Oesophageal hypervigilance and visceral anxiety relate to reflux symptom severity and psychological distress but not to acid reflux parameters

Author(s):  
Ming‐Wun Wong ◽  
Tso‐Tsai Liu ◽  
Chih‐Hsun Yi ◽  
Wei‐Yi Lei ◽  
Jui‐Sheng Hung ◽  
...  
2020 ◽  
Vol 10 (4) ◽  
pp. 1355-1364 ◽  
Author(s):  
Anouk van der Heide ◽  
Marjan J. Meinders ◽  
Bastiaan R. Bloem ◽  
Rick C. Helmich

Background: The ongoing COVID-19 pandemic has many consequences for people with Parkinson’s disease (PD). Social distancing measures complicate regular care and result in lifestyle changes, which may indirectly cause psychological stress and worsening of PD symptoms. Objective: To assess whether the COVID-19 pandemic was associated with increased psychological distress and decreased physical activity in PD, how these changes related to PD motor and non-motor symptom severity, and what frequency and burden of COVID-related stressors were. Methods: We sent an online survey to the Personalized Parkinson Project (PPP) cohort (n = 498 PD patients) in the Netherlands. In the survey, we distinguished between COVID-related stressor load, psychological distress, PD symptom severity, and physical activity. We related inter-individual differences to personality factors and clinical factors collected before the pandemic occurred. Results: 358 PD patients completed the survey between April 21 and May 25, 2020 (response rate 71.9%). Patients with higher COVID-related stressor load experienced more PD symptoms, and this effect was mediated by the degree of psychological distress. 46.6% of PD patients were less physically active since the COVID-19 pandemic, and reduced physical activity correlated with worse PD symptoms. Symptoms that worsened most were rigidity, fatigue, tremor, pain and concentration. Presence of neuropsychiatric symptoms (anxiety, depression) before the pandemic, as well as cognitive dysfunction and several personality traits predicted increased psychological distress during the COVID-19 pandemic. Conclusion: Our findings show how an external stressor (the COVID-19 pandemic) leads to a worsening of PD symptoms by evoking psychological distress as well as lifestyle changes (reduced physical activity).


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e033986
Author(s):  
Nicol Holtzhausen ◽  
Haider Mannan ◽  
Nasim Foroughi ◽  
Phillipa Hay

ObjectivesThis study examined formal and informal healthcare use (HCU) in community women with disordered eating, and associations of HCU with mental health-related quality of life (MHRQoL), psychological distress, mental health literacy (MHL) and eating disorder (ED) symptoms over time.HypothesisWe hypothesised that HCU would lead to improvement in ED symptom severity, MHRQoL, MHL and psychological distress.Design, setting, participantsData were from years 2, 4 and 9 of a longitudinal cohort of 443 community women (mean age 30.6, SE 0.4 years) with a range of ED symptoms, randomly recruited from the Australian Capital Territory electoral role or via convenience sampling from tertiary education centres. Data were collected using posted/emailed self-report questionnaires; inclusion criteria were completion of the HCU questionnaire at time point of 2 years (baseline for this study). HCU was measured using a multiple-choice question on help seeking for an eating problem. To test the effect of HCU over time on MHRQoL (Short Form-12 score), psychological distress (Kessler Psychological Distress Scale score), ED symptom severity (Eating Disorder Examination Questionnaire score) and ED–MHL, linear or logistic mixed-effects regression analyses were used.Results20% of participants sought ED-specific help at baseline; more than half of participants sought help that was not evidence based. HCU at baseline was significantly associated with improved MHRQoL and ED symptom severity and decreased psychological distress over time (Cohen’s d all >0.3, ie, small). HCU was not significantly associated with MHL over time. The predictive ability of the fitted models ranged from 32.18% to 42.42% for psychological distress and MHL treatment, respectively.ConclusionsFormal and informal HCU were associated with small improvements in ED symptoms, MHRQoL and psychological distress but not with improved MHL. Informal services in ED management should be investigated further along with efforts to improve ED–MHL.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1857-1857
Author(s):  
K. Kyriaki Kosidou ◽  
C. Dalman ◽  
M. Lundberg ◽  
J. Hallqvist ◽  
G. Isacsson ◽  
...  

