Role of history of traumatic life experiences in current psychosomatic manifestations.

OBJECTIVES: Although the relationship between traumatic experiences (TEs) and psychosomatic manifestations (pain, somatization, somatosensory amplification [SSA], and alexithymia) has been widely described, very few studies have investigated how these variables correlate with each other and with a history of TEs. The aim of this study was to investigate whether and how current psychosomatic manifestations are correlated with major and minor adult- and childhood TEs. METHODS: One hundred and forty-six patients (91 with pain) from the Pisa Gift Institute for Integrative Medicine Psychosomatics Lab., Italy, were assessed for pain, history of TEs (divided into major and minor based on whether or not they meet the DSM-5 Criterion A for post-traumatic stress disorder), alexithymia, somatization, and SSA. RESULTS: TEs were positively correlated with age, the sensorial dimension and intensity of pain, somatization, psychopathology index, SSA, and alexithymia. Using the somatization score (controlled for age) as a covariate, the previous correlations between psychosomatic dimensions and TEs lost their statistical significance: SSA (total TEs: from r = 0.30, p = 0.000 to r = -0.04, p = 0.652); alexithymia (total TEs: from r = 0.28, p = 0.001 to r = 0.04, p = 0.663); sensorial dimension of pain (total TEs: from r = 0.30, p = 0.015 to r = 0.12, p = 0.373); and pain intensity (total TEs: from r = 0.38, p = 0.004 to r = -0.15, p = 0.317). Interestingly, the tendency to report more intense pain was mainly predicted by minor TEs in childhood (ß = 0.28; p = 0.030). CONCLUSIONS: The number of lifetime TEs is positively correlated with the sensorial dimension and intensity of pain but not its affective and cognitive dimensions. However, the former relationship depends on the presence of somatization. The intensity of pain is associated with minor rather than major TEs, especially when they occur in childhood.

[Endocrine and psychosomatic disorders in patients with amenorrhea].

The article presents data on the relationship of pathogenetic mechanisms for the development of menstrual disorders of functional and organic origin in connection with mental disturbances from the point of view of the psychosomatic concept. According to the latter, functional disorders of the menstrual cycle are considered as psychosomatic, in which gynecological pathology develops as a result of psychopathological illness. A striking example of such a disorder is functional hypothalamic amenorrhea. At the same time, endocrinopathies, such as polycystic ovary syndrome and premature ovarian insufficiency, can also be considered in the paradigm of psychosomatic illnesses of ovarian function due to the high prevalence of anxiety and depressive disorders in this cohort of patients. This review highlights the importance of interdisciplinary collaboration between a gynecologist and a psychiatrist for the most effective reproductive rehabilitation of patients with amenorrhea. Literature search was carried out in national (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases in Russian and English. The priority was free access to the full text of articles. The choice of sources was prioritized for the period from 2018 to 2023.However, taking into account the insufficient knowledge of the chosen topic, the choice of sources dates back to 1985.

Loneliness, belonging and psychosomatic complaints across late adolescence and young adulthood: a Swedish cohort study.

BACKGROUND: Loneliness and belonging refer to social connectedness and are associated with young people's health; however, the relationship between these constructs and their impact on health is still being discussed. A dual continuum model of belonging and loneliness has been suggested, consisting of four groups depending on the state of loneliness and belonging: socially fulfilled (low loneliness, high belonging), socially indifferent (low loneliness, low belonging), socially searching (high loneliness, high belonging), and socially distressed (high loneliness, low belonging). The aim of this study is to examine loneliness and belonging in a Swedish sample of 17-18-years-olds who were followed over 3 years, and the associations that these aspects share with young people's psychosomatic complaints during these ages. METHODS: Swedish cohort data collected among late adolescents (age 17-18 in 2019) who were followed up in young adulthood (age 20-21 in 2022) (n = 2684) was used to examine the associations between loneliness, belonging, and psychosomatic complaints. Loneliness and belonging were measured by single items and the cross-combinations of these. Three psychosomatic complaints were assessed: stomach ache, headache, and difficulties falling asleep, and a summary index was calculated. RESULTS: Linear regression analyses showed that loneliness was positively and belonging was negatively cross-sectionally associated with psychosomatic complaints. The socially fulfilled group reported fewer psychosomatic complaints compared to all other groups, while the socially distressed group reported the highest level of psychosomatic complaints. Additional adjustment for sociodemographic characteristics barely affected the estimates. The prospective analysis supported these patterns; however, after adjustment for earlier psychosomatic complaints, the only statistically significant difference in subsequent psychosomatic complaints was found between the socially fulfilled and the socially distressed groups. CONCLUSIONS: Loneliness and belonging (separately and the cross-combinations of these) were cross-sectionally associated with psychosomatic complaints in late adolescence and in young adulthood. Prospectively, only the most vulnerable group in the dual continuum model, the socially distressed group, experienced more psychosomatic complaints than the socially fulfilled group, indicating a temporal relationship. Knowledge about the more nuanced links may be useful for developing specific public health recommendations and interventions for youth, targeting the most vulnerable groups.

