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Journal of Neurology, Neurosurgery, and... Oct 2023Functional neurological disorder (FND) is a common and disabling disorder, often misunderstood by clinicians. Although viewed sceptically by some, FND is a diagnosis... (Review)
Review
Functional neurological disorder (FND) is a common and disabling disorder, often misunderstood by clinicians. Although viewed sceptically by some, FND is a diagnosis that can be made accurately, based on positive clinical signs, with clinical features that have remained stable for over 100 years. Despite some progress in the last decade, people with FND continue to suffer subtle and overt forms of discrimination by clinicians, researchers and the public. There is abundant evidence that disorders perceived as primarily affecting women are neglected in healthcare and medical research, and the course of FND mirrors this neglect. We outline the reasons why FND is a feminist issue, incorporating historical and contemporary clinical, research and social perspectives. We call for parity for FND in medical education, research and clinical service development so that people affected by FND can receive the care they need.
Topics: Humans; Female; Nervous System Diseases; Conversion Disorder; Biomedical Research
PubMed: 36977553
DOI: 10.1136/jnnp-2022-330192 -
American Journal of Psychoanalysis Mar 2024Psychoanalysis had its origins in an era when feelings that could not be recognized by the mind were being manifested in the body. Psychoanalysis works towards resolving...
Psychoanalysis had its origins in an era when feelings that could not be recognized by the mind were being manifested in the body. Psychoanalysis works towards resolving this type of split by recognizing the existence of a dual language structure that includes both body and mind as constituents of the fabric of embodied meanings. The field of psychosomatics helps to provide keys to this language, marking the essential, patterned truths that are recognized at very basic levels and increasingly organize our perceptions as we make sense of the world. In disrupting the integration of embodied meanings, trauma impedes identity development. For some patients, learning to make meaning from somatic symptoms is an important adjunct to coming to know their own embodied experience. Two cases will be offered in which somatic symptoms provided important information that was channeled through the analytic experience as a way of making sense of what otherwise remained unknown.
Topics: Humans; Medically Unexplained Symptoms; Language; Emotions; Psychoanalysis
PubMed: 38424252
DOI: 10.1057/s11231-024-09441-1 -
American Journal of Psychoanalysis Sep 2023This paper attempts to deal with a specific kind of pathological identification-"raw object identification"-which tends to appear as concrete physiological phenomena,...
This paper attempts to deal with a specific kind of pathological identification-"raw object identification"-which tends to appear as concrete physiological phenomena, trying to escape meaning and integration. These somatic manifestations stem from early traumatic experiences with a meaningful object and entrap-as revealed through analysis-specific significant qualities of that object. A massive splitting ensues between body and mind, self and object, relation and identification. Certain properties of the object are then experienced as a foreign body in the subject and are defensively identified with. Thus, raw object identification is often manifested in stubborn bodily symptoms.
Topics: Humans; Unconscious, Psychology; Transference, Psychology; Mental Disorders; Object Attachment; Psychoanalytic Therapy
PubMed: 37528215
DOI: 10.1057/s11231-023-09416-8 -
Zeitschrift Fur Psychosomatische... Feb 2024Primaryemotions and attachment in mental disorder Objectives: There is increasing evidence for associations between primary emotions and attachment with mental illness....
UNLABELLED
Primaryemotions and attachment in mental disorder Objectives: There is increasing evidence for associations between primary emotions and attachment with mental illness. This study illuminates the mediation relationship of these psychodynamic constructs in relation to psychiatric disorders.
METHODS
921 subjects (69.9 % female) were examined, who completed the questionnaires Brief Affective Neuroscience Personality Scales including a LUST Scale, Experiences in Close Relationships - Revised 8, and ICD-10 Symptom Rating online. A path analysis was conducted to evaluate the mediation effects of attachment anxiety.
RESULTS
A disease-specific pattern of direct associations between primary emotions, attachment anxiety, and psychological impairment emerged (all p < .01). Attachment exerted mediating effects primarily for SADNESS (p < .01), and to a lesser extent for LUST and CARE (p > .01).The model provided variance resolution ranging from7%(eating disorders) to 47%(depression).
CONCLUSION
The results demonstrate the relevance of affective explanations regarding the development of psychological symptoms, as well as therapeutic implications.
Topics: Humans; Female; Male; Emotions; Mental Disorders; Anxiety Disorders; Anxiety; Surveys and Questionnaires
PubMed: 38229550
DOI: 10.13109/zptm.2024.70.oa1 -
Journal of Psychosomatic Research Oct 2023We investigated the differences in fatigue and somatization between shift and non-shift workers and explored the effects of sleep and depression on fatigue and...
