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1.
Med Sci Monit ; 27: e930447, 2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33854028

RESUMO

BACKGROUND The present study was designed to reveal the trajectory of self-reported somatic symptom burden and sleep quality over time in patients with COVID-19 and to identify prognostic factors for greater somatic symptom burden and sleep disturbance. MATERIAL AND METHODS Seventy-four patients with COVID-19 were prospectively followed for longitudinal assessment of somatic symptom burden and sleep quality. We used the 8-item Somatic Symptom Scale (SSS-8) and the modified Medical Research Council (mMRC) scale for somatic symptom burden and the Pittsburgh Sleep Quality Index for sleep quality investigation. Univariate and multivariate analyses were performed to identify independent factors associated with somatic symptom burden and sleep quality. RESULTS Although the degree of physical discomfort and sleep quality issues tended to decline during self-quarantine, patients still experienced these problems to a certain degree. Univariate and multivariate analyses showed that SSS-8 scores at admission (relative risk [RR] 1.234, 95% CI 1.075-1.417, P=0.003) and mMRC scores at discharge (RR 2.420, 95% CI 1.251-4.682, P=0.009) were 2 independent prognostic indicators of somatic symptom burden. In addition, muscle pain as a chief complaint (RR 4.682, 95% CI 1.247-17.580, P<0.022) and history of use of hypnotic drugs (RR 0.148, 95% CI 0.029-0.749, P<0.019) were 2 independent indicators of patient sleep quality during hospitalization. CONCLUSIONS To the best of our knowledge, the present study was the first dynamic assessment of the somatic symptom burden and sleep quality in patients with COVID-19 during hospitalization and quarantine after discharge. Patients with high somatic symptom burden at admission, especially muscle pain as the chief complaint, are prone to having a higher physical burden and more sleep disturbance at discharge.


Assuntos
/complicações , Efeitos Psicossociais da Doença , Sintomas Inexplicáveis , Mialgia/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Adulto , Idoso , /epidemiologia , China/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Mialgia/diagnóstico , Mialgia/etiologia , Mialgia/fisiopatologia , Admissão do Paciente/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricos , Prognóstico , Estudos Prospectivos , Quarentena/estatística & dados numéricos , Medição de Risco/estatística & dados numéricos , Autorrelato/estatística & dados numéricos , Índice de Gravidade de Doença , Sono/fisiologia , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/etiologia
2.
Psychosom Med ; 83(4): 338-344, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33818055

RESUMO

OBJECTIVE: Persistent somatic symptoms, such as pain and fatigue, have been referred to as somatization. Somatization is commonly associated with histories of trauma and posttraumatic stress disorder (PTSD). Although previous research has demonstrated that PTSD can predict somatic problems, there has been no examination of this at the level of PTSD symptom clusters and multidimensional assessment of somatic symptoms. We examined the association between the three International Classification of Disease (11th Edition) PTSD symptom clusters (reexperiencing in the here and now, avoidance, and sense of threat), measured in relation to the COVID-19 pandemic as the stressor, and somatic symptoms while statistically adjusting for confounding variables. METHODS: Participants were a nationally representative sample of 1041 adults from the general population of the Republic of Ireland. Physical health problems across the domains of pain, gastrointestinal, cardiopulmonary, and fatigue were assessed by the Patient Health Questionnaire, and PTSD symptoms were assessed using the International Trauma Questionnaire. RESULTS: Sense of threat was associated with the presence of pain (ß = 0.254), fatigue (ß = 0.332), gastrointestinal (ß = 0.234), and cardiovascular symptoms (ß = 0.239). Avoidance was associated with pain (ß = 0.347). Reexperiencing was not associated with any physical health variable. CONCLUSIONS: In the context of COVID-19, the sense of threat symptoms in PTSD is most strongly related to somatic problems. Findings suggest that interventions addressing sense of threat symptoms might provide relief from somatization.


