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1.
J Affect Disord ; 277: 893-900, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33065831

RESUMO

BACKGROUND: The mental health status caused by major epidemics is serious and lasting. At present, there are few studies about the lasting mental health effects of COVID-19 outbreak. The purpose of this study was to investigate the mental health of the Chinese public during the long-term COVID-19 outbreak. METHODS: A total of 1172 online questionnaires were collected, covering demographical information and 8 common psychological states: depression, anxiety, somatization, stress, psychological resilience, suicidal ideation and behavior, insomnia, and stress disorder. In addition, the geographical and temporal distributions of different mental states were plotted. RESULTS: Overall, 30.1% of smokers increased smoking, while 11.3% of drinkers increased alcohol consumption. The prevalence rates of depression, anxiety, mental health problems, high risk of suicidal and behavior, clinical insomnia, clinical post-traumatic stress disorder symptoms, moderate-to-high levels of perceived stress were 18.8%, 13.3%, 7.6%, 2.8%, 7.2%, 7.0%, and 67.9%, respectively. Further, the geographical distribution showed that the mental status in some provinces/autonomous regions/municipalities was relatively more serious. The temporal distribution showed that the psychological state of the participants was relatively poorer on February 20, 24 to 26 and March 25, especially on March 25. LIMITATIONS: This cross-sectional design cannot make causal inferences. The snowball sampling was not representative enough. CONCLUSION: Our findings suggest that the prevalence rate of mental disorders in the Chinese public is relatively low in the second month of the COVID-19 pandemic. In addition, people's mental state is affected by the geographical and temporal distributions.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus , Depressão/epidemiologia , Pandemias , Pneumonia Viral , Transtornos Somatoformes/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Ideação Suicida , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Ansiedade/psicologia , Betacoronavirus , China/epidemiologia , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Prevalência , Resiliência Psicológica , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Fumar/epidemiologia , Fumar/psicologia , Transtornos Somatoformes/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adulto Jovem
2.
J Affect Disord ; 277: 436-442, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32866802

RESUMO

BACKGROUND: Somatization is a common comorbidity in anxious people. From January 31 to February 2, 2020, a high prevalence of moderate to severe anxiety was detected due to COVID-19 outbreak. The purpose of this study was to investigate the prevalence and correlates of somatization among Chinese participants with anxiety receiving online crisis interventions from Feb 14 to Mar 29 during the COVID-19 epidemic. METHODS: A total of 1134 participants who participated in online crisis interventions completed the Generalized Anxiety Disorder-7 (GAD-7) scale and the Symptom Checklist-90 (SCL-90) and demographic questions online. Somatization was defined as the average score of each item ≥ 2 in SCL-90 somatization subscale. Moderate to severe anxiety was defined as a score ≥ 10 in the GAD-7 scale. RESULTS: Among all participants, 8.0% reported moderate to severe anxiety and 7.4% reported somatization. After March 1, the prevalence of anxiety with or without somatization did not significantly change (both p > 0.05), while the prevalence of somatization increased significantly (p < 0.01). Logistic regression analysis indicated that somatization was associated with chronic disease history (with an odds ratio of 4.80) and female gender (with an odds ratio of 0.33). CONCLUSIONS: Our findings suggest that the history of chronic diseases is associated with somatization in individuals with anxiety, indicating some stress-related mechanisms. Chinese men in crisis intervention need more attention because they are more likely to report anxiety comorbid somatization.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus , Intervenção na Crise , Pandemias , Pneumonia Viral , Transtornos Somatoformes/epidemiologia , Adolescente , Adulto , Ansiedade/psicologia , Transtornos de Ansiedade/epidemiologia , Betacoronavirus , China/epidemiologia , Doença Crônica/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Saúde Mental , Questionário de Saúde do Paciente , Prevalência , Fatores de Risco , Fatores Sexuais , Transtornos Somatoformes/psicologia , Adulto Jovem
3.
J Affect Disord ; 277: 510-514, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32882508

