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Winfried Rief - One of the best experts on this subject based on the ideXlab platform.
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diagnostic classifications in depression and Somatization should include biomarkers such as disorders in the tryptophan catabolite trycat pathway
Psychiatry Research-neuroimaging, 2012Co-Authors: Michael Maes, Winfried RiefAbstract:The tryptophan catabolite (TRYCAT) pathway is induced by indoleamine 2,3-dioxygenase (IDO), which upon activation depletes plasma tryptophan (TRP) and increases the synthesis of TRYCATs. Both phenomena are associated with Somatization and depression. The aims of this study are to examine whether disorders in the TRYCAT pathway are specific to depression or Somatization and whether the diagnoses Somatization, depression, and comorbid depression+Somatization reflect qualitatively distinct clinical and biological categories. Plasma TRP, the kynurenine (KY)/TRP and KY/kynurenic acid (KA) ratios were measured in 36 patients with Somatization, 35 depressed and 38 depressed+Somatization patients and 22 controls. Using pattern recognition methods, the diagnosis comorbid depression+Somatization could not be validated, while there was an important overlap between depression and Somatization, which form one continuum. Cluster analysis detected a) a control cluster; b) a cluster with lower tryptophan, and higher KY/TRP and KY/KA ratios and Somatization scores; and c) a cluster with increased depression but lower KY/TRP values. The differences between both patient clusters were quantitative and not qualitative. Within the patient group, cluster analysis has generated a "pathway phenotype", i.e. aberrations in the TRYCAT pathway, which are associated with Somatization rather than with depression.
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Somatization but not depression is characterized by disorders in the tryptophan catabolite trycat pathway indicating increased indoleamine 2 3 dioxygenase and lowered kynurenine aminotransferase activity
Neuro endocrinology letters, 2011Co-Authors: Michael Maes, Piotr Galecki, Robert Verkerk, Winfried RiefAbstract:BACKGROUND: Reduced plasma tryptophan occurs in depression and Somatization. Induction of indoleamine 2,3-dioxygenase (IDO) with consequent synthesis of tryptophan catabolites (TRYCATs) and lowered tryptophan are associated with the onset of depression in the puerperium and during interferon-alpha treatment. Depression is accompanied by lowered kynurenic acid, a neuroprotectant, or increased kynurenine, a neurotoxic TRYCAT. AIMS AND METHODS: To examine plasma tryptophan; kynurenine; kynurenic acid; the kynurenine / tryptophan (KY/TRP) ratio, indicating IDO activity; and the kynurenine / kynurenic acid (KY/KA) ratio, indicating kynurenine aminotransferase (KAT) activity, in Somatization; depression; Somatization + depression; and controls. Illness severity is measured by the Somatic Symptom Index (SSI), the Screening for Somatoform Symptoms (SOMS), and the Beck Depression Inventory (BDI). RESULTS: Tryptophan is significantly lower in patients than in controls and lower in Somatization than in depression. KY/TRP is significantly increased in Somatization. Kynurenic acid is significantly lower in patients than in controls, and lower in Somatization than in depression. KY/KA is significantly higher in Somatization and Somatization + depression than in depression and controls. There are significant correlations between the severity of Somatization, but not depression, and KY/TRP and KY/KA (positive) and tryptophan (negative). Kynurenine and kynurenic acid are significantly correlated in controls, Somatization + depression, and depression, but not in Somatization. CONCLUSIONS: Somatization is characterized by increased IDO activity and disorders in KAT activity and an increased neurotoxic potential. The TRYCAT pathway may play a role in the pathophysiology of somatizing and “psychosomatic” symptoms through effects on pain, gut motility, the autonomic nervous system, peripheral NMDA receptors, etc. Even more, biological disorders, such as aberrations in the TRYCAT pathway, which are considered to be a hallmark for depression, are in fact attributable to Somatization rather than to depression per se. Future research in depression on the TRYCAT pathway should always control for the possible effects of Somatization.
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Psychobiological differences between depression and Somatization.
