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Increased sensitivity to supra-threshold painful stimuli in patients with multiple functional somatic symptoms (MFS).

Brain Res Bull. 2010 Mar 8;

Authors: Kuzminskyte R, Kupers R, Videbech P, Gjedde A, Fink P

Many patients in a variety of medical settings suffer from persistently painful bodily symptoms that are not explained by known pathophysiological mechanisms. In the most severe cases, these patients complain of multiple functional somatic symptoms (MFS). We tested the hypothesis of reduced pain threshold and pain tolerance levels in patients with MFS. Twenty-two patients with MFS and 27 age -and sex-matched healthy control subjects volunteered for this study. The subjects received innocuous and noxious thermal stimuli to the volar forearm by means of a Peltier contact heat probe. We assessed pain threshold and pain tolerance with an ascending staircase method. Anxiety levels and hemodynamic (blood pressure, pulse rate) and endocrine (cortisol and prolactin release) responses were measured before and after pain testing. We found no group differences for any of the physiological or self-rated subjective emotional responses to the pain stressor. Contrary to the hypothesis, the pain threshold was not lower in MFS; the data even showed a trend in the opposite direction. Pain tolerance scores were identical in the two groups but they correlated negatively with the number of functional somatic symptoms in MFS patients. Importantly, patients had a smaller temperature range between their pain threshold and pain tolerance scores, suggesting that they differentiate poorly within the noxious range. Minor increases in stimulus intensity of supra-threshold painful stimuli may lead to disproportionate increases in pain intensity in MFS patients, suggesting a defunct endogenous pain modulatory system.

PMID: 20223284 [PubMed - as supplied by publisher]

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Lack of Social Support in the Etiology and the Prognosis of Coronary Heart Disease: A Systematic Review and Meta-Analysis.

Psychosom Med. 2010 Mar 11;

Authors: Barth J, Schneider S, von Känel R

Objective: To conduct a systematic review and meta-analysis on the relevance of low social support for the development and course of coronary heart disease (CHD). Methods: Three electronic databases were searched (MEDLINE, PsycINFO/PSYNDEX, and Web of Science 2007/03). More than 1700 papers were screened in a first step. We included prospective studies assessing the impact of social support in either an initially healthy study population (etiologic studies) or in a study population with preexisting CHD (prognostic studies). Outcomes: Myocardial infarction in etiologic studies; cardiovascular mortality and all-cause mortality in prognostic studies. Effects were reported as relative risk (RR) or hazard ratio (HR). Results: There is some evidence for an impact of low functional social support on the prevalence of CHD in etiologic studies (RR, range, 1.00-2.23). In contrast, there is no evidence of an impact of low structural social support on the prevalence of myocardial infarction in healthy populations (RR, range, 1.01-1.2). In prognostic studies, results consistently show that low functional support negatively affects cardiac and all-cause mortality (pooled RR, range, 1.59-1.71). These results were also confirmed in analyses adjusted for other risk factors for disease progression (pooled HR, 1.59). It remains unclear whether low structural social support increases mortality in patients with CHD (pooled RR, between 1.56; pooled HR, 1.12, NS). Conclusions: Because the perception of social support seems important for CHD prognosis, monitoring of functional social support is indicated in patients with CHD, and interventions to increase the perception of positive social resources are warranted.

PMID: 20223926 [PubMed - as supplied by publisher]

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Altered cardiovascular adaptability in depressed patients without heart disease.

World J Biol Psychiatry. 2010 Apr;11(3):223-30

Authors: Ehrenthal JC, Herrmann-Lingen C, Fey M, Schauenburg H

Abstract Objectives. Despite its clinical importance and relevance for health care policy, the pathways between depression and stress regulation remain poorly understood. The objective of our study was to compare cardiovascular and autonomic responses to brief psychosocial stress in a group of severely depressed subjects without heart disease and a non-depressed control-group. Methods. We recorded cardiovascular and autonomic reactions to two different stress tasks including anger recall and mental arithmetic in a sample of 25 severely depressed and 25 non-depressed subjects. Aggregated data were compared with repeated-measures MANOVA. We used contrasts to evaluate different response patterns concerning cardiovascular and autonomic reactivity vs. recovery. Results. Depressed subjects showed overall reduced high-frequency heart rate variability and an altered cardiovascular adaptability concerning heart rate, blood pressure, cardiac output, and, on a trend level, peripheral resistance. With few exceptions, we found no differences between reactivity vs. recovery response patterns. Conclusions. Our results provide further evidence for altered cardiovascular reactivity and impaired cardiac autonomic functioning in depression. Further research is needed on psychophysiological response to either more disease-oriented or more personality-oriented stressors.

PMID: 20218928 [PubMed - in process]

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How Does Your Doctor Talk with You? Preliminary Validation of a Brief Patient Self-Report Questionnaire on the Quality of Physician-Patient Interaction.

