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Central psychological symptoms from a network analysis of patients with anxiety, somatoform or personality disorders before psychotherapy.

BACKGROUND: Cross-sectional network analysis examines the relationships between symptoms to explain how they constitute disorders. Up to now, research focuses mostly on depression, posttraumatic stress disorder, and rarely assesses larger networks of various symptoms measured with instruments independent of classifications. Studies on large groups of psychotherapy patients are also rare. METHODS: Analyzing triangulated maximally filtered graph (TMFG) networks of 62 psychological symptoms reported by 4616 consecutive nonpsychotic adults in 1980-2015. RESULTS: Case-dropping and nonparametric bootstrap proved the accuracy, stability and reliability of networks in patients' sex-, age-, and time of visit divided subgroups. Feeling that others are prejudiced against the patient was the most central symptom, followed by catastrophic fears, feeling inferior and underestimated. Sadness, panic, and sex-related complaints were less central than we expected. All analysed symptoms were connected, and we found only small sex-related differences between subsamples' networks. No differences were observed for time of visit and age of patients. LIMITATION: Analyses were cross-sectional and retrospective, not allowing examination of directionality or causality. Further, data are at the between-person level; thus, it is unknown whether the network remains constant for any person over time. One self-report checklist and building binary network method may bias results. Our results indicate how symptoms co-occured before psychotherapy, not longitudinally. Our sample included public university hospital patients, all White-Europeans, predominantly females and university students. CONCLUSIONS: Hostile projection, catastrophic fears, feeling inferior and underestimated were the most important psychological phenomena reported before psychotherapy. Exploring these symptoms would possibly lead to enhancement of treatments.

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What are we afraid of when we fear for our health? The symptom context of hypochondriacal complaints. / Czego sie boimy bojac sie o swoje zdrowie? Kontekst objawowy skarg hipochondrycznych.

OBJECTIVES: To identify the set of symptoms most frequently co-occurring with hypochondriacal complaints in patients with neurotic or personality disorders. METHODS: Nonparametric Spearman rank correlations between the variables of symptom checklist "O" describing hypochondriacal symptoms and other symptoms were analyzed. To increase the reliability of the results, the analyses were performed independently in two groups: 3,929 patients before admission to a day hospital in the years 1980-2002 (group A) and 3,190 patients before admission in the years 2004-2015 (group B). RESULTS: For selected groups of patients, lists of correlation coefficients were obtained showing the most important (strongest) and statistically significant associations between five hypochondriacal symptoms and somatization symptoms coming from the muscular system, breathlessness, symptoms coming from the cardiovascular system, anxiety symptoms, and compulsive thoughts without specific content. CONCLUSIONS: The multidimensional nature of hypochondriacal complaints and their association with somatization symptoms similar to infection or inflammation were confirmed. Apart from the fears about patient's own health, fears about close relatives are also an important symptom, to which clinical attention should be paid.

Usefulness of controlled breathing in psychiatry. A review of recent findings. Part 1 - Eastern approach. / Uzytecznosc technik kontrolowanego oddychania w psychiatrii. Przeglad badan z ostatnich lat. Czesc 1 ­ tradycje Wschodu.

The topic of this review is the clinical usefulness of techniques involving controlled breathing, based on Eastern traditions, aimed at restoring autonomic balance in psychiatry. Although these techniques have a long tradition as "relaxation methods", they gain additional meaning in the context of prolonged stress resulting from the ongoing COVID-19 pandemic. This review, however, is not limited to the pandemic; it also focuses on recent findings regarding clinical populations and provides basic information on the biological mechanisms of respiration and related markers (respiratory rate - RR and heart rate variability - HRV) and their use as effect indicators in research on the population of patients with mental disorders. On the basis of the available data from empirical studies and previous systematic and narrative reviews, it is possible to indicate the possible benefits of using techniques based on controlled breathing as a complementary method in the treatment of a number of mental health disorders. Possible side effects associated with the proposed techniques are also discussed.

Network analysis of body-related complaints in patients with neurotic or personality disorders referred to psychotherapy.

Background: Psychopathology theory and clinical practice require the most complex knowledge about patients' complaints. In patients seeking for psychotherapy, body-related symptoms often complicate treatment. Aim: This study aimed at examining connections between body-related symptoms, and identification of symptoms which may be responsible for emergency and sustaining of anxiety, somatoform and personality disorders with the use of network analysis. Methods: In our retrospective research we used data from a sample of 4616 patients of the Department of Psychotherapy, University Hospital in Cracow, diagnosed with anxiety, somatoform or personality disorders. We constructed the Triangulated Maximally Filtered Graph (TMFG) networks of 44 somatoform symptoms endorsed in the symptom checklist "O" (SCL-O) and identified the most central symptoms within the network for all patients and in subgroups of women vs. men, older vs. younger, and diagnosed in 1980-2000 vs. 2000-2015. We used bootstrap to determine the accuracy and stability of five networks' parameters: strength, expected influence, eigenvector, bridge strength and hybrid centrality. Results: The most central symptoms within the overall network, and in six subnetworks were dyspnea and migratory pains. We identified some gender-related differences, but no differences were observed for the age and time of diagnosis. Conclusions: Self-reported dyspnea and migratory pains are potential important targets for treatment procedures.

