Diagnostic assessment and clinical characteristics of patients suffering from Somatic Symptom and Related Disorders

Het onderzoek heeft plaatsgevonden bij het Topklinisch Centrum voor Lichaam, Geest en Gezondheid en was ingebed in de academische werkplaats Geestdrift, Tranzo, Tilburg University. Er is onderzoek gedaan naar de diagnostische kwaliteit van twee vragenlijsten (PHQ-15 en 4DKL) die gebruikt kunnen worden om somatoforme stoornissen vast te stellen. Daarnaast zijn andere kenmerken (alexithymie; het onvermogen om emoties te uiten, Type D persoonlijkheid en neurocognitief functioneren) van patiënten met somatische-symptoomstoornis (SSS) onderzocht, en hun invloed op de behandeling. De PHQ-15 en de 4DKL blijken ongeveer even goed bruikbaar als screener, maar enkel het gebruik van vragenlijsten is onvoldoende voor het stellen van de diagnose of om een duidelijk beeld te krijgen van de patiënt. Op het gebied van neurocognitief functioneren laten patiënten met SSS op meerdere domeinen (forse) stoornissen zien, die erger worden wanneer er ook sprake is van een comorbide depressie, hetgeen vaak het geval is. Alexithymie blijkt vaak voor te komen bij SSS maar blijkt niet van klinisch relevante invloed op de behandeluitkomsten. Type D persoonlijkheid blijkt wel gerelateerd aan een slechtere behandeluitkomst. Met name hoge niveaus van negatieve affectiviteit zijn geassocieerd met negatieve behandeluitkomst. Zowel neurocognitief functioneren als Type D persoonlijkheid zijn dus belangrijke klinische aspecten van patiënten met SSS om bij de diagnostiek en tijdens behandeling rekening mee te houden. Locatie: Cobbenhagengebouw, Aula (ingang via Koopmansgebouw) Wanneer: 18 april 2018 16.0

Substantial impact of COVID-19 on self-reported mental health of healthcare professionals in the Netherlands

Initially, the COVID-19 pandemic caused a continued pressure on professionals working in hospitals due to the increase of affected patients. At the moment, the pandemic continues but thanks to all kinds of measures (e.g., social distancing) workload seems to decrease at the hospitals. On the contrary, patients with long-lasting symptoms due to COVID-19 infection or the pandemic begin to merge at the mental healthcare institutions in the Netherlands but this also holds true for other countries. Furthermore, healthcare professionals are affected by safety measures such as working from home, which led to an increased feeling of stress and may have led to a misbalance in work and private life. As a result, the question whether healthcare employees in mental healthcare experience impaired mental health remains unclear and chances are fair that mental health problems such as exhaustion and burnout may be prevalent. This study describes an online survey in which mental health amongst mental healthcare professionals is investigated. About 1,300 professionals from a large number of mental healthcare institutions replied the survey. Around 50% of the respondents experienced increased levels of stress. Feelings of anxiety, anger, and sadness were also increasingly experienced due to the COVID-19 pandemic. Furthermore, 4.2% replied that they were considering resigning their jobs which is alarming considering the shortage of healthcare professionals in mental healthcare institutions. The results support the importance of treatment or support of professionals in mental healthcare that experience psychological ailments

Results of mental support for health care professionals and mental care during the COVID-19 pandemic

The coronavirus disease 2019 (COVID-19) resulted into a global pandemic and continues to thrive until vaccines have been successfully developed and distributed around the world. The outcomes of COVID-19 contaminations range from death to minor health-related complaints. Furthermore, and not less significant, the increasing pressure on local as well as global health care is rising. In The Netherlands but also in other countries, further intensified regulations are introduced in order to contain the second wave of COVID-19, primarily to limit the number contaminations but also to prevent the health care professionals for giving in to the rising pressure on them. The results of the campaign for health care professionals in The Netherlands show that health care professionals are increasingly searching for information regarding psychological symptoms such as feeling of uncertainty, pondering and advice regarding the support of care teams. In this short update, we provide the results of the previous campaign and stress the importance of support after COVID-19 based on these results

The moderating effect of the COVID-19 pandemic on the mental wellbeing of health care workers on sustainable employability:A scoping review

Sustainable employability (SE) amongst healthcare workers (HCW) is an important asset for healthcare institutions. However, SE is under strain due to high work pressure, a shortage of employees, and absenteeism amongst employees based on mental problems. These developments had already started before the COVID-19 pandemic. The aim of this review is to explore whether there is a moderating effect of the COVID-19 pandemic on the mental wellbeing of HCW in the context of SE. A double blinded systematic review was conducted for this article in accordance with preferred reporting items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were subjected to quality evaluation and narrative synthesis. The analysis of the selected literature led to the understanding that mental problems amongst HCW were already abundantly present before the COVID-19 pandemic. Mental health problems have increased in prevalence, severity, and variation. In general, a negative relation between (mental) health and SE exists. Our findings show that mental health problems have heavily impacted the SE of HCW: absenteeism has increased and perspective on work has changed. It is time to prioritize the mental health of HCW to prevent acute care capacity from declining even further and ending up in a vicious circle

Personality factors and cognitive functioning in patients with somatic symptom and related disorders