J Clin Psychol Med Settings. 2010 Mar 10;

Authors: Bieber C, Müller KG, Nicolai J, Hartmann M, Eich W

The quality of physician-patient interaction is increasingly being recognized as an essential component of effective treatment. The present article reports on the development and validation of a brief patient self-report questionnaire (QQPPI) that assesses the quality of physician-patient interactions. Data were gathered from 147 patients and 19 physicians immediately after consultations in a tertiary care outpatient setting. The QQPPI displayed good psychometric properties, with high internal consistency and good item characteristics. The QQPPI total score showed variability between different physicians and was independent of patients’ gender, age, and education. The QQPPI featured high correlations with other quality-related measures and was not influenced by social desirability, or patients’ clinical characteristics. The QQPPI is a brief patient self-report questionnaire that allows assessment of the quality of physician-patient interactions during routine ambulatory care. It can also be used to evaluate physician communication training programs or for educational purposes.

PMID: 20217195 [PubMed - as supplied by publisher]

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Gender-specific differences associated with living donor liver transplantation: A review study.

Liver Transpl. 2009 Dec 16;16(3):375-386

Authors: Hermann HC, Klapp BF, Danzer G, Papachristou C

Living donor liver transplantation (LDLT) has developed into an important therapeutic option for liver diseases. For living donor kidney transplantation (LDKT), gender-specific differences have been observed among both donors (two-thirds being women and one-third being men) and recipients (two-thirds being men and one-third being women). The aim of this study was to determine whether there is a gender disparity for LDLT. We contacted 89 national and international transplantation registries, single transplant centers, and coordinators. In addition, a sample of 274 articles dealing with LDLT and its outcomes was reviewed and compared with the registry data. The data included the gender of the donors and recipients, the country of transplantation, and the donor-recipient relationship. The investigation showed that overall there were slightly more men among the donors (53% male and 47% female). As for the recipients, 59% of the organs were distributed to males, and 41% were distributed to females. Differences in the gender distribution were observed with respect to individual countries. Worldwide, 80% of the donors were blood-related, 11% were not blood-related, and 9% were spouses. The data acquired from the publications were similar to the registry data. Our research has shown that there are hardly any registry data published, a lot of countries do not have national registries, or the access to these data is difficult. Even widely ranging published studies often do not give information on the gender distribution or the donor-recipient relationship. Further investigations are needed to understand the possible medical, psychosocial, or cultural reasons for gender distribution in LDLT and the differences in comparison with LDKT. Liver Transpl 16:375-386, 2010. (c) 2009 AASLD.

PMID: 20209639 [PubMed - as supplied by publisher]

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The relationship between job-anxiety and trait-anxiety-A differential diagnostic investigation with the Job-Anxiety-Scale and the State-Trait-Anxiety-Inventory.

J Anxiety Disord. 2010 Feb 11;

Authors: Muschalla B, Linden M, Olbrich D

Job-related anxiety, in contrast to general trait-anxiety, is by its very nature associated with problems of participation at work. The aim of this study is to investigate the relation between general trait-anxiety and specific job-related anxiety and to examine whether job-anxiety and trait-anxiety are differently associated with sick leave. 190 inpatients of a psychosomatic and orthopaedic rehabilitation center with mental and somatic disorders filled in the Job-Anxiety-Scale (JAS) and the State-Trait-Anxiety-Inventory (STAI-T). Additionally, informations on age, gender, the current duration of sick leave in weeks, employment status, duration of unemployment, and position at the workplace were collected. Highest scores of job-anxiety were found for the JAS-dimensions “job-related worries” and “health anxieties”, followed by “cognitions of insufficiency,” “stimulus-related anxieties,” and “social anxieties.” JAS and STAI-T were significantly correlated. Job-anxiety, in contrast to trait-anxiety, was significantly related to duration of sick leave. Women showed higher scores on the STAI-T but not on the JAS. It can be concluded that job-anxiety is related to but not identical with trait-anxiety. Job-anxiety is important to understand sick leave and appears as a multidimensional and clinically important phenomenon.

PMID: 20207103 [PubMed - as supplied by publisher]

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Relationships among alexithymia and pain intensity, pain interference, and vitality in persons with neuromuscular disease: Considering the effect of negative affectivity.

Pain. 2010 Mar 4;

Authors: Hosoi M, Molton IR, Jensen MP, Ehde DM, Amtmann S, O’Brien S, Arimura T, Kubo C

