The plasma microRNA levels and their relationship with the general health and functional status in female patients with fibromyalgia syndrome

Objectives: The aim of this study was to identify the plasma level of micro-ribonucleic acid (microRNA) expressions and the relationship between plasma microRNA levels with the general health and functional status in female patients with fibromyalgia syndrome (FMS). Patients and methods: Thirty-five female patients (mean age: 42.0±11.8 years; range, 21 to 62 years) diagnosed as FMS and 35 sex-and age-matched healthy controls (mean age: 43.7±8.8 years; range, 21 to 56 years) were enrolled in the study. MicroRNA measurements of the participants in plasma were carried out by using the quantitative polymerase chain reaction (qPCR). A total of 11 plasma levels of microRNA expressions were examined in both groups. The general health and functional status of the patients and controls were assessed by the Fibromyalgia Impact Questionnaire (FIQ) and the Short Form-36 (SF-36) scale. Results: No significant difference was observed between the plasma levels of microRNA expressions in patients with FMS and healthy controls. The plasma level of miR-320a expression was found to be negatively correlated with the total FIQ score in female patients with FMS (p=0.05, r=-0.34). Negative correlations were also detected between the plasma level of miR-320a and miR-320b expressions and the subscale score of SF-36 physical function in female patients with FMS (p=0.01, r=-0.43 and p=0.01, r=-0.43, respectively). A strong positive correlation was found between miR-142-3p and the subscale score of SF-36 mental symptom score in female patients with FMS (p<0.001, r=1.00). Conclusion: The expression levels of microRNAs in plasma between female patients with FMS and controls were not significantly different. Only plasma levels of miR-320a, miR-320b, and miR-142-3p expressions were associated with the general health, functional status, and mental symptom score in female patients with FMS.

A historical perspective on neurological and neuropsychiatric definitions

Taking a historical epistemological perspective, this chapter explores how neurology and neuropsychiatry were constructed. As a medical specialism developing in the 19th century, neurology resulted from the convergence of: (1) the term ‘neurology’; (2) a set of concepts; and (3) a list of disorders. Such a convergence was facilitated by changes in the manner in which the concepts of neuroses, central nervous system, and lesion were to be defined after 1860. Neuropsychiatry carries a less stable epistemology. Underpinned by the foundational claim that mental diseases are diseases of the brain, its meaning has changed pari passu with redefinitions of the concepts such as mind, mental symptom, cause, and meaning. In the UK, there is no agreed definition of neuropsychiatry either and hence what is currently known as ‘organic/biological psychiatry’ and the claim that psychiatry is just a subregion of neurology cannot be considered as coterminous.

Prevalence of internet addiction in healthcare professionals: Systematic review and meta-analysis

Background: Internet addition is becoming increasingly recognised as an important mental health problem. Aim: This study examined prevalence of internet addiction in healthcare professionals. Method: Systematic literature review was undertaken of June 4, 2020 with goal to identify studies that evaluated prevalence of internet addiction or problematic internet use in medical professionals. Reported associations with other mental health symptoms were also considered. Results: Prevalence of internet addiction was studied in medical residents only ( n = 770; three studies), faculty members only ( n = 69; one study), nurses only ( n = 564; one study) and mixed samples of medical professionals ( n = 415; three studies). Pooled prevalence rate of internet addiction in 1,818 healthcare professionals was 9.7% (95% confidence interval: 5.8%–13.6%). Internet addiction was associated with greater mental symptom burden and fatigue of healthcare workers. Conclusion: Internet addiction is present in healthcare professionals, however, to a lesser extent than in medical students suggesting that increasing clinical responsibilities and increasing age can be important moderators of risk for internet addiction. Internet addiction is associated with greater burden of unfavourable mental health outcomes of healthcare professionals. Further studies exploring global burden of internet addiction in healthcare professionals and possible impact of internet addiction on work performance of healthcare professionals are encouraged.

Multimodal Treatment of Patients with Mental Symptom Load: A Pre–Post Comparison

The Traditional Chinese Medicine (TCM) Hospital in Bad Kötzting, Germany, is treating chronically ill patients, covering a broad range of indications. The aim of this study was to prove the efficacy of a multimodal intervention combining mainstream medicine with TCM treatments on the severity of psychopathological symptoms. Out of 966 patients with chronic psychosomatic disease treated 2017 at the TCM Hospital, we selected 759 patients according to specific criteria and analyzed the outcomes after multimodal intervention. The patients completed a validated questionnaire (International Statistical Classification of Diseases (ICD) Symptom-Rating-(ISR)) at admission, discharge, and follow-up. The most frequent ICD-10 diagnoses were “diseases of the musculoskeletal system and connective tissue” (28.5%), “mental and behavioral disorders” (23.7%), and “diseases of the nervous system” (13.8%). Regarding ISR symptom load, “depressive syndrome” and “anxiety syndrome” were the leading burdens showing remissions of about 40%–60% with moderate (0.588) to strong (1.115) effect sizes (Cohen’s d) after treatment. ISR total scores at discharge and follow-up were remarkably lower after intervention (0.64 and 0.75, respectively) compared to 1.02 at admission with moderate to strong effect sizes (0.512–0.815). These findings indicate a clinically relevant relief from mental symptom load after intervention with lasting clinical effects for at least six months.