Long COVID: a new word for naming fibromyalgia?

Long COVID is the name given to a syndrome comprising a wide variety of symptoms persisting more than 3 months after acute benign COVID-19, with a prevalence ranging from 10 to 80%. Symptoms are very close to fibromyalgia. Several studies showed that long COVID prevalence was much higher after the first wave of the pandemics and was associated to the fact of thinking having had COVID rather than having had really COVID. Thus, it was the stress of the first wave with the lockdown and not the consequences of the infection that probably induced this high frequency of long COVID. Numbers of studies tried to find objective biological abnormalities for explaining long COVID but none of them could be replicated and convincing. The concept of long COVID seems to be a repetition of history of medicine, in which the doctors and the society gave different names to fibromyalgia with the objective of trying to highlight the fact that fibromyalgia could be a somatic disease with a well understood pathophysiology and to avoid to focus on the psychosomatic aspects of the disease. In conclusion, "to name is to soothe" as said by Roland Barthes. However, "Naming things wrongly adds to the world's unhappiness" was saying Albert Camus. Thus, the term of long COVID, which suggests viral persistence of impaired immune response to the virus, is unappropriated and should be replaced by fibromyalgia-like post-COVID syndrome. Research on the psychosomatic and somatic mechanisms involved in these fibromyalgia-like post-viral syndromes must be encouraged.

Trust and Psychosomatic Complaints in Adolescence: Findings From a Swedish Cohort Study.

Objectives: To examine the cross-sectional and longitudinal associations between generalised and institutional trust and psychosomatic complaints in mid and late adolescence. Methods: Data were derived from the Swedish cohort study Futura01, using survey information collected amongst 3,691 grade 9 students (∼15-16 years, t1) who were followed-up 2 years later (∼17-18 years, t2). Registry information on sociodemographic characteristics was linked to the data. Linear regression analyses were performed. The longitudinal analyses applied the first difference (FD) approach as well as the lagged dependent variable (LDV) approach. Covariates included gender, family type, parental education, parental country of birth, and upper secondary programme. Results: Higher levels of generalised and institutional trust were cross-sectionally associated with lower levels of psychosomatic complaints at both time points. The FD analyses showed that increases in generalised and in institutional trust between ages 15-16 and 17-18 years were associated with corresponding decreases in psychosomatic complaints. The LDV analyses demonstrated reciprocal temporal associations between trust and psychosomatic complaints. Conclusion: The findings indicate that trust is a social determinant of psychosomatic complaints in adolescents, but also that health may affect trust.

Pediatric psychogenic non-epileptic seizures: A retrospective observational cohort study at a quaternary center.