RESUMO

BACKGROUND: To our best knowledge, this was the first time to investigate the prevalence and risk factors of psychological disturbances, including depression, anxiety, somatization symptoms, insomnia and suicide, among frontline medical staff, who were working with the COVID-10 infected patients directly. METHODS: Patient Health Questionnaire Depression (PHQ-9), Generalized Anxiety Disorder Questionnaire scale (GAD-7), Symptom Check List-90 (SCL-90) somatization, Insomnia Severity Index (ISI), and the suicidal module of the Mini International Neuropsychiatric Interview were used for online survey. RESULTS: A total of 606 frontline hospital staff and1099 general population were recruited. The prevalence of depression, anxiety, somatization symptoms, insomnia, and suicide risk in frontline medical staffs were 57.6%, 45.4%, 12.0%, 32.0% and 13.0%, respectively. Except for suicide risk, the prevalence of other psychological disorders in frontline medical staff were higher than those in general population (all p<0.01). Among the frontline medical staff, the daily working hours were associated with all psychological disturbance (all p<0.01), women with anxiety (p = 0.02), body mass index (BMI) with anxiety and insomnia (p = 0.02, p = 0.03). Age was negatively associated with depression, anxiety, and insomnia (all p<0.01). Finally, years of working and family income were negatively associated with suicide risk (p = 0.03, p<0.001). CONCLUSION: Our study demonstrates that during the outbreak of COVID-19, the frontline medical staff are more likely to suffer from psychological disturbances than general population. It is noticeable that daily working hours are a risk factor for all measured psychological disturbances, and some other variables may be involved in certain psychological disturbances of frontline medical staff.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus , Depressão/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Pandemias , Admissão e Escalonamento de Pessoal , Pneumonia Viral , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Transtornos Somatoformes/epidemiologia , Carga de Trabalho , Adulto , Fatores Etários , Ansiedade/psicologia , Betacoronavirus , Índice de Massa Corporal , Estudos Transversais , Depressão/psicologia , Feminino , Pessoal de Saúde/psicologia , Humanos , Renda , Masculino , Saúde Mental , Questionário de Saúde do Paciente , Prevalência , Medição de Risco , Fatores de Risco , Fatores Sexuais , Transtornos Somatoformes/psicologia , Suicídio , Adulto Jovem
4.
PLoS One ; 15(6): e0233153, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32492037

RESUMO

Body dysmorphic disorder (BDD), together with its subtype muscle dysmorphia (MD), has been relocated from the Somatoform Disorders category in the DSM-IV to the newly created Obsessive-Compulsive and Related Disorders category in the DSM-5. Both categorizations have been criticized, and an empirically derived classification of BDD is lacking. A community sample of N = 736 participants completed an online survey assessing different psychopathologies. Using a structural equation modeling approach, six theoretically derived models, which differed in their allocation of BDD symptoms to various factors (i.e. general psychopathology, somatoform, obsessive-compulsive and related disorders, affective, body image, and BDD model) were tested in the full sample and in a restricted sample (n = 465) which indicated primary concerns other than shape and weight. Furthermore, measurement invariance across gender was examined. Of the six models, only the body image model showed a good fit (CFI = 0.972, RMSEA = 0.049, SRMR = 0.027, TLI = 0.959), and yielded better AIC and BIC indices than the competing models. Analyses in the restricted sample replicated these findings. Analyses of measurement invariance of the body image model showed partial metric invariance across gender. The findings suggest that a body image model provides the best fit for the classification of BDD and MD. This is in line with previous studies showing strong similarities between eating disorders and BDD, including MD. Measurement invariance across gender indicates a comparable presentation and comorbid structure of BDD in males and females, which also corresponds to the equal prevalence rates of BDD across gender.


Assuntos
Transtornos Dismórficos Corporais/classificação , Adolescente , Adulto , Idoso , Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Imagem Corporal , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Alemanha/epidemiologia , Humanos , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Transtornos do Humor/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Prevalência , Psicopatologia , Transtornos Somatoformes/psicologia , Inquéritos e Questionários , Adulto Jovem
5.
Orv Hetil ; 161(25): 1050-1058, 2020 06.
Artigo em Húngaro | MEDLINE | ID: mdl-32516123