Realizing Derealization

Derealization is a dissociative disorder with the primary symptom of experiencing one’s surroundings as unreal, as if one were living in an elaborate dream. The disorder is usually associated with depersonalization, although according to Philip M. Coons (1996), it should not be considered a subset of depersonalization. Little research has been conducted on derealization unaccompanied by depersonalization. The following highlights a personal case study in which the characteristics of derealization are presented in an attempt to distinguish it from depersonalization and other dissociative disorders. In addition, examples of derealization from a broader perspective help distinguish it from a purely diagnostic mental symptom, thereby suggesting that it could be more of a philosophical view of life rather than a mental disorder.

The theory of symptom complexes, mind and madness

Kahlbaum’s seminal approach to symptom complexes, as opposed to disease entities, is still relevant. Many psychopathologists have approached mental symptom complexes without prejudging them as necessary physical deficits or diseases, favouring a broader dimensional and anthropological view of mental disorders. Discussions of symptom complexes gained prominence in psychiatry in the early twentieth century – through Hoche – and in the period leading up to World War II – through Carl Schneider. Their works, alongside those of Kraepelin, Bumke, Kehrer, Jaspers and others, are reviewed in relation to the theme of symptom complexes, the mind, and mental disorders. A particular feature of symptom complexes is their relationship to aspects of the normal mind and how this affects clinical manifestations. It is further suggested that symptom complexes might offer a useful bridge between the psychic and the biological in theories of the mind.

The treatment to make home life peaceful

<p><strong>Background:</strong> Studies have reported that acupuncture using the specific pattern of needle placement is effective in treating the mental symptoms of Premenstrual syndrome (PMS).</p><p><strong>Methods:</strong> Subjects were 45 patients who received acupuncture using the specific pattern of needle placement. Acupuncture was performed by placing needles at certain combinations of acupuncture points. Needles were inserted only slightly by gently tapping the handle protruding from the guide tube. Patients underwent 6 acupuncture sessions in total, with 1 session taking place each week. Patients’ mental state before menses was assessed using the Stress Response Scale-18 (SRS-18). The SRS-18 was administered before and after treatments. The percentage of subjects whose total score on the SRS-18 decreased to 0.5 points or lower served as the rate of improvement. The percent decrease in a subject’s total score on the SRS-18 after treatment served as the extent of improvement.</p><p><strong>Results: </strong>The rate of improvement and the extent of improvement in total score on the SRS-18 were 77.8% (35/45), 0.37. The rate of effectiveness and the rate of satisfaction were respectively 91.1% (41/45), 75.6% (34/45). When asked “Is your home life peaceful?”, 51.1% (23/45) answered “ Yes “.</p><p><strong>Conclusions:</strong> The efficacy for mental symptom of PMS in shallow acupuncture using the specific pattern of needle placement was excellent, and this treatment made home life peaceful.</p>

The hermeneutics of mental symptoms in the Cambridge School

Current Psychiatry is in crisis. Decades of neuroscientific research have not yet delivered adequate explanations or treatments. One reason for this failure may be the wrongness of its central assumption, namely that mental symptoms and disorders are natural kinds. The Cambridge School has proposed that a new Epistemology must be constructed for Psychiatry, and that this should start with the development of a new model of mental symptom-formation. ‘Mental symptoms’ should be considered as hermeneutic co-constructions occurring in a intersubjective space created by the dialogue between sufferer and healer. Subjective experiences (caused either by neurobiological or psychosocial upheaval) penetrate the awareness of sufferers causing perplexity and/or distress. To understand, handle and communicate these experiences, sufferers proceed to configure them by means of templates borrowed from their own culture. Importantly, however, the same neurobiological information can be configured into different symptoms; and different neurobiological information into the same symptom. Therefore, ‘mental symptoms’ are dissimilar hybrid combinations of neurobiological and cultural information. To be ethical, therapeutic interventions must take into account such dissimilarities. Blind manipulation of the brain in all cases should be considered as counterproductive.