Symptoms of mental disorders and oral contraception use: A systematic review and meta-analysis.

Worldwide, over 150 million adolescent and adult women use oral contraceptives (OC). An association between OC-use and the emergence of symptoms of mental disorders has been suggested. This systematic review and meta-analysis provide an overview of published research regarding symptoms of mental disorders in association with OC-use, factoring the influence of OC types, age of first-use, duration of OC-intake, and previous diagnoses of mental disorders. A systematic literature search was conducted between June-July 2022. 22 studies were included. While most found no significant OC-use effects on mental symptoms, some hinted at OCs as a potential risk. The existing evidence regarding the potential link between progestin-only OC-use and an elevated risk of mental symptoms in comparison to combined OC-use remains inconclusive. However, due to emerging indications suggesting that the formulation of OC might play a role in mental health outcomes, this topic warrants further investigation. Moreover, indications of an increased risk for depressive symptoms in adolescent OC-users should be noted. Hence, while general population effects seem unlikely, they cannot be completely disregarded. The decision on OC-use should depend on the patient's medical history and should be re-evaluated regularly.

The interplay of personality pathology and treatment outcome in psychosomatic psychotherapy: A longitudinal analysis using latent change score modelling.

INTRODUCTION: While ample data demonstrate the effectiveness of inpatient psychosomatic treatment, clinical observation and empirical evidence demonstrate that not all patients benefit equally from established therapeutic methods. Especially patients with a comorbid personality disorder often show reduced therapeutic success compared to other patient groups. Due to the heterogeneous and categorical personality assessment, previous studies indicated no uniform direction of this influence. This complicates the derivation of therapeutic recommendations for mental disorders with comorbid personality pathology. METHODS: Analyzing n = 2094 patients from German university hospitals enrolled in the prospective "MEPP" study, we tested the dynamic interaction between dimensionally assessed personality functioning and psychopathology of anxiety and depression. RESULTS: Longitudinal structural equation modelling replicated the finding that the severity of symptoms at admission predicts symptom improvement within the same symptom domain. In addition, we here report a significant coupling parameter between the baseline level of personality function and the change in general psychopathology - and vice versa. DISCUSSION AND CONCLUSION: These results imply that personality pathology at admission hinders the therapeutic improvement in anxiety and depression, and that improvement of personality pathology is hindered by general psychopathology. Furthermore, the covariance between both domains supports the assumption that personality functioning and general psychopathology cannot be clearly distinguished and adversely influence each other. A dimensional assessment of the personality pathology is therefore recommendable for psychotherapy research and targeted therapeutic treatment.

Determinants for positive and negative experiences of interpersonal touch: context matters.

The goal of the study was to determine which aspects of interpersonal touch interactions lead to a positive or negative experience. Previous research has focused primarily on physical characteristics. We suggest that this may not be sufficient to fully capture the complexity of the experience. Specifically, we examined how fulfilment of psychological needs influences touch experiences and how this relates to physical touch characteristics and situational factors.In two mixed-method studies, participants described their most positive and most negative interpersonal touch experience within a specific time frame. They reported fulfilment of nine needs, affect, intention, and reason for positivity/negativity, as well as the body part(s) touched, location, type of touch, interaction partner, and particular touch characteristics (e.g. humidity).Positive and negative touch experiences shared similar touch types, locations, and body parts touched, but differed in intended purpose and reasons. Overall, the valence of a touch experience could be predicted from fulfilment of relatedness, the interaction partner and initiator, and physical touch characteristics. Positive affect increased with need fulfilment, and negative affect decreased.The results highlight the importance of relatedness and reciprocity for the valence of touch, and emphasise the need to incorporate psychological needs in touch research.

An olfactory perceptual fingerprint in people with olfactory dysfunction due to COVID-19.