BACKGROUND: Psychogenic non-epileptic seizures (PNES) represent a common functional disorder in the pediatric population. We aimed to characterize pediatric PNES by describing their clinical characteristics, PNES semiologies, and healthcare pathway towards and after diagnosis. MATERIAL AND METHODS: This was a retrospective, observational chart review of pediatric patients aged 6 to 18 years admitted between December 2020 and December 2021 for spell classification or suspected PNES. Psychogenic non-epileptic seizure diagnosis was made by the capture of a typical event on video electroencephalogram (vEEG). We used descriptive statistics to summarize demographic and clinical characteristics. RESULTS: We included 26 patients (18 females, 69.2%) with a mean age (SD) of 13.9 (2.5) years. Pre-morbid neurologic and psychiatric conditions included: epilepsy (23.1%), migraine (46.2%), mild traumatic brain injury (26.9%), anxiety (57.7%), ADHD (34.6%), and depression (30.8%). Six patients (23.1%) had a prior diagnosis of PNES. 14 patients (53.8%) presented with convulsive, and 6 (23.1%) each with non-convulsive and mixed PNES. Patients were seen by a range of providers prior to diagnosis including ED providers (50%), neurologists (53.8%), pediatricians (34.6%), and psychology/psychiatry (11.5%). Emergency department evaluation occurred for 13 patients (50%) on 15 occasions, and six (23.1%) were admitted to the hospital. The median (p25-p75) time from PNES onset to presentation and diagnosis at our institution was 3.5 (1.5-6.2) and 4.1 (3-7) months, respectively. A total of 33 events from the 26 patients were captured on vEEG. The most frequent semiologies in our cohort were rhythmic motor (27.3%) followed by equal frequency (18.2%) of complex motor and dialeptic. Eighteen patients (69.2%) were followed after the PNES diagnosis, for a median (p25-p75) of 17.3 months (6.3-21) with variable outcome. CONCLUSION: Pediatric PNES has female predominance and often presents with comorbid psychosocial stressors and psychiatric conditions. High clinical suspicion and early recognition are crucial to decrease healthcare utilization and establish timely diagnosis and treatment.

[Nosogenic psychosomatic disorders in patients with skin diseases]. / Nozogennye psikhosomaticheskie rasstroistva u patsientov s kozhnymi zabolevaniyami.

OBJECTIVE: Development of a clinical typology of nosogenic psychosomatic disorders in patients with skin diseases. MATERIAL AND METHODS: The study was carried out in the interclinical psychosomatic department of the Clinical Center and the Clinic of Skin and Venereal Diseases named after. V.A. Rakhmanov Sechenov University in 2007 to 2022. Nine hundred and forty-two patients (253 males, 689 females, average age 37.3±12.4 years) with nosogenic psychosomatic disorders in chronic dermatoses, including ichen planus (n=143), psoriasis (n=137), atopic dermatitis (n=132), acne (n=118), rosacea (n=115), eczema n=10), seborrheic dermatitis (n=88), vitiligo (n=52), pemphigus (n=48), were studied. Index of clinical symptoms (ICS); the Dermatology Quality of Life Index (DQLI); itching severity questionnaire - Behavioral rating scores (BRS); the Hospital Anxiety and Depression Scale (HADS) and statistical methods were used. RESULTS: In patients with chronic dermatoses, nosogenic psychosomatic disorders were diagnosed according to ICD-10 criteria within adaptation disorders [F43.8] (n=465; 49.3%); hypochondriacal disorder [F45.2] (n=235; 24.9%); constitutionally determined and acquired (hypochondriac development) personality disorders [F60] (n=118; 12.5%); schizotypal disorder [F21] (n=65; 6.9%); recurrent depressive disorder [F33] (n=59; 6.2%). A typological model of nosogenic disorders in dermatology has been developed: hypochondriacal nosogenies in severe clinical forms of dermatosis (pemphigus, psoriasis, lichen planus, atopic dermatitis, eczema) and dysmorphic nosogenies in objectively mild, but cosmetically significant forms of dermatosis (acne, rosacea, seborrheic dermatitis, vitiligo). When analyzing socio-demographic and psychometric indicators, significant differences were revealed between the selected groups (p<0.001). In turn, the selected groups of nosogenic disorders demonstrate significant clinical heterogeneity and include various types of nosogenies that form a unique palette of the nosogenic spectrum in the structure of an extensive psychodermatological continuum. Along with the severity of the skin process, the dominant role in the formation of the clinical picture of nosogeny, including cases of paradoxical dissociation of the quality of life with the severity of dermatosis, amplification and somatization of itching, has a premorbid personality structure and somatoperceptive accentuation of the patient, as well as the presence of a comorbid mental disorder. CONCLUSION: The typology of nosogenic psychosomatic disorders in patients with skin diseases requires consideration of both the psychopathological structure of the disorders under discussion and the severity/clinical features of the skin process.

The dynamic changes of psychosomatic symptoms in three waves of COVID-19 outbreak and fatigue caused by enduring pandemic in China.