RESUMO

INTRODUCTION: About 25-30% of patients present themselves in general practice and specialized healthcare with medically unexplained somatic symptoms. The prevalence of these symptoms is the highest among the elderly, children and adolescents. Approximately 20% of patients in primary care and 47% of them in specialized clinics are children between the age of 7-12 who seem to have somatic symptom disorder (SSD). Somatization disorder most frequently occur with symptoms of headache, stomach ache or various kinds of pain in the limbs that show high comorbidity with other mental disorders, predominantly with anxiety. SSDs are always multicausal issues where biological, social-environmental and psychological factors are interconnected in a complex manner. According to our experience, somaziting patients are often drifting in the healthcare system for years, and instead of getting adequate treatment, they only receive medication, thus their symptoms may easily become chronic. Aim, method: Our aim was to review the current literature and guidelines concerning evidence-based treatments for SSD in childhood. Furthermore, to underline the importance of psychotherapy in SSD, we present the cognitive behavior therapy of a 16-year-old adolescent with vertigo, gastrointestinal symptoms and insomnia over a 8-month period. DISCUSSION: The results of effectiveness studies unequivocally recommend cognitive behavioral therapy in the treatment of SSD patients, accompained by family therapy or family consultation. The therapy should focus on reducing psychosocial stressors, health anxiety and catastrophizing thinking style in the family, while developing adequate coping and communication skills as well as maintaining the patient's age-appropriate activity level. CONCLUSION: Cognitive behavior therapy is the treatment of choice in SSD for children and young people. Applying the biopsychosocial approach is a key issue in the assessment of predisposing and maintaining factors, ensuring that only methods based on scientific evidence will be applied to help these children. Orv Hetil. 2020; 161(25): 1050-1058.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Sintomas Inexplicáveis , Transtornos Somatoformes/psicologia , Transtornos Somatoformes/terapia , Adolescente , Idoso , Transtornos de Ansiedade/terapia , Medicina Baseada em Evidências , Humanos , Psicoterapia , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/terapia , Transtornos Somatoformes/diagnóstico , Resultado do Tratamento , Vertigem/diagnóstico , Vertigem/terapia
6.
Neurology ; 94(23): 1028-1031, 2020 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-32467130

RESUMO

Treatment of functional symptoms has a long history, and interventions were often used in soldiers returning from battle. On the 75th anniversary of the end of the Second World War, I review the portrayal of neurology in documentary film. Two documentaries were released in 1946 and 1948 (Let There Be Light and Shades of Gray, respectively), which showed a number of soldiers with functional neurology including paralysis, stuttering, muteness, and amnesia. The films showed successful treatments with hypnosis and sodium amytal by psychoanalytic psychiatrists. These documentaries link neurology with psychiatry and are remarkable examples of functional neurology and its treatment on screen.


Assuntos
Distúrbios de Guerra/história , Medicina Militar/história , Filmes Cinematográficos/história , Neurologia/história , Transtornos Somatoformes/história , Transtornos de Estresse Pós-Traumáticos/história , II Guerra Mundial , Adulto , Amobarbital/uso terapêutico , Distúrbios de Guerra/psicologia , Distúrbios de Guerra/reabilitação , Distúrbios de Guerra/terapia , Diagnóstico Diferencial , Seguimentos , História do Século XX , História do Século XXI , Humanos , Hipnose/história , Histeria/história , Masculino , Simulação de Doença/diagnóstico , Militares , Neurologia/educação , Transtornos Somatoformes/psicologia , Transtornos Somatoformes/reabilitação , Transtornos Somatoformes/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/reabilitação , Transtornos de Estresse Pós-Traumáticos/terapia , Veteranos
7.
J Psychosom Res ; 133: 110101, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32224345

RESUMO

OBJECTIVE: To investigate the relationship between alexithymia and depression and their influence on the subjective versus experimental pain perception in somatoform pain disorder. METHODS: Three groups consisting of 40 patients with somatoform pain disorder, 40 patients with depression, and 40 healthy controls were matched. They completed questionnaires regarding alexithymia (TAS26) and depressive feelings (BDI-II). In addition, pain patients rated their subjective pain intensity (NRS). Quantitative sensory testings were conducted in all participants examining temperature (CPT, HPT) and mechanical (MPT, PPT) thresholds. RESULTS: Analysis of variance showed that alexithymia was significantly increased in both patient groups compared to healthy controls, but with the highest amount in somatoform pain. Regression analyses confirmed that this finding was in part due to a high comorbidity of depressive feelings in both patient groups. We found a discrepancy between increased clinical pain ratings and elevated pressure pain thresholds, indicating a less intense mechanical pain perception in somatoform pain. Correlation analyses demonstrated a significant connection of subjective pain ratings and pressure pain thresholds with depressive feelings. CONCLUSION: Contrary to the results of other experimental pain studies on chronic muskuloskeletal pain syndromes, we could not confirm central sensitization in somatoform pain disorder. Our findings place the somatoform pain disorder more in the direction of affective disorder such as depression. These findings may improve a better understanding of the disease and also have direct therapeutic implications. The high occurrence of alexithymia and depressive feelings in somatoform pain should be considered in diagnostic and therapeutic regimens of these patients.


