Search Results (915)

Background: Hwabyung is a psychosomatic condition characterized by suppressed anger accompanied by somatic distress. Although traditionally considered a culture-bound syndrome, evidence suggests that Hwabyung reflects culturally shaped manifestations of universal emotional and interoceptive processes. The Hwabyung Comprehensive Test (HCT) was developed to assess Hwabyung symptoms; however, its accuracy for clinical identification and differential discrimination requires further validation in clinically representative samples. Methods: Patients presenting Hwabyung symptoms were recruited from a university hospital and classified using a structured clinical interview as the reference standard. Participants were categorized into a Hwabyung group (HG; n = 100) and a non-Hwabyung group (NHG; n = 82), including a non-Hwabyung clinical group (NHCG; n = 36) and a non-clinical group (NCG; n = 46). The HCT symptom scale, including physical (HCT-P) and emotional (HCT-E) subscales, served as the index test. ROC analyses were conducted to evaluate diagnostic accuracy and optimal cut-off scores. Results: For distinguishing HG from NHG, HCT-total demonstrated good diagnostic accuracy for identifying Hwabyung, with an optimal cut-off score of 33.5 (sensitivity = 0.710, specificity = 0.820). In differentiating HG from NHCG, both HCT-total and HCT-P showed fair discriminative performance, with HCT-P exhibiting higher specificity. A cut-off score of 16.5 for HCT-P yielded a sensitivity of 0.540 and a specificity of 0.833. Conclusions: The HCT demonstrated good diagnostic accuracy for identifying Hwabyung and fair performance in differentiating it from psychiatric disorders. These findings support a stepwise clinical application in which HCT-total is used for initial screening and HCT-P is a supplementary measure for supporting differential diagnostic decision-making. Full article

We examined how sociodemographic, parental, and temporal factors are associated with parent-reported reasons for seeking consultation in a child and adolescent psychotherapeutic clinic. Data were derived from a large retrospective sample of more than 3000 cases collected between 2011 and 2023. Multivariable binary logistic regression analyses assessed the independent effects of age, gender, living arrangements, migration background, parental education, parental age at childbirth, parental separation or bereavement, and pandemic-related periods. School-aged children and adolescents were more likely than younger children to present with learning difficulties, depression, anxiety, mobbing and media addiction. Female patients showed lower odds of consultations related to learning difficulties, aggression, behavioral addiction, attention deficit/hyperactivity, but higher odds of depression, psychosomatic symptoms, anxiety, eating disorders and sleeping disorders. Parental separation increased the likelihood of consultations related to problematic social behavior within the family, delinquency and trauma and grief. Consultations for attention deficit/hyperactivity concerns were more frequent in the post-pandemic period compared to pre-pandemic. The findings highlight that sociodemographic, familial, and temporal factors are systematically associated with distinct patterns of parent-reported help-seeking patterns in child and adolescent psychotherapeutic care. Full article

Background: Refugees arriving from conflict zones often continue to experience trauma and are at increased risk of anxiety and depression. Those seeking asylum form a group at higher risk of suffering adverse mental health outcomes, with higher needs for psychosocial and therapeutic care. This study aimed to determine metabolic changes potentially associated with psychological distress in refugees from Syria, using a saliva-based metabolomics approach via proton nuclear magnetic resonance (1H NMR) spectroscopy. Methods: Participants were recruited from Lethbridge Family Services and categorized into high and low stress burden groups using questionnaires assessing depression (PHQ-9) and generalized anxiety (GAD-7). Salivary metabolomic profiles from 26 female and 32 male participants were analyzed using supervised and unsupervised multivariate statistical methods to identify metabolic differences linked to composite stress, depression, and anxiety. Results: Salivary metabolic profiles showed the most prominent differences associated with anxiety in female participants and depression in male participants. Multivariate statistical analyses identified 31 metabolites and 13 biological pathways that were significantly altered according to mental health status, with the greatest changes observed in glycolysis/gluconeogenesis, sphingolipid metabolism, and taurine/hypotaurine metabolism. Conclusions: These findings indicate that salivary 1H NMR metabolomic profiling can identify a quantifiable “metabolic fingerprint” related to impaired mental health and psychological distress in a cost-effective, objective, and non-invasive way. This analytical strategy shows potential as a screening tool to support effective decision-making, enabling early identification of individuals at highest risk who require timely emotional and medical support. Full article