BACKGROUND: Two years have passed since the 2019 novel coronavirus disease (COVID-19) was first reported. The persistent pandemic might lead to severe psychosomatic problems and fatigue. In addition, the recent rapid rising COVID-19 cases in China have become a trending issue. Therefore, this study aimed to investigate the dynamic changes in psychosomatic problems at the initial and current stages of the pandemic. METHODS: Three waves of cross-sectional online survey were conducted during the initial COVID outbreak in China. The psychosomatic symptom scale (PSSS), perceived stress scale (PSS), and pandemic fatigue scale (PFS) were used to assess the psychosomatic problems, stress, and fatigue. RESULTS: 4317, 1096, and 2172 participants completed the first, second, and third surveys. The prevalence of psychosomatic disorder was 22 %, 28 %, and 39 %, respectively. The network structure of PSSS symptoms has not significantly changed as the pandemic progresses. However, the global strength of the PSSS networks, indicating the overall connectivity, in the third wave was significantly higher than in the first wave (s = 0.54, P = 0.007). The most central symptoms in the first and third wave networks were depressed mood and tiredness. The PFS score was higher in the people concerned with indirect impact than those concerned with health (P < 0.001). PFS has positive relationships with PSSS and PSS score (R = 0.41, P < 0.001 and R = 0.35, P < 0.001, respectively). CONCLUSIONS: The persistence of the pandemic caused critical psychosomatic issues, stress, and indirect burden over time, leading to inevitable fatigue. People endured needing immediate attention to prevent or reduce psychosomatic disorders.

Mental-health profiling with person-centred analysis: A study of adolescents in Sweden.

BACKGROUND: Studies that have examined time trends in adolescents' mental health have frequently been based on analyses of adolescents' psychosomatic symptoms. Adolescents' reports of psychosomatic complaints need to be seen in the light of their overall evaluations of their health. The objectives of this study were to apply a person-centred approach to identifying adolescents' mental-health profiles based on evaluations of their overall health and psychosomatic complaints. The relationships between these mental-health profiles and indicators of positive mental health and psychological and social-adjustment problems are examined. METHODS: A dual-factor approach was used for nationally representative adolescent samples and examined adolescents' self-rated psychosomatic complaints and perceived overall health simultaneously. Cluster analyses of data from the Swedish Health Behaviour in School-aged Children (HBSC) 2017/18 survey, including 3222 children aged 11, 13 and 15, were used to identify mental-health profiles. RESULTS: Four mental-health profiles were identified by cluster analyses in all age groups. The profiles showed good construct validity in relation to mental well-being, life satisfaction and self-esteem. The poorest psychological adjustment was found among the adolescents with high levels of psychosomatic symptoms together with low levels of perceived overall health. Adolescents with high levels of psychosomatic symptoms only or with low levels of overall health only showed considerably better psychological adjustment. CONCLUSIONS: Cluster analyses identified distinct, valid and consistent mental-health profiles based on differing levels of perceived health and psychosomatic complaints. The dual-factor model in population health research may increase our potential to understand the mental health of adolescents better.

A framework for the implementation of consultation-liaison psychiatry from the characteristics of psychosomatic consultations at a general hospital in China.

OBJECTIVE: To describe the characteristics of a consultation-liaison psychiatry (CLP) service at a general hospital in China, compare the literature on CLP in other hospitals in China and abroad, and identify reasons for the differences. METHODS: The medical records of all inpatients who received liaison consultations in the first year of the establishment of Xi'an International Medical Center Hospital were reviewed. Demographic data, specific department, number of consultations, reasons for consultation, outcome of consultation, and follow-up information on patients was collected. RESULTS: A total of 630 patients were enrolled during the first year of the hospital's opening, of which 45.2% were male and 54.8% were female. A total of 89.2% of non-psychiatric departments requested a psychosomatic consultation. The percentage of middle-aged and elderly patients was 75.6%, of whom 61.6% were aged 45 to 74 years. The internal medicine department requested the highest number of consultations (48.2%), including those from respiratory medicine (12.1%), neurology (12.1%), gastroenterology (12.1%), and cardiology (12.1%). Among surgical patients, orthopedic patients (6.5%) comprised the majority of consults. The main reasons for requesting a psychosomatic consultation were depressive symptoms (139 cases, 22.8%), anxiety symptoms (137 cases, 22.5%), sleep problems (111 cases, 18.2%), and hallucinations, delusions, or behavioral problems (68 cases, 11.2%), accounting for a total of 74.6% of consultations (455/630). CONCLUSION: A significant gap exists between the level of CLP services in China and developed regions in Europe and the United States, mainly due to low psychiatric consultation rates and poor quality CLP services.