Alexithymia, the inability to identify or label emotions, has been shown to be associated with pain in patients with a number of chronic pain conditions. We sought to: (1) replicate this association in samples of persons with chronic pain secondary to neuromuscular disease, (2) extend this finding to other important pain-related measures, and (3) to determine whether relationships among alexithymia and study variables existed after controlling for negative affect. One hundred and twenty-nine individuals with muscular dystrophy and chronic pain were administered measures of alexithymia (Toronto Alexithymia Scale, TAS-20), pain intensity (0-10 NRS), pain interference (Brief Pain Inventory Interference scale), mental health (SF-36 Mental Health scale; as a proxy measure of negative affect) and vitality (SF-36 Vitality scale). Higher TAS scores were associated significantly with higher pain intensity and interference, and less vitality. Although the strengths of these associations were reduced when mental health was used as a control, the associations between the Difficulty Identifying Feelings scale and vitality, and the Externally Oriented Thinking and Total TAS scales and pain intensity remained statistically significant. The findings replicate and extend previous findings concerning the associations between alexithymia and important pain-related variables in a sample of persons with chronic pain and neuromuscular disease. Future research is needed to determine the extent to which the associations are due to (1) a possible causal effect of alexithymia on patient functioning that is mediated via its effects on negative affect or (2) the possibility that alexithymia/outcome relationships reflect response bias caused by general negative affectivity.

PMID: 20207082 [PubMed - as supplied by publisher]

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Type-D personality and depersonalization are associated with suicidal ideation in the German general population aged 35-74: Results from the Gutenberg Heart Study.

J Affect Disord. 2010 Mar 3;

Authors: Michal M, Wiltink J, Till Y, Wild PS, Münzel T, Blankenberg S, Beutel ME

BACKGROUND: Suicidal ideation (SID) is a major risk factor for suicide attempts. Mental disorders are among the strongest correlates of suicide, with depression and anxiety disorders playing a major role. The present study aims to investigate the contribution of under researched factors contributing to SID such as depersonalization, Type-D personality and cardiovascular risk factors. METHODS: Factors associated with SID were investigated in a sample of N=5000 participants (aged 35-74years) of the community-based survey “Gutenberg Heart Study”. The factors were assessed by self-report instruments, computer-assisted interviews and medical examination. RESULTS: 7.5% of the sample reported SID over the last 2weeks. In the univariate analysis SID was significantly associated with female sex, living without a partner, low socioeconomic status, diagnosis of coronary heart disease, family history of myocardial infarction, smoking and mental distress. In the full adjusted model significant associations remained with age (in years) OR 1.02 (95%CI 1.01-1.04, p=0.002), self-reported depression OR 3.21 (95%CI 2.23-4.62, p<0.0001), panic disorder OR 1.56 (95%CI 1.03-2.36, p=0.036), depersonalization OR 2.45 (95%CI 1.78-3.38, p<0.0001), Type-D personality OR 1.98 (95%CI 1.49-2.63, p<0.0001) and impairment by mental distress OR 2.15 (95%CI 1.74-2.67, p<0.0001). LIMITATIONS: Main limitations are the reliance on self-report measures of SID and of mental distress. CONCLUSIONS: For the first time it has been shown that in the general population depersonalization and Type-D personality are uniquely associated with SID. These associations need further elucidation.

PMID: 20206385 [PubMed - as supplied by publisher]

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[Peculiarities of psychophysiological status of flying staff of fighter aircraft of land basing]

Voen Med Zh. 2009 Dec;330(12):36-40

Authors:

It was investigated the influence of professional activity on psychophysiological peculiarities of fighter pilot of different types of aircraft of land basing and afloat aircraft. As a result of investigation, it was determined that on base of social parameters they are equal. Airmen of the aviation of land basing have a similar personality profile, but different types of interpersonal relations. Station of depletion among airmen of the aviation of land basing was absent. Among airmen of afloat aircraft every third had a forming stage of depletion, characterized by emotional deficit, personal suspension, psychosomatic and psychovegetative disorders.

PMID: 20201368 [PubMed - in process]

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Development and Factorial Validation of a Short Version of the Narcissism Inventory (NI-20).

Psychopathology. 2010 Feb 27;43(3):150-158

Authors: Daig I, Burkert S, Fischer HF, Kienast T, Klapp BF, Fliege H

Background: Narcissism is seen as a normal but heterogeneously formed personality variable, ranging from ‘grandiosity-exhibitionism’ to ‘vulnerability-sensitivity’. This article reports the development and factorial validation of a short version of a narcissism inventory. Sampling and Methods: The sample includes data of 4,509 consecutive psychosomatic inpatients. The overall sample was divided in 2 equally sized randomized subsamples. One sample (n = 2,262) was used for exploratory factor analysis (principal component analysis). The other sample (n = 2,265) was used for confirmatory tests of the model fit of the newly built NI-20 version, and to analyze the model fit separately for men and women using structural equation modeling with AMOS software. Results: The short version (NI-20) consists of 20 items, with items representing almost all of the original 18 subscales and 4 second-order dimensions. The NI-20 possesses properties similar to the NI-90, with a considerable gain in test economy. The 4-factor structure of the NI-20 was confirmed, and reaches good fit indices. Conclusions: The NI-20 is an economical instrument with acceptable psychometric characteristics that reflects the heterogeneous aspects of narcissism. A methodological limitation is that the interactions between sociodemographic variables were not included as potential predictors.

PMID: 20197708 [PubMed - as supplied by publisher]

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