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Psychiatry and Clinical... Sep 2022This non-systematic narrative review aims to summarize the results of clinical studies evaluating the effectiveness of antidepressants used to treat mental illnesses... (Review)
Review
BACKGROUND
This non-systematic narrative review aims to summarize the results of clinical studies evaluating the effectiveness of antidepressants used to treat mental illnesses including major depressive disorder, obsessive-compulsive disorder, somatization disorder, and anxiety disorders in Turkey. Conclusions drawn from this article can guide ongoing efforts by Turkish health policymakers to improve public health development in the country by further regulating the prescription of antidepressants.
METHODS
Relevant articles regarding the effectiveness of antidepressant use were collected in June 2021 using Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus and Academic Search Complete online databases. The collected articles were then appraised using the Critical Appraisal Skills Programme to determine the reliability and quality of each article and to assess the risk of bias in each article. The summary of key findings/evidence, Critical Appraisal Skills Programme appraisal summary results, funding, study designs applied, settings covered, period covered (years), and additional comments were extracted from each article for analysis. The inclusion criteria involved articles that recounted adverse effects and effectiveness of antidepressant use in Turkey to treat mental illnesses, including anxiety disorders, major depressive disorder, somatization disorder, and obsessive-compulsive disorder. The exclusion criteria consisted of articles that included participants who resided outside of the geographic region of Turkey, abstracts, the pharmacology of antidepressant use, antidepressant off-label use, and alternative treatments.
RESULTS
A total of 15 articles out of the 104 derived from the databases were included in the study that fell into 1 of the following main themes, "adverse effects" and "mixed results," which accounted for 53% (8 articles) and 40% (6 articles), respectively. One outlying article was identified (7%).
CONCLUSIONS
Totally 8 out of 15 articles that recounted antidepressants prescribed for mental illnesses produced adverse effects without treatment success and 6 out of 15 articles recounted adverse effects with treatment success. One outlying article found a confound that precluded determining whether an adverse effect was caused by antidepressant use or confounded by pre-existing conditions. Given that 14 out of 15 articles recounted adverse effects associated with antidepressant use and 6 out of 15 articles recounted antidepressant treatment success, Turkish policymakers are encouraged to adopt a restrictive drug policy strategy. To sum up, antidepressant prescription and consumption should be conducted with caution to limit unnecessary risk of exposure to adverse effects associated with antidepressant use. Limitations in the research included using a non-systematic tool instead of conducting a systematic review, a limited number of articles (15 out of 104), and risk of bias was detected from appraising the articles via Critical Appraisal Skills Programme.
PubMed: 38766671
DOI: 10.5152/pcp.2022.22408 -
Environmental Research Mar 2022Early, chronic, low-level fluoride exposure has been linked to attention-deficit hyperactivity disorder (ADHD) and learning deficits in children. Rodent studies suggest...
BACKGROUND
Early, chronic, low-level fluoride exposure has been linked to attention-deficit hyperactivity disorder (ADHD) and learning deficits in children. Rodent studies suggest a link between fluoride exposure and internalizing behaviors. No human studies have examined the impact of fluoride on internalizing behaviors during adolescence.
OBJECTIVE
Evaluate the relationship between urinary fluoride and early adolescent internalizing symptoms in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS).
METHODS
Participants in CCAAPS provided non-fasting spot urine samples at age 12 years (n = 286). Urine samples were analyzed using a microdiffusion method to determine childhood urinary fluoride (CUF) concentrations and were log-transformed for analyses. Caregivers of CCAAPS participants completed the Behavior Assessment System for Children-2 (BASC-2) at the age 12 study visit to assess internalizing symptoms (e.g., anxiety, depression, somatization), and a composite score of the three domains; T-scores ≥ 60 were used to identify adolescents in a clinically "at-risk" range. Race, age of the adolescent, household income, maternal age at birth, caregiver depression, caregiver-child relationships, and age 12-year serum cotinine concentrations were considered covariates in regression models. Sex-specific effects of fluoride exposures were investigated through the inclusion of interaction terms.
