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Acta Medica Portuguesa 2011The authors have brought together and analised texts about the history of the concept of hysteria. In these texts hysteria is fundamentally considered a disease of... (Review)
Review
The authors have brought together and analised texts about the history of the concept of hysteria. In these texts hysteria is fundamentally considered a disease of organic origin (of the womb), and, in the Middle Age, evidence of demonic possession. From the XVII century onwards, apart from the etiopathogenic concepts, also taken into consideration are aspects connected to the differential diagnosis with other similar entities and the therapy used each period. Even, in subsequent centuries, authors such as Syndenham, who consider hysteria to be a multidimensional entity, are rare. Empiricism has contributed to discoveries in biology and physiology, both general and of the nervous system itself, and given birth to the formulation of the Spinal Irritation Theory and Reflex Theory. These theories have led to strictly organic treatment of hysteria, in the same way that hysterectomies were performed to alleviate somatic symptoms connected to this disease. The introduction of hypnosis in medical practice, with Charcot in X1X century, allowed for the element of suggestion to be observed ( a non organic element) which accompanies the symptoms of hysteria. Two of his disciples, Janet and Freud, would define and isolate psychic mechanisms in the symptoms of hysteria: Dissociation of the consciousness (Janet) and Conversion (Freud). The last one developed a therapeutic method of a psychological nature for hysteria. The therapeutic implications and the pertinence of the distinction between unspecific somatization or functional (of somatic origin) somatization and somatization linked to disassociation mechanisms and conversion (psychic origin) are discussed as well as the evolution of international classification systems of somatization and the questions posed by the algorithms chosen for the cataloguing of symptoms. A revision of the relevant empirical studies about the association of somatization with depressive and anxiety disorders, within the general population, is made. The characteristics that permeate the clinical descriptions of somatoform disorders (whose validity criteria remain weak) and are not integrated within the diagnostic criteria for somatoform disorders are considered. We draw conclusions about the difficulties and consequences of the changes that some authors advocate in relation to the new classification system for somatoform syndromes.
Topics: Humans; Hysteria; Somatoform Disorders
PubMed: 22525627
DOI: No ID Found -
BMC Gastroenterology Mar 2023To develop the modified 4-item version of Perceived Stress Scale (PSS) with a better reliability and validity than the 4-item version of PSS (PSS-4) in evaluating...
BACKGROUND
To develop the modified 4-item version of Perceived Stress Scale (PSS) with a better reliability and validity than the 4-item version of PSS (PSS-4) in evaluating psychological stress in patients with functional dyspepsia (FD). The present study also aimed to explore the correlation between dyspepsia symptoms severity (DSS), anxiety, depression, somatization, quality of life (QoL), and psychological stress assessed by two approaches in FD.
METHODS
A total of 389 FD patients who met the Roman IV criteria completed the 10-item version of the PSS (PSS-10), and 4/10 items were selected by five methods, such as Cronbach's coefficient, exploratory factor analysis (EFA), correlation coefficient, discrete degree, and item analysis, to develop the modified PSS-4. The reliability and validity of the modified PSS-4 and the PSS-4 were compared by internal consistency, EFA, and confirmatory factor analysis (CFA). The correlation between psychological stress assessed by two approaches and DSS, anxiety, depression, somatization, and QoL was explored by Pearson's correlation coefficient and multiple linear regression analysis.
RESULTS
Cronbach's α coefficient of the modified PSS-4 and the PSS-4 was 0.855 and 0.848, respectively, and a common factor was extracted. The cumulative contribution rate of one factor to the overall variance for the modified PSS-4 and the PSS-4 was 70.194% and 68.698%, respectively. The model used for the modified PSS-4 showed that the values of the goodness-of-fit index (GFI) and the adjusted GFI (AGFI) were 0.987 and 0.933, respectively, indicating that the model fitted well. Psychological stress was correlated to DSS, anxiety, depression, somatization, and QoL as assessed by the modified PSS-4 and PSS-4. Multiple linear regression analysis revealed that psychological stress was correlated to somatization, as assessed by the modified PSS-4 (β = 0.251, P < 0.001) and PSS-4 (β = 0.247, P < 0.001). Psychological stress, DSS, and somatization were correlated to QoL, as assessed by the modified PSS-4 (β = 0.173, P < 0.001) and the PSS-4 (β = 0.167, P < 0.001).
