A Psychosomatic Approach

Cambridge University Press eBooks, Год журнала: 2018, Номер unknown, С. 105 - 126

Опубликована: Сен. 10, 2018

Язык: Английский

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Physicians’ knowledge and practices regarding screening adult patients for adverse childhood experiences: a survey

BMC Health Services Research, Год журнала: 2020, Номер 20(1)

Опубликована: Апрель 15, 2020

Adverse Childhood Experiences (ACEs) are common and associated with many illnesses. Most physicians do not routinely screen for ACEs. We aimed to determine if screening is related knowledge or medical specialty, assess perceived barriers.Physicians in Ontario, Canada completed an online survey 2018-2019. Data were analyzed 2019.Participants 89 family physicians, 46 psychiatrists 48 other specialists. Participants screened ACEs "never usually" (N = 58, 31.7%), "when indicated" 67, 36.6%), "routinely" 50, 27.3%) "other" 5, 2.7%). Screening was strongly specialty (Chi2 181.0, p < .001). The modal responses were: - (66.3%), (91.3%), specialists (77.1%). of prevalence ACEs, the link between mental health, but significantly knowing that physical health. Knowing linked stroke, ischemic heart disease, COPD, diabetes predicted greater 15.0-17.7, each ≤ most prevalent barriers lack health resources (59.0%), time concern about causing distress (49.7%) confidence (43.7%).Enhancing ACEs' negative influence on illness may increase screening. Efforts promote should address concerns time-consuming will referrals resources. Education focus increasing managing patient distress.

Язык: Английский

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