RESULTS
Higher CUF concentrations were significantly associated with increased somatization (β = 3.64, 95% CI 0.49, 6.81) and internalizing composite T-scores in a clinically "at-risk" range (OR = 2.9, 95% CI 1.24, 6.9). Compared to females, males with higher CUF concentrations had more internalizing (p = 0.04) and somatization symptoms (p = 0.02) and were nearly seven times more likely to exhibit "at-risk" internalizing symptomology. CUF concentrations were not significantly associated with depression or anxiety symptoms.
CONCLUSIONS
This is the first study to link fluoride exposure and internalizing symptoms, specifically somatization. Somatization represents an interface of physical and psychological health. Continued follow-up will help shed light on the sex-specific relationship between fluoride and mental health and the role of somatization.
Topics: Adolescent; Air Pollution; Anxiety; Attention Deficit Disorder with Hyperactivity; Child; Female; Fluorides; Humans; Male; Mental Health
PubMed: 34755609
DOI: 10.1016/j.envres.2021.112296 -
PloS One 2021We investigated, if migration status, and additional sociodemographic and clinical factors, are associated with somatization and depressiveness at admission and with...
BACKGROUND
We investigated, if migration status, and additional sociodemographic and clinical factors, are associated with somatization and depressiveness at admission and with remission after inpatient psychotherapy.
METHODS
Multiple linear and binary logistic regression analyses were used to identify predictors for severity of somatoform and depressive symptoms at admission of inpatient psychotherapy (T0), and for remission after inpatient psychotherapy (T1). We tested the association between symptoms concerning somatization (PHQ-15: Patient-Health-Questionnaire Somatization Module) and depression (PHQ-9: Patient-Health-Questionnaire Depression Module) and several sociodemographic and clinical factors in 263 patients at admission. For remission after treatment, we additionally included severity of symptoms at admission, number of diagnoses and duration of treatment in the regression models. Remission after treatment was defined as response plus a post value of less than 10 points in the respective questionnaire. Clinical relevance was interpreted using effect sizes (regression coefficients, Odds Ratio (OR)) and Confidence Intervals (CI).
FINDINGS
Significant and clinically relevant predictors for high symptom severity at T0 were lower education (β = -0.13, p = 0.04), pretreatment(s) (β = 0.205, p = 0.002) and migration status (β = 0.139, p = 0.023) for somatization, and potential clinically relevant predictors (|β|>0.1) for depression were living alone (β = -0.116, p = 0.083), pretreatment(s) (β = 0.118, p = 0.071) and migration status (β = 0.113, p = 0.069). At T1 patients with pretreatment(s) (OR = 0.284 [95% CI: 0.144, 0.560], p<0.001) and multiple diagnoses (OR = 0.678 [95% CI: 0.472, 0.973], p = 0.035) were significantly and clinically relevant less likely to show a remission of depressive symptoms. In addition, a potentially clinically meaningful effect of migration status on remission of depressive symptoms (OR = 0.562 [95% CI: 0.264, 1.198], p = 0.136) cannot be ruled out. For somatoform symptoms pretreatment(s) (OR = 0.403, [95% CI: 0.156, 1.041], p = 0.061) and education (OR = 1.603, [95% CI: 0.670, 3.839], p = 0.289) may be regarded as clinically relevant predictors for remission.
CONCLUSION
The results of our study suggest that migration status has a clinically relevant influence on severity of somatoform and depressive symptoms at admission. Clinical relevance of migration status can also be assumed regarding the remission of depression. Migration status and further factors affecting the effectiveness of the treatment should be analyzed in future research among larger samples with sufficient power to replicate these findings.
