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Clinical Psychology Review Apr 2016Psychogenic non-epileptic seizures (PNES) are common in neurological settings and often associated with considerable distress and disability. The psychological... (Review)
Review
Psychogenic non-epileptic seizures (PNES) are common in neurological settings and often associated with considerable distress and disability. The psychological mechanisms underlying PNES are poorly understood and there is a lack of well-established, evidence-based treatments. This paper advances our understanding of PNES by providing a comprehensive systematic review of the evidence pertaining to the main theoretical models of this phenomenon. Methodological quality appraisal and effect size calculation were conducted on one hundred forty empirical studies on the following aspects of PNES: life adversity, dissociation, anxiety, suggestibility, attentional dysfunction, family/relationship problems, insecure attachment, defence mechanisms, somatization/conversion, coping, emotion regulation, alexithymia, emotional processing, symptom modelling, learning and expectancy. Although most of the studies were only of low to moderate quality, some findings are sufficiently consistent to warrant tentative conclusions: (i) physical symptom reporting is elevated in patients with PNES; (ii) trait dissociation and exposure to traumatic events are common but not inevitable correlates of PNES; (iii) there is a mismatch between subjective reports of anxiety and physical arousal during PNES; and (iv) inconsistent findings in this area are likely to be attributable to the heterogeneity of patients with PNES. Empirical, theoretical and clinical implications are discussed.
Topics: Humans; Seizures
PubMed: 27084446
DOI: 10.1016/j.cpr.2016.01.003 -
Frontiers in Psychology 2022The World Health Organization (WHO), in its last review of its International Classification of Diseases, established a new classification for chronic pain. Among the...
The World Health Organization (WHO), in its last review of its International Classification of Diseases, established a new classification for chronic pain. Among the principal categories, of particular interest is chronic primary pain as a new type of diagnosis in those cases in which the etiology of the disease is not clear, being termed as chronic primary visceral pain when it is situated in the thorax, abdomen, or pelvis. Due to the novelty of the term, the objective of the systematic review was to examine the psychopathological and neuropsychological disorders associated with chronic primary visceral pain. We carried out a search of the scientific literature following the PRISMA directives using the Pubmed, Medline, PsycInfo and Scopus databases. A total of 33 articles were selected after applying the inclusion and exclusion criteria. The analysis of the studies showed that most persons with chronic primary visceral pain suffer from at least one psychological disorder; the most prevalent being anxiety, depressive or somatoform disorders. The most frequent psychopathological symptoms are anxiety, depression and somatization. Similarly, the findings are insufficient to determine the existence of deficits in the domains of executive functioning, memory and intelligence. However, the existence of attention biases does seem to be clear. This review supposes a starting point for conceptualizing chronic primary visceral pain. It is necessary to continue further research so as to obtain a better understanding of this pathology and the disorders associated.
PubMed: 36337545
DOI: 10.3389/fpsyg.2022.1031923 -
Acta Dermatovenerologica Alpina,... Jun 2018Hematidrosis is an eccrine sweat disorder characterized by one or more episodes of spontaneous, bloody sweating from non-traumatized skin. The author carried out a... (Review)
Review
Hematidrosis is an eccrine sweat disorder characterized by one or more episodes of spontaneous, bloody sweating from non-traumatized skin. The author carried out a systematic review of all cases of hematidrosis reported in PubMed over the past 20 years. A total of 25 cases were reviewed; 21 were women (84%), the median age was 13 years (range 9-72), and the majority (62%) were from Asia, mainly India. Hematidrosis was located on the face-including the forehead (40%), eyes (40%), and ears (36%)-in 96% of the cases and on the umbilicus in 24% and the palms in 20%. Prodromal symptoms were reported by almost 30% of the patients. Possible triggering factors were identified in 56% of the cases; most of these (86%) were stress factors within families (conflicts or abuse) or at school. In two cases, platelet dysfunction and epilepsy were suspected as culprits. Nine patients had a psychiatric diagnosis associated with hematidrosis. The outcome was favorable in most of the cases with medical treatment (e.g., beta-blocker, anxiolytics) and psychological support. The number of cases has increased in recent years. Hematidrosis appears to be a somatization disorder that mainly affects children from developing countries. Its physiopathology remains largely unknown. It deserves better recognition because it is usually a temporary condition when managed properly.
