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175-ALEXITHYMIA-EPIDEMIOLOGICAL FINDINGS
Abstracts / Journal of Psychosomatic Research 56 (2004) 581–673
treatment compared to normalweight subjects. Prevalences of psychiatric disorders were considerably higher in women participating in conventional treatment (Optifastaˆ) or about to undergo obesity surgery compared to normalweight women (OR 3.4, 95% CI 1.8 – 6.3; OR 3.1, 95% CI 1.8 – 5.3). Similar results yet less pronounced could be observed in obese men and women not seeking weight loss treatment compared to normalweight subjects (OR 1.6, 95% CI 0.5 – 5; OR 2.2, 95% CI 1.2 – 4.2). No considerable difference could be found between obese subjects with and without request at weight loss treatment. With regard to MC4R mutation only one obese carrier (0.25%) of the whole sample could be identified. Conclusions: Obese subjects suffer considerably more from psychiatric comorbidity compared to normalweight individuals. However no clinical important difference could be observed between obese subjects seeking and not seeking weight loss treatment. Our data do not indicate mutations in MC4R to be a strong contributor to the development of hyperphagia-induced morbid obesity.
191 ASSOCIATIONS OF NT-PRO BNP WITH QUALITY OF LIFE AND ANXIETY IN MEN AND WOMEN WITH CHF RISK FACTORS Herrmann-Lingen C, Rautenstrauch N, Binder L, Lu¨ers C, Wetzel D, Pouwels C, Kochen MM, Pieske B. Department of Psychosomatics and Psychotherapy, Go¨ttingen, Germany. Natriuretic peptides have been shown to exhibit anxiolytic-like effects in animal studies. It has also been suggested that the very high endogenous levels of atrial natriuretic peptide typically found in severe heart failure might limit anxiety in heart failure patients. However, nothing is known about the psychological impact of moderately elevated natriuretic peptide levels found in patients with asymptomatic ventricular dysfunction. We therefore studied 422 patients (62.8 ± 10.8 years, 58% men) with risk factors (diabetes, hypertension, stable coronary disease) but without clinical signs of heart failure. Patients completed the SF12 quality of life scale and the Hospital Anxiety and Depression Scale (HADS). All patients also underwent detailed cardiological diagnostics, including assessment of plasma levels of the N-terminal pro-Brain Natriuretic Peptide (NT-proBNP). NT-proBNP was elevated ( >100 pg/ml) in 54% of patients, indicating at least slight ventricular dysfunction. Although patients had no clinical signs of heart failure, high NT-proBNP was significantly (rho = 0.15; p = .002) associated with reduced physical quality of life (SF12). This effect was somewhat larger in men than in women. In men, anxiety (HADS) showed a significant association with (bad) physical quality of life (rho = 0.38; p < .0005) and an insignificant negative correlation with NT-proBNP. However, after adjusting for physical quality of life in linear regression, the inverse relationship between log-transformed NT-proBNP levels and HADS anxiety scores became significant (beta = 0.14; p < .02). Although NTproBNP increased with age, controlling for age didn’t change this result. In contrast, neither physical quality of life nor NT-proBNP were associated with anxiety in women. In conclusion, even the moderately elevated endogenous natriuretic peptide levels found in patients with subclinical ventricular dysfunction are associated with reduced physical quality of life, but, at the same time, relatively low levels of anxiety in men. The observation that no such effect can be found in women, requires further study.