Topics: Adult; Depressive Disorder; Female; Germany; Hospitalization; Hospitals, Psychiatric; Human Migration; Humans; Inpatients; Italy; Male; Middle Aged; Odds Ratio; Patient Health Questionnaire; Patient Readmission; Poland; Psychiatric Status Rating Scales; Psychotherapy; Romania; Russia; Social Class; Surveys and Questionnaires; Symptom Assessment; Turkey
PubMed: 34529716
DOI: 10.1371/journal.pone.0257387 -
Brain Communications 2020With the creation of the Somatic Symptom and Related Disorders category of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition in 2013, the... (Review)
Review
With the creation of the Somatic Symptom and Related Disorders category of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition in 2013, the functional neurological (symptom) disorder diagnostic criteria underwent transformative changes. These included an emphasis on 'rule-in' physical examination signs/semiological features guiding diagnosis and the removal of a required proximal psychological stressor to be linked to symptoms. In addition, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition somatization disorder, somatoform pain disorder and undifferentiated somatoform disorder conditions were eliminated and collapsed into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition somatic symptom disorder diagnosis. With somatic symptom disorder, emphasis was placed on a cognitive-behavioural (psychological) formulation as the basis for diagnosis in individuals reporting distressing bodily symptoms such as pain and/or fatigue; the need for bodily symptoms to be 'medically unexplained' was removed, and the overall utility of this diagnostic criteria remains debated. A consequence of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition restructuring is that the diagnosis of somatization disorder that encompassed individuals with functional neurological (sensorimotor) symptoms prominent other bodily symptoms, including pain, was eliminated. This change negatively impacts clinical and research efforts because many patients with functional neurological disorder experience pain, supporting that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition would benefit from an integrated diagnosis at this intersection. We seek to revisit this with modifications, particularly since pain (and a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition somatization disorder comorbidity, more specifically) is associated with poor clinical prognosis in functional neurological disorder. As a first step, we systematically reviewed the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition somatization disorder literature to detail epidemiologic, healthcare utilization, demographic, diagnostic, medical and psychiatric comorbidity, psychosocial, neurobiological and treatment data. Thereafter, we propose a preliminary revision to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition allowing for the specifier functional neurological disorder 'with prominent pain'. To meet this criterion, core functional neurological symptoms (e.g. limb weakness, gait difficulties, seizures, non-dermatomal sensory loss and/or blindness) would have 'rule-in' signs pain (>6 months) impairing social and/or occupational functioning would also be present. Two optional secondary specifiers assist in characterizing individuals with cognitive-behavioural (psychological) features recognized to amplify or perpetuate pain and documenting if there is a pain-related comorbidity. The specifier of 'with prominent pain' is etiologically neutral, while secondary specifiers provide additional clarification. We advocate for a similar approach to contextualize fatigue and mixed somatic symptoms in functional neurological disorder. While this preliminary proposal requires prospective data and additional discussion, these revisions offer the potential benefit to readily identify important functional neurological disorder subgroups-resulting in diagnostic, treatment and pathophysiology implications.
PubMed: 33426523
DOI: 10.1093/braincomms/fcaa156 -
Italian Journal of Dermatology and... Oct 2022Self-inflicted skin disorders are artefact diseases inflicted by the use of multiple different means, for various different purposes. They account for about 2% of...
Self-inflicted skin disorders are artefact diseases inflicted by the use of multiple different means, for various different purposes. They account for about 2% of dermatology patient visits and include disorders with a denied or hidden pathological behavior (factitious disorders) and disorders with a non-denied and non-hidden pathological behavior (compulsive disorders). In turn, factitious skin disorders are subdivided into two groups: factitious disorders without an external incentive and factitious disorders with external incentives. In addition to the general diagnostic criteria, the present work examines the clinical forms of diseases of the first group (including dermatitis artefacta, Munchausen Syndrome, Munchausen Syndrome by proxy, and Morgellons Syndrome). In this case, the subject suffers from psychological problems and generally aims to attract the attention of the people around him, and in particular of his general practitioner, or else is reacting to difficult or unfavorable environmental conditions by means of an involuntary somatization at the level of the skin. The second part of the work on self-inflicted skin disorders will comprise the factitious disorders with external incentives and the compulsive disorders.
Topics: Factitious Disorders; Humans; Male; Morgellons Disease; Munchausen Syndrome; Skin; Skin Diseases
PubMed: 36062949
DOI: 10.23736/S2784-8671.22.07273-5 -
Indian Journal of Medical Ethics 2021During the COPASAH Global Symposium 2019, a group of therapists and mental health practitioners tried to highlight the issue of women's mental health with two specific...