IntroductionIt is not well known whether the association between common mental disorders and low socioeconomic status vary with symptom severity, type of socioeconomic indicator or gender.ObjectivesTo study the association between socioeconomic status and risk for different severity levels of psychological distress as well as depression.MethodsA population-based survey was conducted among a random sample of Stockholm County residents aged 18–84 years in 2002, and respondents were reassessed via a follow-up questionnaire in 2007. Participants in both surveys (n = 23 794) were categorized according to socioeconomic status at baseline and followed up for onset of psychological distress (according to the twelve-item general health questionnaire) and depression (according to health data registers).ResultsOccupational class had little impact on risk for distress regardless of severity or gender, but was strongly associated with onset of depression - albeit only in men (ORs being 3.0 [95% CI 1.5–5.9] in men and 1.1 [95% CI (0.7–1.7]) in women, comparing unskilled manual workers with higher non-manual workers). Income was associated with risk for onset of all outcomes and the association grew stronger with symptom severity. High household income was particularly protective of depression in women. Education was unrelated to either outcome in men and women overall.ConclusionsWhile psychological distress appears to occur at a similar rate regardless of socioeconomic position, risks for severe distress and especially clinically overt depression are markedly linked with occupational class in men and with family income in women. The socioeconomic gradient in common mental disorders increases with symptom severity.


2018 ◽  
Vol 27 (3) ◽  
pp. 257-263 ◽  
Author(s):  
Mădălina Radu ◽  
Ramona Moldovan ◽  
Sebastian Pintea ◽  
Adriana Băban ◽  
Dan Dumitrașcu

Background & Aims: Cognitive behavioural therapy (CBT) has small to medium effects in alleviating emotional distress and psychosomatic symptoms in irritable bowel syndrome (IBS). However, the mechanism through which CBT exerts its effects is less studied. Mediation analysis examines the extent to which intermediate variables explain the effect of the intervention on outcomes. The meta-analysis aims to identify and assess the impact of CBT mediators identified in previous research on IBS. Methods: An extensive search of studies investigating the effects of CBT for IBS published before January 2018 was conducted. A total of 699 studies were identified through database search and 6 studies including data from 638 patients were analysed. The selected studies had to clearly define the CBT intervention, include IBS patients, report sufficient data to allow calculation of effect sizes and provide a clear mediation analysis of one or several variables on the outcome. Results: The total effect of CBT was significant for both categories of outcomes (i.e. IBS symptom severity and psychosocial distress), with a low-to-moderate effect on psychosocial distress (r=0.222) and a medium-to-large effect on IBS symptom severity (r=0.413). In fact, the total effect of CBT on IBS symptom severity is significantly higher than the total effect on psychosocial distress Q(1)= 5.06, p= 0.024. Both behaviours and emotions (r=0.158) as well as cognitions (r=0.141) generated significant mediated effects on psychosocial distress, with no significant differences between them (Q(1)= 0.05, p=0.825). Behaviours and emotions mediated 71.1% of the total effect of CBT on psychosocial distress and cognitions mediated 63.5% of the total effect. Conclusion: Although significant for both outcomes, the statistical analysis revealed CBT interventions have a greater effect on alleviating IBS symptoms severity rather than on reducing psychological distress. Of the mediators investigated, behaviours, emotions and cognitions seem to have a small to moderating effect in reducing IBS symptom and psychological distress.


2021 ◽  
Vol 12 ◽  
Author(s):  
Anna Vogel ◽  
Hannah Comtesse ◽  
Agnes Nocon ◽  
Anette Kersting ◽  
Winfried Rief ◽  
...  

