Body, Mind & Spirit Articles and Latest News

Ambulatory monitoring in the genetics of psychosomatic medicine.

Psychosom Med. 2012 May;74(4):349-55

Authors: Finan PH, Tennen H, Thoemmes F, Zautra AJ, Davis MC

Abstract
Psychosomatic disorders are composed of an array of psychological, biologic, and environmental features. The existing evidence points to a role for genetic factors in explaining individual differences in the development and maintenance of a variety of disorders, but studies to date have not shown consistent and replicable effects. As such, the attempt to uncover individual differences in the expression of psychosomatic disorders as a function of genetic architecture requires careful attention to their phenotypic architecture or the various intermediate phenotypes that make up a heterogeneous disorder. Ambulatory monitoring offers a novel approach to measuring time-variant and situation-dependent intermediate phenotypes. Recent examples of the use of ambulatory monitoring in genetic studies of stress reactivity, chronic pain, alcohol use disorders, and psychosocial resilience are reviewed in an effort to highlight the benefits of ambulatory monitoring for genetic study designs.

PMID: 22582332 [PubMed - in process]

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The gut microbiota and irritable bowel syndrome: friend or foe?

Int J Inflam. 2012;2012:151085

Authors: Ghoshal UC, Shukla R, Ghoshal U, Gwee KA, Ng SC, Quigley EM

Abstract
Progress in the understanding of the pathophysiology of irritable bowel syndrome (IBS), once thought to be a purely psychosomatic disease, has advanced considerably and low-grade inflammation and changes in the gut microbiota now feature as potentially important. The human gut harbours a huge microbial ecosystem, which is equipped to perform a variety of functions such as digestion of food, metabolism of drugs, detoxification of toxic compounds, production of essential vitamins, prevention of attachment of pathogenic bacteria to the gut wall, and maintenance of homeostasis in the gastrointestinal tract. A subset of patients with IBS may have a quantitative increase in bacteria in the small bowel (small intestinal bacterial overgrowth). Qualitative changes in gut microbiota have also been associated with IBS. Targeting the gut microbiota using probiotics and antibiotics has emerged as a potentially effective approach to the treatment of this, hitherto enigmatic, functional bowel disorder. The gut microbiota in health, quantitative and qualitative microbiota changes, and therapeutic manipulations targeting the microbiota in patients with IBS are reviewed in this paper.

PMID: 22577594 [PubMed - in process]

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Mothers of infants with congenital heart defects: well-being from pregnancy through the child’s first six months.

Qual Life Res. 2012 Feb;21(1):115-22

Authors: Dale MT, Solberg O, Holmstrøm H, Landolt MA, Eskedal LT, Vollrath ME

Abstract
PURPOSE: This study compared the well-being among mothers of children with congenital heart defects (CHD) with mothers of children without CHD (controls), at pregnancy and at 6 months postpartum.
METHODS: We linked prospective data from the Norwegian Mother and Child Cohort Study (MoBa), conducted by the Norwegian Institute of Public Health, with a nationwide medical CHD registry. In the MoBa cohort of 61,456 mothers, we identified 212 mothers of infants with mild (n = 92), moderate (n = 50), or severe CHD (n = 70). Subjective well-being was operationalized by means of maternal life satisfaction, joy, and anger at the 30th week of gestation and at 6 months postpartum.
RESULTS: Subjective well-being in mothers of children with CHD remained unchanged and similar to that of controls on satisfaction with life (P = 0.120) and feelings of joy (P = 0.065). However, at child age 6 months, mothers of infants with severe CHD reported slightly elevated feelings of anger compared with controls (P = 0.006).
CONCLUSIONS: Joy and life satisfaction remained intact among mothers of children with CHD. Yet, elevated feelings of anger in mothers of children with the most severe CHD suggest that they may experience more frustration.

PMID: 21544659 [PubMed - indexed for MEDLINE]

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Longitudinal predictors of health-related quality of life in middle-aged and older adults with hypertension: results of a population-based study.