Assuntos
Sintomas Afetivos/psicologia , Depressão/psicologia , Percepção da Dor , Dor/psicologia , Transtornos Somatoformes/psicologia , Adulto , Sintomas Afetivos/complicações , Doença Crônica/psicologia , Comorbidade , Depressão/complicações , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/complicações , Transtornos Somatoformes/complicações , Inquéritos e Questionários , Adulto Jovem
8.
BMC Med ; 18(1): 34, 2020 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-32122350

RESUMO

BACKGROUND: Functional somatic symptoms and disorders are common and complex phenomena involving both bodily and brain processes. They pose major challenges across medical specialties. These disorders are common and have significant impacts on patients' quality of life and healthcare costs. MAIN BODY: We outline five problems pointing to the need for a new classification: (1) developments in understanding aetiological mechanisms; (2) the current division of disorders according to the treating specialist; (3) failure of current classifications to cover the variety of disorders and their severity (for example, patients with symptoms from multiple organs systems); (4) the need to find acceptable categories and labels for patients that promote therapeutic partnership; and (5) the need to develop clinical services and research for people with severe disorders. We propose 'functional somatic disorders' (FSD) as an umbrella term for various conditions characterised by persistent and troublesome physical symptoms. FSDs are diagnosed clinically, on the basis of characteristic symptom patterns. As with all diagnoses, a diagnosis of FSD should be made after considering other possible somatic and mental differential diagnoses. We propose that FSD should occupy a neutral space within disease classifications, favouring neither somatic disease aetiology, nor mental disorder. FSD should be subclassified as (a) multisystem, (b) single system, or (c) single symptom. While additional specifiers may be added to take account of psychological features or co-occurring diseases, neither of these is sufficient or necessary to make the diagnosis. We recommend that FSD criteria are written so as to harmonise with existing syndrome diagnoses. Where currently defined syndromes fall within the FSD spectrum - and also within organ system-specific chapters of a classification - they should be afforded dual parentage (for example, irritable bowel syndrome can belong to both gastrointestinal disorders and FSD). CONCLUSION: We propose a new classification, 'functional somatic disorder', which is neither purely somatic nor purely mental, but occupies a neutral space between these two historical poles. This classification reflects both emerging aetiological evidence of the complex interactions between brain and body and the need to resolve the historical split between somatic and mental disorders.


Assuntos
Transtornos Psicóticos/classificação , Transtornos Somatoformes/classificação , Humanos , Transtornos Somatoformes/psicologia , Transtornos Somatoformes/terapia
10.
Psychol Health ; 35(9): 1033-1048, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32064931

RESUMO

Objective: We developed and validated a drawing test version of the Pictorial Representation of Illness and Self Measure (PRISM), a visual method to assess the perceived burden of illness and illness perception. Our aim was to test whether the drawing version would allow patients more freedom to deliberately vary both the size and position of circles symbolizing illness and individual coping resources, as well as gain more information about illness representations and available resources. Design and Main Outcome Measures: We applied the PRISM-D test to 500 patients with severe somatic diseases under active hospital treatment. We used Spielberger's State and Trait Anxiety Inventory and Beck's Depression Inventory to assess convergent validity. Results: The PRISM-D test is applicable for inpatients and it can be used to explore their subjective representations. The modifications did not cause any loss in convergent validity as the Self-Illness Separation and the Illness Perception Measure are significantly correlated with levels of depression and anxiety. Conclusion: The drawing test enables more detailed measurement of suffering caused by illness, illness perception and more complex assessment of important factors in a patient's life. The test is adequate for clinical use as well as research among a wide range of somatic inpatients.


Assuntos
Atitude Frente a Saúde , Efeitos Psicossociais da Doença , Obras Pictóricas como Assunto , Testes Psicológicos , Transtornos Somatoformes/psicologia , Adaptação Psicológica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Feminino , Humanos , Pacientes Internados/psicologia , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Transtornos Somatoformes/terapia , Adulto Jovem
11.
J Psychosom Res ; 130: 109932, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31981896