Meditation-related difficulties have been systematically documented in contemporary contemplative science, yet the prescriptive resources preserved in the ancient Buddhist commentarial literature remain underutilized in comparative research. This study analyzes the case of five hundred monks in the Paramatthajotikā I’s commentary on the Karaṇīya-metta-sutta. During intensive practice, these monks experienced complex psychosomatic symptoms—perceptual disturbances, fear, somatic distress, and cognitive impairment—and received from the Buddha an integrated prescription of five protective practices (pañca rakkhā). Through Pāli textual and comparative analysis with Lindahl et al.’s taxonomy of meditation-related difficulties, this study demonstrates that the monks’ symptoms correspond systematically to the perceptual, affective, somatic, and cognitive domains of the modern taxonomy, with the critical difference residing in interpretive frameworks rather than in the phenomena themselves. The five practices—loving-kindness meditation, protective chant recitation, contemplation of impurity, mindfulness of death, and the arousal of religious urgency—constitute a sequentially structured system progressing from the emotional reframing of fear to the deconstruction of bodily and existential attachment, culminating in the restoration of soteriological motivation. This study argues that Paramatthajotikā I’s prescriptive system provides a historically grounded, soteriologically oriented complement to contemporary contemplative science, particularly in bridging the gap between phenomenological classification and meaning-centered intervention. Full article

Background and Objectives: While associations between attachment styles and certain dermatologic conditions have been documented, their role in chronic pruritus remains unexplored. Given the significant psychosomatic component in the etiology of chronic pruritus, this study aimed to assess attachment styles in patients with chronic pruritus in the absence of organic or psychiatric disorders and to examine their potential contribution to its development. Methods: Sixty patients with chronic pruritus were compared with a healthy control group (n = 60). Socio-demographic data, the duration of the disease, and the itch severity were noted. Additionally, assessments performed via the Questionnaire of Relation Scale, Questionnaire of Relation, Hospital Anxiety and Depression Scale, General Health Questionnaire, and Dermatology Life Quality Index (DLQI). Results: Statistically higher scores of fearful, dismissive, and preoccupied attachment styles were observed in the patient group compared to the control group. Among patients, those with moderate to high itch severity had higher mean scores of anxiety and preoccupied attachment than those with low itch severity. In contrast, secure attachment scores were significantly higher in the control group than in the patient group. Limitations: Attachment styles were examined with a self-report instrument without stimulated recall procedures. Conclusions: Our findings clearly demonstrate that patients with chronic pruritus exhibit significantly higher levels of insecure attachment styles alongside elevated anxiety, depression, and psychosocial burden. Notably, the association between preoccupied attachment and greater itch severity highlights how emotional dysregulation may intensify pruritus symptoms. Due to limited research directly examining attachment in chronic pruritus, our study provides novel insight and supports a biopsychosocial approach to care. Full article

Background and Objectives: Coronary artery ectasia (CAE) is defined as a localized or diffuse dilatation of the coronary arteries and is often associated with atherosclerosis, congenital factors, or inflammatory conditions. Given emerging evidence that psychological factors may influence cardiovascular health, this study investigated whether psychological hardiness and past traumatic experiences are associated with CAE. Materials and Methods: This study employed a retrospective, cross-sectional, observational design involving 80 participants. All participants were administered a socio-demographic data form, the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Personal Views Scale III-R (PVS III-R), and the Stressful Life Events Screening Form (SLESF). Results: The PVS III-R scale score for patients with CAE was significantly higher than that of the control group. The SLESF scores were markedly lower in the CAE group when compared to the control group, demonstrating that the control group experienced substantially more intense traumatic events when compared to CAE patients. Binary logistic regression was applied to determine variables associated with CAE, and the results were statistically significant. Notably, higher self-reported PVS III-R scores were independently associated with the presence of CAE. Conclusions: This study may provide a preliminary psychosomatic perspective on the pathophysiology of CAE, emphasizing the complexities of mind–body interactions. It suggests that high psychological hardiness may be associated with unexpected biological outcomes and warrants further investigation. Full article

