BACKGROUND With the growing scholarly and clinical fascination with somatic symptom dis-order(SSD),a bibliometric analysis is lacking.AIM To conduct a bibliometric analysis to investigate the current status and fronti...BACKGROUND With the growing scholarly and clinical fascination with somatic symptom dis-order(SSD),a bibliometric analysis is lacking.AIM To conduct a bibliometric analysis to investigate the current status and frontiers of SSD.METHODS The documents related to SSD are obtained from the web of science core collection database(WoSCC),and VOSviewer 1.6.16 from January 1,2000 to December 31,2023,and the WoSCC’s literature analysis wire were used to conduct the biblio-metric analysis.RESULTS A total of 567 documents related to SSD were included,and 2325 authors across 947 institutions from 57 countries/regions have contributed to SSD research,published in 277 journals.The most productive author,institution,country and journal were Löwe B,University of Hamburg,Germany,and Journal of Psycho-somatic Research respectively.The first high-cited document was published in the Journal of Psychosomatic Research in 2013 by Dimsdale JE and colleagues,which explored the rationale behind the SSD diagnosis introduction in diagnostic and statistical manual of mental disorders.CONCLUSION In conclusion,the main research hotspots and frontiers in the field of SSD are validity and reliability of the SSD criteria,functional impairment of SSD,and the treatment for SSD.More high-quality studies are needed to assess the diagnosis and treatment of SSD.展开更多
In many places in the world, General Practitioners are only able to identify depression in a small fraction of depressed patients presenting to general outpatient department. The effect of somatic symptoms on its reco...In many places in the world, General Practitioners are only able to identify depression in a small fraction of depressed patients presenting to general outpatient department. The effect of somatic symptoms on its recognition was investigated. The study determines the identification rate of depression by general practitioners among outpatients with somatic symptoms and those without somatic symptoms. This descriptive cross sectional study was conducted in Family Medicine Department, Aminu Kano Teaching Hospital, Kano, Nigeria. The Hospital Anxiety and Depression Scale (HADS) was used to screen selected participants. Forms were used by GPs to itemize medical and psychiatric symptoms elicited as well as medical and psychiatric diagnoses made. Schedule for Clinical Assessment in Neuropsychiatry (SCAN) version 2.1, was used to confirm the diagnosis of depression. Hamilton Depression Rating Scale (HDRS) was used for severity using items 11-14 of Hamilton Depression Rating Scale. Those with somatic symptoms score of 1-3 were rated as having low and those with 4-10 were rated as having high. Of the 410 outpatients recruited, 402 participated in the study. Two hundred and thirteen were screened depressed (HADS). Two hundred were confirmed depressed using SCAN (49.8%). The GPs identified 31.3% of those participants diagnosed depressed without somatic symptoms compared to 15.2% of those who were diagnosed depressed with somatic symptoms. However, no significant association was found between GPs ability to identify depression in the presence or absence of somatic symptoms (p = 0.09). This study found no association between GPs ability to identify depression and presence or absence of somatic symptoms (χ2 = 2.75, p = 0.09). However, this study found that the higher the level of somatic symptoms the more unlikely it’s for GPs to identify depression. To reduce the burden of depression by early detection and treatment, continuing medical education of GPs should include skills in identification of depression.展开更多
Background: Somatic symptoms that are not attributable to organic pathology are common in general practice settings however, data in most parts of Africa including southern Nigeria are still scarce. The aim of our stu...Background: Somatic symptoms that are not attributable to organic pathology are common in general practice settings however, data in most parts of Africa including southern Nigeria are still scarce. The aim of our study was to examine such somatic symptoms reported by patients attending a primary care facility at a tertiary hospital in southern Nigeria as well as to motivate future research in this area. Method: The study was conducted at the General Out Patient Clinic (GOPC) of the University of Calabar Teaching Hospital (UCTH). It was a cross sectional study in which data were obtained from the case notes of 115 patients that presented in the clinic