RESUMO

OBJECTIVE: Problems in childhood and adolescence are often present with recurring physical signs of illness, called somatoform symptoms. These symptoms are a common reason for consultation at both paediatric care and psychotherapeutic/psychiatric praxis. We propose that attachment is a possible predictive factor. This article provides a systematic overview of the existing research literature concerning the relationship between attachment and somatoform symptoms in children and adolescents. METHODS: A systematic search for empirical articles from 1990 up to August 2018 focusing on this association was conducted. Out of six databases, 4994 studies were detected by using defined keywords. One study was added identified by checking reference lists. Finally, 15 studies were selected, which were the bases for the narrative review. Ten studies were included in meta-analysis. RESULTS: Combining study results, we found that attachment cannot solely predict somatoform symptoms. Mixed results are shown. The quantitative analysis substantiated these narrative results, revealing a small but significant combined effect size of Δ ≈ .12 (95% CI .04 - .19). CONCLUSIONS: The findings suggest that a relationship exists, but further investigations need to demonstrate that these are not only superficial. There are many developmental factors that affect the relationship between attachment and somatoform symptoms in children and adolescents. Further research should explore this interplay in order to gain a holistic and comprehensive understanding of the underlying mechanisms that lead to these correlations and to discover possible predicting factors.


Assuntos
Relações Interpessoais , Transtornos Somatoformes/psicologia , Adolescente , Criança , Humanos
12.
J Neuropsychiatry Clin Neurosci ; 32(2): 125-131, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31466516

RESUMO

Psychogenic nonepileptic seizures (PNES) are a highly disabling disorder frequently encountered by neurologists, psychiatrists, and emergency medicine physicians. There is accumulating evidence for the efficacy of psychological therapies, yet the majority of patients do not complete treatment. A range of health care system-based, clinician-based, and patient-based barriers to treatment exists, including stigma, poor clinician-patient communication, and patient ambivalence about the diagnosis and treatment of PNES. These barriers frequently lead to treatment nonadherence. Motivational interviewing (MI) is a patient-centered counseling style targeting ambivalence about behavior change, which has been shown to be effective in improving psychotherapy adherence and outcomes among patients with PNES. The authors review MI processes and techniques that may be useful to health care providers helping patients with PNES and other functional neurological disorders to engage in psychotherapy. The authors examine common challenges arising during MI for patients with PNES, including somatic symptoms distracting from clinician-patient communication, ambivalence about making concrete plans for treatment, and psychiatric comorbidities. Strategies for overcoming these obstacles are reviewed, including the use of complex reflections to enhance patient engagement; the use of an ask-tell-ask format and specific, measurable, achievable, relevant, and time-limited (SMART) goals to facilitate treatment planning; and close collaboration between the neurology and psychotherapy teams.


Assuntos
Entrevista Motivacional , Cooperação do Paciente , Psicoterapia , Convulsões/terapia , Transtornos Somatoformes/terapia , Humanos , Cooperação do Paciente/psicologia , Convulsões/fisiopatologia , Convulsões/psicologia , Transtornos Somatoformes/fisiopatologia , Transtornos Somatoformes/psicologia
13.
Clin Child Psychol Psychiatry ; 25(1): 273-290, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31232094

RESUMO

BACKGROUND: Medically unexplained symptoms affect between 4% and 20% of children and adolescents; 30-60% of these children also experience mental health difficulties. Trials and reviews have focussed on physical gains in this population, often overlooking mental health outcomes. OBJECTIVES: To use a systematic review methodology guided by the PRISMA checklist to (1) investigate the effectiveness of psychological interventions for mental health difficulties in children and adolescents with medically unexplained symptoms and (2) identify aspects of interventions associated with their success. METHODS: Randomised controlled studies investigating the impact of psychological interventions on mental health in children and adolescents with medically unexplained symptoms were included. Systematic searches of PsycINFO, MEDLINE and CINAHL were undertaken from inception to January 2018. Studies were appraised using the quality appraisal checklist. A qualitative synthesis of studies was completed. RESULTS: In all, 18 studies were identified. Interventions targeting parental responses to illness and family communication appeared to have the best outcomes. CONCLUSIONS: Psychological interventions may be effective in improving mental health outcomes within this population; however, evidence for the efficacy of these interventions is limited due to a high risk of bias within the majority of reviewed studies. Future research using rigorous methodology and non-cognitive behavioural therapy interventions is recommended.


