Over the last several years there has been a growing interest in placebo, not only as an inert control in clinical trials, but also in the placebo effect as a group effect as well as a reaction in individual subjects....Over the last several years there has been a growing interest in placebo, not only as an inert control in clinical trials, but also in the placebo effect as a group effect as well as a reaction in individual subjects. Methodological factors such as regression to the mean and natural history of the disease play a role in the evaluation of a possible placebo effect. In this report, we discuss several factors including PavIovian conditioning, beliefs outcome, expectations, and other factors as potential mediators of the placebo response. Placebo effects are common in gastrointestinal diseases and there seems to be no clear difference between placebo effects in functional gastrointestinal diseases （functional dyspepsia and irritable bowel syndrome） and organic gastrointestinal disease （duodenal ulcer and inflammatory bowel disease）.展开更多
Irritable bowel syndrome （IBS） and chronic pelvic pain （CPP） are both somatoform disorders with a high prevalence within the population in general. The objective was to compare both entities, to find the differenc...Irritable bowel syndrome （IBS） and chronic pelvic pain （CPP） are both somatoform disorders with a high prevalence within the population in general. The objective was to compare both entities, to find the differences and the similarities related to epidemiology and psychosocial aspects like stressful life events, physical and sexual abuse, illness behaviour and comorbidity. The technical literature was reviewed systematically from 1971 to 2006 and compared. According to literature, IBS and CPP seem to be one rather than two different entities with the same Iocalisation of pain. Both syndromes also are similar concerning prevalence, the coexistence of mental and somatoform disorders, the common history of sexual and physical abuse in the past and their health care utilization. It could be shown that there were many similarities between IBS and CPP. Nevertheless both are traded as different clinical pictures as far. Therefore it seems to be reasonable and necessary to generate a common diagnosis algorithm and to bring gynaecologists and gastroenterologists into dialogue.展开更多
Background Eye movement abnormality in schizophrenia has been studied for several decades.However,patient differences in eye movements across phases of schizophrenia from eye-tracking studies have not been well docume...Background Eye movement abnormality in schizophrenia has been studied for several decades.However,patient differences in eye movements across phases of schizophrenia from eye-tracking studies have not been well documented.Aims This pilot study used eye-tracking technology to investigate attentive bias towards interpersonal communication information across different clinical phases of schizophrenia.Methods This study included 78 persons at clinical high risk(CHR)for schizophrenia,68 first-episode(FEZ)patients,and 39 chronically ill patients from the Shanghai At Risk for Psychosis Extending Project(SHARP Extending cohort)as well as 74 healthy controls(HCs).The experiment was an unguided-viewing task composed of 24 trials showing three types of pictures which varied in the degree of interpersonal communication.Type 1 was a scenery picture without people,type 2 was a picture with four people not communicating,and type 3 was a picture with four people communicating.We used two measures:(1)initial fixation duration and(2)total fixation duration.Results A ratio for both measures was calculated between measures for pictures with more or less interpersonal communication.The ratio of initial fixation duration for pictures with people communicating versus pictures with people not communicating was lowest in chronically ill patients(0.13(0.34))compared with HCs(0.31(0.36)),FEZ patients(0.31(0.46)),and CHR patients(0.36(0.42)).The difference in the ratios of initial fixation duration for type 2 and type 3 pictures was also significant for female participants(HCs vs chronically ill patients,t=2.706,p=0.009;CHR patients vs chronically ill patients,t=4.079,p<0.001).In addition,the ratio of initial fixation duration on pictures with people not communicating versus pictures without people negatively correlated with participants’high-risk symptoms(r=−0.35,p=0.002)among the CHR group and also correlated with the negative symptom subscore on the Positive and Negative Syndrome Scale(PANSS)among chronically ill patients(r=−0.33,p=0.037).The ratio of initial fixation duration between type 1 and type 3 pictures was associated with PANSS negative symptoms only in female patients with schizophrenia(r=−0.46,p=0.004).Conclusions These findings suggest an altered attentive bias towards pictures with a high degree of interpersonal communication information across different clinical phases in schizophrenia.The ratio of initial attentive orienting was associated with negative symptoms in female patients.展开更多
Nausea and/or vomiting are aversive gastrointestinal （GI） symptoms. Nausea and vomiting manifest unconditionally alter a nauseogenic experience. However, there is correlative, quasiexperimental and experimental evid...Nausea and/or vomiting are aversive gastrointestinal （GI） symptoms. Nausea and vomiting manifest unconditionally alter a nauseogenic experience. However, there is correlative, quasiexperimental and experimental evidence that nausea and vomiting can also be learned via classical （Pavlovian） conditioning and might occur in anticipation of the nauseogenic event. Classical conditioning of nausea can develop with chemotherapy in cancer patients. Initially, nausea and vomiting occur during and alter the administration of cytotoxic drugs （post-treatment nausea and vomiting） as unconditioned responses （UR）. In addition, 20%-30% of cancer patients receiving chemotherapy report these side effects, despite antiemetic medication, when being re-exposed to the stimuli that usually signal the chemotherapy session and its drug infusion. These symptoms are called anticipatory nausea （AN） and/or anticipatory vomiting （ANV） and are explained by classical conditioning. Moreover, there is recent evidence for the assumption that post- chemotherapy nausea is at least partly influenced by learning. Alter summarizing the relevant assumptions of the