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293 PSYCHOBIOLOGICAL FACTORS IN INFLAMMATORY BOWEL DISEASE—THE DESIGN OF THE NORWEGIAN-GERMAN MULTICENTER STRESS INTERVENTION STUDY Jantschek G, Boye B, Leganger S, Moekleby K, Heldal A, Leiknes KA, Dahlstrom A, Wojniusz S, Blomhoff S, Hausken T, Jahnsen J, Vatn M, Wilhemsen I, Lundin K, Malt UF. Universities Lu¨beck/ Germany and Oslo and Bergen/Norway. Introduction: In Inflammatory bowel diseases (IBD) ulcerative colitis (UC) and Chrohn’s disease (CD) mechanisms influencing immunological and endocrinological mechanisms are of interest. There is evidence that subjective perceived stress may worsen IBD. Objective: To characterise IBD-patients with high perceived stress levels and to study whether stress management will improve outcome in IBD. Methods: 120 patients from four clinical university centers in Norway and Germany with UC or CD endoscopically and histologically verified. Active disease: Simple index/activity index > 5 and stable on medication last 4 weeks. Distress level on the perceived stress questionnaire > 60. After informed consent Randomisation of six groups of each 20 patients to a psychological intervention or treatment as usual group (1:1). The intervention group of 10 patients receives: a manualiszed stress management program, psychoeducation and relaxation techniques in 3 group sessions and 6 individual sessions of cognitive behavioural therapy once a week. Booster sessions after 6 and 12 month. Follow up time is 18 months, with assessment of somatic activity (assessment by an gastroenterologist baseline 3, 6, 12 and 18 month) and psychological data at baseline 6, 12 and 18 month. Main outcome measures: Symptomatic disease activity and endoscopic assessment. Calprotectin in stools. Inflammatory activity in blood and mucosa.
175 ALEXITHYMIA-EPIDEMIOLOGICAL FINDINGS Joukamaa M. University of Tampere, School of Public Health, Finland. During the 30 years since its definition alexithymia has been the topic of about one thousand scientific publications. Most of the papers have dealt with the association of alexithymia and some somatic disease or mental disorder. Only few papers have been published on the epidemiology of alexithymia. According to them some fairly clear associations between alexithymia and sociodemographic factors have been found so far. Alexithymia seems to be normally distributed in population. Roughly one out of ten persons in general population is alexithymic, men more commonly than women. The prevalence of alexithymia seems to increase with age. Still, alexithymia has been shown to associate with low educational level, poor social situation, unemployment and living alone. The results of two large-scale population studies on alexithymia (measured with the Toronto Alexithymia Scale 20) are described in more detail in the presentation.
treatment compared to normalweight subjects. Prevalences of psychiatric disorders were considerably higher in women participating in conventional treatment (Optifastaˆ) or about to undergo obesity surgery compared to normalweight women (OR 3.4, 95% CI 1.8 – 6.3; OR 3.1, 95% CI 1.8 – 5.3). Similar results yet less pronounced could be observed in obese men and women not seeking weight loss treatment compared to normalweight subjects (OR 1.6, 95% CI 0.5 – 5; OR 2.2, 95% CI 1.2 – 4.2). No considerable difference could be found between obese subjects with and without request at weight loss treatment. With regard to MC4R mutation only one obese carrier (0.25%) of the whole sample could be identified. Conclusions: Obese subjects suffer considerably more from psychiatric comorbidity compared to normalweight individuals. However no clinical important difference could be observed between obese subjects seeking and not seeking weight loss treatment. Our data do not indicate mutations in MC4R to be a strong contributor to the development of hyperphagia-induced morbid obesity.