During the COPASAH Global Symposium 2019, a group of therapists and mental health practitioners tried to highlight the issue of women's mental health with two specific focuses, one being the lived experiences of persons living with mental illness and the secondary burn-out and shame faced by their caretakers. The second session explored the contours of somatisation that is often seen in the human body as a result of the impact of trauma. The participants reflected on the value of lived experiences and also discussed the challenges faced in getting representation for people living with mental illness. The challenges listed by participants were concentrated around the participation and representation of persons living with intellectual disability and psychosocial disability. Somatisation of traumatic experiences needs recognition in a country like India where women's life-stressors exist right from childhood that keeps them on the threshold of mental illness and/or psychosomatic illnesses. Psychosocial health issues are relegated to a subordinate category of discussion while public health, reproductive health, and health rights feature in mainstream discussions in various seminars, researches and conferences in India. This paper is based on two sessions of the COPASAH Global Symposium 2019 and focuses on the gender and psychosocial dimensions of health from the framework of women being subjected to unpaid care work, through social and reproductive labour and stressors resulting in psycho-social distress. To this end, it is important to build a community of practitioners that looks beyond the reproductive health of women.
Topics: Child; Female; Health Services Accessibility; Human Rights; Humans; Mental Disorders; Mental Health; Women's Health
PubMed: 34666967
DOI: 10.20529/IJME.2021.077 -
Alpha Psychiatry May 2021This study aimed to investigate the relationship between the somatization level and dyadic adjustment, gratitude, forgiveness, and perfectionism in patients with...
OBJECTIVE
This study aimed to investigate the relationship between the somatization level and dyadic adjustment, gratitude, forgiveness, and perfectionism in patients with psychosomatic dermatologic complaints.
METHODS
In this correlational survey study, participants were recruited using the purposive sampling method from patients with psychosomatic dermatologic complaints, who were 18 or older, married, and living in the Turkish Republic of Northern Cyprus. Data were collected from patients diagnosed as having a dermatological disease with probable psychological etiology by a dermatologist at the dermatology outpatient unit of Nicosia Dr. Burhan Nalbantoğlu Hospital during April-December 2018. The demographic information form, symptom checklist, dyadic adjustment scale, gratitude questionnaire, Heartland forgiveness scale, and almost perfect scale were administered to the participants.
RESULTS
In this study, female sex, low education level, being an immigrant, low dyadic adjustment, perfectionism with a high level of discrepancy, low forgiveness of self and situations, and low gratitude levels were found to be probable risk factors for somatization.
CONCLUSION
During the psychiatric treatment of patients with somatic complaints, marital problems, forgiveness, and perfectionism with a high level of discrepancy should be considered.
PubMed: 36425448
DOI: 10.5455/apd.113545 -
Agri : Agri (Algoloji) Dernegi'nin... Jul 2022Psychiatric disorders including somatization impact pain severity and chronicity. This study aimed to determine sleep quality and the presence of psychiatric disorders...
OBJECTIVES
Psychiatric disorders including somatization impact pain severity and chronicity. This study aimed to determine sleep quality and the presence of psychiatric disorders in patients with chronic lateral epicondylitis (LE) and to investigate the effect of these comorbidities on pain levels.
METHODS
This study included 46 patients diagnosed with chronic LE and 46 healthy controls. Visual analog scale (VAS) was used for the assessment of pain intensity. The prevalence of depression and other psychological factors was examined using Beck Depression Inventory (BDI) and the Symptom Checklist-90-Revised test (SCL-90-R). Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality.
RESULTS
The mean BDI (p<0.001), all subdivisions of SCL-90-R including somatization (p<0.001), and the mean global PSQI scores (p=0.002) were found to be significantly higher in patients with chronic LE than those in the control group. The presence of depression according to BDI was 41.3% in the patient group. About 60.8% of the patients had somatization and 71.7% had poor sleep quality. VAS scores were significantly higher in the patients with depression, somatization, and low sleep quality indicating a low positive linear relationship (r=0.357, r=0.360, and r=0.463, respectively, and all p<0.05).
CONCLUSION
Psychiatric disorders and poor sleep quality are frequently observed in patients with chronic LE. These comorbidities negatively affect pain levels and may be linked to pain chronicity. Therefore, the potential coexistence of psychiatric disorders should be kept in mind when determining the treatment protocols for patients with chronic LE and adjunctive treatment should be given if necessary.
