Insulin Resistance Is Associated with Multiple Chemical Sensitivity in a Danish Population-Based Study—DanFunD

Multiple chemical sensitivity (MCS) is a multisystem syndrome, and limited knowledge of its pathophysiology exists. Based on the population-based Danish cohort DanFunD, this study investigated metabolic health in people with MCS compared to individuals who did not have MCS. From 9656 cohort participants aged 18–76 years old, 1.95% were categorized as MCS individuals with comorbid functional somatic disorders (MCS + FSD, n = 188), and 1.13% were categorized as MCS without functional somatic disorders (MCS ÷ FSD, n = 109). MCS was characterized based on three criteria: the experience of symptoms upon exposure to common odors and airborne chemicals, symptoms related the central nervous systems and others organ symptoms, and significant impact on every day, social, and occupational life. The remaining study population without MCS or any other functional somatic disorders were regarded as controls. We used adjusted multiple linear regression with link-function to evaluate the associations between lipid and glucose metabolism markers and MCS. We also tested the odds ratio of metabolic syndrome in MCS. Results did not point to statistically significant associations between lipid biomarkers or metabolic syndrome and both MCS groups compared to the controls. We found that MCS individuals may be more insulin resistant and that MCS ÷ FSD may have an impaired glucose metabolism when compared to controls.

Diogenes Syndrome: Identification and Distinction from Hoarding Disorder

“Severe domestic squalor” or Diogenes syndrome is characterised by extreme self-neglect of environment, health, and hygiene, excessive hoarding, squalor, social withdrawal, and a distinct lack of concern or shame regarding one’s living condition. This report presents a case of a 51-year-old male admitted to the hospital psychiatric ward following the police removing him from his home. Police officers attended the man’s home following the alarm being raised by his stepfather that he had not been seen or heard from in 3 weeks. His home was covered in several feet of rubbish, rotting food, and debris and smelled intensely of rotting mould, urine, and faeces. He was found lying nude on top of garbage with a rug over him. Diogenes syndrome is highly comorbid with psychiatric and somatic disorders, including depression, obsessive-compulsive disorder, personality disorder, and stress. This case report provides a rare opportunity to better understand the distinction of Diogenes syndrome from the closely related condition hoarding disorder. Furthermore, creating an agreed-upon constellation of symptoms representative of Diogenes is essential to creating a formal Diagnostic and Statistical Manual of Mental Disorders (DSM) entry, which would facilitate the much-needed development of assessment measures to enable accurate diagnosis and treatment.

Social position and functional somatic disorders: The DanFunD study

Background and aim: It is generally accepted that functional somatic disorders (FSDs) are a product of biological, psychological, and social factors. Social position might be part of this complex, but the literature on this issue is currently heterogeneous and inconsistent. The aim of the present study was – in a population-based cohort – to test the hypothesis that lower social position would be associated with higher a risk of FSD. Method: The association between social position and FSD was examined in a cross-sectional study with various measures of social position (education as measured by vocational training; employment; cohabitation; subjective social status) and delimitations of FSD (irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, bodily distress syndrome, and symptom profiles). The associations were analyzed using logistic regressions to calculate odds ratios and 95% confidence intervals. Each social measure was analyzed independently and was adjusted for age and sex. Results: Lower levels of vocational training, being unemployed, and living alone were associated with higher risk of FSD, regardless of the FSD delimitation. There was also a significant negative association between subjective evaluated social status and FSD. The associations remained after multiple adjustments, and seemed to be strongest for the more severe FSD-types. Conclusions: Lower social position is associated with higher risk of FSD, especially the more severe FSD delimitations, which might constitute an especially vulnerable group. However, the mechanisms behind the relations remain unknown.

Psychotherapy for comorbid depression and somatic disorders: a systematic review and meta-analysis

Background The treatment of depression in patients with somatic disorders is crucial, given its negative impact on quality of life (QoL), functioning, and even on the somatic disease prognosis. We aimed to examine the most updated evidence on the effects of psychotherapy in patients with depression and somatic disorders, including HIV, oncological, cardiometabolic, and neurological disorders. Methods We conducted a meta-analysis of 75 randomized trials (8209 participants) of psychotherapy for adults with somatic disorders and a diagnosis or elevated symptoms of depression. Outcomes included depression, QoL, somatic health-related outcomes, and mortality. Results Psychotherapy significantly reduced the severity of depression at post-treatment across all categories of somatic disorders (Hedges'g = 0.65; 95% CI 0.52–0.79), with sustained effects at 6–11 months (g = 0.38; 95% CI 0.22–0.53) and at 12 months follow-up or longer (g = 0.13; 95% CI 0.04–0.21). Psychotherapy also showed significant effects on QoL (g = 0.26; 95% CI 0.17–0.35), maintained up to 11 months follow-up (g = 0.25; 95% CI 0.16–0.34). No significant effects were observed on the most frequently reported somatic health-related outcomes (glycemic control, pain), and neither on mortality. Heterogeneity in most analyses was very high, and only 29 (38%) trials were rated at low risk of bias (RoB). Conclusions Psychotherapy may be an effective treatment option for patients with depression and somatic disorders, with long-term effects on depression severity and QoL. However, these results should be interpreted with caution due to heterogeneity and RoB.