CONCLUSIONS
The modified PSS-4 showed better reliability and validity, and psychological stress had a greater effect on the somatization and QoL of FD patients assessed by the modified PSS-4 than PSS-4. These findings were helpful for further investigation of the clinical application of the modified PSS-4 in FD.
Topics: Humans; Dyspepsia; Quality of Life; Reproducibility of Results; Psychometrics; Stress, Psychological; Factor Analysis, Statistical; Surveys and Questionnaires
PubMed: 36991374
DOI: 10.1186/s12876-023-02728-0 -
Frontiers in Public Health 2023Psychosocial factors frequently occur in kidney transplant recipients (KTRs), leading to behavioral alterations and reduced therapeutic adherence. However, the burden of... (Observational Study)
Observational Study
INTRODUCTION
Psychosocial factors frequently occur in kidney transplant recipients (KTRs), leading to behavioral alterations and reduced therapeutic adherence. However, the burden of psychosocial disorders on costs for KTRs is unknown. The aim of the study is to identify predictors of healthcare costs due to hospital admissions and emergency department access in KTRs.
METHODS
This is a longitudinal observational study conducted on KTRs aged >18 years, excluding patients with an insufficient level of autonomy and cognitive disorder. KTRs underwent psychosocial assessment via two interviews, namely the Mini-International Neuropsychiatric Interview 6.0 (MINI 6.0) and the Diagnostic Criteria for Psychosomatic Research Interview (DCPR) and via the Edmonton Symptom Assessment System Revised (ESAS-R) scale, a self-administrated questionnaire. Sociodemographic data and healthcare costs for hospital admissions and emergency department access were collected in the 2016-2021 period. Psychosocial determinants were as follows: (1) ESAS-R psychological and physical score; (2) symptomatic clusters determined by DCPR (illness behavior cluster, somatization cluster, and personological cluster); and (3) ICD diagnosis of adjustment disorder, anxiety disorder, and mood disorder. A multivariate regression model was used to test the association between psychosocial determinants and total healthcare costs.
RESULTS
A total of 134 KTRs were enrolled, of whom 90 (67%) were men with a mean age of 56 years. A preliminary analysis of healthcare costs highlighted that higher healthcare costs are correlated with worse outcomes and death ( < 0.001). Somatization clusters ( = 0.020) and mood disorder ( < 0.001) were positively associated with costs due to total healthcare costs.
CONCLUSIONS
This study showed somatization and mood disorders could predict costs for hospital admissions and emergency department access and be possible risk factors for poor outcomes, including death, in KTRs.
Topics: Male; Humans; Middle Aged; Female; Somatoform Disorders; Kidney Transplantation; Psychophysiologic Disorders; Anxiety Disorders; Delivery of Health Care
PubMed: 37333548
DOI: 10.3389/fpubh.2023.1158387 -
The Journal of the Canadian... Aug 2017The association between depression, somatization and low back pain has been minimally investigated in a Canadian emerging adult population.
INTRODUCTION
The association between depression, somatization and low back pain has been minimally investigated in a Canadian emerging adult population.
METHODS
1013 first year Canadian university students completed the Modified Zung Depression Index, the Modified Somatic Perception Questionnaire, and a survey about low back pain frequency and intensity. Multinomial logistic regression was used to measure associations between low back pain and depression and somatization, both independently and co-occurring.
RESULTS
Over 50% of subjects reported low back pain across grades, and both depression and somatization were significantly positively associated with low back pain. Several positive associations between the cooccurrence of somatization and depression with various grades of low back pain were observed.