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Lower urinary tract symptoms and sexual functioning in patients with depression. / Dolegliwosci z dolnych dróg moczowych oraz funkcje seksualne u pacjentów z depresja.

OBJECTIVES: A link between sexual functioning and depression has been reported. However, it is still unknown whether lower urinary tract symptoms (LUTS) coexist or correlate with sexual dysfunction (SD) in depressed individuals. Depressed patients represent a unique population because of a possible bidirectional relationship between SD and depression and between LUTS and depression. Thus, the aim of this study was to investigate relationships between depression severity, SD and LUTS for patients with depression. METHODS: In this cross-sectional study, we analyzed data on depression, sexual functioning and LUTS from depressed patients who were treated in our department of adult psychiatry. Data were obtained from the Hamilton Rating Scale for Depression, the International Index of Erectile Function (IIEF), the Female Sexual Function Index (FSFI), and the International Prostate Symptom Score (IPSS). RESULTS: We included one hundred two patients diagnosed with, and treated for, depression. The participants reported a high overall prevalence of SD (60.8%), and SD correlated with depression severity. LUTS were also highly prevalent with 86% of the participants reporting at least mild LUTS severity. Despite coexistence of LUTS and SD in multiple patients, we did not find a statistically significant relationship between LUTS and SD in our cohort. CONCLUSIONS: In our exclusive group of individuals diagnosed with, and treated for, depression, depression severity had a negative effect on sexual functioning. Although there was no statistically significant relationship between LUTS and SD, they coexisted in multiple patients. Therefore, LUTS and SD should still be systematically assessed in patients with depression.

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Complaints of dyspnea and their associations with personality traits in patients referred to psychotherapy in a day hospital.

BACKGROUND: Breathing difficulties are present in different medical conditions, yet seem to be underresearched in psychiatric patients. AIM: Assessment of prevalence of dyspnea complaints and their associations with personality traits in patients with neurotic or personality disorders referred to psychotherapy. METHODS: Retrospective chart review of medical records of 2450 patients with diagnoses F4-F6 (ICD-10). Analyses of associations between dyspnea reported in a symptom checklist SCL-O and pathological scores in the Neurotic Personality Questionnaire were carried out using univariate and multivariate regression analyses with ORs and 95%CI estimated with licensed STATISTICA 13 (StatSoftPL) software, and R version 4.1.0, RStudio version 1.4.1717 software. RESULTS: Dyspnea was reported by 46.3% women and 36.6% men (14.5% and 10.1% respectively assessed it as severely burdensome). Univariate regression analysis revealed several significant associations between reporting dyspnea or its extreme intensity and pathological scores in the NPQ. Multivariate regression analyses in women confirmed the importance of impulsiveness and exaltation for dyspnea occurrence, and feeling of being dependent on the environment, demobilization, and narcissistic attitude for its extreme intensity. In men impulsiveness, sense of being in danger, irrationality, and ponderings were associated with the presence of dyspnea, and sense of being in danger and envy with its extreme intensity. CONCLUSIONS: Complaints of dyspnea were pretty frequent. Several personality traits measured by the NPQ questionnaire were predictors of their occurrence and feeling of extreme burden.

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Neurotic symptoms profile in a day hospital patients with an anamnesis of head injury in the past. / Profil objawów nerwicowych u pacjentów dziennego oddzialu leczenia zaburzen nerwicowych z historia urazów glowy.

OBJECTIVES: The aim of the study was to assess the relationship between the occurrence of brain damage and symptoms of neurotic disorders, reported by patients of the psychotherapeutic day hospital for neurotic and personality disorders before starting treatment. METHODS: Analysis of the cooccurrence of neurotic symptoms with previous head or brain tissue damage. The trauma was reported in a structured interview (Life Questionnaire) completed before treatment in the day hospital for neurotic disorders. Illustrated with OR coefficients (odds ratios), the performed regression analyzes showed statistically significant correlations between brain damage (caused by brain trauma, stroke, etc.) and symptoms listed in the symptom checklist KO"0". RESULTS: In a group of 2,582 women and 1,347 men, some of respondents reported (in the self-completed Life Questionnaire) a previous head or brain injury. Men reported a history of trauma much more often than women (20.2% vs. 12.2%; p < 0.0005). Patients who had a history of head trauma obtained a significantly higher value of the global severity of neurotic symptoms (OWK) in the symptom checklist KO "0" than patients without head trauma. This applied to both the male and female groups. Regression analyzes showed a significant relationship between head injuries and the group of anxiety and somatoform symptoms. In both groups (men and women), ?paraneurological', dissociative, derealization, and anxiety symptoms occurred more frequently. Men more often reported difficulties in controlling the expression of emotions, muscle cramps and tension, obsessive-compulsive symptoms, skin and allergic symptoms, and symptoms of depressive disorders. Women more often reported vomiting when feeling nervous. CONCLUSIONS: Patients with a history of head injuries have a higher global severity of neurotic disorders symptoms than people without such history. Men experience head injuries more often than women, and the risk of developing symptoms of neurotic disorders is higher in men. It seems that patients with head injuries are a special group when it comes to reporting some psychopathological symptoms, especially in the group of men.

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