Objective Somatic symptom and related disorders (SSRD) are often complicated by cognitive symptoms, including reduced information processing speed, memory, and planning. Depression has been related to poor cognitive functioning in SSRD, but the role of underlying personality factors is poorly understood. This study investigates the association between personality factors (neuroticism, extraversion, openness, agreeableness, and conscientiousness) with cognitive functioning in patients with SSRD. Methods Data from 366 patients with SSRD from a tertiary care expert center (mean age = 42.1 years (SD = 13.4), 59.6% women) were analyzed using a cross-sectional design. Neuropsychological assessments included measures of information processing speed, memory, attention, and executive function. Personality factors were assessed using the NEO-FFI and depressive symptoms using the PHQ-9. Results Regression analyses showed associations between neuroticism with poorer performance on visual memory (B = −0.09, SE = 0.04, β = −0.14, p = .019), and planning (B = −0.09. SE = 0.02, β = −0.23, p < .001). Extraversion was also inversely associated with visual memory (B = −0.13, SE = 0.05, β = −0.18, p = .011) and planning (B = −0.07, SE = 0.03, β = −0.17, p = .021) and openness was associated with better visual memory (B = 0.17, SE = 0.05, β = 0.19, p = .002). These associations were attenuated but remained significant after adjusting for depressive symptoms. Conclusion Neuroticism, extraversion, and low openness were associated with lower cognitive functioning (particularly planning and visual memory) in patients with SSRD, which remained significant after taking depressive symptoms into account

The prevalence of anxiety and depression symptoms (ADS), persistent and chronic ADS among the adult general population and specific subgroups before and during the COVID-19 pandemic until December 2021

BackgroundIt is unclear to what extent the prevalence of moderate and severe anxiety and depression symptoms (ADS) is higher during the first 20 months after the COVID-19 outbreak than before the outbreak. The same holds for persistent and chronic ADS among the adult general population and subgroups (such as employed, minorities, young adults, work disabled).MethodsData were extracted from six surveys conducted with the Dutch longitudinal LISS panel, based on a traditional probability sample (N = 3493). Biographic characteristics and ADS (MHI-5 scores) were assessed in March–April 2019, November–December 2019, March–April 2020, November–December 2020, March–April 2021, and November–December 2021. Generalized estimating equations were conducted to examine differences in the prevalence of post-outbreak ADS, persistent and chronic ADS compared to the pre-outbreak prevalence in similar periods. The Benjamini-Hochberg correction for multiple testing was applied.ResultsAmong the general population chronic moderate ADS increased significantly but slightly in the period March–April 2020 to March–April 2021 compared to a similar period before the pandemic (11.9 % versus 10.9 %, Odds Ratio = 1.11). In the same period a somewhat larger significant increase in chronic moderate ADS was observed among 19–24 years old respondents (21.4 % versus 16.7 %, Odds Ratio = 1.35). After the Benjamini-Hochberg correction several other differences were no longer significant.LimitationsNo other mental health problems were assessed.ConclusionsThe Dutch general population and most of the assessed subgroups were relatively resilient given the limited increase or absence of increases in (persistent and chronic) ADS. However, young adults suffered from an increase of chronic ADS

Neurocognitive functioning in patients with conversion disorder/functional neurological disorder

Neurocognitive symptoms are common in individuals with somatic symptom and related disorders (SSRD), but little is known about the specific impairments in neurocognitive domains in patients with conversion disorder (CD)/functional neurological disorder (FND). This study examines neurocognitive functioning in patients with CD/FND compared to patients with other SSRD. The sample consisted of 318 patients. Twenty-nine patients were diagnosed with CD/FND, mean age 42.4, standard deviation (SD) = 13.8 years, 79.3% women, and 289 patients had other SSRD (mean age 42.1, SD = 13.3, 60.2% women). Patients completed a neuropsychological test battery that addressed a broad range of neurocognitive domains, including information processing speed, attention and executive functioning. Patients with CD/FND had clinically significant neurocognitive deficits in all neurocognitive domains based on normative data comparison. Patients with CD/FND also performed significantly worse than patients with other SSRD on information processing speed (Digit Symbol Substitution Test (V = .115, p = .035), Stroop Color-Word Test (SCWT) card 1 (V = .190, p = .006), and SCWT card 2 (V = .244, p < .001). No CD/FND vs. other SSRD differences were observed in other neurocognitive domains. These findings indicate the patients with CD/FND perform worse on information processing speed tests compared to patients with other SSRD

Psychometric properties of the Bermond-Vorst Alexithymia Questionnaire (BVAQ) in the general population and a clinical population

Introduction: The Bermond-Vorst Alexithymia Questionnaire (BVAQ) has been validated in student samples and small clinical samples, but not in the general population; thus, representative general-population norms are lacking. Aim: We examined the factor structure of the BVAQ in Longitudinal Internet Studies for the Social Sciences panel data from the Dutch general population (N = 974). Results: Factor analyses revealed a first-order five-factor model and a second-order two-factor model. However, in the second-order model, the factor interpreted as analyzing ability loaded on both the affective factor and the cognitive factor. Further analyses showed that the first-order test scores are more reliable than the second-order test scores. External and construct validity were addressed by comparing BVAQ scores with a clinical sample of patients suffering from somatic symptom and related disorder (SSRD) (N = 235). BVAQ scores differed significantly between the general population and patients suffering from SSRD, suggesting acceptable construct validity. Age was positively associated with alexithymia. Males showed higher levels of alexithymia. Discussion: The BVAQ is a reliable alternative measure for measuring alexithymia