J Hypertens. 2012 Apr 19;

Authors: Maatouk I, Wild B, Herzog W, Wesche D, Schellberg D, Schöttker B, Müller H, Rothenbacher D, Stegmaier C, Brenner H

Abstract
OBJECTIVE:: The aim of the study was to assess the longitudinal association between cardiovascular risk factors including albuminuria and other variables (e.g. awareness of hypertension, number of types of antihypertensive drugs, comorbidity), and health-related quality of life (HRQOL) in a large cohort of patients with hypertension, over a follow-up period of 5 years. METHODS:: Nine thousand nine hundred and fifty-three participants of the ESTHER (Epidemiologische Studie zu Chancen der Verhütung, Früherkennung und optimierten Therapie chronischer Erkrankungen) study - a population-based cohort study of middle-aged and older adults aged 50-74 years at baseline - were recruited by general practitioners (GPs) in 2000-2002 and included in the follow-up (2005-2007). HRQOL at baseline and follow-up was measured using the Short-Form General Health Survey (SF-12). Mental component scores (MCS) and physical component scores (PCS) were calculated. Multiple linear regression models were used to determine longitudinal predictors of HRQOL at follow-up. RESULTS:: Four thousand, two hundred and three patients with hypertension (98.2%) responded to the SF-12 both at baseline and after 5 years and were therefore included in the study. Smoking status, BMI, diabetes, macroalbuminuria, comorbid diseases, history of depression, and lower HRQOL at baseline predicted lower PCS at the 5-year follow-up. Lower MCS after 5 years was predicted by smoking status, dyslipidaemia, a reported history of depression, and HRQOL at baseline. No significant association was detected between awareness of hypertension and any HRQOL component score after 5 years. CONCLUSIONS:: Macroalbuminuria and other variables related to increased cardiovascular risk have a negative impact on PCS. Suggestions of a link of treatment and awareness of hypertension with HRQOL from previous cross-sectional studies are not supported by our longitudinal findings.

PMID: 22573129 [PubMed - as supplied by publisher]

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Decision-making in oncology: a selected literature review and some recommendations for the future.

Curr Opin Oncol. 2012 May 8;

Authors: Ménard C, Merckaert I, Razavi D, Libert Y

Abstract
PURPOSE OF REVIEW: Decision-making in oncology is associated with uncertainty and potential decisional conflict. The purpose of this paper is to review strategies suggested to improve treatment decision-making, discuss their limits and describe recommendations that have been made to improve the decision-making process. RECENT FINDINGS: To improve the decision-making process, uncertainty reduction, shared decision-making and multidisciplinary teamwork have been initially proposed. Due to their limits, alternative approaches such as uncertainty management, collaborative decision-making and collaborative multidisciplinary teamwork have been recommended. Uncertainty management considers uncertainty as a multilevel concept. It may be achieved through collaborative decision-making and collaborative multidisciplinary teamwork. Collaborative decision-making is an in-depth personalized iterative assessment of patient medical, psychological and social status. It promotes the patient’s proactive role as a key stakeholder of decision-making and the physician’s proactive role as a key support to patient decision-making. Collaborative multidisciplinary teamwork promotes an optimal environment for collaborative decision-making in which patients are key stakeholders and all relevant healthcare professionals are actively involved. These approaches require developing interventions for patients, and trainings for physicians and multidisciplinary teams. SUMMARY: On the basis of these recent approaches, we propose a ‘three-step model of multidisciplinary collaborative treatment decision-making’ in oncology. This model should be tested for its validity.

PMID: 22572724 [PubMed - as supplied by publisher]

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Sexual force at sexual debut. Swedish adolescents with disabilities at higher risk than adolescents without disabilities.

Child Abuse Negl. 2012 May 8;

Authors: Brunnberg E, Boström ML, Berglund M

Abstract
The aims of this study are first to compare the incidence of force on the first occasion of sexual intercourse reported by participants with disabilities to that of students without disabilities; second to determine whether there are significant differences in mental health, substance abuse, and school performance as reported by participants forced into their sexual debut as opposed to those who were not forced, analysed by gender; and finally to identify the significant variables that predict girls reporting force at sexual debut as opposed to girls not reporting force, as well as to identify similar variables within the male group. There were no data on sexual abuse prior to the first occasion of full sexual intercourse. METHOD: This cross-sectional study is based on 2 surveys: Life and Health—Young People 2005 and 2007. All 17/18-year-old adolescents in upper-secondary schools in a county in Sweden were asked the same questions both years. A total of 2,254 students completed the survey in 2005 and 2,641 in 2007. RESULTS: The main finding is that force at sexual debut (intercourse) is more common among adolescents with a disability (4.0%) than those not reporting any disability (1.6%), and is most common among those reporting multiple disabilities (10.4%). This was found both for girls and boys, even if the rates for girls were several times higher. Other findings are that girls and boys reporting force at sexual debut (disability and non-disability groups taken together) reported different profiles. For girls, their country of origin and who they live with are significant. This background data is not significant for boys. Boys report a strong psychosomatic reaction. CONCLUSION: Culture-, functionality-, and gender-sensitive studies of adolescents’ reactions to sexual abuse are needed to help determine relevant and effective interventions.

