Search Results (54)

Background/Objectives: The intersection of mental health and acute coronary syndromes has become an increasingly prominent area of cardiovascular and psychosomatic research, yet its temporal dynamics and intellectual structure remain incompletely characterized. Methods: This study analyzed 13,646 peer-reviewed documents spanning five decades, employing advanced changepoint detection (PELT) algorithms, network visualization (VOSviewer), and bibliometric performance metrics (Bibliometrix) to quantify the evolution of the mental health–ACS intersection. Results: Statistical analysis identified two robust inflection points at 1990 and 2005 that demarcate distinct developmental periods. The 1990 breakpoint marked an important transition, although additional metadata-completeness analysis indicated that part of the increase from 72 to 142 publications may reflect improved availability of non-title Topic-field metadata in WoSCC around 1990–1991. The 2005 breakpoint represented the most critical transition (Cohen’s d = 4.05, p < 0.000001), initiating exponential growth from 349 to over 600 annual publications by 2022 and coinciding with growing research attention to psychiatric comorbidity within ACS literature. Keyword co-occurrence networks revealed a shift in research focus: early publications predominantly addressed mental health as a psychological reaction to cardiac events, whereas more recent publications increasingly frame depression, anxiety, and PTSD alongside mechanistic constructs such as inflammatory pathways, autonomic dysfunction, and platelet reactivity. Although seminal intervention trials (i.e., ENRICHD, SADHART) established pharmacological safety and symptom improvement, keyword analyses indicate that following these trials, research attention increasingly shifted toward precision psychiatry concepts and mechanistic pathway elucidation. Conclusions: These findings provide a quantitative map of how publication activity at the mental health–ACS intersection has evolved, offering a structured basis for identifying under-researched areas and informing future research agendas. Full article

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

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: 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

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

Background: Burnout is a syndrome resulting from long-term, unmanaged work-related stress. This study aimed to evaluate the validity and reliability of the Serbian versions of BAT among fifth-year medical students at the University of Belgrade Faculty of Medicine. Methods: This cross-sectional study, which included a total of 431 students at the Faculty of Medicine, University of Belgrade, was conducted during the last week of November 2024. The study instruments used were the Burnout Assessment Tool (BAT) and the Copenhagen Burnout Inventory (CBI). Results: Cronbach’s alpha for the entire BAT scale was α = 0.946; for core burnout symptoms, it was α = 0.938; for the exhaustion scale, α = 0.865; for mental distance, α = 0.858; for cognitive impairment, α = 0.907; for emotional impairment, α = 0.878; for secondary symptoms, α = 0.863; for psychological distress, α = 0.791; and for psychosomatic complaints, α = 0.801. The EFA showed six factors that explained a total of 63.76% of the variance. Factor 1 explained 35.71% of the variance; factor 2 explained 9.81%; factor 3, 5.785%; factor 4, 5.415%; factor 5, 3.956%; and factor 6 explained 3.076% of the variance. After the elimination of the three items with the lowest loadings, the EFA showed five factors that explained a total of 63.347% of the total variance. Factor 1 explained a total of 36.637% of the variance; factor 2, 10.544%; factor 3, 6.345%; factor 4, 5.612%; and factor 5 explained a total of 4.209%. Conclusions: This study showed that the Serbian version of the BAT exhibits excellent reliability, clear factorial validity, and strong convergent and discriminative performance. Full article