DISCUSSION
These results suggest that low back pain, depression and somatization are relatively common at the onset of adulthood, and should be considered an important focus of public health.
PubMed: 28928493
DOI: No ID Found -
Journal of Psychosomatic Research Nov 2012To create and validate empirically derived questionnaires that measure non-gastrointestinal symptoms and disorders that co-exist with irritable bowel syndrome (IBS).
OBJECTIVE
To create and validate empirically derived questionnaires that measure non-gastrointestinal symptoms and disorders that co-exist with irritable bowel syndrome (IBS).
METHODS
A systematic review of the world literature identified all non-GI symptoms and diagnoses known to have excess frequency in IBS patients. These data were used to create the Recent Physical Symptoms Questionnaire (RPSQ), which measures somatization (the psychological tendency to report multiple physical symptoms), and the Comorbid Medical Conditions Questionnaire (CMCQ). The psychometric properties of these questionnaires were assessed in two studies: 109 IBS patients in Study I; 286 IBS patients and 67 healthy controls in Study II.
RESULTS
In Study I, the RPSQ and CMCQ showed high test-retest reliability (r=.88 and .95) and good internal consistency (Cronbach alphas: .86 and .70, respectively). In Study II, principal components analysis demonstrated that the RPSQ is a homogeneous somatization scale, but the CMCQ could be divided into 4 subscales: one for psychiatric disorders and 3 for different types of somatic disorders. Concurrent validity of the RPSQ was shown by strong correlations with the Cornell Medical Index (CMI) and the Brief Symptom Inventory-18 (BSI-18) somatization scales. The validity of CMCQ responses was not assessed. Discriminant validity was modest: the BSI-18 anxiety and depression scales were less strongly correlated with the RPSQ than the BSI-18 somatization scale. The RPSQ and CMCQ scores of IBS patients were significantly higher than the scores of healthy controls (P<.001).
CONCLUSIONS
The RPSQ and CMCQ are psychometrically sound measures of somatization and medical comorbidities in IBS.
Topics: Adult; Comorbidity; Female; Humans; Irritable Bowel Syndrome; Male; Middle Aged; Psychometrics; Reproducibility of Results; Sensitivity and Specificity; Somatoform Disorders; Surveys and Questionnaires
PubMed: 23062808
DOI: 10.1016/j.jpsychores.2012.08.007 -
Journal of Psychosomatic Research Aug 2015Patient encounters for medically unexplained physical symptoms are common in primary health care. Somatization ('experiencing and reporting unexplained somatic...
BACKGROUND
Patient encounters for medically unexplained physical symptoms are common in primary health care. Somatization ('experiencing and reporting unexplained somatic symptoms') may indicate concurrent or future disability but this may also partly be caused by psychiatric disorders. The aim of this study was to examine the cross-sectional and longitudinal association between somatization and disability in primary care patients with and without anxiety or depressive disorder.
METHODS
Data were obtained from 1545 primary care patients, participating in the longitudinal Netherlands Study of Depression and Anxiety (NESDA). Somatization was assessed using the somatization scale of the Four-Dimensional Symptom Questionnaire (4DSQ). Disability was determined by the WHO Disability Assessment Schedule 2.0 (WHO-DAS II). The relationships between somatization and both the total and subdomain scores of the WHO-DAS II were measured cross-sectionally and longitudinally after one year of follow-up using linear regression analysis. We examined whether anxiety or depressive disorder exerted a modifying effect on the somatization-disability association.
RESULTS
Cross-sectionally and longitudinally, somatization was significantly associated with disability. Somatization accounted cross-sectionally for 41.8% of the variance in WHO-DAS disability and, longitudinally, for 31.7% of the variance in disability after one year of follow-up. The unique contribution of somatization to disability decreased to 16.7% cross-sectionally and 15.7% longitudinally, when anxiety and/or depressive disorder was added to the model.