Assuntos
Sintomas Inexplicáveis , Saúde Mental , Psicoterapia , Transtornos Somatoformes/terapia , Adolescente , Criança , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos Somatoformes/psicologia
14.
Clin Child Psychol Psychiatry ; 25(1): 45-61, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31079473

RESUMO

BACKGROUND: Functional disorders, defined as disorders with no clear medical explanation, are common and impose a significant burden on youths, their families, healthcare services and society as a whole. Currently, the literature describes resistance among patients and their families towards psychological symptom explanations and treatments. More knowledge about the thoughts and understandings of youths with functional disorders and their parents is needed. The aim of this study was to explore the illness perceptions of youths with severe functional disorders and their parents. METHODS: A qualitative interview study using interpretative phenomenological analyses. The study included 11 youths aged 11-15 years with functional disorders and their parents, where interviews were performed at the point of referral from a somatic to a psychiatric treatment setting. RESULTS: Analyses identified three main themes. Themes 1(Ascribing identity to the disorder) and 2 (Monocausal explanations) explore key elements of the participants' illness perceptions, and theme 3 (Mutable illness perceptions) explores how illness perceptions are influenced by experiences from healthcare encounters. CONCLUSIONS: The label 'functional disorder' was poorly integrated in the illness perceptions of the youths and their parents. Participants used a monocausal and typically physical explanation rather than a multicausal biopsychosocial explanation for their symptoms.


Assuntos
Sintomas Inexplicáveis , Transtornos Somatoformes/psicologia , Estresse Psicológico/psicologia , Adolescente , Adulto , Criança , Terapia Familiar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pais , Pesquisa Qualitativa , Transtornos Somatoformes/terapia , Estresse Psicológico/terapia
15.
Qual Life Res ; 29(3): 693-703, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31732910

RESUMO

PURPOSE: Medically Unexplained Physical Symptoms (MUPS) have a large impact on patient's quality of life. Most studies have been limited to chronic MUPS and thus, little is known about moderate MUPS. Improved knowledge concerning determinants influencing quality of life in moderate MUPS patients can be helpful in managing MUPS. This study is aimed at describing the common characteristics seen in moderate MUPS patients and compare them with characteristics seen in chronic MUPS patients and general population. We also identified determinants of the physical and mental components of quality of life in moderate MUPS patients. METHODS: In a cross-sectional study, moderate MUPS patients (n = 160) were compared with chronic MUPS patients (n = 162) and general population (n = 1742) based on demographic characteristics and patient's quality of life. Multivariable linear regression analyses were performed to identify determinants associated with a patient's quality of life, assessed with the RAND-36. RESULTS: Moderate MUPS patients experienced a better quality of life than chronic MUPS patients, but a worse quality of life as compared to the general population. Determinants associated with the physical and mental components of quality of life explain 49.1% and 62.9% of the variance, respectively. CONCLUSION: Quality of life of patients with MUPS varies with MUPS disease stage. Based on their quality of life scores, moderate MUPS patients would be adequately distinguished from chronic MUPS patients. Half of the variance in the physical component and almost two thirds of the mental component would be explained by a number of MUPS-related symptoms and perceptions.


Assuntos
Sintomas Inexplicáveis , Qualidade de Vida/psicologia , Transtornos Somatoformes/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exame Físico , Atenção Primária à Saúde
16.
Internist (Berl) ; 61(1): 44-50, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31853579

RESUMO

Somatoform disorders are encountered in primary medical care with above-average frequency but are too rarely named as such in the differential diagnostics. The prevalence is approximately 30 % with a predominance of female patients. This patient group puts the physician-patient relationship to the acid test from the very beginning due to the fixation on organ-related symptoms, the expectations of repeated instrumental diagnostics and the special way of acting. The consequences are frequent changes of physicians, chronification and disappointment on both sides; however, a workable physician-patient relationship can be developed through an empathic but critically distanced fundamental attitude of the general internist based on a biopsychosocial illness concept. In the further course corrections in the understanding and expression of the illness on the part of the patient can be achieved with a pacing and leading strategy and with psychoeducative measures. The primary psychologization of functional complaints will not satisfy the affected person but outpatient psychotherapy should be initiated only after the patient has been well-prepared. Measures with medications mostly remain unspecific and serve only for relief of symptoms. For comorbidities with anxiety and/or depressive disorders the use of selective serotonin reuptake inhibitors should be considered.