Background and Objectives: Monday syndrome refers to a psychosomatic stress response occurring at the beginning of the work week and has been implicated in triggering acute cardiovascular events. This study aimed to evaluate the association between Monday syndrome and the incidence of cardiovascular emergencies. Materials and Methods: Between June 2024 and June 2025, a total of 500 patients aged 18–65 years who presented with acute cardiovascular events at two centers were retrospectively analyzed. Diagnoses included STEMI, NSTEMI, unstable angina, ventricular tachycardia/fibrillation, and hypertensive emergency. The distribution of events by weekday and hour was examined. Poisson regression was used to assess the effect of Mondays on event incidence. Results: Of 500 patients (mean age 49.1 ± 9.7 years, 50.4% male), the most common diagnoses were STEMI (31.8%) and NSTEMI (27.4%). The incidence of cardiovascular events was highest on Mondays (19.6%) and lowest on Sundays (10.6%). The early-morning period (06:00–10:00) showed the most significant clustering of events (p < 0.001). Systolic blood pressure (145 ± 18 vs. 139 ± 17 mmHg, p = 0.008) and heart rate (87 ± 12 vs. 82 ± 13 bpm, p = 0.01) were significantly higher on Mondays. Monday presentation was associated with a 23% higher event rate (incidence rate ratio [IRR] 1.23, 95% CI 1.10–1.38, p = 0.002). Conclusions: Monday syndrome is associated with a significant increase in the incidence of cardiovascular emergencies, especially in the early-morning hours. Increased sympathetic tone, hormonal activation, and psychosocial stress are possible contributors. Full article

Background: Metabolic syndrome (MetS), a cluster of cardiometabolic abnormalities including elevated blood pressure, impaired glucose regulation, dyslipidemia, and increased waist circumference is increasingly recognized as a condition linked to both physical and psychological health risks. This study aims to investigate genotype-specific differences in psychological distress between healthy individuals and those with metabolic disorders, as well as to examine potential gene metabolic status interactions. Methods: This study is a cross-sectional analysis conducted in Turkistan city in the Southern region of Kazakhstan. Participants (healthy and those with metabolic syndrome) were invited to take part in the study by random sampling from the Khoja Akhmet Yassawi Kazakh-Turkish International University Medical Center. Consenting individuals provided a genetic analysis. Psychosomatic indicators were assessed using the Perceived Stress Questionnaire (PSQ) and the Depression, Anxiety, and Stress Scale (DASS-21). Results: A total of 200 individuals participated, with an approximately 3:1 ratio of women to men. The mean age in years was 50.4 ± 9.5 and 48.8 ± 7.7 for men and women, respectively. Preliminary analyses showed variations in cognitive and psychosomatic measures among individuals with metabolic syndrome, but no associations with genetic variants, and no significant group differences across key psychosomatic indicators when stratified by metabolic or genetic factors. However, a significant difference in LPL-Anxiety between genotypes GA-GG (p < 0.05) was found. Conclusions: Variations in metabolic and genetic factors within the studied population were not associated with measurable differences in stress or depressive symptoms. Full article

Background/Objectives: Inflammatory bowel diseases (IBDs) are chronic conditions with significant psychological comorbidities. Research on subclinical psychosomatic syndromes in this category of patients remains limited. This study aimed to identify distinct psychosomatic profiles using the Diagnostic Criteria for Psychosomatic Research—Revised (DCPR-R) framework and to examine their associations with health behaviors. Methods: A total of 111 adult IBD patients in clinical remission or with low disease activity were enrolled and underwent a comprehensive assessment of sociodemographic and clinical variables, psychosomatic syndromes and health behaviors. Hierarchical clustering using complete linkage and Jaccard distance was performed on two subsets of common psychosomatic syndromes in this sample. Associations between psychosomatic syndromes and profiles and health behaviors were examined using multiple regression models, controlling for IBD severity and applying Benjamini–Hochberg correction. Analyses were conducted according to a pre-registered protocol. Results: Six distinct clusters were identified: irritability (9.3%), pure allostatic overload (18.7%), pure alexithymia (26.7%), overwhelmed type A behavior (12%), subclinical depressive mood (13.3%), and alexithymic type A behavior (26.7%). Pure alexithymia patients showed higher smoking odds (OR = 3.85, p = 0.033) and overwhelmed type A behavior patients showed less frequent physical activity (OR = 0.27, p = 0.018). For individual syndromes, irritable mood was associated with lower alcohol consumption (OR = 0.29, p = 0.035) while type A behavior was associated with higher consumption (OR = 1.87, p = 0.030). However, all associations became non-significant after false discovery rate correction. Conclusions: IBD patients with low disease activity exhibit distinct psychosomatic profiles. While specific syndromes and profiles showed trends toward certain health behaviors, associations were not robust to multiple comparison correction. Psychosomatic profiling may inform personalized clinical approaches, though larger studies are needed to establish definitive associations with health behaviors. Full article