with somatic complaints which could not be attributed to organic pathology by their physicians. Results: While 46 of the patients were males, 69 were females. Their mean age was 37.7 (SD = 11.9). Internal heat, crawling sensation, body pains and palpitations were the most prevalent symptoms reported by the patients. When the symptoms were sorted into various groups, the “subjective abnormal bodily sensation” was the most prevalent and far outnumbered the “pseudo neurological symptoms”. Conclusion: A number of patients attending the GOPC of the UCTH seek consultations for medically unexplained somatic symptom. The most prevalent of these symptoms are internal heat and crawling sensations both of which are not stated in the criteria recognized by the International Classification of Diseases—version 10 (ICD-10) for the diagnosis of psychiatric disorders.展开更多
With the new category of somatic symptom disorder/bodily distress disorder in ICD-11,research into pathogenetic and therapeutic pathways is stimulated.By turning away from the definition of somatoform disorders as“th...With the new category of somatic symptom disorder/bodily distress disorder in ICD-11,research into pathogenetic and therapeutic pathways is stimulated.By turning away from the definition of somatoform disorders as“the lack of something physical explaining everything”,this new classification might offer a way to put the focus on the individual patient’s psychodynamic balance and conflicts and their condensation in the symptom.Modelling and simulation have a long history in science to gain insight also into complex phenomena.Considering the evolution of precision medicine many different parameters are meanwhile operationalised and ready for consequent process research.Calculation models have to fit to the complexity of this disorder category.In an interdisciplinary discourse between computer and medical/psychoanalytic scientists a multilayer,fine grained calculation model is elaborated.Starting from a clinical case history,within iterative discussion,by acknowledging the demand for interdisciplinary synergy and cooperation in science,psychoanalytic theory served as the basis for computer-scientific information technique.A parallelisation with the Mealy model helped to establish a meaningful calculation possibility for further process research.How psychic transformations can be understood properly in order to provide meaningful treatments,the respective training,and to conduct appropriate process-and outcome-research is established in simulating the mind and applications.展开更多
BACKGROUND: This cross-sectional study aimed to assess the association between self-reported somatic and mental symptoms and the presence of major depressive disorder (MDD) and suicidal risk among community dwellers i...BACKGROUND: This cross-sectional study aimed to assess the association between self-reported somatic and mental symptoms and the presence of major depressive disorder (MDD) and suicidal risk among community dwellers in Japan. METHODS: From two locations in Japan, we recruited 734 community dwellers who underwent an annual health screening. Basic symptoms of MDD, dysthymia, and the presence of associated suicidal risk were determined using a brief structured diagnostic psychiatric interview, Mini International Neuropsychiatric Interview (MINI). Information regarding self-reported somatic and mental symptoms was obtained from a self-administered questionnaire used in the annual health check-up. Suicidal risk was evaluated on the basis of six relevant questions asked in MINI. Logistic regression model was used to calculate age- and gender-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for MDD. Further adjustment for basic symptoms of MDD was performed to calculate ORs and CIs for suicidal risk. RESULTS: A myriad of somatic symptoms, including headache, heavy headedness, eye strain, and shoulder stiffness [adjusted OR (95% CI), 11.4 (1.22 - 107) at location 1;5.17 (1.23 - 21.7) at location 2], were associated with the presence of MDD. Dysmenorrhea [6.07 (1.14 - 32.3) at location 1] and dysesthesia, arthralgia, and swelling in the extremities [2.72 (1.14 - 6.47) at location 2] were significantly associated with an increase in suicidal risk, independent of the presence of basic symptoms of MDD. CONCLUSION: Several somatic symptoms, especially pain-related ones, may serve as possible signs of depression and suicidal risk among community dwellers.展开更多
