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Psychological and physical exhaustion of the patients with fibromyalgia syndrome
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Poster abstracts / Journal of Psychosomatic Research 55 (2003) 147–178
psychosocial work characteristics on monocyte activation. We studied two activation markers: CD62L is a major adhesion molecule of human leukocytes, mediating rolling on activated endothelial cells at sites of inflammation. HLA-DR expression reflects the monocyte’s ability to present antigen and to partake in the immune response. Decreased HLA-DR is found in immunosuppression and is associated with increased susceptibility to infections. Methods/results: Monocytes from participants of the Augsburg Cohort Project (n = 490, mean age = 41.1 years, 88% male) were studied by flow cytometry. Subjects with evidence of acute inflammation (history, C-reactive protein > 10 mg/l) were excluded. CD62L and HLA-DR monocyte counts were regressed against a model comprising (a) demographic variables, (b) the Framingham cardiovascular risk index, (c) health behavior (smoking, exercise, alcohol intake sleep), and (d) work-related characteristics (exhaustion, effort – reward imbalance, job demands, social support). CD62L counts were positively related to smoking ( P = .027) and showed a U-shaped relation with alcohol intake ( P < .0l). Smokers ( P = .006) and exhausted individuals ( P = .05) had lower HLADR counts. Conclusion: After controlling for demographic and medical variables, health behavior and exhaustion are related to monocyte activation.
The efficacy of venlafaxine in the treatment of fibromyalgia : an open study Sayar K, Aksu G, Ak I, Tosun M Fifteen patients with fibromyalgia were assessed prior to and after treatment with a fixed dose, 75 mg/day, venlafaxine. Before initiation of pharmacotherapy, patients were interviewed with the structured clinical interview for the DSM-IV axis I disorders. The study lasted for 12 weeks and patients were evaluated on the 6th and 12th weeks of treatment. The primary outcome measures were the Fibromyalgia Impact Questionnaire total score and pain score. The anxiety and depression levels of the patients were measured with the Beck Depression, the Beck Anxiety, the Hamilton Anxiety, and the Hamilton Depression Scales. There was a significant improvement in the intensity of pain ( F = 14.3, P < .05) and in the disability caused by fibromyalgia ( F = 42.7, P < .05) from baseline to the 12th week of treatment. The depression and anxiety scores also decreased significantly from baseline to the 12th week. The improvement in the FIQ scores did not correlate with the decrease of scores in both patient- and physician-rated depression and anxiety inventories. Change in pain scores also was not correlated with the change in depression and anxiety scores. Venlafaxine was quite promising in alleviating the pain and disability induced by the disease. This effect seems to be independent of its anxiolytic and antidepressant properties. Blockade of both norepinephrine and serotonin reuptake might be more effective than blockade of either neurotransmitter alone in the treatment of fibromyalgia.
Study on psychosomatic factors and infertility Yimin C, Zhaohui L, Xianmi W, Bianfang Y, Shaozheng Y, Zhanying Y, Yanchao S, Zhizhou Z, Yujiao Z Objectives: To find out the relationship between psychosomatic factors and infertility. Methods: From April to October 2002, we investigated 3052 married women in rural areas of Dengfeng and Xinmi counties in Henan province. We considered 1421 infertile women as case group and 1631 fertile woman as control group. Results: The proportions of somatic factors among the infertile women were significantly higher than that among the fertile women and the differences were statistically significant. These somatic factors included ‘‘dysmenorrhea’’ (v2 = 9.61, P < .01), ‘‘menstrual cycle abnormal’’ (v2 = 36.37, P < .001), ‘‘little amount of menstruation’’ (v2 = 160.07, P < .05), ‘‘no sex orgasm’’ (v2 = 25.35, P < .001), ‘‘reducing sexual desire’’ (v2 = 44.47, P < .001), and ‘‘loss of sexual desire’’ (v2 = 7.05, P < .01). The
proportions of the psychological factors (including ‘‘psychentonia,’’ ‘‘anxiety,’’ ‘‘agrypnia,’’ ‘‘multidream,’’ and ‘‘depression’’) among the infertile women were significantly higher than that among the fertile women (the rates in infertile woman was 5 – 8%, while that in fertile women was 1 – 4%) and the differences were statistically significant ( P < .01). Our study indicated that domestic violence increased both somatic factors and psychological factors, which resulted in infertility. Conclusion: The infertility associate with psychological factors and psychological factors can influence some somatic factors, e.g., menstruation, sexual life, and endocrine so as to result in infertility.