OBJECTIVE
We investigated the differences in fatigue and somatization between shift and non-shift workers and explored the effects of sleep and depression on fatigue and somatization in shift workers.
METHODS
In total, 4543 shift workers and 2089 non-shift workers completed self-reported questionnaires. The Center for Epidemiologic Studies Depression Scale (CESD), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), and Somatization subscale of the Symptom Checklist 90-item version (SCL-SOM) were used to measure depression, sleep quality, fatigue, and somatization, respectively. Fatigue and somatization were compared between shift and non-shift workers after controlling for different sets of covariates.
RESULTS
Compared to non-shift workers, shift workers reported higher FSS (mean difference: 2.19 ± 0.30, p < 0.01) and SCL-SOM (mean difference: 1.77 ± 0.21, p < 0.01) scores after controlling for age, gender, presence of medical illness, occupational category, monthly income, length of service, and weekly working hours. The between-group difference in FSS score was no longer significant after additionally controlling for CES-D (p = 0.15) or PSQI (p = 0.18). The between-group difference in SCL-SOM score showed only non-significant trends after additionally controlling for CES-D (p = 0.09) or PSQI (p = 0.07). The group difference in SCL-SOM scores disappeared after controlling for both CES-D and PSQI scores (p = 0.99).
CONCLUSIONS
Shift workers had higher fatigue and somatization levels than non-shift workers and the group difference was associated with disturbed sleep and depressed mood in shift workers.
Topics: Humans; Depression; Sleep; Fatigue; Sleep Wake Disorders; Surveys and Questionnaires
PubMed: 37619432
DOI: 10.1016/j.jpsychores.2023.111467 -
JAMA Network Open Jul 2023Different types of traumatic life events have varying impacts on symptoms of depression, anxiety, and somatization. For women from areas of the world experiencing war...
IMPORTANCE
Different types of traumatic life events have varying impacts on symptoms of depression, anxiety, and somatization. For women from areas of the world experiencing war and humanitarian crises, who have experienced cumulative trauma exposure during war and forced migration, it is not known whether cumulative trauma or particular events have the greatest impact on symptoms.
OBJECTIVE
To examine which traumatic life events are associated with depression, anxiety, and somatization symptoms, compared with the cumulative amount, in a sample of female refugees.
DESIGN, SETTING, AND PARTICIPANTS
For this cross-sectional study, data were collected in 2016 as a part of The Study on Female Refugees. The current analysis was conducted in 2022 to 2023. This multicenter study covered 5 provinces in Germany. Participants were recruited at reception centers for refugees. Women volunteered to participate and to be interviewed after information seminars at the different centers.
EXPOSURE
Traumatic life events experienced by refugees from areas of the world experiencing war and humanitarian crises.
MAIN OUTCOMES AND MEASURES
Demographic variables (age, country of origin, religion, education, relationship status, and children), traumatic and adverse life events, and self-reported depression, anxiety, and somatization symptoms were measured. Random forest regressions simultaneously examined the importance of these variables on symptom scores. Follow-up exploratory mediation models tested potential associative pathways between the identified variables of importance.
RESULTS
For the final sample of 620 refugee women (mean [SD] age, 32.34 [10.35] years), family violence was most associated with depression (mean [SD] variable of importance [VIM], 2.93 [0.09]), anxiety (mean [SD] VIM, 4.15 [0.11]), and somatization (mean [SD] VIM, 3.99 [0.15]), even though it was less common than other traumatic experiences, including war, accidents, hunger, or lack of housing. Other factors, such as childhood sexual abuse, injury, near-death experiences, and lack of access to health care, were also important. Follow-up analyses showed partial mediation effects between these factors in their association with symptoms, supporting the unique importance of family violence in understanding mental health.
CONCLUSIONS AND RELEVANCE
The findings of this cross-sectional study of refugee women who experienced multiple severe traumas related to war in their home countries and danger encountered during their migration suggest that family violence was key to their current mental health problems. Culturally sensitive assessment and treatment need to place special emphasis on these family dynamics.
Topics: Child; Female; Humans; Adult; Refugees; Depression; Stress Disorders, Post-Traumatic; Cross-Sectional Studies; Anxiety
PubMed: 37471088
DOI: 10.1001/jamanetworkopen.2023.24511