Objective: Treatment of psychiatric patients with psychosomatic or somatic symptoms needs special attention. Methods: We examined correlates, change and recovery from depression among psychiatric patients (n = 150) du...Objective: Treatment of psychiatric patients with psychosomatic or somatic symptoms needs special attention. Methods: We examined correlates, change and recovery from depression among psychiatric patients (n = 150) during the assessment of their work ability. Patients were referred to an open psychiatric ward during 8/2004-9/2005. Psychiatric diseases were diagnosed with the ICD-10 by the psychiatrist, but also the Structured Clinical Interview for DSM-IV (SCID I and II) was conducted. The patients replied to questionnaires after admission and before discharge including questions on life changes, somatic health, psychosocial and health-related factors as well as psychometric scales for depression (BDI), life satisfaction (LS) and general psychopathology (SCL). RESULTS. At baseline, 75% of the patients reported clinically significant depression (BDI > 15) and a quarter of them experienced their depression as severe (BDI ≥ 30). Whereas, according to ICD-10 guidelines, 91% of the patients suffered from depressive disorder and 66% of them from major depression. The average duration of inpatient evaluation was 24 (SD 9, 4) days. Baseline poor general health, life dissatisfaction, psychosomatic symptoms, bodily pains as well as poor financial situation and adverse life events predicted prevailing depression at discharge. Clinical symptoms improved significantly, especially among younger patients, recovery could not be reached by the time of discharge. Conclusions: Psychiatric patients with somatic complaints tended to under-rate their depression. To enhance their recovery, long-term and individually planned out-patient treatment and surveillance are needed.展开更多
This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is consi...This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is largely congruent with the concepts of somatoform and somatic symptom disorders. Roughly 50% of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity. IBS concepts, treatment approaches, as well as health care structures should acknowledge its variability and multidimensionality by: (1) awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS; (2) general and collaborative care rather than specialist and separated care; and (3) implementation of “interface disorders” to abandon the dualistic classification of purely organic or purely mental disorders.展开更多
Objective: This study is to investigate the clinical therapeutic effects and safety of treating mild or moderate depression with somatic symptoms with electroacupuncture combined with Fluoxetine. Methods: 95 cases of ...Objective: This study is to investigate the clinical therapeutic effects and safety of treating mild or moderate depression with somatic symptoms with electroacupuncture combined with Fluoxetine. Methods: 95 cases of mild or moderate depression with somatic symptoms were randomly divided into a Fluoxetine group, and an electroacupuncture plus Fluoxetine group. Hamilton Depression Scale (HAMD) was used for the assessment of clinical therapeutic effects and Treatment Emergent Symptom Scale (TESS) was used for assessment of adverse reactions. Results: The total effective rate was 77.27% in the Fluoxetine group and 78.26% in the electroacupuncture plus Fluoxetine group, showing no statistically significant difference between these two groups (P>0.05). However, the treatment took effect after two weeks in the electroacupuncture plus Fluoxetine group but after four weeks in Fluoxetine group. During this time, a better therapeutic effect on depression with mild or moderate somatic symptoms was found in the electroacupuncture plus Fluoxetine group, which also had fewer adverse reactions than the Fluoxetine group. Conclusion: Electroacupuncture combined with Fluoxetine takes effect faster for relieving the somatic symptoms with fewer adverse reactions. It is worth popularizing clinically.展开更多
BACKGROUND The clinical presentation of gastroesophageal reflux disease(GERD) shows a large symptom variation also in different intensities among patients. As several studies have shown, there is a large overlap in th...BACKGROUND The clinical presentation of gastroesophageal reflux disease(GERD) shows a large symptom variation also in different intensities among patients. As several studies have shown, there is a large overlap in the symptomatic spectrum between proven GERD and other disorders such as dyspepsia, functional heartburn and/or somatoform disorders.AIM To prospectively evaluate the GERD patients with and without somatoform disorders before and after laparoscopic antireflux surgery.METHODS In a tertiary referral center for foregut surgery over a period of 3 years patients with