Background/Objectives: Fibromyalgia is a chronic pain syndrome influenced by both physical and psychological factors, but their interaction remains unclear. We evaluated tools combining physical and emotional dimensions to characterise fibromyalgia and assess associations with persistent physical symptoms (PPS) and the emotional distress in its clinical interpretation. Methods: This cross-sectional study included 1588 patients referred to the Pain Management Unit, Complejo Asistencial Universitario de León. Fibromyalgia cases had a prior diagnosis to referral using the 2019 ACTTION–American Pain Society Pain Taxonomy diagnostic criteria. At the first consultation, participants completed a standardized protocol including sociodemographic variables, a Central Sensitization Inventory Part B checklist of previously physician-diagnosed physical and psychological conditions, and the visual analogue scale for pain, the Modified Somatic Perception Questionnaire (MSPQ), and the Zung Self-Rating Depression Scale. The Distress and Risk Assessment Method (DRAM) was used to integrate MSPQ and Zung data. Results: Women had higher odds of fibromyalgia (p = 0.003). Fibromyalgia was associated with PPS (p < 0.001), with chronic fatigue predominating in women (p < 0.001) and neck injury/whiplash in men (p = 0.005). The MSPQ had the highest OR among the instruments evaluated (overall: p < 0.001; women: p < 0.001; men: p = 0.005). Fibromyalgia status differed by DRAM category (nominal model, p < 0.001), suggesting higher odds in the Depressive and Somatic categories compared with Normal. Conclusions: In our sample, sex was associated with fibromyalgia and PPS profiles; PPS profiles were also associated with fibromyalgia. The MSPQ appeared to be among the most informative instruments, and its integration with Zung through the DRAM may have potential utility for psychosomatic risk profiling in fibromyalgia, warranting further study. Full article

Burnout syndrome is conceptualized as a work-related psychological condition primarily marked by persistent exhaustion, emotional and cognitive impairment and mental distancing. In addition to these core dimensions, burnout may give rise to secondary symptoms, including psychological distress, psychosomatic complaints, and depressive mood. The Burnout Assessment Tool (BAT) includes specific measures for both primary and secondary symptoms. This study aimed to evaluate the validity evidence of the BAT’s secondary symptoms Brazilian version scale (BAT-S). The sample consisted of 1.750 professionals (71% women), with a mean age of 39 years (SD = 11). Confirmatory Factor Analyses indicated that a model of two oblique first-order factors, differentiating psychological distress from psychosomatic complaints, provided a superior fit compared to the unidimensional solution. The scale also presented satisfactory internal consistency for the scales of psychological distress (α = 0.88 and ω = 0.90) and psychosomatic complaints (α = 0.85 and ω = 0.87). The BAT-S represents a reliable tool to assess these secondary symptoms of burnout, advancing research that integrates behavioral and physiological markers, offering practical applications for occupational health interventions and preventive strategies in the workplace. Full article

Background/Objectives: Ageing is associated with reduced adaptive capacity, which may influence responses to chronic stress and contribute to adverse lifestyle changes. This study examined the relationships among diet quality, nutritional status, and psychosomatic health in adults aged 60+, while considering the role of psychological stress. Methods: A total of 372 participants were assessed using a validated FFQ to evaluate diet quality, the MNA to determine nutritional status, and anthropometric measurements. Psychological functioning was measured using the PSS-10, the 4DSQ, and the geriatric GDS scale. Results: No association was identified between adherence to the MIND diet and depressive or anxiety symptoms. However, depressive symptoms were positively associated with the consumption of unhealthy foods. Gender differences also emerged: women reported higher levels of perceived stress (PSS10 F: 13.5 M: 10.5; p < 0.001), anxiety (F: 0.97; M: 0.39; p < 0.01), and somatisation (F: 6.18; M: 4.22; p < 0.001), suggesting greater vulnerability to everyday stressors. Participants at risk of malnutrition displayed significantly higher levels (p < 0.05) of stress (8.33), depression (0.73), and anxiety (1.76) compared with well-nourished individuals (5.03; 0.33; 0.77, respectively). Conclusions: These findings underscore the significant relationship between nutritional status and mental functioning in older adults. They emphasise the need to integrate nutritional assessment with somatic and psychological evaluation to better support the health and well-being of seniors and to improve understanding of the interactions between diet, stress, and psychosomatic functioning in the ageing process. Full article