Assuntos
/psicologia , Medo/psicologia , Sintomas Inexplicáveis , Transtornos de Estresse Pós-Traumáticos/etiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Inquéritos e Questionários , Adulto Jovem
3.
BMC Psychiatry ; 21(1): 144, 2021 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-33691663

RESUMO

BACKGROUND: It is still unknown whether the "Somatic symptom disorders (SSD) and related disorders" module of the Structured Clinical Interview for DSM-5, research version (SCID-5-RV), is valid in China. This study aimed to assess the SCID-5-RV for SSD in general hospital outpatient clinics in China. METHODS: This multicentre cross-sectional study was conducted in the outpatient clinics of nine tertiary hospitals in Beijing, Jincheng, Shanghai, Wuhan, and Chengdu between May 2016 and March 2017. The "SSD and related disorders" module of the SCID-5-RV was translated, reversed-translated, revised, and used by trained clinical researchers to make a diagnosis of SSD. Several standardized questionnaires measuring somatic symptom severity, emotional distress, and quality of life were compared with the SCID-5-RV. RESULTS: A total of 699 patients were recruited, and 236 were diagnosed with SSD. Of these patients, 46 had mild SSD, 78 had moderate SSD, 100 had severe SSD, and 12 were excluded due to incomplete data. The SCID-5-RV for SSD was highly correlated with somatic symptom severity, emotional distress, and quality of life (all P < 0.001) and could distinguish nonsevere forms of SSD from severe ones. CONCLUSIONS: This study suggests that SCID-5-RV for SSD can distinguish SSD from non-SSD patients and severe cases from nonsevere cases. It has good discriminative validity and reflects the DSM-5 diagnostic approach that emphasizes excessive emotional, thinking, and behavioural responses related to symptoms.


Assuntos
Sintomas Inexplicáveis , China , Estudos Transversais , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Ambulatório Hospitalar , Qualidade de Vida , Reprodutibilidade dos Testes , Transtornos Somatoformes
4.
BMJ Open ; 11(3): e044244, 2021 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-33762239

RESUMO

INTRODUCTION: Persistent somatic symptoms (PSS) are common both in the general population and primary care. They are bothersome in terms of psychological and somatic symptom burden. Health professionals often struggle with communication, as there is a lack of scientifically supported explanatory models for PSS or a focus merely on somatic aspects of the complaints, which both frustrate patients' needs. The objective of the present study is therefore to develop a psychoeducational intervention based on a current evidence-based explanatory model, to examine its feasibility and form the basis for a large-scale randomised controlled trial. METHODS AND ANALYSIS: In a randomised controlled mixed-methods pilot trial, 75 adult psychosomatic outpatients with PSS (duration of symptoms ≥6 months) and accompanying psychological (Somatic Symptom B-Criteria Scale total score ≥18) and somatic symptom burden (Patient Health Questionnaire-15 score >10) and no prior psychosomatic treatment will be eligible. Participants will be presented with either the explanatory model without (intervention group 1, n=25) or with elements of personalisation (intervention group 2, n=25). Participants in the control group (n=25) will receive information on current PSS guidelines. Participants will be blinded to group assignment and interventions will be shown on tablet computers at the outpatient clinic. After 1 month, qualitative follow-up telephone interviews will be conducted. As primary outcomes, mean changes in psychological and somatic symptom burden will quantitatively be compared between groups, respectively. Behavioural change mechanisms and feasibility of the three interventions will be evaluated using quantitative and qualitative measures. ETHICS AND DISSEMINATION: Ethics approval has been granted by the medical ethics board of the Hamburg Medical Chamber (PV5653). Results from this study will be published in peer-reviewed journals and presented at national and international conferences. TRIAL REGISTRATION NUMBER: DRKS00018803.