The sense of smell is based on sensory detection of the molecule(s), which is then further perceptually interpreted. A possible measure of olfactory perception is an odor-independent olfactory perceptual fingerprint (OPF) defined by Snitz et al. We aimed to investigate whether OPF can distinguish patients with olfactory dysfunction (OD) due to coronavirus disease (COVID-19) from controls and which perceptual descriptors are important for that separation. Our study included 99 healthy controls and 41 patients. They rated 10 odors using 8 descriptors such as "pleasant," "intense," "familiar," "warm," "cold," "irritating," "edible," and "disgusting." An unsupervised machine learning method, hierarchical cluster analysis, showed that OPF can distinguish patients from controls with an accuracy of 83%, a sensitivity of 51%, and a specificity of 96%. Furthermore, a supervised machine learning method, random forest classifier, showed that OPF can distinguish patients and controls in the testing dataset with an accuracy of 86%, a sensitivity of 64%, and a specificity of 96%. Principal component analysis and random forest classifier showed that familiarity and intensity were the key qualities to explain the variance of the data. In conclusion, people with COVID-19-related OD have a fundamentally different olfactory perception.

What Kind of Patients Receive Inpatient and Day-Hospital Treatment in Departments of Psychosomatic Medicine and Psychotherapy in Germany?

INTRODUCTION: Germany is one of the few countries with a medical specialty of psychosomatic medicine and psychotherapy and many treatment resources of this kind. OBJECTIVE: This observational study describes the psychosomatic treatment programs as well as a large sample of day-hospital and inpatients in great detail using structured diagnostic interviews. METHODS: Mental disorders were diagnosed according to ICD-10 and DSM-IV by means of Mini-DIPS and SCID-II. In addition to the case records, a modified version of the CSSRI was employed to collect demographic data and service use. The PHQ-D was used to assess depression, anxiety, and somatization. RESULTS: 2,094 patients from 19 departments participated in the study after giving informed consent. The sample consisted of a high proportion of "complex patients" with high comorbidity of mental and somatic diseases, severe psychopathology, and considerable social and occupational dysfunction including more than 50 days of sick leave per year in half of the sample. The most frequent diagnoses were depression, somatoform and anxiety disorders, eating disorders, personality disorders, and somato-psychic conditions. CONCLUSIONS: Inpatient and day-hospital treatment in German university departments of psychosomatic medicine and psychotherapy is an intensive multimodal treatment for complex patients with high comorbidity and social as well as occupational dysfunction.

Effects of sickness manipulation on disgust and pleasantness in interpersonal touch.

The theory of the behavioral immune system (BIS) describes a set of behaviors that protect the individual from infectious diseases and that are motivated by disgust and the perceived vulnerability to disease. As interpersonal touch is one of the most common situations of potential transmission of infectious diseases in our everyday life, it seems likely that being touched by an apparently sick individual activates disgust. Our aim was to determine if risk of contamination from interpersonal touch alters the pleasantness of interpersonal touch and modulates facially expressed emotions. In total, 64 participants received interpersonal stroking by either a healthy or by sick-appearing experimenter. Half the strokes were performed at a slow velocity of 3 cm/s and half at a faster velocity of 30 cm/s, to modulate the degree of C-tactile fiber activation in the touch perceiver. While the experimental sickness manipulation did not influence the reported touch pleasantness, there was a tendency for a diminished expression of happiness in the slow stroking condition. In addition, the desire to clean the arm after stroking correlated positively to disgust sensitivity and to germ aversion, which is a subscale of the perceived vulnerability to disease. Contrary to previous studies, participants did not prefer the slow over the fast stroking velocity, irrespective of sickness induction. Our results lead us to assume that disgust in interpersonal touch depends especially on the touch receiver and we speculate that a rather conservative reactivity of the BIS allows for an adaptive behavioral balance in interpersonal relations. This balance may be needed to weight the risks of contamination against the benefits of interpersonal touch for social interaction.

Smells as Communication Pathways - why Emotions Pass through the Nose. / Gerüche als Kommunikationspfade ­ warum Emotionen durch die Nase gehen.

For many species, the sense of smell is the most important sensory system for interacting with the environment and conspecifics. In contrast, the role of perception and communication of chemosensory information in humans has long been underestimated. The human sense of smell was considered less reliable, so that it was given less importance compared to visual and auditory sensory impressions. For some time now, a growing branch of research has been dealing with the role of the sense of sell in emotion and social communication, which is often only perceived subconsciously. This connection will be examine in more detail in this article. First, he basics regarding the structure and function of our olfactory system will be described for better understanding and classification. Then, with this background knowledge, the significance of olfaction for interpersonal communication and emotions will be discussed. Finally, we conclude that people suffering from olfactory disorders have specific impairments in their quality of life.