Topics: Adolescent; Adult; Aged; Child; Female; Hemorrhage; Humans; Male; Middle Aged; Somatoform Disorders; Sweat Gland Diseases; Sweating; Young Adult
PubMed: 29945265
DOI: No ID Found -
PloS One 2017Pain relief has been shown to be the most frequently reported goal by patients undergoing lumbar disc surgery. There is a lack of systematic research investigating the... (Review)
Review
OBJECTIVES
Pain relief has been shown to be the most frequently reported goal by patients undergoing lumbar disc surgery. There is a lack of systematic research investigating the course of postsurgical pain intensity and factors associated with postsurgical pain. This systematic review focuses on pain, the most prevalent symptom of a herniated disc as the primary outcome parameter. The aims of this review were (1) to examine how pain intensity changes over time in patients undergoing surgery for a lumbar herniated disc and (2) to identify socio-demographic, medical, occupational and psychological factors associated with pain intensity.
METHODS
Selection criteria were developed and search terms defined. The initial literature search was conducted in April 2015 and involved the following databases: Web of Science, Pubmed, PsycInfo and Pubpsych. The course of pain intensity and associated factors were analysed over the short-term (≤ 3 months after surgery), medium-term (> 3 months and < 12 months after surgery) and long-term (≥ 12 months after surgery).
RESULTS
From 371 abstracts, 85 full-text articles were reviewed, of which 21 studies were included. Visual analogue scales indicated that surgery helped the majority of patients experience significantly less pain. Recovery from disc surgery mainly occurred within the short-term period and later changes of pain intensity were minor. Postsurgical back and leg pain was predominantly associated with depression and disability. Preliminary positive evidence was found for somatization and mental well-being.
CONCLUSIONS
Patients scheduled for lumbar disc surgery should be selected carefully and need to be treated in a multimodal setting including psychological support.
Topics: Humans; Lumbar Vertebrae; Orthopedic Procedures; Pain Measurement; Pain, Postoperative; Risk Factors; Treatment Outcome
PubMed: 28107402
DOI: 10.1371/journal.pone.0170303 -
Acta Medica Portuguesa 2010The prevalence of somatization is dependent on the classification methods and measures used to define it and the context from which the collected data are gathered. The... (Review)
Review
AIM
The prevalence of somatization is dependent on the classification methods and measures used to define it and the context from which the collected data are gathered. The aim of this study was to compare the prevalence of somatization and Somatoform Disorders (SFD) in Primary Health Care.
METHOD
A systematic review of the studies of the prevalence of somatization and SFD in PC (Primary Care) was made, from July 1998 to June 2009. The key words of this investigation, in Pub Med, were; somatoform disorders; somatization; somatisation; medically unexplained symptoms; MUS; functional somatic symptoms, the link with each of these key words having been made to Primary Care. A grid was drawn up for the selection of each article. The criteria for the inclusion of the studies took into account aspects related to the methodology and the instruments used (use of interview) and the clear definition of medically unexplained symptoms, amongst others.
RESULTS
Twelve studies with prevalence values in a PC setting and 1 study of metaanalysis were selected. The values found for the total prevalence of SFD were extremely disperse, taking into consideration the various studies, being between 12% and 57.9%. The same results were found in relation to somatization disorder (between 0.5% and 16.1%) with 10.1%, referred to one study, following the very restrictive criteria of ICD-10. Results were more homogeneous for somatization defined by more abridged criteria, the Somatic Symptom Index 4.6 (SSI4,6) presenting values around 20% in almost the majority of selected studies that estimate the prevalence following this criteria. In the great majority of the studies, SFD increased the relative risk of other mental disorders (depressive and anxiety disorders). Some studies concluded that there was a relative independence of somatization in relation to those disorders, certified by the existence of a specific and cumulative effect of somatization (in relation to depressive and anxiety disorders) on the level of disability and of functional limitations as well as the level of use of resources in PC.
CONCLUSION
This last decade has enabled a group of new studies that allow us to understand the extent of somatization in PC, especially in Europe and North America, and to have a more clearly based idea of the needs at service level and investigation level, within the referred area.
Topics: Humans; Prevalence; Primary Health Care; Somatoform Disorders
PubMed: 21144328
DOI: No ID Found -
Journal of Affective Disorders Sep 2021We aimed to investigate the psychological problems on people infected with SARS-CoV-2 during the pandemic. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
We aimed to investigate the psychological problems on people infected with SARS-CoV-2 during the pandemic.
METHODS
In this living systematic review and meta-analyses, we searched seven electronic databases for cross-sectional studies and longitudinal studies on psychological problems on COVID-19 patients from Jan 1, 2020 to Oct 7, 2020. The primary outcome was prevalence of various psychological problems such as anxiety, depression, stress, insomnia, somatization, and fear. We pooled data for prevalence with their 95% confidence interval (CI) using random effect models and assessed the study quality based on the 11-item checklist recommended by the Agency for Healthcare Research and Quality.