Background: Psychological factors such as alexithymia, somatization, and their associated effects on health are consistently observed as key characteristics in the onset, maintenance, and chronic course of irritable bowel syndrome (IBS). This study aimed to investigate the presence and role of alexithymia, psychosomatic syndromes, and health status in individuals affected by IBS. Methods: The sample comprised 143 patients diagnosed with IBS, ranging in age from 18 to 78 years (M = 30.90, SD = 14.39), with a predominance of females (81.8%). The diagnostic protocol included a sociodemographic questionnaire, the Toronto Alexithymia Scale-20 (TAS-20), the Diagnostic Criteria for Psychosomatic Research-Structured Interview (DPCR-SI), and the SF-36 Health Survey. Descriptive, correlational, and generalised regression analyses were conducted to examine the relationships among these variables. Results: The findings revealed significant positive correlations between alexithymia and psychosomatic syndromes, while significant negative correlations were observed with health status. Furthermore, alexithymia was identified as a predictor of increased psychosomatic syndrome severity and reduced health status. Conclusions: These results highlight the critical role of alexithymia in IBS and underscore the importance of developing targeted interventions to address this psychological factor in affected individuals. Full article

Bruxism is increasingly recognized as a psychosomatic behavior influenced by stress, anxiety, and sleep disturbances, which generates occlusal forces of non-physiological magnitude, potentially compromising the stability of dental implants. This narrative review examines the causal pathway linking psychological factors, bruxism, and implant complications. The literature from PubMed, Scopus, and Cochrane (2000–2025) was analyzed. Evidence consistently associates psychosocial stressors with increased mechanical complications, while biological outcomes remain heterogeneous. Digital occlusal analysis, finite element modeling, and AI-based monitoring show promise for early overload detection. An interdisciplinary model integrating dentistry, psychology, and sleep medicine is proposed to optimize implant outcomes and guide future research. Full article

Background: Due to communication problems, people with primary progressive aphasia (PwPPA) are often affected in their self-image and experience a reduced quality of life (QoL). Biographic-narrative therapy is an effective approach to improve QoL in post-stroke aphasia. This study describes how PwPPA experienced their participation in the biographic-narrative intervention called Cope PPA. Methods: The intervention comprised a combination of five individual and seven group therapy sessions as well as the use of music and art therapy elements. Inclusion criteria were a capacity to give consent and sufficient visual/auditory abilities of PwPPA. Exclusion criteria were the presence of severe depression (MADRS > 35) or severe cognitive deficits (MMST < 10). After the therapy, PwPPA and their family members took part in half-hour semi-structured interviews. Interviews were analysed according to the reflexive thematic analysis by Braun and Clarke. Results: The qualitative analysis was based on a data set of 34 interviews. A total of six themes were identified: (1) Participation required adherence; (2) Materials were considered remarkable; (3) Storytelling was conducted in an aphasia-free area; (4) Group participation created a sense of belonging; (5) Experiences encouraged self-reflection and (6) Coping is lengthy and ongoing. Conclusions: The findings of our reflexive thematic analysis suggest that PwPPA experienced the intervention as meaningful. Some PwPPA described the effects of our intervention on their self-image. Others emphasised that coping with their condition was an ongoing process requiring continuous support. Full article