GERD, qualifying for the indication of laparoscopic antireflux surgery, were investigated prospectively regarding their symptomatic spectrum in order to identify GERD and associated somatoform disorders. Assessment of symptoms was performed by an instrument for the evaluation of somatoform disorders[Somatoform Symptom Index(SSI) > 17]. Quality of life was evaluated by Gastrointestinal Quality of Life Index(GIQLI).RESULTS In 123 patients an indication for laparoscopic antireflux surgery was established and in 43 patients further medical therapy was suggested. The portion of somatoform tendencies in the total patient population was 20.48%(34 patients).Patients with a positive SSI had a preoperative GIQLI of 77(32-111). Patients with a normal SSI had a GIQLI of 105(29-140)(P < 0.0001). In patients with GERD the quality of life could be normalized from preoperative reduced values of GIQLI102(47-140) to postoperative values of 117(44-144). In patients with GERD and somatoform disorders, the GIQLI was improved from preoperative GIQLI 75(47-111) to postoperative 95(44-122)(P < 0.0043).CONCLUSION Patients with GERD and associated somatoform disorders have significantly worse levels of quality of life. The latter patients can also benefit from laparoscopic fundoplication, however they will not reach a normal level.展开更多
文摘BACKGROUND With the growing scholarly and clinical fascination with somatic symptom dis-order(SSD),a bibliometric analysis is lacking.AIM To conduct a bibliometric analysis to investigate the current status and frontiers of SSD.METHODS The documents related to SSD are obtained from the web of science core collection database(WoSCC),and VOSviewer 1.6.16 from January 1,2000 to December 31,2023,and the WoSCC’s literature analysis wire were used to conduct the biblio-metric analysis.RESULTS A total of 567 documents related to SSD were included,and 2325 authors across 947 institutions from 57 countries/regions have contributed to SSD research,published in 277 journals.The most productive author,institution,country and journal were Löwe B,University of Hamburg,Germany,and Journal of Psycho-somatic Research respectively.The first high-cited document was published in the Journal of Psychosomatic Research in 2013 by Dimsdale JE and colleagues,which explored the rationale behind the SSD diagnosis introduction in diagnostic and statistical manual of mental disorders.CONCLUSION In conclusion,the main research hotspots and frontiers in the field of SSD are validity and reliability of the SSD criteria,functional impairment of SSD,and the treatment for SSD.More high-quality studies are needed to assess the diagnosis and treatment of SSD.
文摘In many places in the world, General Practitioners are only able to identify depression in a small fraction of depressed patients presenting to general outpatient department. The effect of somatic symptoms on its recognition was investigated. The study determines the identification rate of depression by general practitioners among outpatients with somatic symptoms and those without somatic symptoms. This descriptive cross sectional study was conducted in Family Medicine Department, Aminu Kano Teaching Hospital, Kano, Nigeria. The Hospital Anxiety and Depression Scale (HADS) was used to screen selected participants. Forms were used by GPs to itemize medical and psychiatric symptoms elicited as well as medical and psychiatric diagnoses made. Schedule for Clinical Assessment in Neuropsychiatry (SCAN) version 2.1, was used to confirm the diagnosis of depression. Hamilton Depression Rating Scale (HDRS) was used for severity using items 11-14 of Hamilton Depression Rating Scale. Those with somatic symptoms score of 1-3 were rated as having low and those with 4-10 were rated as having high. Of the 410 outpatients recruited, 402 participated in the study. Two hundred and thirteen were screened depressed (HADS). Two hundred were confirmed depressed using SCAN (49.8%). The GPs identified 31.3% of those participants diagnosed depressed without somatic symptoms compared to 15.2% of those who were diagnosed depressed with somatic symptoms. However, no significant association was found between GPs ability to identify depression in the presence or absence of somatic symptoms (p = 0.09). This study found no association between GPs ability to identify depression and presence or absence of somatic symptoms (χ2 = 2.75, p = 0.09). However, this study found that the higher the level of somatic symptoms the more unlikely it’s for GPs to identify depression. To reduce the burden of depression by early detection and treatment, continuing medical education of GPs should include skills in identification of depression.