RESULTS
Fourty-four studies, including studies from China(35), Italy(2), Iran(2), India(1), Korea(1), Ecuador(1), Switzerland(1), Germany(1), were identified by comprising a total of 8587 completed questionnaires and 38 studies for meta-analyses. The prevalence of anxiety, depression, post-traumatic stress disorder(PTSD), insomnia, somatization, and fear in patients with COVID-19 was 16.6% (10.1%-23.1%), 37.7% (29.3%-46.2%), 41.5% (9.3%-73.7%), 68.3% (48.6%-88.0%), 36.5% (20.2%-52.8%), 47.6% (9.4%-85.7%), respectively. The prevalence of anxiety, depression, and insomnia in severe COVID-19 patients (intensive care unit inpatients) was higher than mild or clinically stable COVID-19 patients.
LIMITATIONS
A significant degree of heterogeneity in terms of populations, sampling methods, scales was noted across studies.
CONCLUSIONS
There existed high proportions of COVID-19 patients with psychological problem. The prevalence of psychological problems was closely related to the patients themselves, their surroundings and social support. It is imperative to provide ontime psychological care service for COVID-19 patients and to follow-up them for a longer period.
Topics: Anxiety; COVID-19; China; Cross-Sectional Studies; Depression; Germany; Humans; India; Iran; Italy; Mental Health; Prevalence; Republic of Korea; SARS-CoV-2; Stress, Psychological; Switzerland
PubMed: 34126309
DOI: 10.1016/j.jad.2021.05.060 -
Frontiers in Psychiatry 2021The purpose of this meta-analysis was to summarize the prevalence and risk factors of mental health problems among healthcare workers during the COVID-19 pandemic. We...
The purpose of this meta-analysis was to summarize the prevalence and risk factors of mental health problems among healthcare workers during the COVID-19 pandemic. We applied an optimized search strategy across the PubMed, EMBASE, Scopus, PsycINFO, and four Chinese databases, with hand searching supplemented to identify relevant surveys. Studies were eligible for inclusion if they were published in peer-reviewed literature and used a validated method to assess the prevalence and risk factors of mental health problems among healthcare workers during the COVID-19 pandemic. Heterogeneity was quantified using statistics and the statistics. The potential causes of heterogeneity were investigated using subgroup analysis and meta-regression analysis. Sensitivity analysis was performed to examine the robustness of the results. We pooled and analyzed data from 20 studies comprising 10,886 healthcare workers. The prevalence of depression, anxiety, insomnia, post-traumatic stress symptoms, phobia, obsessive-compulsive symptoms, and somatization symptoms was 24.1, 28.6, 44.1, 25.6, 35.0, 16.2, and 10.7%, respectively. Female and nurses had a high prevalence of depression and anxiety. Frontline healthcare workers had a higher prevalence of anxiety and a lower prevalence of depression than the those in the second-line. Furthermore, the proportion of moderate-severe depression and anxiety is higher in the frontline. Additionally, four studies reported on risk factors of mental health problems. In this systematic review, healthcare workers have a relatively high prevalence of depression, anxiety, insomnia, post-traumatic stress symptoms, phobia, obsessive-compulsive symptoms, and somatization symptoms during the COVID-19 pandemic, and focus should be on the healthcare workers at high risk of mental problems. Mental health problems in healthcare workers should be taken seriously, and timely screening and appropriate intervention for the high-risk group are highly recommended. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020179189.
PubMed: 34211406
DOI: 10.3389/fpsyt.2021.567381 -
Alimentary Pharmacology & Therapeutics Aug 2009Upper gastrointestinal symptoms impose a substantial illness burden and management costs. Understanding perceptions and reasons for seeking healthcare is a prerequisite... (Review)
Review
BACKGROUND
Upper gastrointestinal symptoms impose a substantial illness burden and management costs. Understanding perceptions and reasons for seeking healthcare is a prerequisite for meeting patients' needs effectively.
AIM
To review systematically findings on consultation frequencies for gastro-oesophageal reflux disease (GERD) and dyspepsia and patients' reasons for consultation.
METHODS
Systematic literature searches.
RESULTS
Reported consultation rates ranged from 5.4% to 56% for GERD and from 26% to 70% for dyspepsia. Consultation for GERD was associated with increased symptom severity and frequency, interference with social activities, sleep disturbance, lack of timetabled work, higher levels of comorbidity, depression, anxiety, phobia, somatization and obsessionality. Some consulted because of fears that their symptoms represented serious disease; others avoided consultation because of this. Inconsistent associations were seen with medication use. Patients were less likely to consult if they felt that their doctor would trivialize their symptoms. Few factors were consistently associated with dyspepsia consultation. However, lower socio-economic status and Helicobacter pylori infection were associated with increased consultation.