Journal of psychosomatic research, 2010Co-Authors: Winfried Rief, Anika Hennings, Sabine Riemer, Frank EuteneuerAbstract:Abstract Background Comorbidity studies have shown that depression and Somatization (multiple somatoform symptoms) often overlap. Therefore it has been suggested to classify at least some patients with Somatization syndromes under the category of depressive disorders. We wanted to investigate whether psychobiological investigations confirm the lumping of Somatization and depression, or whether psychobiological pathways favor distinguishing these disorders. Method An overview is presented summarizing psychobiological studies including patients with depression and/or Somatization-associated syndromes. We focus on the following topics: heritability, polymorphisms in special candidate genes, immune activation, hypothalamic-pituitary-adrenal (HPA) axis reactivity, serotonergic pathways, monoamino acids, and fatty acid concentrations. Results Immunological activation seems to be associated with specific features of somatoform disorders, namely, sickness behavior and pain thresholds. Genetic factors can also contribute to somatic complaints, e.g., via serotonergic pathways, HPA-axis response, immune activation, and other biological systems that contribute to the self-description of not being healthy. Some results indicate that psychobiological aspects of depression and Somatization overlap in part (e.g., the relevance of serotonergic pathways), but there is clearly more evidence for discrepancies of psychobiological pathways in depression and Somatization (e.g., the relevance of proinflammatory immune processes; HPA-axis activity; monoamino acid availability; omega-3-concentration; the role of triallelic subtypes of 5-HTTLPR). Conclusion Many psychobiological pathways act differently in depression and Somatization. These differences in psychobiology favor the distinction of these syndromes in classification approaches.
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is Somatization a habituation disorder physiological reactivity in Somatization syndrome
Psychiatry Research-neuroimaging, 2001Co-Authors: Winfried Rief, Claudia AuerAbstract:The present study investigates whether physiological activity may play a part in maintaining the amplified perception of bodily processes typical for Somatization. Eighty-one persons were classified into three groups by means of a structured clinical interview: 24 patients with Somatization syndrome, 34 patients with Somatization syndrome and comorbid major depression, and 23 healthy controls. Subjects completed four blocks of an attentional task, each of the blocks separated by resting periods. Physiological patterns demonstrated higher activity during mental tasks than during rest. The heart rate deceleration after changing from mental challenge to rest was less pronounced in the groups of patients with Somatization syndrome than in controls. Moreover, patients with Somatization syndrome reported feeling more and more tense during the investigation, while controls showed the tendency to habituate. The effects of heart rate and of feelings of tension partly replicated earlier findings, and demonstrated that physiological activity may interact with psychological processes in Somatization.
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Cortisol and Somatization
Biological psychology, 2000Co-Authors: Winfried Rief, Claudia AuerAbstract:Somatization symptoms are frequently associated with depression, anxiety, and feelings of distress. These features interact with the activity of the HPA-axis. Therefore we investigated relationships between Somatization symptoms and cortisol. Seventy-seven participants were classified into three groups: Somatization syndrome (at least eight physical symptoms from the DSM-IV Somatization disorder list), Somatization syndrome combined with major depression, and healthy controls. The following data were collected: salivary cortisol at three time points (morning, afternoon, evening), nighttime urinary cortisol, serum cortisol after the dexamethasone suppression test (DST), and psychological variables such as depression, anxiety, Somatization, and hypochondriasis. Salivary cortisol showed typical diurnal variations. However, the groups did not differ on any of the cortisol variables. A possible explanation may be counteracting effects of Somatization and depression. Exploratory correlational analyses revealed that associations between cortisol and psychopathological variables were time-dependent. DST results correlated with psychological aspects of Somatization, but not with the number of somatoform symptoms per se.
Magnus Simren - One of the best experts on this subject based on the ideXlab platform.
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relationships between psychological state abuse Somatization and visceral pain sensitivity in irritable bowel syndrome
United European gastroenterology journal, 2018Co-Authors: Cecilia Grinsvall, Hans Tornblom, Jan Tack, Lukas Van Oudenhove, Magnus SimrenAbstract:Background and objectivePsychological states may interfere with visceral sensitivity. Here we investigate associations between psychosocial factors and visceral sensitivity in irritable bowel syndrome (IBS).MethodsTwo IBS patient cohorts (Cohort 1: n = 231, Rome II; Cohort 2: n = 141, Rome III) underwent rectal barostat testing, and completed questionnaires for anxiety, depression, Somatization, and abuse. The associations between questionnaire measures and visceral sensitivity parameters were analyzed in three-step general linear models (step1: demographic and abuse variables; step 2: anxiety and depression; step 3: Somatization).ResultsCohort 1. Pain threshold was positively associated with age and female gender, and negatively with adult sexual abuse and Somatization. Pain referral area was negatively associated with age and positively with Somatization and GI-specific anxiety, the latter effect mediated by Somatization. Cohort 2. Pain threshold was positively associated with age and male gender, and n...
Seong-jin Cho - One of the best experts on this subject based on the ideXlab platform.
