Een nieuwe rol voor stressfysiologie bij functionele lichamelijke klachten

The essential feature of functional somatic syndromes is the presence of symptoms without medical explanation. the syndromes have a high psychiatric co-morbidity, and stress and anxiety are assumed to play a role, at least in the maintenance of the complaints. Psychophysiological models traditionally attribute the symptoms to stress or anxiety-related disregulations in specific physiological mechanisms. In fact, however, there is no convincing empirical proof for such models. The idea of a direct coupling between self-reported symptoms and corresponding physiological disregulations thus seems hardly tenable. Therefore, we propose a reformulation of the potential role of stress physiology in diagnosing functional somatic symptoms. Physiological measures should not be used anymore to demonstrate explanatory physiological disregulations. They should instead be used to provide additional information about the state of activity of the central fear network . This alternative approach is based on the fact that self-reported and physiological manifestations of an emotional state are only loosely coupled, making both aspects complementary indicators of the brain activity involved. Physiological measures may thus provide additional information (above self-report) regarding emotional states implicated in functional complaints. A suggested application of this approach is to define sub-groups of functional somatic patients on the basis of similarities in disregulated physiological stress-response profiles. This in future may contribute to the development of more specific diagnostic tools and better tailored treatments

Титульные страницы и содержание

Chronic severe somatoform disorder (SFD) is resistant to treatment. In a prospective observational study, we evaluated an intensive multidisciplinary treatment focusing on body-related mentalization and acceptance. Patients included in the study were 183 (146 women, 37 men) of 311 eligible patients with chronic severe SFD, referred consecutively to a specialized tertiary care center between 2002 and 2009. Primary outcome measures were somatic symptoms (SCL-90) and health-related quality of life (EuroQol 5-Dimensional [EQ-5D]). These measures were assessed four times before treatment (on intake, twice during an observation period, at start of treatment) and four times after treatment (during follow-up for 2 years). Multilevel analysis was used to separate effects of time (maturation) and treatment. Results revealed significant improvements in SCL-90 somatic symptoms (d = 0.51), EQ-5D index (d = 0.27), and EQ visual analogue scale (d = 0.56). Significant reductions were also observed in SCL-90 anxiety, depression, and overall psychopathology as well as in medical consumption associated with psychiatric illness (Trimbos/iMTA Questionnaire for Costs Associated With Psychiatric Illness). Large interindividual differences were found in treatment outcome. The long-term improvement seen in many patients suggests that intensive multidisciplinary tertiary care treatment is a useful approach to chronic severe SFD

Історія польських поселень Володарсько-Волинського району

В даній роботі описано 10 сіл з переважаючим польським населенням, на що вказують архівні матеріали і опитування жителів сіл

Comparison between the Fourier and Wavelet methods of spectral analysis applied to stationary and nonstationary heart period data.

The aim of this study was to assess the error made by violating the assumption of stationarity when using Fourier analysis for spectral decomposition of heart period power. A comparison was made between using Fourier and Wavelet analysis (the latter being a relatively new method without the assumption of stationarity). Both methods were compared separately for stationary and nonstationary segments. An ambulatory device was used to measure the heart period data of 40 young and healthy participants during a psychological stress task and during periods of rest. Surprisingly small differences (<1%) were found between the results of both methods, with differences being slightly larger for the nonstationary segments. It is concluded that both methods perform almost identically for computation of heart period power values. Thus, the Wavelet method is only superior for analyzing heart period data when additional analyses in the time-frequency domain are required

Exaggerated perception of normal physiological responses to stress and hypercapnia in young women with numerous functional somatic symptoms

Objective: This study tested whether functional somatic symptoms are associated with exaggerated increases in self-reported anxiety and somatic complaints in response to stress and C