[Psychosomatic health inventory: Basic psychosomatic documentation for quality assurance inpatient care]. / Gesundheitsinventar Psychosomatik: Psychosomatische Basisdokumentation zur Qualitätssicherung im stationären Alltag.

Objectives: As part of the quality assurance of inpatient treatment, the severity of the disease and the course of therapy must be mapped. However, there is a high degree of heterogeneity in the implementation of basic diagnostics in psychosomatic facilities.There is a lack of scientifically based standardisation in determining the quality of outcomes. Methods: With the help of scientifically established test instruments, a resource-saving basic documentation instrument was developed. Many existing psychometric instruments were checked for test quality, costs and computer-supported application. Results: The Psychosomatic Health Inventory (gi-ps) consists of three basic modules with a total of 63 items: sociodemography, screening and psychosomatic health status.The latter is represented bymeans of construct-based recording on eight scales. Its collection at admission and discharge allows the presentation of the quality of outcomes.The development of a proprietary software solution with LimeSurvey enables the computer-based collection, evaluation, and storage of data. A list of test inventories for confirming diagnoses and predictors has been compiled, which are recommended for use in clinical routine. Discussion: With the gi-ps, a modular basic documentation instrument including the software solution is available to all interested institutions free of charge.

[Burnout or Depression? - Field Experience from a University Outpatient Clinic]. / Burnout oder Depression? ­ Erfahrungen aus der Burnout-Sprechstunde in der Hochschulambulanz.

OBJECTIVE: With the increasing presence of burnout symptoms in clinical and social everyday life, it is necessary to closely examine patients with symptoms of burnout and to classify their respective symptoms in the spectrum of mental disorders. METHODS: The sample includes 83 patients who presented themselves in a burnout consultation of the university outpatient clinic of the University Hospital Dresden. As part of the diagnostic examination, the patients completed the Structured Clinical Interview (SKID) and a comprehensive questionnaire diagnostic (PHQ-D; MBI, BMI) as well as a clinical interview. RESULTS: The clinical interview led to a burnout diagnosis in 35% of the patients, although for 1/3 of these patients no SKID diagnosis could be affirmed. However, a large proportion of the patients presenting at the university outpatient clinic suffered from a mental disorder, with depressive disorders accounting for the majority of complaints. Patients with burnout differed in a few points from patients with depressive symptoms: They scored lower in the MBI questionnaire and in the scales of mental and physical stress symptoms (p=.031) and boreout (p=.037). In addition, patients diagnosed with burnout were significantly less likely to report previous mental disorders requiring treatment (p=.017). DISCUSSION: Previous standardized diagnostic instruments are less able to differentiate between burnout and depressive disorders. The present study supports the hypothesis that burnout and depression are part of the same spectrum of symptoms, with patients with burnout being less distressed than patients with depressive disorders. CONCLUSION: There appears to be a significant overlap between depression and symptoms of burnout making the differentiation difficult in everyday clinical practice and calling for a accurate diagnostic.

[Effectivity of Inpatient and Day-clinic Psychosomatic-Psychotherapeutic Treatment]. / Effektivität stationärer und teilstationärer psychosomatisch-psychotherapeutischer Behandlung.

AIM: (Partial) inpatient psychotherapy is well implemented in Germany. To better understand efficacy factors and effects, efficacy studies are necessary. This naturalistic study investigates the effectiveness of inpatient and day clinic psychotherapy as well as patient-and disorder-related factors influencing individual symptom improvements. METHODS: Patients at a psychosomatic-psychotherapeutic university hospital treated from 2015 to 2019 who completed the BSI-18 either at admission and discharge (n=1366) or at admission and three-month catamnesis (n=497) were included in the analysis. RESULTS: Improvements in global symptom severity showed moderate effect sizes. Descriptively, these were larger for day clinic patients than for those receiving treatment as inpatients-especially in the follow-up comparison (immediately after discharge: dinpatient=0.401, dday clinic=0.482; three months after discharge: dinpatient=0.403, dday clinical=0.807). Day hospitalized patients differed significantly from inpatients-slightly in age, employment status, ability to work and initial symptom burden, moderately in the number of mental comorbidities and strongly in their main diagnoses. Socio-demographic factors showed no positive influence on symptom improvement, initial symptom severity a moderate positive influence and the number of mental comorbidities a complex influence. DISCUSSION: In general, this study confirms the effectiveness of (partial) inpatient psychosomatic therapy. The relevance of day clinic offers is emphasised in the context of cost efficiency and good integration into everyday life, but under consideration of individual treatment indications.