conditioning model, revealing that a context can become a conditioned stimulus （CS）, the present paper summarizes data that nausea and/or vomiting is acquired by classical conditioning and, consequently, may be alleviated by conditioning techniques. Our own research has focussed on two aspects and is emphasized here. First, a conditioned nausea model was established in healthy humans using body rotation as the nausea- inducing treatment. The validity of this motion-sickness model to examine conditioning mechanisms in the acquisition and alleviation of conditioned nausea and associated endocrine and immunological responses is summarized. Results from the rotation-induced motion sickness model showed that gender is an important moderator variable to be considered in further studies. This paper concludes with a review of the application of the demonstrated conditioning principles as interventions to ameliorate distressing AN/ANV in cancer patients undergoing chemotherapy, which is the second focus of our work.展开更多
One fifth of the population report adverse reactions to food. Reasons for these symptoms are heterogeneous, varying from food allergy, food intolerance, irritable bowel syndrome to somatoform or other mental disorders...One fifth of the population report adverse reactions to food. Reasons for these symptoms are heterogeneous, varying from food allergy, food intolerance, irritable bowel syndrome to somatoform or other mental disorders. Literature reveals a large discrepancy between truly diagnosed food allergy and reports of food allergy symptoms by care seekers. In most studies currently available the characterization of patient groups is incomplete, because they did not distinguish between immunologic reactions and other kinds of food reactions. In analysing these adverse reactions, a thorough physical and psychological diagnostic approach is important. In our qualitative review, we present those diagnostic measures that are evidenced-based as well as clinically useful, and discuss the various psychological dimensions of adverse reactions to food. It is important to acknowledge the complex interplay between body and mind： Adults and children suffering from food allergy show impaired quality of life and a higher level of stress and anxiety. Pavlovian conditioning of adverse reactions plays an important role in maintaining symptoms. The role of personality, mood, or anxiety in food reactions is debatable. Somatoform disorders ought to be identified early to avoid lengthy and fiustrating investigations. A future task will be to improve diagnostic algorithms, to describe psychological aspects in clearly characterised patient subgroups, and to develop strategies for an optimized management of the various types of adverse reactions to food.展开更多
Research on gut-brain interactions has increased over the last decade and has brought about a number of new topics beyond ＂classical＂ subjects, such as ＂stress＂ and personality; which have dominated the psychosoma...Research on gut-brain interactions has increased over the last decade and has brought about a number of new topics beyond ＂classical＂ subjects, such as ＂stress＂ and personality; which have dominated the psychosomatic literature on gastrointestinal disorders over the past century. These novel topics include brain imaging of intestinal functions, placebo responses in gastroenterology, learning of gastrointestinal symptoms, quality of life in patients with intestinal complaints, and psychotherapy and familial aggregation of functional intestinal disorders. Currently, these new topics appear with a frequency of 1% to 3% in leading gastroenterological journals, either as data presentation or review papers. Increasing focus underlines the importance of enhandng our understanding on how the psyche and the brain communicate in order to better meet the needs of our patients.展开更多
Objective: The main purpose of the present study was to evaluate sleep duration for nighttime sleep from early infancy to late adolescence in a German sample to illustrate the developmental course and age-specific var...Objective: The main purpose of the present study was to evaluate sleep duration for nighttime sleep from early infancy to late adolescence in a German sample to illustrate the developmental course and age-specific variability of these variables among subjects. Methods: A total of 17,641 subjects from the KiGGS study were evaluated. The questionnaires contained questions about physical health, living circumstances, health behavior and risks, health supply, mental health, health-related quality of life and sleep. KiGGS assessed sleep by using parent questionnaire of children aged 0 to 10 years (n = 9944) and self-reports of adolescents (n = 7697) aged 11 to 17 years. Results: Total sleep duration decreased from 14.28 hours (SD = 2.33) at the ages 0 - 0.5 to 9.50 hours (SD = 0.82) at the ages of 10.5 - 11. Above the age of 11 adolescents report a decrease of sleep at night from 9.41 hours (SD = 1.33) at the age of 11 - 11.5 to 7.42 (SD = 1.73) at the age of 17.5 - 18 years. Unspecified sleep problems were reported of 19.5%, 13.0% of the children had difficulties falling asleep, difficulties sleeping through the night showed 8.8% of the children, whereas 3.0% report both symptoms—difficulties falling asleep and difficulties sleeping through the night. Conclusions: Age-specific variability of sleep duration is reported as well as sleep difficulties from infancy to adolescence. This is important knowledge for the health care professional who deals with sleep problems in pediatric practice.展开更多
文摘Over the last several years there has been a growing interest in placebo, not only as an inert control in clinical trials, but also in the placebo effect as a group effect as well as a reaction in individual subjects. Methodological factors such as regression to the mean and natural history of the disease play a role in the evaluation of a possible placebo effect. In this report, we discuss several factors including PavIovian conditioning, beliefs outcome, expectations, and other factors as potential mediators of the placebo response. Placebo effects are common in gastrointestinal diseases and there seems to be no clear difference between placebo effects in functional gastrointestinal diseases （functional dyspepsia and irritable bowel syndrome） and organic gastrointestinal disease （duodenal ulcer and inflammatory bowel disease）.