Worry and Psychosomatic Problems Among Adolescents in Sweden in the Wake of the COVID-19 Pandemic: Unequal Patterns Among Sociodemographic Groups?

PURPOSE: To analyze potential associations between sociodemographic factors and adolescents' worry about family finances and other types of worries during the COVID-19 pandemic and the potential associations between different worry themes and psychosomatic problems. METHODS: From December 2020 to March 2021, 3,068 16-17 years old students in Sweden completed a questionnaire about the impact of the COVID-19 pandemic on their schooling and everyday life. From April to June 2020, 70% of these students also responded to questions about their psychosomatic health. Logistic regression was applied to analyze the associations between sociodemographic factors and different worry themes and estimate the association between worry and psychosomatic problems. RESULTS: Across all 13 worry themes, girls reported worry to a higher degree than boys. In most of the cases, adolescents with a lower parental educational background or immigrant background reported more frequent worrying. This was most evident for worry about family finances. The differences between adolescents with a Swedish background and those with a foreign background were large except for worry about climate change. All worry themes were associated with the students' psychosomatic health. Those who often or always experienced worry were more likely to report psychosomatic problems. Worry about family finances showed the highest odds ratio and marginal effect. DISCUSSION: Worry about family finances during the COVID-19 pandemic turns out to be a strong and socially structured stressor that may widen the health inequalities among young people. This underlines the need for preventive and promoting measures aimed at supporting socioeconomic disadvantaged groups.

Clinimetric properties of the diagnostic criteria for psychosomatic research among the elderly.

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.

The association between self-reported psychosomatic complaints and bullying victimisation and disability among adolescents in Finland and Sweden.

AIM: To analyse the associations between bullying victimisation, disability, and self-reported psychosomatic complaints in adolescents, and to investigate the role of support from parents and teachers in such associations. METHODS: The study was based on Finnish and Swedish data from two waves (2013/2014 and 2017/2018) of the Health Behaviour in School-aged Children survey (n=16,057). Descriptive statistics were produced for four groups of adolescents: (a) bullied with disabilities; (b) not bullied with disabilities; (c) bullied without disabilities; and (d) not bullied without disabilities (reference group). Two multilevel multinomial logistic regression models were performed for the Finnish and Swedish samples separately. The first model analysed associations between psychosomatic complaints and bullying victimisation, controlling for a range of confounders. The second model analysed associations between psychosomatic complaints and social support from parents and teachers. RESULTS: Across both countries, bullied adolescents with disabilities were more likely to self-report psychosomatic complaints than the reference group, even after adjusting for other potential confounders. Teacher support was identified as a potential protective factor as the odds ratio for psychosomatic complaints decreased when including teacher support as a factor in the model. The association with parent support showed mixed findings in Finland and Sweden. CONCLUSIONS: Disability in combination with bullying victimisation generated the highest levels of self-reported psychosomatic complaints compared to adolescents that were not bullied nor had disabilities. High teacher support may be a protective factor against psychosomatic complaints for bullied and/or disabled adolescents.

Trends in adolescent psychosomatic complaints: a quantile regression analysis of Swedish HBSC data 1985-2017.