Topics: Humans; Mental Disorders; Pain; Sleep Quality; Sleep Wake Disorders; Tennis Elbow
PubMed: 35792693
DOI: 10.14744/agri.2021.24119 -
Indian Journal of Community Medicine :... Oct 2019Common mental disorders (CMDs) such as somatization and anxiety are prevalent in general practice. These are twice more common in women.
BACKGROUND
Common mental disorders (CMDs) such as somatization and anxiety are prevalent in general practice. These are twice more common in women.
OBJECTIVES
The objective of this study is to estimate the prevalence and determinants of somatization and anxiety among adult women in an urban population of Kochi.
MATERIALS AND METHODS
A cross-sectional study was conducted among 1210 adult women of Kochi in 2016-2017. The Patient Health Questionnaire-15; the Generalized Anxiety Disorder-7 questionnaire; the Hurt, Insult, Threaten, and Scream tool; and a semi-structured questionnaire were used to estimate the prevalence of somatization and anxiety. Descriptive statistics and univariate and multivariate analysis were done for factors associated with CMDs.
RESULTS
Most of the respondents were married (77.7%), with a mean age of 45.24 ± 15.59. In the current study, 40.8% (95% confidence interval [CI] =38.09-43.62) had somatization and 23.9% (95% CI = 21.57-26.37) had anxiety disorders. In the final logistic regression model, hypertension, perception of illness, positive family history of mental illness, and arthritis were the four determinants common to somatization and anxiety. Menstrual problems (odds ratio [OR] =3.19; 95% CI = 1.12-5.9), cardiac illness (OR = 2.31; 95% CI = 1.08-4.9), and history of major surgeries (OR = 1.62; 95% CI = 1.14-2.41) were independent determinants of somatization. The status of being single (OR = 1.71; 95% CI = 1.25-2.32), adverse life circumstances (OR = 5.85; 95% CI = 3.98-8.6), diabetes (OR = 2.04; 95% CI = 1.25-3.34), sleep problems (OR = 1.64; 95% CI = 1.77-2.91), and history of drug use (OR = 4.89; 95% CI = 1.92-12.46) were independent determinants of anxiety.
CONCLUSION
Mental health services for urban women deserve immediate attention as the prevalence of somatization and anxiety is high. Hence, it is important to screen for somatization and anxiety among women with noncommunicable diseases.
PubMed: 31728095
DOI: 10.4103/ijcm.IJCM_55_19 -
Diagnostics (Basel, Switzerland) Dec 2021Neuroelectric measures derived from human magnetoencephalographic (MEG) recordings hold promise as aides to diagnosis and treatment monitoring and targeting for chronic...
Neuroelectric measures derived from human magnetoencephalographic (MEG) recordings hold promise as aides to diagnosis and treatment monitoring and targeting for chronic sequelae of traumatic brain injury (TBI). This study tests novel MEG-derived regional brain measures of tonic neuroelectric activation for long-term test-retest reliability and sensitivity to symptoms. Resting state MEG recordings were obtained from a normative cohort (CamCAN, baseline: = 613; 16-month follow-up: = 245) and a chronic symptomatic TBI cohort (TEAM-TBI, baseline: = 62; 6-month follow-up: = 40). The MEG-derived neuroelectric measures were corrected for the empty-room contribution using a random forest classifier. The 16-month correlation between baseline and 16-month follow-up CamCAN measures was 0.67; test-retest reliability was markedly improved in this study compared with previous work. The TEAM-TBI cohort was screened for depression, somatization, and anxiety with the Brief Symptom Inventory and for insomnia with the Insomnia Severity Index and was assessed via adjudication for six clinical syndromes: chronic pain, psychological health, and oculomotor, vestibular, cognitive, and sleep dysfunction. Linear classifiers constructed from the 136 regional measures from each TEAM-TBI cohort member distinguished those with and without each symptom, < 0.0003 for each, i.e., the tonic regional neuroelectric measures of activation are sensitive to the presence/absence of these symptoms and clinical syndromes. The novel regional MEG-derived neuroelectric measures obtained and tested in this study demonstrate the necessary and sufficient properties to be clinically useful, i.e., good test-retest reliability, sensitivity to symptoms in each individual, and obtainable using automatic processing without human judgement or intervention.
PubMed: 35054252
DOI: 10.3390/diagnostics12010084