Assuntos
Sintomas Inexplicáveis , Adulto , Humanos , Projetos Piloto , Atenção Primária à Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
Medicine (Baltimore) ; 100(6): e23859, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578513

RESUMO

BACKGROUND: We aimed to examine the feasibility of our newly-developed, integrated, and high-intensity individual cognitive behavioral therapy (CBT) protocol for treatment-resistant chronic pain. METHODS: We conducted an open-labeled prospective single-arm trial for patients aged 18 years and above, suffering from chronic pain, and diagnosed with somatic symptom disorder with predominant pain. We provided 16 weekly sessions of CBT, each lasting for 50 minutes, which included 4 new strategies: attention shift, memory work, mental practice, and video feedback. For comparison, the study had a pre-test post-test design. The primary outcome was the change from baseline (week 1) to 16, as indicated by the Numerical Rating Scale and Pain Catastrophizing Scale. In addition, we evaluated depression, anxiety, disability, and quality of life as secondary outcomes. RESULTS: Sixteen patients with chronic pain underwent our CBT program. Though there was no reduction in pain intensity, catastrophic cognition showed statistically significant improvement with a large effect size. Depression, anxiety, and disability demonstrated statistically significant improvements, with small to moderate effect sizes. No adverse events were reported. CONCLUSION: Our newly integrated CBT program for chronic pain may improve catastrophic cognition, depression, anxiety, and disability. Large-scale randomized controlled studies are necessary to investigate the program's effectiveness in the future.


Assuntos
Dor Crônica/terapia , Terapia Cognitivo-Comportamental/métodos , Manejo da Dor/métodos , Adulto , Idoso , Ansiedade/etiologia , Ansiedade/terapia , Dor Crônica/complicações , Dor Crônica/psicologia , Terapia Cognitivo-Comportamental/estatística & dados numéricos , Depressão/etiologia , Depressão/terapia , Avaliação da Deficiência , Estudos de Viabilidade , Feminino , Humanos , Japão/epidemiologia , Masculino , Sintomas Inexplicáveis , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento
6.
J Affect Disord ; 283: 317-324, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33578344

RESUMO

BACKGROUND: The factor structure of depression differs for different sub-samples. The purpose of this study was to explore the factor structure of Beck Depression Inventory-II in patients with chronic depression presenting for inpatient treatment. METHODS: Using exploratory structural equation modeling (ESEM), we explored whether a two-factor solution or a bifactor solution provided best model fit for a sample of 377 patients. For the best fitting model stability was assessed with tests for invariance across primary diagnosis (persistent depressive disorder v. recurrent major depressive disorder), and presence of comorbidity. RESULTS: A bifactor solution with one general factor and two specific factors provided best model fit. Invariance analyses provided support for measurement invariance and stability of the factor solution. LIMITATIONS: The naturalistic study design implies some uncertainty regarding possible systematic differences between the patients on demographic and clinical characteristics. CONCLUSION: The factor structure in our sample was best explained by a general depression factor, one specific factor pertaining to self-criticism, and one consisting of the somatic items fatigue, disturbance of sleep, and appetite. Clinicians could benefit from paying special attention to the subfactors identified, as these findings may have implications for treatment choice for patients with chronic depression.


Assuntos
Transtorno Depressivo Maior , Sintomas Inexplicáveis , Depressão , Transtorno Depressivo Maior/diagnóstico , Análise Fatorial , Humanos , Pacientes Internados , Psicometria , Autoavaliação (Psicologia)
7.
J Psychosom Res ; 143: 110386, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33588284

RESUMO

OBJECTIVE: Medically Unexplained Symptoms (MUS) are physical symptoms that last for longer than several weeks and for which no (sufficient) somatic explanation can be found. Interventions for treating MUS in primary care are available, but their implementation in daily practice appears difficult. In the current study we aim to explore key barriers and facilitators to the implementation of MUS-interventions in primary care. METHODS: A three-round modified Delphi study was performed, using the input of 58 experts that are (in)directly involved in the care for patients with MUS (e.g. general practitioners (GPs), GP mental health workers, policy advisors). In the first online questionnaire, we generated ideas about relevant barriers and facilitators on different implementation levels. These ideas were independently coded by two researchers, and reformulated into unique barriers and facilitators. In round two, participants selected the ten most relevant barriers and facilitators from round one, which were ranked on importance in round three. RESULTS: We identified 42 unique barriers and 57 unique facilitators to the implementation of MUS-interventions. The three highest ranked barriers were all related to time, i.e. too little time for treating complex MUS-patients. The most important facilitator was a positive attitude towards MUS-patients. Results varied somewhat per profession. CONCLUSION: Key barriers and facilitators to the implementation of MUS-interventions seem to exist on the level of the patient, intervention, professional, organization, and external context. All of these levels should be taken into account in order to increase implementation success of MUS-interventions in primary care.