Individual odor hedonic perception is coded in temporal joint network activity.

INTRO: The human sense of smell is highly individual and characterized by a strong variability in the perception and evaluation of olfactory stimuli, depending on cultural imprint and current physiological conditions. Since this individual perspective has often been neglected in fMRI studies on olfactory hedonic coding, this study focuses on the neuronal activity and connectivity patterns resulting from subject-specific olfactory stimulation. METHODS: Thirty-one normosmic participants took part in a fMRI block designed paradigm consisting of three olfactory stimulation sessions. The most pleasant and unpleasant odors were individually specified during a pre-test for each participant and validated in the main experiment. Mean activation and functional connectivity analysis focusing on the right and left piriform cortex were performed for the predefined olfactory regions-of-interest (ROIs) and compared between the three olfactory conditions. RESULTS: Individual unpleasant olfactory stimulation as compared to pleasant or neutral did not alter mean BOLD activation in the predefined olfactory ROIs but led to a change in connectivity pattern in the right piriform cortex. CONCLUSION: Our data suggests that the individual pleasantness of odors is not detectable by average BOLD magnitude changes in primary or secondary olfactory brain areas, but reflected in temporal patterns of joint activation that create a network between the right piriform cortex, the left insular cortex, the orbitofrontal cortex, and the precentral gyrus. This network may serve the evolutionary defense mechanism of olfaction by preparing goal-directed action.

Sex differences in human mate preferences vary across sex ratios.

A wide range of literature connects sex ratio and mating behaviours in non-human animals. However, research examining sex ratio and human mating is limited in scope. Prior work has examined the relationship between sex ratio and desire for short-term, uncommitted mating as well as outcomes such as marriage and divorce rates. Less empirical attention has been directed towards the relationship between sex ratio and mate preferences, despite the importance of mate preferences in the human mating literature. To address this gap, we examined sex ratio's relationship to the variation in preferences for attractiveness, resources, kindness, intelligence and health in a long-term mate across 45 countries (n = 14 487). We predicted that mate preferences would vary according to relative power of choice on the mating market, with increased power derived from having relatively few competitors and numerous potential mates. We found that each sex tended to report more demanding preferences for attractiveness and resources where the opposite sex was abundant, compared to where the opposite sex was scarce. This pattern dovetails with those found for mating strategies in humans and mate preferences across species, highlighting the importance of sex ratio for understanding variation in human mate preferences.

Human olfactory dysfunction: causes and consequences.

The sense of smell essentially contributes to social communication, guides nutrition behaviour and elicits avoidance towards environmental hazards. Olfactory smell impairment may hence entail severe consequences for affected individuals. Compared with sensory loss in other modalities, reduced olfactory function is often unnoticed by those affected and diagnosed late. Those patients seeking help frequently suffer from long-term impairments resulting in reduced well-being and quality of life. The current review provides an overview of aetiology, prevalence and specifics of diagnostics in acquired and congenital olfactory loss and focusses on short- and long-term consequences. Compensation strategies are elaborated, and treatment options are mentioned. Individual characteristics associated with the development of serious mental health impairment are discussed in order to help practitioners identifying populations at risk.

Symptoms of Depression in Patients with Chemosensory Disorders.