文摘Background: Somatic symptoms that are not attributable to organic pathology are common in general practice settings however, data in most parts of Africa including southern Nigeria are still scarce. The aim of our study was to examine such somatic symptoms reported by patients attending a primary care facility at a tertiary hospital in southern Nigeria as well as to motivate future research in this area. Method: The study was conducted at the General Out Patient Clinic (GOPC) of the University of Calabar Teaching Hospital (UCTH). It was a cross sectional study in which data were obtained from the case notes of 115 patients that presented in the clinic with somatic complaints which could not be attributed to organic pathology by their physicians. Results: While 46 of the patients were males, 69 were females. Their mean age was 37.7 (SD = 11.9). Internal heat, crawling sensation, body pains and palpitations were the most prevalent symptoms reported by the patients. When the symptoms were sorted into various groups, the “subjective abnormal bodily sensation” was the most prevalent and far outnumbered the “pseudo neurological symptoms”. Conclusion: A number of patients attending the GOPC of the UCTH seek consultations for medically unexplained somatic symptom. The most prevalent of these symptoms are internal heat and crawling sensations both of which are not stated in the criteria recognized by the International Classification of Diseases—version 10 (ICD-10) for the diagnosis of psychiatric disorders.
文摘With the new category of somatic symptom disorder/bodily distress disorder in ICD-11,research into pathogenetic and therapeutic pathways is stimulated.By turning away from the definition of somatoform disorders as“the lack of something physical explaining everything”,this new classification might offer a way to put the focus on the individual patient’s psychodynamic balance and conflicts and their condensation in the symptom.Modelling and simulation have a long history in science to gain insight also into complex phenomena.Considering the evolution of precision medicine many different parameters are meanwhile operationalised and ready for consequent process research.Calculation models have to fit to the complexity of this disorder category.In an interdisciplinary discourse between computer and medical/psychoanalytic scientists a multilayer,fine grained calculation model is elaborated.Starting from a clinical case history,within iterative discussion,by acknowledging the demand for interdisciplinary synergy and cooperation in science,psychoanalytic theory served as the basis for computer-scientific information technique.A parallelisation with the Mealy model helped to establish a meaningful calculation possibility for further process research.How psychic transformations can be understood properly in order to provide meaningful treatments,the respective training,and to conduct appropriate process-and outcome-research is established in simulating the mind and applications.
文摘BACKGROUND: This cross-sectional study aimed to assess the association between self-reported somatic and mental symptoms and the presence of major depressive disorder (MDD) and suicidal risk among community dwellers in Japan. METHODS: From two locations in Japan, we recruited 734 community dwellers who underwent an annual health screening. Basic symptoms of MDD, dysthymia, and the presence of associated suicidal risk were determined using a brief structured diagnostic psychiatric interview, Mini International Neuropsychiatric Interview (MINI). Information regarding self-reported somatic and mental symptoms was obtained from a self-administered questionnaire used in the annual health check-up. Suicidal risk was evaluated on the basis of six relevant questions asked in MINI. Logistic regression model was used to calculate age- and gender-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for MDD. Further adjustment for basic symptoms of MDD was performed to calculate ORs and CIs for suicidal risk. RESULTS: A myriad of somatic symptoms, including headache, heavy headedness, eye strain, and shoulder stiffness [adjusted OR (95% CI), 11.4 (1.22 - 107) at location 1;5.17 (1.23 - 21.7) at location 2], were associated with the presence of MDD. Dysmenorrhea [6.07 (1.14 - 32.3) at location 1] and dysesthesia, arthralgia, and swelling in the extremities [2.72 (1.14 - 6.47) at location 2] were significantly associated with an increase in suicidal risk, independent of the presence of basic symptoms of MDD. CONCLUSION: Several somatic symptoms, especially pain-related ones, may serve as possible signs of depression and suicidal risk among community dwellers.