Background: A subset of patients with chronic dyspepsia exhibits palpable upper abdominal hardness and systemic symptoms like headache, chest discomfort, neck/shoulder stiffness, fatigue, and depression. In traditional Korean medicine (TKM), this symptom complex is referred to as Damjeok syndrome (痰积症候群, DJS). Although DJS is frequently observed in TKM practice, it lacks a clear case definition and biological mechanism, limiting its integration in gastroenterology research and evidence-based practice. Clarifying its clinical and biological features is essential to understand its pathophysiology and clinical significance. Methods: This case–control study aimed to characterize DJS by comparing 16 female patients diagnosed with DJS and 15 age-matched healthy females as controls. A female-only cohort was selected to reflect the higher prevalence of chronic dyspepsia in women and reduce biological variability. Clinical characteristics and potential DJS-specific biomarkers were evaluated through complete blood count (CBC), serum biochemical tests, heart rate variability (HRV) for autonomic function, and plasma 5-hydroxyindoleacetic acid (5-HIAA), a serotonin metabolite linked to gastrointestinal motility and autonomic regulation. Results: The DJS group had a mean disease duration of 58.0 ± 46.2 months, with epigastric fullness and underlying abdominal hardness as primary complaints. Postprandial distress syndrome (PDS) was the most common (43.8%) dyspepsia subtype, often combined with epigastric pain syndrome (EPS). Extra-gastrointestinal symptoms such as headache/fatigue (87.5%) and anxiety/depression (81.3%) were highly prevalent. Neutrophil counts were significantly lower in the DJS group (p = 0.01), while other hematological or biochemical markers showed no differences (p > 0.1). HRV analysis revealed decreased parasympathetic activity (RMSSD and HF, p < 0.1), and plasma 5-HIAA levels were significantly elevated compared to healthy controls (p = 0.01). Conclusions: DJS aligns with functional gastrointestinal disorders (FGIDs), sharing psychosomatic symptoms and reduced parasympathetic activity, suggesting gut–brain axis dysregulation. However, distinct features like palpable upper abdominal hardness and elevated plasma 5-HIAA levels indicate that DJS may represent a unique subtype within the category of FGIDs. These findings highlight the need for larger, well-designed studies to further elucidate the pathophysiology of DJS. Full article

Among the leading etiologies of limb amputations are diabetes mellitus, alongside trauma and peripheral vascular disease conditions, whose complications are major indications for surgery, which can subsequently elicit chronic refractory postamputation pain. ‘Phantom limb pain’ (PLP) denotes pain that is perceived as occurring in an absent part of the limb following amputation. Even though it is a relatively common complication among amputees—with an estimated prevalence as high as ~80 percent—the underlying mechanisms of this puzzling condition remain poorly understood. Current theories predominantly emphasize the role of the nervous system and neuropsychopathology in the development of PLP. However, these neurocentric explanations are disputed and have not yet been translated into effective treatments or a definitive cure for the condition, nor have several notable anomalies been settled, which has prompted researchers to call for the exploration of alternative theories. The aim of this paper is to offer an alternative mechanical mechanism for explaining PLP and spontaneous phantom sensations. This work introduces a theoretical model for the mechanism of PLP, drawing on a recent study that proposed this model to explain fibromyalgia-type psychosomatic syndromes as disorders driven by overactive soft tissue myofibroblasts. The manuscript proposes a shift from purely neurocentric models of PLP to a framework where the extracellular matrix and connective tissue, specifically myofascial tissue and inflammatory myofibroblasts—which are often overlooked in research—take part in its pathogenesis. In this suggested model, surgical interventions disrupt the biomechanical stability of the fascio-musculoskeletal biotensegrity-like system, thus acting as a contributing factor in the chronic pain manifestation. The term ‘biotensegrity’ refers to the dynamic biomechanical behavior of a living system that is stabilized by compressive and tensile force elements, a characteristic quality of myofascial tissue. In this framework, abnormal extracellular matrix remodeling, driven by overactive peripheral myofibroblasts, and the concomitant mechanical effects exerted on sensory nerves embedded within the fascia and reaching the neuroma microenvironment contribute to the generation and perception of spontaneous PLP and phantom sensations. The interplay between abnormal extracellular matrix, the neuroma’s intrinsic excitability, as well as peripheral and central neurophysiological mechanisms, collectively provide a biophysical neuropathophysiological basis to help explain PLP. This offers a different unexplored perspective on a condition with poorly understood mechanisms. Full article