Assuntos
Técnica Delfos , Sintomas Inexplicáveis , Atenção Primária à Saúde/estatística & dados numéricos , Adulto , Humanos , Masculino
8.
J Psychiatr Res ; 136: 246-255, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33621910

RESUMO

OBJECTIVE: Patients with somatic symptom disorder (SSD) may have declined parasympathetic activity and selective attention to negative information. We combined Stroop tasks and heart rate variability (HRV) measurements to explore the brain mechanism of SSD. METHODS: 104 SSD patients (64 women) and 100 healthy adults (76 women) received three Stroop tasks (the "cognitive" color-word Stroop, "emotional" emotion Stroop, and "cognitive and emotional" face-word Stroop) with low and high interference conditions. The key HRV indexes included high-frequency power (HF) and standard deviation of normal to normal RR intervals (SDNN). The generalized estimating equation model was used to examine the effects of SSD on three Stroop tasks performance (accuracy and reaction time) and HRV (HF and SDNN) controlling for sex, age, body mass index, and the levels of anxiety and depression. RESULTS: For Stroop tasks, the significant group difference in emotion Stroop task with the high level of interference (SSD patients had lower accuracy than healthy ones) was only found in women. As for HRV, only men during color-word Stroop, women during emotion Stroop revealed significant between-group differences; SDNN in SSD men was higher than healthy men, and HF in SSD women was lower than healthy women controlling for the confounding factors. The significantly longer reaction time in SSD women than in healthy women diminished in the adjusted analysis. CONCLUSION: Emotion Stroop task and HRV helps distinguish SSD patients from healthy adults, particularly in women. Sex-specific measures for early detection and intervention for SSD are suggested.


Assuntos
Sintomas Inexplicáveis , Adulto , Transtornos de Ansiedade , Emoções , Feminino , Frequência Cardíaca , Humanos , Masculino , Teste de Stroop
9.
J Homosex ; 68(4): 577-591, 2021 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-33399504

RESUMO

Deaths from COVID-19 continue to rise, and this virus has asymmetric impacts on marginalized communities though specific impacts on sexual and gender minority communities are not well understood. From March 23 to June 20, 2020, in an online cross-sectional survey among 1380 US adults, we assessed physical symptoms, psychological symptoms, rumination, and perceived social support in order to describe differences between sexual and gender minority (n = 290) and cisgender heterosexual (n = 1090) respondents. Sexual and gender minority respondents had more frequent COVID-19-associated physical symptoms and depression and anxiety symptoms. Sexual and gender minorities had a significantly higher proportion of depression and anxiety scores exceeding the clinical concern threshold. Longitudinal studies on the physical and psychological impacts of COVID-19 among sexual and gender minority communities are needed to inform interventions to eliminate these disparities.


Assuntos
/psicologia , Saúde Mental , Pandemias , Minorias Sexuais e de Gênero , Adulto , Ansiedade/etiologia , /fisiopatologia , Estudos Transversais , Feminino , Heterossexualidade/psicologia , Humanos , Estudos Longitudinais , Masculino , Sintomas Inexplicáveis , Apoio Social
10.
BMJ Open ; 11(1): e040730, 2021 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-33419906