Assuntos
Transtorno Depressivo/diagnóstico , Medicina Interna , Medicina Psicossomática/métodos , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/terapia , Assistência Ambulatorial , Assistência à Saúde , Transtorno Depressivo/psicologia , Feminino , Humanos , Pacientes Ambulatoriais , Relações Médico-Paciente , Transtornos Somatoformes/psicologia
17.
Clin Child Psychol Psychiatry ; 25(1): 62-77, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30818976

RESUMO

BACKGROUND: Medically unexplained symptoms (MUS) are common among children and adolescents and may be highly impairing. Even after long diagnostic and/or therapeutic trajectories, many of these children and their parents feel dissatisfied with the advice and therapies they were given. OBJECTIVES: After a 2-week hospitalisation for somatic and psychiatric reassessment, children and their families were given recommendations for further treatment. This study evaluates which of these recommendations were carried out (primary outcome measure) and which factors influenced the (non-)adherence to therapeutic advice. METHODS: Parents of 27 children aged 7-17 with impairing MUS took part in a structured telephone survey to assess adherence to and perceived effectiveness of therapeutic recommendations (cross-sectional study). Influencing factors were analysed retrospectively. RESULTS: Psychotherapy was recommended to all 27 patients and their families; 19 of them (70.4%) carried out this advice. When physiotherapy was recommended, adherence proved lower (6/22 children; 27.3%). No influencing factors were found to have a statistically significant correlation with adherence. Effect sizes may be indicative of clinically relevant influential factors, but should be considered cautiously. CONCLUSION: Results suggest that more efforts need to be made to ensure adherence to therapeutic recommendations. Known risk factors for non-adherence to treatments for chronic somatic disorders may not apply for children with somatoform disorders.


Assuntos
Sintomas Inexplicáveis , Cooperação do Paciente/psicologia , Satisfação do Paciente , Transtornos Somatoformes/terapia , Adolescente , Criança , Estudos Transversais , Terapia Familiar , Feminino , Humanos , Masculino , Pais , Psicoterapia/métodos , Estudos Retrospectivos , Transtornos Somatoformes/psicologia , Resultado do Tratamento
18.
Psicol. Estud. (Online) ; 25: e41796, 2020. tab
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1143503

RESUMO

RESUMO Este estudo apresenta como tema as explicações de familiares sobre o sofrimento psíquico pelos itinerários terapêuticos de usuários na atenção em saúde mental a partir da ótica da família. O Itinerário Terapêutico (I.T.) é entendido como todos os movimentos suscitados por grupos ou indivíduos a fim de resguardar ou recuperar a saúde, que podem impulsionar diversos recursos, desde práticas religiosas e cuidados caseiros até os dispositivos biomédicos predominantes. O objetivo deste estudo foi identificar as explicações dadas pelo familiar a respeito do problema de saúde mental da pessoa em sofrimento psíquico. Efetuou-se um estudo qualitativo em que foram realizadas dez entrevistas com familiares de usuários de um Centro de Atenção Psicossocial (CAPS). De acordo com a análise das entrevistas com base na Teoria Fundamentada em Dados foi possível o agrupamento das explicações dadas em: (1) espirituais, (2) orgânicas, (3) histórico familiar, (4) eventos de vida, (5) diagnóstico e (6) outros. As explicações dadas pelos familiares envolvem um olhar múltiplo, que incorpora diferentes causas e motivos, aproximando-se da ideia de integralidade em saúde.


RESUMEN En este estudio se presenta como tema las explicaciones de familiares sobre el sufrimiento psíquico por intermedio de los itinerarios terapéuticos de usuarios en la atención en salud mental a partir de la óptica de la familia. El Itinerario Terapéutico (I.T.) es entendido como todos los movimientos suscitados por grupos o individuos a fin de resguardar o recuperar la salud, que pueden impulsar diversos recursos, desde prácticas religiosas y cuidados caseros hasta los dispositivos biomédicos predominantes. El objetivo de este estudio fue identificar las explicaciones dadas por el familiar acerca del origen del problema de salud mental de la persona en sufrimiento psíquico. Se efectuó un estudio cualitativo en el que se realizaron 10 entrevistas con familiares de usuarios de un Centro de Atención Psicosocial (CAPS). De acuerdo con el análisis de las entrevistas con base en la Teoría Fundamentada en Datos fue posible la agrupación de las explicaciones dadas en: (1) Espiritual, (2) Orgánico, (3) Historia familiar, (4) Eventos de la vida (5) Diagnóstico y (6) Otros. Las explicaciones, dadas por los familiares, involucra una mirada múltiple, que incorpora diferentes causas y motivos, aproximándose a la idea de integralidad en salud.


ABSTRACT. This study presents the explanations of family members about psychological distress through the therapeutic itineraries of patients in mental health care from the perspective of the family. The Therapeutic Itinerary (T.I.) is understood as all movements raised by groups or individuals in order to safeguard or recover health, which can boost various resources, from religious practices and home care to the predominant biomedical devices. This study aimed to identify the explanations given by the family member regarding the mental health problem of the person in psychological distress. A qualitative study was carried out in which 10 interviews were conducted with family members of users of a Psychosocial Care Center (CAPS). According to the analysis of the interviews based on the Grounded Theory, it was possible to group the explanations into: (1) Spiritual, (2) Organic, (3) Family history, (4) Life events, (5) Diagnosis and (6) Others. The explanations given by family members involve a multiple look, which incorporates different causes and reasons, approaching the idea of integrality in health.