BACKGROUND AND AIMS: According to recent criticism, survey-based measures of adolescent psychosomatic complaints have poor content validity insofar as they conflate trivial with severe complaints. It is argued that this means that estimates of prevalence and trends in complaints may reflect trivial complaints that are not indicators of health problems. In this study, two observable implications of this criticism were investigated: (a) that self-reported psychosomatic complaints should have a bimodal distribution; and (b) that the increase in complaints over time should be of approximately equal size throughout the distribution of complaints. METHODS: Three decades (1985/1986-2017/2018) of repeated cross-sectional data from the Swedish Health Behaviour in School-aged Children survey were used. Psychosomatic complaints were measured using the screening instrument Health Behaviour in School-aged Children symptom checklist. Histograms, bar charts and quantile regression models were used for the analysis. RESULTS AND CONCLUSIONS: With regard to the first implication, the results showed that the distribution of complaints was not bimodal and that there were no clusters of respondents. This suggests that binary categorisations of students can be reductive and conceal important variations across students. With regard to the second implication, the results showed that the increase in complaints was greatest among students who report frequent and co-occurring complaints. This suggests that reports of increasing complaints in adolescents cannot be explained as being primarily due to a greater inclination to report trivial complaints. It is concluded that any conflation of trivial and more severe complaints in surveys of psychosomatic complaints is not reflected in population-based estimates.

Latent Profile Analysis for Classification of Psychosomatic Symptoms in Perimenopausal Women.

BACKGROUND: Over 80% of perimenopausal women experience various physical and neuropsychiatric symptoms due to changes in hormones. However, accurate evaluation and treatment of menopausal symptoms are lacking due to limited evidence regarding customized treatment for each symptom type. OBJECTIVE: This study aimed to identify and cluster psychosomatic symptoms in Korean perimenopausal women and to investigate the characteristics of each cluster type. METHODS: This Web-based survey assessed 1060 Korean perimenopausal women recruited from nationally representative panels available from a commercial research company. Menopausal symptoms were evaluated using the Menopause Rating Scale, Patient Health Questionnaire-15, Patient Health Questionnaire-9, Insomnia Severity Index, Subjective Memory Complaints Questionnaire, and Overactive Bladder Symptom Score. Data were analyzed using latent profile analysis and multinomial logistic regression. RESULTS: Latent profile analysis identified 4 latent classes: "all unimpaired (class 1)," "impaired sexual function, while others are unimpaired (class 2)," "unimpaired sexual function, while others are impaired (class 3)," and "all impaired (class 4)." Classes 3 and 4 were significantly more likely to have a family history of perimenopausal syndrome and a history of other mental disorders, postpartum depression, and postpartum psychosis than classes 1 and 2. CONCLUSIONS: Psychosomatic symptoms appear during perimenopause along with depression, somatic symptoms, insomnia, impaired memory, and overactive bladder symptoms. Individuals with these symptoms are more likely to have a history of postpartum depression, psychosis, and other psychiatric disorders. Therefore, sexual dysfunction must be independently treated. Further studies are needed to develop and verify individualized treatments according to symptom class.

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.

Early physical maturation and subjective health complaints in adolescent girls: a pooled cross-sectional analysis.

BACKGROUND: Although adolescents are generally healthy, subjective health complaints (SHC) are common in this age group, especially in adolescent girls. We explored the association between early menarche and the frequency of psychosomatic symptoms and how this association varies between countries. METHODS: Our sample included 298 000 adolescent girls from 2002, 2006, 2010 and 2014 cycles of the Health Behaviour in School-aged Children (HBSC) study in 41 European and North American countries. School surveys measured the frequency of eight psychosomatic symptoms in the past 6 months. Early maturation was defined as self-reported age at menarche below 11 years. Using logistic regression, we estimated adjusted ORs (aORs) and 95% CIsof experiencing each psychosomatic symptom at least more than once a week and experiencing two or more symptoms at least more than once a week. RESULTS: Early menarche occurred in 4.73% of the sample and was positively related to headache, stomachache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties in sleeping, feeling dizzy and two or more of these symptoms, respectively (all p values<0.001). The interactions between early menarche and survey circle were non-significant. Changing the age criterion to 12 years did not affect the results. The associations between early menarche and psychosomatic symptoms were robust across the HBSC-participating counties with two age criteria. CONCLUSIONS: Early menarche positively relates to various psychosomatic symptoms in European and North American adolescent girls. Our findings suggest that early-maturing girls may need early supportive interventions.

Parenting Practices and Psychosomatic Complaints Among Swedish Adolescents.