Background: Frailty is a state of increased vulnerability to psychosomatic dysfunction associated with aging, with sarcopenia being a major contributing factor. Metabolic-syndrome-related metabolic diseases are recognized as risk factors for sarcopenia. While previous studies have examined the relationship between metabolic disease history or elevated metabolic syndrome indicators and sarcopenia, limited evidence exists regarding the association between metabolic indicators within reference ranges and sarcopenia in the absence of metabolic disease. This study aimed to investigate the relationship between metabolic syndrome indicators within reference ranges and the presence or absence of possible sarcopenia, as well as changes in these indicators over a four-year period, in women aged ≥65 years. Methods: A total of 224 community-dwelling women aged ≥65 years from M City and O Town who participated in health check-ups were included (approval no. 20MH017, 1 October 2020). Data were collected on height, body weight, and metabolic indicators (triglycerides, HDL cholesterol, LDL cholesterol, systolic and diastolic blood pressure, and HbA1c) at baseline and after four years. Physical performance was assessed using calf circumference, grip strength, and the five-time sit-to-stand test. Possible sarcopenia was defined according to AWGS2019 criteria. Results: Higher baseline HDL cholesterol levels were found to be protective against possible sarcopenia. An increase in triglyceride levels over four years was also associated with a reduced likelihood of possible sarcopenia. Conclusions: Maintaining high HDL cholesterol levels and increasing or preserving triglyceride levels may contribute to the prevention of sarcopenia in older women with metabolic indicators within reference ranges. Full article

Physician burnout is a psychosomatic syndrome that arises from feeling overwhelmed with confronting issues in those with dedication or commitment to their job. It presents with emotional, mental, and physical fatigue that negatively influences patient treatment decisions and care, representing a primary occupational hazard affecting a significant number of these healthcare providers at some point in their career such that there is an urgency to the need for improvement. Full article

Objective: The study analyzed the role of traumatic experiences and psychosomatic components as potential predictors of the likelihood of chronic pain patients having or not having fibromyalgia. Methods: We examined the role of stressful life events (Traumatic Experiences Checklist), psychosomatic syndromes (Toronto Alexithymia Scale and Diagnostic Criteria for Psychosomatic Research), pain, and psychological distress (Beck Depression Inventory—II and State-Trait Anxiety Inventory) in 104 patients with fibromyalgia compared with a sample of 104 patients with rheumatoid arthritis. Results: Patients with fibromyalgia reported significantly more traumatic events, a higher prevalence of psychosomatic syndromes, and higher levels of pain, anxiety and depressive symptoms compared with patients with rheumatoid arthritis (all p < 0.01). Hierarchical binary logistic regression with group membership as the dependent variable showed that somatization syndromes (OR = 3.67), pain (OR = 1.56), and childhood trauma (OR = 1.11) were statistically significant predictors of group belonging, and the model explained 67% of the variance in diagnosis [χ²(9) = 143.66, p < 0.001]. Conclusion: These results highlighted that patients with fibromyalgia are characterized primarily by marked somatization and a high prevalence of early stressful life events compared with patients with rheumatoid arthritis, a primarily nociceptive chronic pain condition. A better knowledge of these mechanisms could allow clinicians to develop tailored interventions that take greater account of the psychological dimension of the disease. Full article