191 ASSOCIATIONS OF NT-PRO BNP WITH QUALITY OF LIFE AND ANXIETY IN MEN AND WOMEN WITH CHF RISK FACTORS Herrmann-Lingen C, Rautenstrauch N, Binder L, Lu¨ers C, Wetzel D, Pouwels C, Kochen MM, Pieske B. Department of Psychosomatics and Psychotherapy, Go¨ttingen, Germany. Natriuretic peptides have been shown to exhibit anxiolytic-like effects in animal studies. It has also been suggested that the very high endogenous levels of atrial natriuretic peptide typically found in severe heart failure might limit anxiety in heart failure patients. However, nothing is known about the psychological impact of moderately elevated natriuretic peptide levels found in patients with asymptomatic ventricular dysfunction. We therefore studied 422 patients (62.8 ± 10.8 years, 58% men) with risk factors (diabetes, hypertension, stable coronary disease) but without clinical signs of heart failure. Patients completed the SF12 quality of life scale and the Hospital Anxiety and Depression Scale (HADS). All patients also underwent detailed cardiological diagnostics, including assessment of plasma levels of the N-terminal pro-Brain Natriuretic Peptide (NT-proBNP). NT-proBNP was elevated ( >100 pg/ml) in 54% of patients, indicating at least slight ventricular dysfunction. Although patients had no clinical signs of heart failure, high NT-proBNP was significantly (rho = 0.15; p = .002) associated with reduced physical quality of life (SF12). This effect was somewhat larger in men than in women. In men, anxiety (HADS) showed a significant association with (bad) physical quality of life (rho = 0.38; p < .0005) and an insignificant negative correlation with NT-proBNP. However, after adjusting for physical quality of life in linear regression, the inverse relationship between log-transformed NT-proBNP levels and HADS anxiety scores became significant (beta = 0.14; p < .02). Although NTproBNP increased with age, controlling for age didn’t change this result. In contrast, neither physical quality of life nor NT-proBNP were associated with anxiety in women. In conclusion, even the moderately elevated endogenous natriuretic peptide levels found in patients with subclinical ventricular dysfunction are associated with reduced physical quality of life, but, at the same time, relatively low levels of anxiety in men. The observation that no such effect can be found in women, requires further study.
611
293 PSYCHOBIOLOGICAL FACTORS IN INFLAMMATORY BOWEL DISEASE—THE DESIGN OF THE NORWEGIAN-GERMAN MULTICENTER STRESS INTERVENTION STUDY Jantschek G, Boye B, Leganger S, Moekleby K, Heldal A, Leiknes KA, Dahlstrom A, Wojniusz S, Blomhoff S, Hausken T, Jahnsen J, Vatn M, Wilhemsen I, Lundin K, Malt UF. Universities Lu¨beck/ Germany and Oslo and Bergen/Norway. Introduction: In Inflammatory bowel diseases (IBD) ulcerative colitis (UC) and Chrohn’s disease (CD) mechanisms influencing immunological and endocrinological mechanisms are of interest. There is evidence that subjective perceived stress may worsen IBD. Objective: To characterise IBD-patients with high perceived stress levels and to study whether stress management will improve outcome in IBD. Methods: 120 patients from four clinical university centers in Norway and Germany with UC or CD endoscopically and histologically verified. Active disease: Simple index/activity index > 5 and stable on medication last 4 weeks. Distress level on the perceived stress questionnaire > 60. After informed consent Randomisation of six groups of each 20 patients to a psychological intervention or treatment as usual group (1:1). The intervention group of 10 patients receives: a manualiszed stress management program, psychoeducation and relaxation techniques in 3 group sessions and 6 individual sessions of cognitive behavioural therapy once a week. Booster sessions after 6 and 12 month. Follow up time is 18 months, with assessment of somatic activity (assessment by an gastroenterologist baseline 3, 6, 12 and 18 month) and psychological data at baseline 6, 12 and 18 month. Main outcome measures: Symptomatic disease activity and endoscopic assessment. Calprotectin in stools. Inflammatory activity in blood and mucosa.
175 ALEXITHYMIA-EPIDEMIOLOGICAL FINDINGS Joukamaa M. University of Tampere, School of Public Health, Finland. During the 30 years since its definition alexithymia has been the topic of about one thousand scientific publications. Most of the papers have dealt with the association of alexithymia and some somatic disease or mental disorder. Only few papers have been published on the epidemiology of alexithymia. According to them some fairly clear associations between alexithymia and sociodemographic factors have been found so far. Alexithymia seems to be normally distributed in population. Roughly one out of ten persons in general population is alexithymic, men more commonly than women. The prevalence of alexithymia seems to increase with age. Still, alexithymia has been shown to associate with low educational level, poor social situation, unemployment and living alone. The results of two large-scale population studies on alexithymia (measured with the Toronto Alexithymia Scale 20) are described in more detail in the presentation.