Objectives: Parent-adolescent relationships play a crucial role in youth development. This study examines the associations between parenting practices (parental support, knowledge, and rule-setting) and psychosomatic complaints across middle and late adolescence. Methods: The study utilised data from a Swedish national cohort (n = 3,678). Participants completed self-report questionnaires in 2017 (∼15-16 years) and again in 2019 (∼17-18 years). Results: Parental support exhibited the strongest and most consistent inverse cross-sectional associations with psychosomatic complaints during both middle and late adolescence. Furthermore, increases in parental support and parental knowledge were associated with decreases in adolescent psychosomatic complaints. However, parental support and knowledge at age 15-16 were not prospectively associated with psychosomatic complaints at age 17-18. Conclusion: These findings underscore the importance of ongoing parental engagement, particularly in terms of providing constant support, throughout middle and late adolescence.

Among the swedish generation of adolescents who experience an increased trend of psychosomatic symptoms. Do they develop depression and/or anxiety disorders as they grow older?

BACKGROUND: Despite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of Swedish youth, the extent to which these problems correspond to an increase in adult mental problems is unknown. The present study investigates whether Swedish adolescents with high levels of psychosomatic symptoms are at risk of developing depression and anxiety problems in adulthood and whether sex moderates any association. Moreover, we aim to understand whether different clusters of youth psychosomatic symptoms - somatic, psychological and musculoskeletal - have different impacts on adult mental health. METHODS: One thousand five hundred forty-five Swedish adolescents - aged 13 (49%) and 15 (51%) - completed surveys at baseline (T1) and 3 years later (T2); of them, 1174 (61% females) also participated after 6 years (T3). Multivariate logistic models were run. RESULTS: Youth with high levels of psychosomatic symptoms had higher odds of high levels of depressive symptoms at T2 and T3. Moreover, psychosomatic symptoms at T1 predicted a high level of anxiety symptoms and diagnoses of anxiety disorders at T3. When analyzed separately, musculoskeletal symptoms predicted higher odds of having high levels of depressive symptoms at T2 and T3 while somatic symptoms predicted high levels of anxiety symptoms at T2. Moreover, somatic symptoms at T1 predicted diagnoses of depression and anxiety disorders at T3. Sex did not moderate any of the relationships. CONCLUSIONS: The study supports the idea that an increase in mental health problems, such as psychosomatic symptoms, can seriously impact the psychological health of new generations of young adults.

[Outcome Quality of Medical Rehab in the Mirror of Singular and Multiple Outcome Criteria - Where is Psychosomatic Rehab when Comparing Indications?] / Ergebnisqualität medizinischer Rehabilitation im Spiegel singulärer und multipler Ergebniskriterien ­ Wo steht die Psychosomatische Rehabilitation im Indikationenvergleich?

BACKGROUND: A series of studies proves a good outcome quality of psychosomatic rehabilitation. However, outcome-related comparisons with other indications are hardly available. METHODS: As part of a multicenter study, n=6608 rehabilitants from the indications psychosomatics, cardiology, neurology, oncology and orthopedics were checked regarding starting features and longer-term outcome quality (one-point survey 1 year after the end of the rehab). With a generic measurement and evaluation approach, direct and quasi-indirect change measurements and status measurements were made. In addition to comparing singular and multiple outcome criteria ("Patient Reported Outcomes", PRO), outcome criteria from the rehab statistics database (RSD) have also been checked. RESULTS: The 5 indication groups differ in both starting and process characteristics as well as in the short and longer-term outcome criteria. However, the effect sizes of the associations are mostly low. In all indications, there are positive changes in the field of health-related characteristics. The highest pre-post effect sizes are mostly found in psychosomatics, the least in neurology. In all indications, social security contributions in the first year after rehab are a bit declining - least in oncology, most clearly in neurology. Despite the biggest pre-post effects sizes in the health-related features, the rehabilitants of psychosomatics are less satisfied with the rehab and evaluate the benefits of rehab less positive. At the level of multiple outcome criteria, the indications - except neurology - are relatively little different. The multiple outcome criterion can be predicted to 28% from starting and process characteristics. Best predictor is the user sided rating regarding the job-related orientation of the rehab. CONCLUSION: The study once again proves a good longer-term outcome quality of psychosomatic rehab. However, it also shows that the longer-term outcome quality of all major indications measured by means of multiple outcome criteria is at a similar level (except neurology).Possible limitations of the study result from the one-point measurement and the resulting mode of change measurement.