RESUMO

OBJECTIVES: Patients who present in primary care with chronic functional somatic symptoms (FSS) have reduced quality of life and increased health care costs. Recognising these early is a challenge. The aim is to develop and internally validate a clinical prediction rule for repeated consultations with FSS. DESIGN AND SETTING: Records from the longitudinal population-based ('Lifelines') cohort study were linked to electronic health records from general practitioners (GPs). PARTICIPANTS: We included patients consulting a GP with FSS within 1 year after baseline assessment in the Lifelines cohort. OUTCOME MEASURES: The outcome is repeated consultations with FSS, defined as ≥3 extra consultations for FSS within 1 year after the first consultation. Multivariable logistic regression, with bootstrapping for internal validation, was used to develop a risk prediction model from 14 literature-based predictors. Model discrimination, calibration and diagnostic accuracy were assessed. RESULTS: 18 810 participants were identified by database linkage, of whom 2650 consulted a GP with FSS and 297 (11%) had ≥3 extra consultations. In the final multivariable model, older age, female sex, lack of healthy activity, presence of generalised anxiety disorder and higher number of GP consultations in the last year predicted repeated consultations. Discrimination after internal validation was 0.64 with a calibration slope of 0.95. The positive predictive value of patients with high scores on the model was 0.37 (0.29-0.47). CONCLUSIONS: Several theoretically suggested predisposing and precipitating predictors, including neuroticism and stressful life events, surprisingly failed to contribute to our final model. Moreover, this model mostly included general predictors of increased risk of repeated consultations among patients with FSS. The model discrimination and positive predictive values were insufficient and preclude clinical implementation.


Assuntos
Sintomas Inexplicáveis , Idoso , Regras de Decisão Clínica , Estudos de Coortes , Feminino , Humanos , Atenção Primária à Saúde , Qualidade de Vida , Encaminhamento e Consulta
11.
Clin Med (Lond) ; 21(1): 13-18, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33479063

RESUMO

Medically unexplained symptoms or persistent physical symptoms are common, real and are associated with significant distress, loss of functioning and high healthcare costs. History, examination and appropriate investigations are essential to make a diagnosis. Once the diagnosis has been made, exploring the impact of the symptoms helps us to tailor our advice to patients. This paper sets out a practical approach to taking a history, assessment and stepwise management principles.


Assuntos
Sintomas Inexplicáveis , Humanos , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/terapia
13.
Ansiedad estrés ; 26(2/3): 188-201, jul.-dic. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-199766

RESUMO

AIM: Improving Access to Psychological Therapies (IAPT) services were set up in the United Kingdom in 2008. Recent service expansion now accommodates patients with long-term conditions (LTC) and medically unexplained symptoms (MUS) through the use of cognitive-behaviour therapy (CBT). A systematic review is yet to be completed to identify specific adaptions that may be effective for improving outcomes. Many countries are building upon this model within the United Kingdom; therefore, the findings can inform developing services internationally. METHODS: Electronic databases were searched and studies were screened against an inclusion/exclusion criteria. Studies evaluating the effectiveness of CBT interventions on mental health outcomes for adults with LTC/MUS within primary care were included. Data were extracted for analysis and a narrative synthesis was conducted. Quality assessments were made using the Effective Public Health Practice Project tool. RESULTS: Of 14,380 papers, eight papers were included within the review. Moderate to strong evidence found CBT adaptions were effective in improving outcomes, including the specific focus on the LTC/MUS within treatment, the inclusion of collaborative care or implementing a range of therapeutic skills. Weak methodology was associated with selection bias, lack of blinding and reporting around the validity and reliability of data collection tools. CONCLUSIONS: CBT adaptions may be effective at improving mental health outcomes for those with LTC/MUS in the short term. Due to the small amount of studies included within the review, conclusions remain tentative. It is unclear as to whether interventions can sustain outcomes and provide financial gains in the long term