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2190 – Effect of major depressive disorder and insomnia on Somatization
European Psychiatry, 2013Co-Authors: Sujeong Kim, J Y Jun, Youngjin Lee, Seong-jin ChoAbstract:Introduction Somatization is a common symptom of depression. Somatization is also related to sleep problem including insomnia.Depression is the one of the most common cuase of insomnia. Therefore, it would be needed to investigate the interaction between depression, insomnia and Somatization. Objectives To investigate the independent effects of major depressive disorder (MDD) and insomnia on Somatization. Aims To compare Somatization of primary insomnia, MDD with insomnia, MDD without insomnia, and normal controls. Methods A total of 181 participants without serious medical problem were recruited. Subjects were divided into 4 groups based on the SCID-IV and ICD-10 insomnia criteria: 1) normal controls, 2) primary insomnia, 3) MDD without insomnia, and 4) MDD with insomnia. The Somatization subscores of the SCL-90-R were completed by participants. Results There were significant between-group differences in Somatization (F=25.30, p Conclusions In the current study, insomnia was associated with Somatization independently from major depression. Subjects with primary insomnia showed higher Somatization. Within MDD patients, presence of insomnia was related to higher Somatization. Our finding suggests that insomnia may partly mediate the relationship between depression and Somatization.
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Prevalence and correlates of psychiatric symptoms in north korean defectors.
Psychiatry investigation, 2011Co-Authors: Hyo Hyun Kim, Seung Min Bae, Yu Jin Lee, Ha Kyoung Kim, Jung Eun Kim, Seog Ju Kim, Seong-jin ChoAbstract:ResultsaaNKDs mainly reported Somatization (42.4%) and depressive symptoms (38.9%). Female NKDs showed higher prevalence of Somatization (p=0.001), anxiety (p=0.020), hostility (p=0.026) and psychoticism (p=0.022) than males. The presence of physical illness was strongly related to most psychiatric symptoms on the SCL-90-R including Somatization (p
Zhengkui Liu - One of the best experts on this subject based on the ideXlab platform.
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prevalence and correlates of Somatization in anxious individuals in a chinese online crisis intervention during covid 19 epidemic
Journal of Affective Disorders, 2020Co-Authors: Fangfang Shangguan, Xiao Quan, Wei Qian, Chenhao Zhou, Chen Zhang, Xiang Yang Zhang, Zhengkui LiuAbstract:Abstract Background Somatization is a common comorbidity in anxious people. From January 31 to February 2, 2020, a high prevalence of moderate to severe anxiety was detected due to COVID-19 outbreak. The purpose of this study was to investigate the prevalence and correlates of Somatization among Chinese participants with anxiety receiving online crisis interventions from Feb 14 to Mar 29 during the COVID-19 epidemic. Methods A total of 1134 participants who participated in online crisis interventions completed the Generalized Anxiety Disorder-7 (GAD-7) scale and the Symptom Checklist-90 (SCL-90) and demographic questions online. Somatization was defined as the average score of each item ≥ 2 in SCL-90 Somatization subscale. Moderate to severe anxiety was defined as a score ≥ 10 in the GAD-7 scale. Results Among all participants, 8.0% reported moderate to severe anxiety and 7.4% reported Somatization. After March 1, the prevalence of anxiety with or without Somatization did not significantly change (both p > 0.05), while the prevalence of Somatization increased significantly (p Conclusions Our findings suggest that the history of chronic diseases is associated with Somatization in individuals with anxiety, indicating some stress-related mechanisms. Chinese men in crisis intervention need more attention because they are more likely to report anxiety comorbid Somatization.
John W. Greene - One of the best experts on this subject based on the ideXlab platform.
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Somatization symptoms in pediatric abdominal pain patients: Relation to chronicity of abdominal pain and parent Somatization
Journal of Abnormal Child Psychology, 1991Co-Authors: Lynn S. Walker, Judy Garber, John W. GreeneAbstract:Symptoms of Somatization were investigated in pediatric patients with recurrent abdominal pain (RAP) and comparison groups of patients with organic etiology for abdominal pain and well patients. Somatization scores were higher in RAP patients than well patients at the clinic visit, and higher than in either well patients or organic patients at a 3- month followup. Higher Somatization scores in mothers and fathers were associated with higher Somatization scores in RAP patients, but not in organic or well patients. Contrary to the findings of Ernst, Routh, and Harper (1984), chronicity of abdominal pain in RAP patients was not significantly associated with their level of Somatization symptoms. Psychometric information about the Children's Somatization Inventory is presented .