文摘Irritable bowel syndrome （IBS） and chronic pelvic pain （CPP） are both somatoform disorders with a high prevalence within the population in general. The objective was to compare both entities, to find the differences and the similarities related to epidemiology and psychosocial aspects like stressful life events, physical and sexual abuse, illness behaviour and comorbidity. The technical literature was reviewed systematically from 1971 to 2006 and compared. According to literature, IBS and CPP seem to be one rather than two different entities with the same Iocalisation of pain. Both syndromes also are similar concerning prevalence, the coexistence of mental and somatoform disorders, the common history of sexual and physical abuse in the past and their health care utilization. It could be shown that there were many similarities between IBS and CPP. Nevertheless both are traded as different clinical pictures as far. Therefore it seems to be reasonable and necessary to generate a common diagnosis algorithm and to bring gynaecologists and gastroenterologists into dialogue.
文摘Background Eye movement abnormality in schizophrenia has been studied for several decades.However,patient differences in eye movements across phases of schizophrenia from eye-tracking studies have not been well documented.Aims This pilot study used eye-tracking technology to investigate attentive bias towards interpersonal communication information across different clinical phases of schizophrenia.Methods This study included 78 persons at clinical high risk(CHR)for schizophrenia,68 first-episode(FEZ)patients,and 39 chronically ill patients from the Shanghai At Risk for Psychosis Extending Project(SHARP Extending cohort)as well as 74 healthy controls(HCs).The experiment was an unguided-viewing task composed of 24 trials showing three types of pictures which varied in the degree of interpersonal communication.Type 1 was a scenery picture without people,type 2 was a picture with four people not communicating,and type 3 was a picture with four people communicating.We used two measures:(1)initial fixation duration and(2)total fixation duration.Results A ratio for both measures was calculated between measures for pictures with more or less interpersonal communication.The ratio of initial fixation duration for pictures with people communicating versus pictures with people not communicating was lowest in chronically ill patients(0.13(0.34))compared with HCs(0.31(0.36)),FEZ patients(0.31(0.46)),and CHR patients(0.36(0.42)).The difference in the ratios of initial fixation duration for type 2 and type 3 pictures was also significant for female participants(HCs vs chronically ill patients,t=2.706,p=0.009;CHR patients vs chronically ill patients,t=4.079,p<0.001).In addition,the ratio of initial fixation duration on pictures with people not communicating versus pictures without people negatively correlated with participants’high-risk symptoms(r=−0.35,p=0.002)among the CHR group and also correlated with the negative symptom subscore on the Positive and Negative Syndrome Scale(PANSS)among chronically ill patients(r=−0.33,p=0.037).The ratio of initial fixation duration between type 1 and type 3 pictures was associated with PANSS negative symptoms only in female patients with schizophrenia(r=−0.46,p=0.004).Conclusions These findings suggest an altered attentive bias towards pictures with a high degree of interpersonal communication information across different clinical phases in schizophrenia.The ratio of initial attentive orienting was associated with negative symptoms in female patients.