A pilot study of oxcarbazepine in treatment of dysphoria with increased impulsivity Strzelec JS Accessive impulsivity and dysphoria are common in patients with depression, schizoaffective disorder, and schizophrenia. Large numbers of patients who respond to their treatment of principal disease still show symptoms of dysphoria or impulsivity. Various treatments, however, show limited efficacy. Thirty-two patients with diagnosis of recurrent depression, schizophrenia, or schizoaffective disorder have been included in the trial of treatment with oxcarbazepine to reduce symptoms of dysphoria or impulsivity. Twenty-five patients completed the trial. Oxcarbazepine given at doses of 600 mg/day markedly diminished symptoms of impulsivity, anxiety, and dysphoria at week 4, 6, and 8, as measured with COVI Anxiety Scale, Impulsivity Rating Scale, MADRS, and CGI Scales. Oxcarbazepine showed better tolerability rate to carbamazepine. No serious adverse events have been reported during the study. Oxcarbazepine may be effective in treatment of dysphoria and impulsivity as an adjunct therapy to the basic one.
Psychological and physical exhaustion of the patients with fibromyalgia syndrome Murakami M, Matsuno T, Koike K, Katsura T, Horie T Background: Fibromyalgia syndrome (FMS) is the most commonly encountered disorder among the extra-articular rheumatic diseases and is characterized by long-lasting generalized pain of the fibromuscular tissue. Since this disease involves a strong psychogenic element, the treatment and diagnosis of FMS has not been well established among rheumatologists in Japan. Methods: We studied 50 patients with FMS who satisfied the preliminary classification criteria described by American College for Rheumatology and 33 control patients with depression. Results: The widespread pain lasted a maximum of 108 months and an average of 32.9 months. Because of the pain, all patients felt inconvenience in their daily lives and attended multiple medical facilities. Many symptoms are common with the pathological manifestation of FMS such as generalized fatigue, headache, loss of appetite, and insomnia. The mean score of SDS (Zung’s Self-Rating Depression Scale) was 48.2 F 9.2 in the FMS group and 50.9 F 9.2 in the control, and depression is suspected to contribute to the pathological manifestation of FMS. The manner of serotonin metabolism and relationship between serotonin- and stress-induced fatigue is similar to depressive patients. The level of acylcarnitine is also similar to depression. Conclusion: Psychological and physical exhaustion due to an irregular life style, physical strain, and accumulated fatigue may be the key stress factors for the organization of symptoms of the patients with FMS.
Knowledge of risk for heart disease: differences among ethnicities and diabetes treatment groups Wagner JA
Poster abstracts / Journal of Psychosomatic Research 55 (2003) 147–178
psychosocial work characteristics on monocyte activation. We studied two activation markers: CD62L is a major adhesion molecule of human leukocytes, mediating rolling on activated endothelial cells at sites of inflammation. HLA-DR expression reflects the monocyte’s ability to present antigen and to partake in the immune response. Decreased HLA-DR is found in immunosuppression and is associated with increased susceptibility to infections. Methods/results: Monocytes from participants of the Augsburg Cohort Project (n = 490, mean age = 41.1 years, 88% male) were studied by flow cytometry. Subjects with evidence of acute inflammation (history, C-reactive protein > 10 mg/l) were excluded. CD62L and HLA-DR monocyte counts were regressed against a model comprising (a) demographic variables, (b) the Framingham cardiovascular risk index, (c) health behavior (smoking, exercise, alcohol intake sleep), and (d) work-related characteristics (exhaustion, effort – reward imbalance, job demands, social support). CD62L counts were positively related to smoking ( P = .027) and showed a U-shaped relation with alcohol intake ( P < .0l). Smokers ( P = .006) and exhausted individuals ( P = .05) had lower HLADR counts. Conclusion: After controlling for demographic and medical variables, health behavior and exhaustion are related to monocyte activation.
The efficacy of venlafaxine in the treatment of fibromyalgia : an open study Sayar K, Aksu G, Ak I, Tosun M Fifteen patients with fibromyalgia were assessed prior to and after treatment with a fixed dose, 75 mg/day, venlafaxine. Before initiation of pharmacotherapy, patients were interviewed with the structured clinical interview for the DSM-IV axis I disorders. The study lasted for 12 weeks and patients were evaluated on the 6th and 12th weeks of treatment. The primary outcome measures were the Fibromyalgia Impact Questionnaire total score and pain score. The anxiety and depression levels of the patients were measured with the Beck Depression, the Beck Anxiety, the Hamilton Anxiety, and the Hamilton Depression Scales. There was a significant improvement in the intensity of pain ( F = 14.3, P < .05) and in the disability caused by fibromyalgia ( F = 42.7, P < .05) from baseline to the 12th week of treatment. The depression and anxiety scores also decreased significantly from baseline to the 12th week. The improvement in the FIQ scores did not correlate with the decrease of scores in both patient- and physician-rated depression and anxiety inventories. Change in pain scores also was not correlated with the change in depression and anxiety scores. Venlafaxine was quite promising in alleviating the pain and disability induced by the disease. This effect seems to be independent of its anxiolytic and antidepressant properties. Blockade of both norepinephrine and serotonin reuptake might be more effective than blockade of either neurotransmitter alone in the treatment of fibromyalgia.