CONCLUSION
Somatization contributes to the presence of disability in primary care patients, even when the effects of baseline demographic and health characteristics and anxiety or depressive disorder are taken into account.
Topics: Adolescent; Adult; Aged; Anxiety Disorders; Cross-Sectional Studies; Depressive Disorder; Disability Evaluation; Disabled Persons; Female; Follow-Up Studies; Humans; Interpersonal Relations; Linear Models; Longitudinal Studies; Male; Middle Aged; Netherlands; Primary Health Care; Psychiatric Status Rating Scales; Self Care; Somatoform Disorders; Young Adult
PubMed: 25824596
DOI: 10.1016/j.jpsychores.2015.03.001 -
Journal of Clinical Medicine Feb 2020The aim of this study was to identify correlations between sleep bruxism (SB) and temporomandibular disorders (TMD) as diagnosed by means of the research diagnostic...
The aim of this study was to identify correlations between sleep bruxism (SB) and temporomandibular disorders (TMD) as diagnosed by means of the research diagnostic criteria for temporomandibular disorders (RDC/TMD). Sleep bruxism was diagnosed on the basis of I) validated questionnaires, II) clinical symptoms, and III) electromyographic/electrocardiographic data. A total of 110 subjects were included in the study. Fifty-eight patients were identified as bruxers and 52 as nonbruxers. A psychosocial assessment was also performed. An RDC/TMD group-I diagnosis (myofascial pain) was made for 10 out of 58 bruxers, whereas none of the nonbruxers received a diagnosis of this type. No significant differences were found between bruxers and nonbruxers with regard to RDC/TMD group-II (disc displacement) and group-III (arthralgia, arthritis, arthrosis) diagnoses. Somatization was significantly more common among bruxers than nonbruxers. Multivariate logistic regression analysis revealed that somatization was the only factor significantly correlated with the diagnosis of myofascial pain. The results of this study indicate a correlation between myofascial pain, as diagnosed using the RDC/TMD, and somatization. It seems that somatization is a stronger predictor of an RDC/TMD diagnosis of myofascial pain than sleep bruxism is.
PubMed: 32102466
DOI: 10.3390/jcm9020611 -
Neurogastroenterology and Motility Mar 2018Most measures of fecal incontinence (FI) severity assess the frequency of solid and liquid FI, but may incorporate other features. We compared two scales-the Fecal...
BACKGROUND
Most measures of fecal incontinence (FI) severity assess the frequency of solid and liquid FI, but may incorporate other features. We compared two scales-the Fecal Incontinence Severity Score (FISS) and Fecal Incontinence Severity Index (FISI)-to determine which questionnaire and which individual questions predict FI Quality of Life (FIQOL).
METHODS
A national sample of American adults completed a health questionnaire, and 234 with monthly FI were selected. Participants completed assessments of FI severity, FIQOL, and somatization. Stepwise linear regression models evaluated whether FISS and FISI total scores, or individual items on the FISS and FISI predicted FIQOL after adjusting for gender, age, income, and somatization (Brief Symptom Inventory-18).
KEY RESULTS
Reliable responses were provided by 186. Age was 49 years, and 52% were women. The mean FISS score was 8.4 (95% confidence interval [CI] 8.0-8.9, 13 questions) and mean FISI was 29.9 (95% CI 27.4-32.4, 62 questions), indicating moderate FI severity. The mean FIQOL was 2.6 (95% CI 2.4-2.7, 5 questions). Lower income, greater somatization, and total FISS and FISI scores explained 69% of FIQOL; and total FISS and FISI scores were independent predictors. On the FISS, frequency, amount, and urgency to defecate were independently associated with FIQOL. After adding somatization, all but amount remained significant. For the FISI scale, solid and liquid FI and gas were significant predictors, but adjusting for somatization excluded solid FI.
CONCLUSIONS AND INFERENCES
Five variables independently explained FIQOL: overall frequency of FI, frequency of liquid and gas leakage, urgency, and somatization.