OBJETIVO: En 2008 se establecieron en el Reino Unido servicios de mejora del acceso a las terapias psicológicas (IAPT). La reciente ampliación de los servicios permite ahora atender a los pacientes con afecciones a largo plazo y síntomas médicamente inexplicados mediante el uso de la terapia cognitivo-conductual. Todavía no se ha completado un examen sistemático para identificar adaptaciones específicas que puedan ser eficaces para mejorar los resultados. Muchos países están aprovechando este modelo en el Reino Unido; por consiguiente, los resultados pueden servir de base para el desarrollo de servicios a nivel internacional. MÉTODOS: Se realizaron búsquedas en las bases de datos electrónicas y se examinaron los estudios en función de un criterio de inclusión/exclusión. Se incluyeron estudios que evaluaban la efectividad de las intervenciones de TCC en los resultados de salud mental para adultos con LTC/MUS dentro de la atención primaria. Se extrajeron los datos para el análisis y se realizó una síntesis narrativa. Las evaluaciones de la calidad se realizaron utilizando la herramienta del Proyecto de Práctica de Salud Pública Efectiva. RESULTADOS: De 14.380 trabajos, ocho fueron incluidos en la revisión. La evidencia moderada a fuerte encontró que las adaptaciones de la TCC fueron efectivas para mejorar los resultados, incluyendo el enfoque específico en el LTC/MUS dentro del tratamiento, la inclusión de la atención colaborativa o la implementación de una gama de habilidades terapéuticas. La metodología débil se asoció con el sesgo de selección, la falta de cegamiento y la presentación de informes sobre la validez y la fiabilidad de las herramientas de recopilación de datos. CONCLUSIONES: Las adaptaciones de la TCC pueden ser efectivas para mejorar los resultados de salud mental de aquellos con LTC/MUS a corto plazo. Debido a la pequeña cantidad de estudios incluidos en la revisión, las conclusiones siguen siendo tentativas. No está claro si las intervenciones pueden sostener los resultados y proporcionar ganancias financieras a largo plazo


Assuntos
Humanos , Masculino , Feminino , Adulto , Terapia Cognitivo-Comportamental/métodos , Sintomas Inexplicáveis , Assistência de Longa Duração/psicologia , Fatores de Tempo , Resultado do Tratamento , Avaliação de Resultados em Cuidados de Saúde
14.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(9): 1142-1148, 2020.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33051431

RESUMO

Somatic symptom disorder (SSD) is a somatic disorder characterized by excessive anxiety over various somatic symptoms for a long time, which makes patients feel very painful and the quality of personal life significantly decreased. Previous studies have shown that there is a connection between the clinical manifestations of SSD patients and their cultural background. The patient in this case report was highly affected by Chinese yin-yang culture, displaying obvious Chinese characteristics.We report a patient with SSD, whose clinical manifestations were mainly sexual dysfunction and mood symptoms which were closely related to the Traditional Chinese culture of Yin and Yang. In this case, Hamilton Anxiety Scale, Hamilton Depression Scale, and International Erectile Function Questionnaire were used to evaluate the patients' anxiety, depression, and sexual function, and the scores were 32, 33, and 9, respectively. The patient was treated with a combination of venlafaxine and mirtazapine. After 5 weeks of treatment, the patient's clinical symptoms improved significantly.The clinical manifestations of some Chinese SSD patients have obvious characteristic relevance to Chinese theory of Yin and Yang, making SSD easily to be misdiagnosed. Therefore, clinicians should pay atlention to this situation. In addition, the combination of venlafaxine and mirtazapine may have a better effect on SSD patients with chronic pain and sexual dysfunction.


Assuntos
Sintomas Inexplicáveis , Yin-Yang , Ansiedade , Transtornos de Ansiedade , China , Características Culturais , Humanos , Masculino , Medicina Tradicional Chinesa , Inquéritos e Questionários
16.
Rev Med Suisse ; 16(708): 1796-1800, 2020 Sep 30.
Artigo em Francês | MEDLINE | ID: mdl-32997449

RESUMO

Behavioural disorders in adults with mental disabilities are very common and represent a diagnostic challenge. In fact, they often hide a somatic problem, which is more frequent in this population compared to the general population. These somatic symptoms may cause or enhance psychiatric symptoms. People with mental disabilities often have difficulties expressing their pain, which often manifests itself as mood changes. Consequently, it is important to be able to identify the pain as a priority and to treat it. The general practitioner should therefore check for the most common somatic complaints in people with mental disabilities, with the help of the acronym DODUGO (Dental, Otic, Digestive, UroGenital, Orthopaedic).