Study on psychosomatic factors and infertility Yimin C, Zhaohui L, Xianmi W, Bianfang Y, Shaozheng Y, Zhanying Y, Yanchao S, Zhizhou Z, Yujiao Z Objectives: To find out the relationship between psychosomatic factors and infertility. Methods: From April to October 2002, we investigated 3052 married women in rural areas of Dengfeng and Xinmi counties in Henan province. We considered 1421 infertile women as case group and 1631 fertile woman as control group. Results: The proportions of somatic factors among the infertile women were significantly higher than that among the fertile women and the differences were statistically significant. These somatic factors included ‘‘dysmenorrhea’’ (v2 = 9.61, P < .01), ‘‘menstrual cycle abnormal’’ (v2 = 36.37, P < .001), ‘‘little amount of menstruation’’ (v2 = 160.07, P < .05), ‘‘no sex orgasm’’ (v2 = 25.35, P < .001), ‘‘reducing sexual desire’’ (v2 = 44.47, P < .001), and ‘‘loss of sexual desire’’ (v2 = 7.05, P < .01). The
proportions of the psychological factors (including ‘‘psychentonia,’’ ‘‘anxiety,’’ ‘‘agrypnia,’’ ‘‘multidream,’’ and ‘‘depression’’) among the infertile women were significantly higher than that among the fertile women (the rates in infertile woman was 5 – 8%, while that in fertile women was 1 – 4%) and the differences were statistically significant ( P < .01). Our study indicated that domestic violence increased both somatic factors and psychological factors, which resulted in infertility. Conclusion: The infertility associate with psychological factors and psychological factors can influence some somatic factors, e.g., menstruation, sexual life, and endocrine so as to result in infertility.
A pilot study of oxcarbazepine in treatment of dysphoria with increased impulsivity Strzelec JS Accessive impulsivity and dysphoria are common in patients with depression, schizoaffective disorder, and schizophrenia. Large numbers of patients who respond to their treatment of principal disease still show symptoms of dysphoria or impulsivity. Various treatments, however, show limited efficacy. Thirty-two patients with diagnosis of recurrent depression, schizophrenia, or schizoaffective disorder have been included in the trial of treatment with oxcarbazepine to reduce symptoms of dysphoria or impulsivity. Twenty-five patients completed the trial. Oxcarbazepine given at doses of 600 mg/day markedly diminished symptoms of impulsivity, anxiety, and dysphoria at week 4, 6, and 8, as measured with COVI Anxiety Scale, Impulsivity Rating Scale, MADRS, and CGI Scales. Oxcarbazepine showed better tolerability rate to carbamazepine. No serious adverse events have been reported during the study. Oxcarbazepine may be effective in treatment of dysphoria and impulsivity as an adjunct therapy to the basic one.
Psychological and physical exhaustion of the patients with fibromyalgia syndrome Murakami M, Matsuno T, Koike K, Katsura T, Horie T Background: Fibromyalgia syndrome (FMS) is the most commonly encountered disorder among the extra-articular rheumatic diseases and is characterized by long-lasting generalized pain of the fibromuscular tissue. Since this disease involves a strong psychogenic element, the treatment and diagnosis of FMS has not been well established among rheumatologists in Japan. Methods: We studied 50 patients with FMS who satisfied the preliminary classification criteria described by American College for Rheumatology and 33 control patients with depression. Results: The widespread pain lasted a maximum of 108 months and an average of 32.9 months. Because of the pain, all patients felt inconvenience in their daily lives and attended multiple medical facilities. Many symptoms are common with the pathological manifestation of FMS such as generalized fatigue, headache, loss of appetite, and insomnia. The mean score of SDS (Zung’s Self-Rating Depression Scale) was 48.2 F 9.2 in the FMS group and 50.9 F 9.2 in the control, and depression is suspected to contribute to the pathological manifestation of FMS. The manner of serotonin metabolism and relationship between serotonin- and stress-induced fatigue is similar to depressive patients. The level of acylcarnitine is also similar to depression. Conclusion: Psychological and physical exhaustion due to an irregular life style, physical strain, and accumulated fatigue may be the key stress factors for the organization of symptoms of the patients with FMS.
Knowledge of risk for heart disease: differences among ethnicities and diabetes treatment groups Wagner JA