Topics: Adult; Aged; Aged, 80 and over; Cohort Studies; Fecal Incontinence; Female; Humans; Male; Middle Aged; Quality of Life; Severity of Illness Index; Surveys and Questionnaires; Young Adult
PubMed: 29094789
DOI: 10.1111/nmo.13241 -
Journal of Clinical Medicine Jun 2021To investigate the joint impact of tinnitus-related distress (TRD), anxiety, depressive symptoms, and other somatization symptoms on health-related quality of life...
OBJECTIVE
To investigate the joint impact of tinnitus-related distress (TRD), anxiety, depressive symptoms, and other somatization symptoms on health-related quality of life (HRQoL) in female vs. male patients with chronic tinnitus.
METHOD
Three-hundred-and-fifty-two patients with chronic tinnitus completed audiological testing and a psychological assessment battery that comprised-among other measures-German versions of the Tinnitus Questionnaire, Hospital Anxiety and Depression Scale, Somatic Symptom Scale-8, and Health-Related Quality of Life scale. Descriptive analyses examined associations as well as within- and between-gender differences of the measured variables. Gender-specific serial indirect effects analyses aimed to explain the impact of TRD on HRQoL through psychological processes, notably anxiety, depressive symptoms, and somatization symptoms.
RESULTS
Both female and male patients yielded lower mental than physical HRQoL and negative associations between the measured psychological variables and HRQoL. Compared to male patients, female patients reported higher levels of tinnitus-related- and wider psychological distress, other somatization symptoms (e.g., headaches), and impairments in mental and physical HRQoL. For each gender, depressive symptoms, anxiety, and somatization symptoms fully mediated the effect of TRD on mental and physical HRQoL. A double-dissociation revealed an interaction of somatization symptoms and depression on the TRD-HRQoL association in women, and of somatization symptoms and anxiety in men.
CONCLUSIONS
In patients with chronic tinnitus, psychological constructs account for reported impairments in both mental and physical HRQoL. To improve patients' HRQoL, treatment conceptualizations should consider gender-specific psychological expressions of low mood or anxiety.
PubMed: 34202097
DOI: 10.3390/jcm10132798 -
Therapeutic Advances in Gastroenterology 2018Fatigue is a well-recognized symptom in patients with inflammatory bowel disease and irritable bowel syndrome (IBS), and has been associated with psychological...
BACKGROUND
Fatigue is a well-recognized symptom in patients with inflammatory bowel disease and irritable bowel syndrome (IBS), and has been associated with psychological comorbidity and impaired quality of life in both. However, features associated with fatigue in patients with microscopic colitis (MC) are less clear.
MATERIALS AND METHODS
We conducted a cross-sectional survey of patients with a new diagnosis of MC including levels of anxiety, depression, somatization, quality of life, and IBS-type symptoms. Levels and impact of fatigue were assessed using the Inflammatory Bowel Disease Fatigue self-assessment scale. Mean scores were compared against various patient characteristics, and were also correlated with anxiety, depression, somatization, and quality-of-life scores.
RESULTS
In total, 129 patients with MC diagnosed between 2010 and 2015 returned completed postal questionnaires. Common histological subtypes were collagenous colitis (53.5%, = 69) and lymphocytic colitis (38.8%, = 50). Higher mean fatigue severity and impact scores were associated with the presence of irritable-bowel-syndrome-type symptoms, abnormal levels of anxiety and depression, and high levels of somatization ( < 0.0001 for all), but those reporting ongoing symptoms attributable to MC did not report significantly higher scores. There were significant positive correlations between total anxiety, depression, or somatization scores and fatigue severity and impact scores, and significant negative correlations with quality-of-life measures ( < 0.001 for all).
CONCLUSIONS
Fatigue in MC appears to be associated with reporting IBS-type symptoms, psychological comorbidity and impaired quality of life. It may therefore represent an important target for treatment.
PubMed: 30228831
DOI: 10.1177/1756284818799599