文摘Nausea and/or vomiting are aversive gastrointestinal （GI） symptoms. Nausea and vomiting manifest unconditionally alter a nauseogenic experience. However, there is correlative, quasiexperimental and experimental evidence that nausea and vomiting can also be learned via classical （Pavlovian） conditioning and might occur in anticipation of the nauseogenic event. Classical conditioning of nausea can develop with chemotherapy in cancer patients. Initially, nausea and vomiting occur during and alter the administration of cytotoxic drugs （post-treatment nausea and vomiting） as unconditioned responses （UR）. In addition, 20%-30% of cancer patients receiving chemotherapy report these side effects, despite antiemetic medication, when being re-exposed to the stimuli that usually signal the chemotherapy session and its drug infusion. These symptoms are called anticipatory nausea （AN） and/or anticipatory vomiting （ANV） and are explained by classical conditioning. Moreover, there is recent evidence for the assumption that post- chemotherapy nausea is at least partly influenced by learning. Alter summarizing the relevant assumptions of the conditioning model, revealing that a context can become a conditioned stimulus （CS）, the present paper summarizes data that nausea and/or vomiting is acquired by classical conditioning and, consequently, may be alleviated by conditioning techniques. Our own research has focussed on two aspects and is emphasized here. First, a conditioned nausea model was established in healthy humans using body rotation as the nausea- inducing treatment. The validity of this motion-sickness model to examine conditioning mechanisms in the acquisition and alleviation of conditioned nausea and associated endocrine and immunological responses is summarized. Results from the rotation-induced motion sickness model showed that gender is an important moderator variable to be considered in further studies. This paper concludes with a review of the application of the demonstrated conditioning principles as interventions to ameliorate distressing AN/ANV in cancer patients undergoing chemotherapy, which is the second focus of our work.
文摘One fifth of the population report adverse reactions to food. Reasons for these symptoms are heterogeneous, varying from food allergy, food intolerance, irritable bowel syndrome to somatoform or other mental disorders. Literature reveals a large discrepancy between truly diagnosed food allergy and reports of food allergy symptoms by care seekers. In most studies currently available the characterization of patient groups is incomplete, because they did not distinguish between immunologic reactions and other kinds of food reactions. In analysing these adverse reactions, a thorough physical and psychological diagnostic approach is important. In our qualitative review, we present those diagnostic measures that are evidenced-based as well as clinically useful, and discuss the various psychological dimensions of adverse reactions to food. It is important to acknowledge the complex interplay between body and mind： Adults and children suffering from food allergy show impaired quality of life and a higher level of stress and anxiety. Pavlovian conditioning of adverse reactions plays an important role in maintaining symptoms. The role of personality, mood, or anxiety in food reactions is debatable. Somatoform disorders ought to be identified early to avoid lengthy and fiustrating investigations. A future task will be to improve diagnostic algorithms, to describe psychological aspects in clearly characterised patient subgroups, and to develop strategies for an optimized management of the various types of adverse reactions to food.
文摘Research on gut-brain interactions has increased over the last decade and has brought about a number of new topics beyond ＂classical＂ subjects, such as ＂stress＂ and personality; which have dominated the psychosomatic literature on gastrointestinal disorders over the past century. These novel topics include brain imaging of intestinal functions, placebo responses in gastroenterology, learning of gastrointestinal symptoms, quality of life in patients with intestinal complaints, and psychotherapy and familial aggregation of functional intestinal disorders. Currently, these new topics appear with a frequency of 1% to 3% in leading gastroenterological journals, either as data presentation or review papers. Increasing focus underlines the importance of enhandng our understanding on how the psyche and the brain communicate in order to better meet the needs of our patients.
文摘Objective: The main purpose of the present study was to evaluate sleep duration for nighttime sleep from early infancy to late adolescence in a German sample to illustrate the developmental course and age-specific variability of these variables among subjects. Methods: A total of 17,641 subjects from the KiGGS study were evaluated. The questionnaires contained questions about physical health, living circumstances, health behavior and risks, health supply, mental health, health-related quality of life and sleep. KiGGS assessed sleep by using parent questionnaire of children aged 0 to 10 years (n = 9944) and self-reports of adolescents (n = 7697) aged 11 to 17 years. Results: Total sleep duration decreased from 14.28 hours (SD = 2.33) at the ages 0 - 0.5 to 9.50 hours (SD = 0.82) at the ages of 10.5 - 11. Above the age of 11 adolescents report a decrease of sleep at night from 9.41 hours (SD = 1.33) at the age of 11 - 11.5 to 7.42 (SD = 1.73) at the age of 17.5 - 18 years. Unspecified sleep problems were reported of 19.5%, 13.0% of the children had difficulties falling asleep, difficulties sleeping through the night showed 8.8% of the children, whereas 3.0% report both symptoms—difficulties falling asleep and difficulties sleeping through the night. Conclusions: Age-specific variability of sleep duration is reported as well as sleep difficulties from infancy to adolescence. This is important knowledge for the health care professional who deals with sleep problems in pediatric practice.