Assuntos
Humanos , Masculino , Feminino , Adulto , Estresse Psicológico/psicologia , Saúde Mental , Relações Familiares/psicologia , Esquizofrenia , Transtornos Somatoformes/psicologia , Diagnóstico da Situação de Saúde , Internação Compulsória de Doente Mental , Espiritualidade , Depressão/psicologia , Serviços de Saúde Mental
19.
Trials ; 20(1): 784, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881990

RESUMO

BACKGROUND: There is a high prevalence of pain and post-traumatic symptoms among refugees and feasible interventions to manage these are needed. However, knowledge about the effect of physiotherapy and psychological group interventions among refugees is scarce. Our aim is to determine whether two different interventions, the Physiotherapy Activity and Awareness Intervention (PAAI) and Teaching Recovery Techniques (TRT), reduce pain and post-traumatic symptoms among refugees from Syria living in Norway. METHODS/DESIGN: Syrian adults with either pain disorders or post-traumatic symptoms, or both, will be recruited to this randomized control trial. The trial will include two separate interventions: participants with dominating pain symptoms will be assigned to the PAAI; and those with a predominance of post-traumatic symptoms will be assigned to the TRT intervention. Participants will be randomized to either the immediate intervention group or the delayed intervention group, for each of the interventions (PAAI and TRT). A minimum of 68 participants will be recruited for the PAAI and 78 participants for TRT, in order to detect clinically and statistically significant symptom improvement, assuming 25-30% attrition after recruitment. The main outcomes for the analyses will be pain intensity measured by the Brief Pain Inventory questionnaire and the scores of the Impact of Events Scale - Revised. The effect will be evaluated at the end of interventions lasting 8 weeks (PAAI) and 6 weeks (TRT) using the same instruments after the end of the intervention, and again 4-6 weeks later. Additionally, a qualitative evaluation will be conducted through an embedded process evaluation and personal interviews with participants after each of the interventions is finished. DISCUSSION: Our study will determine the feasibility of the implementation of two different interventions and the effect of these interventions among refugees from Syria with pain disorders and/or post-traumatic symptoms. TRIAL REGISTRATION: Clinical Trials.gov, NCT03951909. Retrospectively registered on 19 February 2019.


Assuntos
Manejo da Dor , Modalidades de Fisioterapia , Psicoterapia de Grupo/métodos , Refugiados/psicologia , Transtornos Somatoformes , Transtornos de Estresse Pós-Traumáticos , Adulto , Humanos , Noruega , Avaliação de Resultados em Cuidados de Saúde , Manejo da Dor/métodos , Manejo da Dor/psicologia , Medição da Dor/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos Somatoformes/psicologia , Transtornos Somatoformes/terapia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/terapia , Síria/etnologia
20.
Psychiatry Res ; 282: 112620, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31669838

RESUMO

Within the trans-theoretical model (stages of change) and self-determination theory frameworks, we investigated motives for physical activity adoption and maintenance in middle-aged and old age people with a mental disorder from a low-income setting. Ninety Ugandan outpatients completed the Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3) to assess exercise motives and the Patient-centred Assessment and Counselling for Exercise (PACE) to determine stage of change. The relationship between motives for physical activity and stage of change was investigated using MANOVA with post-hoc Scheffe tests. Higher amotivation levels were observed in the pre-action compared with action and maintenance stages, while except for external regulation, all regulation scores were significantly lower in the pre-action compared with action and maintenance stages. There were no significant differences in levels of motivational types between the action and maintenance stage. The study provides a platform for future research to investigate relationships between motivational factors and physical and mental health outcomes within physical activity interventions for middle-aged and old age people with a mental disorder.


Assuntos
Envelhecimento/psicologia , Exercício Físico/psicologia , Transtornos Mentais/psicologia , Motivação/fisiologia , Pacientes Ambulatoriais/psicologia , Idoso , Estudos Transversais , Países em Desenvolvimento , Feminino , Humanos , Masculino , Transtornos Mentais/reabilitação , Pessoa de Meia-Idade , Transtornos Somatoformes/psicologia , Transtornos Somatoformes/reabilitação , Uganda
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