Assuntos
Deficiência Intelectual , Sintomas Inexplicáveis , Comportamento Problema , Adulto , Humanos , Deficiência Intelectual/complicações , Deficiência Intelectual/psicologia , Dor/complicações , Dor/diagnóstico , Dor/psicologia , Transtornos da Personalidade/complicações , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia
17.
Bull Cancer ; 107(9): 844-853, 2020 Sep.
Artigo em Francês | MEDLINE | ID: mdl-32680601

RESUMO

INTRODUCTION: Studies on somatic symptoms among parents of a childhood cancer survivor are less developed in the literature. The purpose of the study is to examine the somatic symptoms intensity (i.e. physical symptoms aggravated by emotional or psychological factors) and its associations with anxious and depressive symptoms and worries. METHODS: Sixty-one parents of a childhood cancer survivor (since 4-years until 6-years of survivorship) participated in this transversal and quasi-experimental study. Parents filled in three clinical questionnaires assessing their anxious, depressive and somatic symptoms and their worries related to the child's health evolution. RESULTS: Parents suffered mainly from a loss of energy and insomnia in the middle of the night. Significant correlations between somatic symptoms and anxious and depressive symptoms were observed. Lastly, depressive symptoms seem to be a significant factor to predict the level of somatic symptoms. CONCLUSION: Recommendations for the management of parents of a childhood cancer survivor have been published. However, longitudinal studies focused on parents are still necessary to improve preventive initiatives and the management of these families.


Assuntos
Ansiedade/diagnóstico , Sobreviventes de Câncer , Depressão/diagnóstico , Sintomas Inexplicáveis , Pais/psicologia , Estresse Psicológico/diagnóstico , Adolescente , Ansiedade/etiologia , Criança , Estudos Transversais , Depressão/etiologia , Autoavaliação Diagnóstica , Humanos , Estresse Psicológico/etiologia , Avaliação de Sintomas
18.
Artigo em Inglês | MEDLINE | ID: mdl-32545781

RESUMO

The World Trade Center attacks of 11 September 2001 (9/11) have been associated with the subsequent development of chronic diseases. Few studies have investigated the burden of somatic symptoms on attack victims, or the association of such symptoms with exposure to the 9/11 attacks. World Trade Center Health Registry (Registry) enrollees who were present south of Chambers Street during or immediately after the 9/11 attacks and who provided consistent answers regarding injury sustained on 9/11 were followed prospectively for up to 16 years post-9/11/01. We employed linear regression to evaluate the associations between injury severity, psychological distress and somatic symptoms in 2322 persons who completed all four Registry surveys and a subsequent Health and Quality of Life survey. Twenty-one percent of subjects had a "very high" burden of somatic symptoms, greater than in populations not exposed to a disaster. Somatic symptoms exhibited a dose-response association separately with injury severity and psychological distress trajectories. Victims of the 9/11 attacks suffer from a substantial burden of somatic symptoms which are associated with physical and psychological consequences of exposure to the attacks. Physical and mental health professionals need to work together when treating those exposed to complex disasters such as 9/11.


Assuntos
Sintomas Inexplicáveis , Angústia Psicológica , Ataques Terroristas de 11 de Setembro , Transtornos de Estresse Pós-Traumáticos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Qualidade de Vida , Sistema de Registros , Ferimentos e Lesões/psicologia , Adulto Jovem
19.
J Oral Pathol Med ; 49(6): 499-504, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32531871

RESUMO

Oral dysaesthesia is a condition characterised by persistent alteration to oral sensation, perceived by the patient to be abnormal and unpleasant, in the absence of mucosal pathology. Its aetiology remains uncertain. The condition was attributed as a psychosomatic disease for much of the 20th century, but with newer technologies, recent literature has mostly focused on a possible peripheral or central neuropathic aetiology to oral dysaesthesia. Despite this, psychotropic medications and psychological treatments remain forefront in the armamentarium for the management of oral dysaesthesia. This article aims to review the literature surrounding the pathogenesis of oral dysaesthesia and explore whether oral dysaesthesia is a somatic symptom disorder.


Assuntos
Síndrome da Ardência Bucal , Sintomas Inexplicáveis , Transtornos Somatoformes , Humanos , Parestesia/etiologia
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