CONCLUSION
Patients' perceptions of their condition, comorbid factors and external reasons such as work and social factors are related to consultation rates for GERD. Awareness of these factors can guide the clinician towards a more effective strategy than one based on drug therapy alone.
Topics: Attitude to Health; Dyspepsia; Female; Gastroesophageal Reflux; Gastrointestinal Agents; Helicobacter Infections; Humans; Male; Patient Acceptance of Health Care; Quality of Life; Referral and Consultation; Socioeconomic Factors
PubMed: 19660016
DOI: 10.1111/j.1365-2036.2009.04047.x -
International Journal of Tryptophan... 2021The kynurenine (KYN) pathway has been implicated in many diseases associated with inflammation and aging ("inflammaging"). Targeting the kynurenine pathway to modify... (Review)
Review
BACKGROUND
The kynurenine (KYN) pathway has been implicated in many diseases associated with inflammation and aging ("inflammaging"). Targeting the kynurenine pathway to modify disease outcomes has been trialled pharmacologically, but the evidence of non-pharmacological means (ie, exercise) remains unclear.
OBJECTIVE
We aim to assess the evidence of the effects of exercise on the kynurenine pathway and psychological outcomes.
METHODS
Under Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, a systematic literature search was performed in MEDLINE, EMBASE, EMCARE, and the Cochrane Central Registry of Controlled Trials. The main outcomes were changes in kynurenine pathway metabolite levels and psychological outcomes.
RESULTS
Six studies were analyzed (total n = 379) with exercise demonstrating significant concomitant effects on kynurenine pathway metabolite levels and associated psychological outcomes in domains of somatization, anxiety, and depression.
CONCLUSION
Exercise has significant concomitant effect on kynurenine pathway metabolite levels and psychological outcomes. However, clear limitations exist in determining if the changes in the kynurenine pathway can fully explain the changes in psychological outcomes, or whether different diseases and exercise interventions act as confounding factors.
PubMed: 33613029
DOI: 10.1177/1178646921991119 -
The Cochrane Database of Systematic... Jul 2007Many patients visit their general practitioner (GP) because of problems that are psychosocial in origin. However, for many of these problems there is no evidence-based... (Review)
Review
BACKGROUND
Many patients visit their general practitioner (GP) because of problems that are psychosocial in origin. However, for many of these problems there is no evidence-based treatment available in primary care, and these patients place time-consuming demands on their GP. Therefore, GPs could benefit from tools to help these patients more effectively and efficiently. In this light, it is important to assess whether structured psychosocial interventions might be an appropriate tool for GPs. Previous reviews have shown that psychosocial interventions in primary care seem more effective than usual care. However, these interventions were mostly performed by health professionals other than the GP.
OBJECTIVES
To examine the effectiveness of psychosocial interventions by general practitioners by assessing the clinical outcomes and the methodological quality of selected studies.
SEARCH STRATEGY
The search was conducted using the CCDANCTR-Studies and CCDANCTR-References on 20/10/2005, The Cochrane Library, reference lists of relevant studies for citation tracking and personal communication with experts.
SELECTION CRITERIA
Randomised controlled trials, controlled clinical trials and controlled patient preference trials addressing the effectiveness of psychosocial interventions by GPs for any problem or disorder. Studies published before November 2005 were eligible for entry.
DATA COLLECTION AND ANALYSIS
Methodological quality was independently assessed by two review authors using the Maastricht-Amsterdam Criteria List. The qualitative and quantitative characteristics of selected trials were independently extracted by two review authors using a standardised data extraction form. Levels of evidence were used to determine the strength of the evidence available. Results from studies that reported similar interventions and outcome measures were meta-analysed.
MAIN RESULTS
Ten studies were included in the review. Selected studies addressed different psychosocial interventions for five distinct disorders or health complaints. There is good evidence that problem-solving treatment by general practitioners is effective for major depression. The evidence concerning the remaining interventions for other health complaints (reattribution or cognitive behavioural group therapy for somatisation, cognitive behavioural therapy for unexplained fatigue, counselling for smoking cessation, behavioural interventions to reduce alcohol reduction) is either limited or conflicting.
AUTHORS' CONCLUSIONS
In general, there is little available evidence on the use of psychosocial interventions by general practitioners. Of the psychosocial interventions reviewed, problem-solving treatment for depression may offer promise, although a stronger evidence-base is required and the effectiveness in routine practice remains to be demonstrated. More research is required to improve the evidence-base on this subject.
Topics: Alcohol Drinking; Cognitive Behavioral Therapy; Counseling; Depression; Family Practice; Humans; Psychotherapy; Randomized Controlled Trials as Topic; Smoking Cessation; Somatoform Disorders
PubMed: 17636726
DOI: 10.1002/14651858.CD003494.pub2