In our longitudinal study, we examined self-reported or explicit basic emotions, i.e., happiness, sadness, anxiety, and anger, in depressed patients during acute illness and inpatient treatment. For exploratory purposes, we also assessed implicit emotions. We analyzed how changes in emotional clarity relate to changes in emotions and depressive symptoms. A sample of depressed inpatients (n = 52) was examined at admission and on average after seven weeks of multimodal psychiatric treatment. A healthy control group (n = 52) was tested at the same time interval. Basic emotions were measured via the Differential Emotions Scale and a discrete-emotions variant of the Implicit Positive and Negative Affect Test. Emotional clarity was measured with the WEFG scales. Patients reported lower explicit happiness and heightened explicit sadness, anxiety, and anger compared to healthy controls, regardless of time of measurement. Across groups and time points, implicit happiness was greater than implicit sadness, anxiety, and anger, with no group differences. Patients’ emotional clarity improved and correlated with improvements in depressive symptoms, explicit happiness, sadness, and implicit anger. In summary, depressed patients experience heightened anxiety and anger, suggesting broader alterations of negative emotions beyond sadness. Increased emotional clarity during treatment was found to be correlated with changes in explicit and implicit affectivity. Full article

Background/Objectives: Palliative care (PC) has traditionally focused on patients with cancer and their families. However, individuals living with advanced non-malignant chronic diseases and their caregivers face comparable challenges that significantly affect their quality of life. This study aimed to explore the PC needs of patients with advanced non-malignant chronic conditions through the lived experiences of both patients and their informal caregivers. Methods: Semi-structured interviews were conducted with eight patients and nine caregivers recruited via the Municipality of Katerini “Help at Home” program (Jan–Mar 2025). Interviews were audio-recorded, transcribed verbatim (in Greek), and analyzed inductively using reflexive thematic analysis. Ethical approval was obtained from the International Hellenic University (Ref. No. 18/22.12.2022), and official consent was gained from the Municipality of Katerini (Approval Ref. No. 7803-/30/01/2025). Results: Five themes emerged: (1) basic daily care and physical support; (2) psychosomatic and emotional impact; (3) social withdrawal and role change; (4) support systems and coping resources; and (5) experience with the healthcare system and organized care. Participants highlighted urgent needs for home-based physiotherapy/nursing, caregiver respite, and psychological support. Coping and resilience-related resources—expressed through family support, familiarity of the home environment, and spirituality—were described as essential mechanisms that helped dyads sustain home care and shaped how needs were experienced across multiple domains, particularly amid service gaps. Conclusions: These findings document complex, interlinked needs among patients with advanced non-malignant chronic conditions and their caregivers and support the development of community-based, integrated PC services. Larger, multicenter studies and the development/validation of a needs-assessment tool are recommended. Full article

Background/Objectives: The aviation sector is characterized by high-density flight operations and chronic stressors that compromise worker health. This study focuses on burnout syndrome as a multidimensional phenomenon resulting from the interaction between high emotional demands and personal resources. The primary objective was to analyze the relationship between job satisfaction and health problems among cabin crew members, testing a structural model where burnout—specifically its dimensions of enthusiasm toward the job, psychological strain, indolence, and guilt—acts as a mediating factor. Methods: A quantitative, cross-sectional design was implemented with a sample of 732 cabin crew members from an international airline. Participants completed the Spanish Burnout Inventory (SBI) and the UNIPSICO subscales for job satisfaction and psychosomatic problems. Data was processed using Structural Equation Modeling (SEM) to evaluate the hypothesized interdependent relationships and global model fit. Results: The structural model demonstrated an acceptable fit (CFI = 0.890; RMSEA = 0.056), confirming that job satisfaction is positively related to enthusiasm toward the job and inversely associated with psychological strain. All burnout dimensions were significantly linked to health outcomes; notably, guilt was identified as a critical mediator between indolence and psychosomatic problems. Conclusions: The findings underscore burnout as an insidiously progressive process that mediates the deterioration of cabin crew health. The study highlights guilt as a determining factor in the syndrome’s severity. Consequently, preventive organizational strategies must move beyond general fatigue management to include emotional labor training and early diagnosis of psychosocial risks to preserve operational safety and crew well-being. Full article