ANXIETY DISORDERS IN SOMATIC HOSPITAL PATIENTS "BEFORE" AND "AFTER"

В статье анализируются тревожные расстройства, возникающие на фоне вирусной пневмонии, вызванной коронавирусом SARS-CoV-19. Прослежены частота проявлений, формы нарушений, особенности тревоги во время инфекционного процесса у пациентов с тяжелыми соматическими заболеваниями. Отмечены изменения тревожных нарушений в процессе затягивания пандемии, свидетельствующие о снижении адаптационных способностей у людей с комбинированными соматическими нарушениями. The article analyzes anxiety disorders that occur against the background of viral pneumonia caused by the SARS-CoV-19 coronavirus. The frequency of manifestations, forms of disorders, features of anxiety during the infectious process in patients with severe somatic diseases were traced. Changes in anxiety disorders in the process of delaying the pandemic were noted, indicating a decrease in adaptive abilities in people with combined somatic disorders.

Psychological peculiarities of mental patient with the comorbid somatic pathology

The paper presents the results of a comprehensive psychodiagnostic study of the psychological characteristics of psychotic patients with schizophrenia with somatic disorders. Based on the results of the study, the features of the representation of mental and somatic illness in the minds of schizophrenic patients with somatic disorders were identified. It has been proven that an important role in the pathogenesis of the formation of psychiatric comorbidity in schizophrenia is played by the categories of self-esteem, awareness, perception and attitude to mental and somatic illness. It was revealed that patients with schizophrenia with cardiovascular disease (CVD), with low assessments of all health parameters, assessed themselves as mentally sicker than physically, and patients with schizophrenia with diabetes mellitus type 2 (DM 2) and obesity, with low assessments of all health parameters, assessed themselves as physically sicker than mentally. In addition, patients with CVD and obesity were more aware of the need for treatment of mental illness, while patients with DM 2 were more aware that their environment would consider it necessary to treat a mental disorder. It was also found that patients with schizophrenia with somatic diseases have significantly higher indicators of the level of threat of mental disorder than patients without somatic burden. The results of the study of attitudes towards somatic illness revealed that patients with schizophrenia were characterized by a predominance of maladaptive forms of attitudes toward the disease: anxious, hypochondriac and melancholic (in schizophrenia with CVD), anosognosic and dysphoric (in schizophrenia with diabetes mellitus and obesity), as well as apathetic (in schizophrenia with obesity). It is advisable to use the obtained results as specific targets of psycho-education and psychotherapeutic work and to take into account when developing complex programs for the treatment of schizophrenic patients with comorbid somatic disorders.

Interpreting softmax predictions of sleep stage classification models

<div>We used a dataset of nocturnal PSG recordings, collected as part of the Healthbed study, which main aim was development of technologies for sleep analyses. The dataset includes one clinical video-PSG recording for each subject, made according to the AASM recommendations in Sleep Medicine Center Kempenhaeghe Heeze, the Netherlands. The study included 96 (60 females) healthy subjects, with an age between 18 and 64. The exclusion criteria were: 1) any diagnosed sleep disorder, 2) a Pittsburgh Sleep Quality Index >= 6, or Insomnia Severity Index > 7, 3) indication of depression or anxiety disorder measured with the Hospital Anxiety and Depression Scale (score > 8), 4) pregnancy, shift work, use of any medication except for birth control medicine, and 5) presence of clinically relevant neurological or psychiatric disorders or other somatic disorders that could influence sleep.</div>

Interpreting softmax predictions of sleep stage classification models

<div>We used a dataset of nocturnal PSG recordings, collected as part of the Healthbed study, which main aim was development of technologies for sleep analyses. The dataset includes one clinical video-PSG recording for each subject, made according to the AASM recommendations in Sleep Medicine Center Kempenhaeghe Heeze, the Netherlands. The study included 96 (60 females) healthy subjects, with an age between 18 and 64. The exclusion criteria were: 1) any diagnosed sleep disorder, 2) a Pittsburgh Sleep Quality Index >= 6, or Insomnia Severity Index > 7, 3) indication of depression or anxiety disorder measured with the Hospital Anxiety and Depression Scale (score > 8), 4) pregnancy, shift work, use of any medication except for birth control medicine, and 5) presence of clinically relevant neurological or psychiatric disorders or other somatic disorders that could influence sleep.</div>

The effect of consumption of selected nutrients on the occurrence and course of depression

Depression is a disease characterized by both mental and somatic disorders. The 21st century turned out to be the time when depression became a real health threat not only to individuals but also to entire societies. There are many theories pointing to the causes of depression, but these immediate causes are still not definitively clear. Equivalent importance of neuroanatomical and psycho-social factors is indicated. Among the theories considered so far, there are biological, hormonal, neurotransmitter-related, describing the malfunctions of the limbic system and hypothalamus, psychological theories. The studies conducted so far show that psychosocial factors play an extremely important role in the etiology of depression. Symptoms of depression are very complex and multifaceted, and may vary in severity. As a result of studies on the risk factors for depression, a relationship between the deficiency of individual nutrients and the manifestation of depressive disorders has been shown. The aim of the study is to present the influence of particular nutrients on the occurrence and course of depression. A properly balanced diet, both quantitatively and qualitatively, has a positive effect on reducing the risk of depression, as well as improving the condition of people who already suffer from it. Among the nutrients of particular importance are vitamin D, magnesium, folic acid, tryptophan, zinc, omega-3 fatty acids, cobalamin, and some probiotic microorganisms.