Present-centered therapy (PCT) was originally developed as a strong comparator for the non-specific effects of psychotherapy in the treatment of posttraumatic stress disorder. PCT qualifies as a not strictly supportive treatment as it is structured and homework is assigned between sessions. It does not focus on cognitive restructuring or exposure. A growing body of literature supports its beneficial effects. For example, it demonstrated only slightly inferior effect sizes and lower dropout rates compared to that of trauma-focused cognitive behavioral therapy in several trials with patients suffering from posttraumatic stress disorder. The current study is the first to evaluate the feasibility and the treatment effects of PCT in adults with prolonged grief disorder (PGD). Meta-analyses on psychotherapy for PGD have yielded moderate effect sizes. N = 20 individuals suffering from PGD were treated with PCT by novice therapists as part of a preparation phase for an upcoming RCT in an outpatient setting. Treatment consisted of 20–24 sessions á 50 min. All outcomes were assessed before treatment, at post-treatment, and at the 3-month follow-up. The primary outcome, PGD symptom severity, was assessed using the Interview for Prolonged Grief-13. Secondary outcomes were self-reported PGD severity, depression, general psychological distress, and somatic symptom severity. Furthermore, therapists evaluated their experiences with their first PCT patient and the treatment manual. In intent-to-treat analyses of all patients we found a significant decrease in interview-based PGD symptom severity at post-treatment (d = 1.26). Decreases were maintained up to the 3-month follow-up assessment (d = 1.25). There were also significant decreases in self-reported PGD symptoms, depression, and general psychological distress. No changes were observed for somatic symptoms. The completion rate was 85%. Therapists deemed PCT to be a learnable treatment program that can be adapted to the patient's individual needs. The preliminary results of PCT as a treatment for PGD demonstrate large effects and indicate good feasibility in outpatient settings. The treatment effects were larger than those reported in meta-analyses. Thus, PCT is a promising treatment for PGD. Possible future research directions are discussed.


2009 ◽  
Vol 136 (5) ◽  
pp. A-119
Author(s):  
Motoyori Kanazawa ◽  
Olafur S. Palsson ◽  
Miranda A. Van Tilburg ◽  
Marsha J. Turner ◽  
Syed Ismail M. Thiwan ◽  
...  

Author(s):  
Darius Kalasauskas ◽  
Naureen Keric ◽  
Salman Abu Ajaj ◽  
Leoni von Cube ◽  
Florian Ringel ◽  
...  

Abstract Purpose The patients’ burden with asymptomatic meningiomas and patients with good clinical outcome after meningioma resection often remains neglected. In this study, we aimed to investigate the longitudinal changes of psychological distress and quality of life in these patient groups. Methods Patients with conservatively managed (CM) or operated (OM) meningiomas and excellent neurological status, who were screened for psychological distress during the follow-up visit (t1), were included. We performed a follow-up mail/telephone-based survey 3–6 months (t2) after t1. Distress was measured using Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), 36-item Short Form (SF-36), and Brief Fatigue Inventory (BFI). Results Sixty-two patients participated in t1 and 47 in t2. The number of patients reporting increased or borderline values remained high 3 months after initial presentation, with n = 25 (53%) of patients reporting increased anxiety symptom severity and n = 29 (62%) reporting increased depressive symptom severity values. The proportion of distressed patients according to a DT score remained similar after 3 months. Forty-four percent of patients reported significant distress in OM and 33% in CM group. The most common problems among distressed patients were fatigue (t2 75%) and worries (t2 50%), followed by pain, sleep disturbances, sadness, and nervousness. Tumor progress was associated with increased depression scores (OR 6.3 (1.1–36.7)). Conclusion The level of psychological distress in asymptomatic meningiomas and postoperative meningiomas with excellent outcome is high. Further investigations are needed to identify and counsel the patients at risk.


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