INTRODUCTION: Patients with chemosensory dysfunction frequently report symptoms of depression. The current study aims to clarify whether the type (smell dysfunction, taste dysfunction, and mixed smell and taste dysfunction), severity, duration, or cause of dysfunction have differential impacts on the symptoms of depression. METHODS: 899 patients with chemosensory disorders and 62 controls were included. Following a structured interview and an otorhinolaryngological examination, subjects underwent olfactory tests (Sniffin' Sticks), gustatory tests (taste sprays) and an assessment of depressive symptoms (Beck Depression Inventory). Information on the cause and duration of disorders was also collected. RESULTS: Patients with combined olfactory/gustatory dysfunction had higher depression scores than patients with smell dysfunction only and controls, and no significant difference was found between the smell dysfunction and controls. Anosmia patients, but not hyposmia patients, exhibited higher depression scores than controls. Among various causes of chemosensory disorders, patients from the posttraumatic group had higher depression scores than patients with other causes of chemosensory dysfunction (sinonasal, idiopathic, or postinfectious). Multiple linear regression analyses suggested that reduced olfactory function was associated with enhanced depression scores in the olfactory disorders group (B = -0.326, t = -2.294, and p = 0.02) and in all patients with chemosensory disorders (B = -0.374, t = -2.550, p = 0.017). DISCUSSION/CONCLUSION: Simultaneously decreased input of olfaction and gustation seems to have an additive effect on the exacerbation of emotional dysfunction. Early intervention should be considered for depression symptoms in patients with mixed olfactory/gustatory dysfunction in clinical practice.

[Improvement of Mental Health and Bonding in Women with Mental Disorders in the Postpartum Period - Evaluation of an Interaction-Centered Treatment of a Mother-Baby Day Clinic]. / Verbesserung der psychischen Gesundheit und Bindung bei postpartal psychisch erkrankten Frauen ­ Evaluation einer interaktionszentrierten Therapie in einer Mutter-Kind-Tagesklinik.

OBJECTIVE: Women with postpartum mental disorders often have a delayed bonding to their child with negative consequences for the child's development. In several countries it has been demonstrated that a specific mother-child treatment has positive effects on maternal psychopathology and mother-child bonding. Data for German-speaking countries are rare, partly due to the lack of adequately financed mother-baby units. The objectives of this study were to characterize the patients and to evaluate the treatment in a psychosomatic-psychotherapeutic mother-child day clinic. METHODS: A total of 270 patients were examined at admission and discharge from the mother-child day clinic. The evaluation included main and secondary diagnoses according to ICD-10, duration of treatment, medication, information on the child, and psychometric questionnaires on maternal psychopathology, mother-child bonding, and parental sense of competence. RESULTS: Of the women examined, 75% had more than one, on average 2.3 mental diagnoses. The most frequent main diagnoses were affective disorders (38.5%), neurotic, stress and somatoform disorders (30.7%) and personality and behavioral disorders (20.4%). About 56% reported impaired mother-child bonding. The average duration of therapy was 32 treatment days. Between admission and discharge, a highly significant improvement in symptoms was observed with a high effect size [F=288.557 (df=1), p<0.001, Eta²=0.549]. At discharge, 86.6% of patients showed no signs of mother-child bonding disorder. DISCUSSION: The results indicate high potential effects of an interaction-centered treatment on maternal mental health and mother-child bonding. CONCLUSIONS: The joint treatment of mother and child should be a fixed and financed component of the mental health system in order to prevent chronification and negative developmental consequences for the child.

Interoceptive accuracy and its impact on neuronal responses to olfactory stimulation in the insular cortex.

The insular cortex plays a key role in the integration of multimodal information and in interoceptive and exteroceptive processing. For instance, neurons in the central dorsal insula that are active during interoceptive tasks, also show an adaptation to gustatory stimulation. We tested the link between interoception and exteroception for the olfactory system (i.e., the second domain of chemosensation). In a sample of 31 participants, olfactory function was assessed in a two dimensional approach while the Heartbeat Perception Task served as a measurement for cardiac interoceptive accuracy. Subsequent fMRI sessions were performed on a 3-Tesla MR scanner containing 12-15 olfactory stimulation trials with a mildly pleasant food-related odor (coffee). Persons scoring high in the cardiac interoceptive accuracy task presented stronger smelling abilities as well as enhanced BOLD responses following olfactory stimulation. The olfactory stimulation triggered enhanced insular activation patterns in the central dorsal insular cortex. Consistent with prior findings on the coherence of gustatory and interoceptive processing in the central dorsal insula, these results base the insula as a common region for the integration of interoception and exteroception. We propose an explanatory model of how exteroception triggers the integration of intero- and exteroceptive sensations in the central dorsal insular cortex.

Marriage does not relate to major histocompatibility complex: a genetic analysis based on 3691 couples.