PMID: 22571912 [PubMed - as supplied by publisher]

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Letter to the Editor: Spinal Cord Stimulation. Is There Still a Role for Psychosomatic Conditions?

Neurosurgery. 2012 May 7;

Authors: Grasso G, Graziano F, Iacopino DG

PMID: 22569061 [PubMed - as supplied by publisher]

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Motivational determinants of interpersonal distress: How interpersonal goals are related to interpersonal problems.

Psychother Res. 2012 May 8;

Authors: Thomas A, Kirchmann H, Suess H, Bräutigam S, Strauss BM

Abstract
Abstract This study aimed to link interpersonal goals with interpersonal problems and psychological distress and to investigate changes in these variables during an inpatient psychotherapeutic treatment. Two hundred and fifty-eight patients treated in a psychosomatic hospital completed the German versions of the Circumplex Scales of Interpersonal Values, the Inventory of Interpersonal Problems, and the Outcome Questionnaire before and at the end of their treatment. Patients initially reported a strong need for bonding in the CSIV. Especially interpersonal goals related to avoidant, submissive, and altruistic behavior were associated with a wide range of different interpersonal problems, and were associated with more psychological distress. At the end of treatment, patients showed no substantial changes in their predominant communal goals, but significantly reduced submissive goals. Additionally, changes of these goals were associated with changes of various interpersonal problems and psychological distress. Focusing the value patients place on submissive experiences could help to improve interpersonal problems.

PMID: 22568475 [PubMed - as supplied by publisher]

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Neural Correlates of Moral Reasoning in Autism Spectrum Disorder.

Soc Cogn Affect Neurosci. 2012 May 7;

Authors: Schneider K, Pauly KD, Gossen A, Mevissen L, Michel TM, Gur RC, Schneider F, Habel U

Abstract
In our study, we tried to clarify whether patients with autism spectrum disorder (ASD) reveal different moral decision patterns as compared to healthy subjects and whether common social interaction difficulties in ASD are reflected in altered brain activation during different aspects of moral reasoning.28 patients with high-functioning ASD and 28 healthy subjects matched for gender, age, and education took part in an event-related functional magnetic resonance imaging study. Participants were confronted with textual dilemma situations followed by proposed solutions to which they could agree or disagree.On a neural level, moral decision making was associated with activation in anterior medial prefrontal regions, the temporo-parietal junction (TPJ), and the precuneus for both groups. However, while patients and healthy controls did not exhibit significant behavioral differences, ASD patients showed decreased activation in limbic regions, particularly the amygdala, as well as increased activation in the anterior and the posterior cingulate gyrus during moral reasoning.Alterations of brain activation in patients might thus indicate specific impairments in empathy. However, activation increases in brain regions associated with the “default mode network” and self-referential cognition also provide evidence for an altered way of patients’ cerebral processing with regard to decision making based on social information.

PMID: 22569187 [PubMed - as supplied by publisher]

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Set shifting and working memory in adults with attention-deficit/hyperactivity disorder.

J Neural Transm. 2012 Jan;119(1):95-106

Authors: Rohlf H, Jucksch V, Gawrilow C, Huss M, Hein J, Lehmkuhl U, Salbach-Andrae H

Abstract
Compared to the high number of studies that investigated executive functions (EF) in children with attention-deficit/hyperactivity disorder (ADHD), a little is known about the EF performance of adults with ADHD. This study compared 37 adults with ADHD (ADHD(total)) and 32 control participants who were equivalent in age, intelligence quotient (IQ), sex, and years of education, in two domains of EF–set shifting and working memory. Additionally, the ADHD(total) group was subdivided into two subgroups: ADHD patients without comorbidity (ADHD(-), n = 19) and patients with at least one comorbid disorder (ADHD(+), n = 18). Participants fulfilled two measures for set shifting (i.e., the trail making test, TMT and a computerized card sorting test, CKV) and one measure for working memory (i.e., digit span test, DS). Compared to the control group the ADHD(total) group displayed deficits in set shifting and working memory. The differences between the groups were of medium-to-large effect size (TMT: d = 0.48; DS: d = 0.51; CKV: d = 0.74). The subgroup comparison of the ADHD(+) group and the ADHD(-) group revealed a poorer performance in general information processing speed for the ADHD(+) group. With regard to set shifting and working memory, no significant differences could be found between the two subgroups. These results suggest that the deficits of the ADHD(total) group are attributable to ADHD rather than to comorbidity. An influence of comorbidity, however, could not be completely ruled out as there was a trend of a poorer performance in the ADHD(+) group on some of the outcome measures.

PMID: 21626411 [PubMed - indexed for MEDLINE]

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