文摘Objective: Treatment of psychiatric patients with psychosomatic or somatic symptoms needs special attention. Methods: We examined correlates, change and recovery from depression among psychiatric patients (n = 150) during the assessment of their work ability. Patients were referred to an open psychiatric ward during 8/2004-9/2005. Psychiatric diseases were diagnosed with the ICD-10 by the psychiatrist, but also the Structured Clinical Interview for DSM-IV (SCID I and II) was conducted. The patients replied to questionnaires after admission and before discharge including questions on life changes, somatic health, psychosocial and health-related factors as well as psychometric scales for depression (BDI), life satisfaction (LS) and general psychopathology (SCL). RESULTS. At baseline, 75% of the patients reported clinically significant depression (BDI > 15) and a quarter of them experienced their depression as severe (BDI ≥ 30). Whereas, according to ICD-10 guidelines, 91% of the patients suffered from depressive disorder and 66% of them from major depression. The average duration of inpatient evaluation was 24 (SD 9, 4) days. Baseline poor general health, life dissatisfaction, psychosomatic symptoms, bodily pains as well as poor financial situation and adverse life events predicted prevailing depression at discharge. Clinical symptoms improved significantly, especially among younger patients, recovery could not be reached by the time of discharge. Conclusions: Psychiatric patients with somatic complaints tended to under-rate their depression. To enhance their recovery, long-term and individually planned out-patient treatment and surveillance are needed.
文摘This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is largely congruent with the concepts of somatoform and somatic symptom disorders. Roughly 50% of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity. IBS concepts, treatment approaches, as well as health care structures should acknowledge its variability and multidimensionality by: (1) awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS; (2) general and collaborative care rather than specialist and separated care; and (3) implementation of “interface disorders” to abandon the dualistic classification of purely organic or purely mental disorders.
文摘Objective: This study is to investigate the clinical therapeutic effects and safety of treating mild or moderate depression with somatic symptoms with electroacupuncture combined with Fluoxetine. Methods: 95 cases of mild or moderate depression with somatic symptoms were randomly divided into a Fluoxetine group, and an electroacupuncture plus Fluoxetine group. Hamilton Depression Scale (HAMD) was used for the assessment of clinical therapeutic effects and Treatment Emergent Symptom Scale (TESS) was used for assessment of adverse reactions. Results: The total effective rate was 77.27% in the Fluoxetine group and 78.26% in the electroacupuncture plus Fluoxetine group, showing no statistically significant difference between these two groups (P>0.05). However, the treatment took effect after two weeks in the electroacupuncture plus Fluoxetine group but after four weeks in Fluoxetine group. During this time, a better therapeutic effect on depression with mild or moderate somatic symptoms was found in the electroacupuncture plus Fluoxetine group, which also had fewer adverse reactions than the Fluoxetine group. Conclusion: Electroacupuncture combined with Fluoxetine takes effect faster for relieving the somatic symptoms with fewer adverse reactions. It is worth popularizing clinically.
文摘BACKGROUND The clinical presentation of gastroesophageal reflux disease(GERD) shows a large symptom variation also in different intensities among patients. As several studies have shown, there is a large overlap in the symptomatic spectrum between proven GERD and other disorders such as dyspepsia, functional heartburn and/or somatoform disorders.AIM To prospectively evaluate the GERD patients with and without somatoform disorders before and after laparoscopic antireflux surgery.METHODS In a tertiary referral center for foregut surgery over a period of 3 years patients with GERD, qualifying for the indication of laparoscopic antireflux surgery, were investigated prospectively regarding their symptomatic spectrum in order to identify GERD and associated somatoform disorders. Assessment of symptoms was performed by an instrument for the evaluation of somatoform disorders[Somatoform Symptom Index(SSI) > 17]. Quality of life was evaluated by Gastrointestinal Quality of Life Index(GIQLI).RESULTS In 123 patients an indication for laparoscopic antireflux surgery was established and in 43 patients further medical therapy was suggested. The portion of somatoform tendencies in the total patient population was 20.48%(34 patients).Patients with a positive SSI had a preoperative GIQLI of 77(32-111). Patients with a normal SSI had a GIQLI of 105(29-140)(P < 0.0001). In patients with GERD the quality of life could be normalized from preoperative reduced values of GIQLI102(47-140) to postoperative values of 117(44-144). In patients with GERD and somatoform disorders, the GIQLI was improved from preoperative GIQLI 75(47-111) to postoperative 95(44-122)(P < 0.0043).CONCLUSION Patients with GERD and associated somatoform disorders have significantly worse levels of quality of life. The latter patients can also benefit from laparoscopic fundoplication, however they will not reach a normal level.