Optimization of chances for healthy offspring is thought to be one of the factors driving mate choice and compatibility of the major histocompatibility complex (MHC) is assumed to determine the offspring's fitness. While humans have been claimed to be able to perceive information of MHC compatibility via the olfactory channel, it remains unknown whether humans use such information for mate choice. By investigation of 3691 married couples, we observed that the high polymorphism of MHC leads to a low chance for homozygous offspring. MHC similarity between couples did not differ from chance, we hence observed no MHC effect in married couples. Hormonal contraception at the time of relationship initiation had no significant effect towards enhanced similarity. A low variety of alleles within a postcode area led to a higher likelihood of homozygous offspring. Based on this data, we conclude that there is no pattern of MHC dis-assortative mating in a genetically diverse Western society. We discuss the question of olfactory mate preference, in-group mating bias and the high polymorphism as potential explanations.

Sex Differences in Mate Preferences Across 45 Countries: A Large-Scale Replication.

Considerable research has examined human mate preferences across cultures, finding universal sex differences in preferences for attractiveness and resources as well as sources of systematic cultural variation. Two competing perspectives-an evolutionary psychological perspective and a biosocial role perspective-offer alternative explanations for these findings. However, the original data on which each perspective relies are decades old, and the literature is fraught with conflicting methods, analyses, results, and conclusions. Using a new 45-country sample (N = 14,399), we attempted to replicate classic studies and test both the evolutionary and biosocial role perspectives. Support for universal sex differences in preferences remains robust: Men, more than women, prefer attractive, young mates, and women, more than men, prefer older mates with financial prospects. Cross-culturally, both sexes have mates closer to their own ages as gender equality increases. Beyond age of partner, neither pathogen prevalence nor gender equality robustly predicted sex differences or preferences across countries.

C-tactile touch perception in migraineurs - a case-control study.

BACKGROUND: Migraine is characterized by sensory hypersensitivity and habituation deficits. Slow brushing over the skin activates C-tactile nerve fibers, which mediate pleasant touch and analgesic effects in healthy subjects. As this function is altered in painful conditions, we aimed to examine whether the C-tactile processing is disrupted in migraines. METHODS: To psychophysically assess C-tactile function, we applied optimal and suboptimal C-tactile stroking stimuli on the dorsal forearm (body reference area) and the trigeminally innervated skin of 52 interictal migraineurs and 52 matched healthy controls. For habituation testing, 60 repeated C-tactile optimal stimuli were presented in both test areas. The participants rated each stimulus on a visual analogue scale by intensity, pleasantness, and painfulness. RESULTS: Regarding C-tactile function, migraineurs showed unphysiological rating patterns but no significantly different pleasantness ratings than controls. During repeated stimulation, controls showed stable pleasantness ratings while migraineurs' ratings decreased, especially in those experiencing tactile allodynia during headaches. Migraineurs taking triptans responded like controls. CONCLUSION: The C-tactile function of migraineurs is subclinically altered. Repeated C-tactile stimulation leads to altered habituation but differs from previous work by the direction of the changes. Although the pathophysiology remains unknown, causative mechanisms could include central and peripheral neuronal sensitization, tactile allodynia and hedonic stimulus attributions.

The "Longing for Interpersonal Touch Picture Questionnaire": Development of a new measurement for touch perception.

Touch is a crucial factor of physiological and psychological health in humans. A lack of touch in contrast is associated with adverse implications on mental health. A new "Longing for Interpersonal Touch Picture Questionnaire (LITPQ)" was developed and tested for its concurrent, predictive, discriminant and face validity as well as its relation to psychological distress. Six different types of touch were depicted and touch frequency and touch wish concerning different interaction partners assessed. A sample of 110 participants aged 18-56 years completed the LITPQ as well as an existing touch deprivation questionnaire and a questionnaire on mental health. Frequency and wish for touch were higher for close interaction partners than for strangers. For 72.7% of the participants, their touch wish exceeded the reported touch frequency. The LITPQ correlated moderately with the existing questionnaire for touch deprivation and was independent of relationship status or gender but positively correlated with depressiveness, anxiety and somatization. Measuring longing for touch is a very complex task considering the many aspects of subjective touch perception and confounds in the method of self-report of touch. In our view, the LITPQ provides promising insights into this matter.