Objective: To screen the physical, psychological and behavioral factors related to patients with temporomandibular disorders (TMD) by using Axis Ⅱ assessment instruments of diagnostic criteria for TMD(DC/TMD). And to provide a reference to establish personalized diagnosis and treatment plans for TMD patients so as to prevent TMD and reduce predisposing factors. Methods: A total of 141 TMD patients, who were admitted in the Department of Oral and Maxillofacial Surgery in School and Hospital of Stomatology, Wuhan University from October 2018 to February 2021 were selected. There were 121 females and 20 males, with an average age of 30 years. A total of 90 healthy people were included as controls. A full-time psychologist conducted relevant questionnaire surveys. The questionnaires include general clinical survey forms and TMD symptom questionnaire. In addition, Axis Ⅱ assessment instruments include graded chronic pain scale, jaw functional limitation scale, oral behaviors checklist, patient health questionnaire-9 (depression), generalized anxiety disorder scale, patient health questionnaire-15 (physical symptoms), etc. The main observational indicators include: pain level, pain impact rates, overall classification of chronic pain, limited chewing function score, limited motor function score, limited communication function score, total jaw function restricted score, depression score, anxiety score, somatic symptom score and oral behavior score.The survey data were imported into SPSS 22.0 software for statistical analysis. Results: In the TMD group 60.3% (85/141) patients had various degrees of pain, 24.1% (34/141) of those with pain effect grades from 1 to 3 and 61.0% (86/141) showed chronic pain overall grades from Ⅰ to Ⅳ. The chewing function restricted score was 2.67(1.17, 4.25), motor function restricted score was 4.25(1.75, 6.12), communication function restricted score was 1.13(1.00, 2.25) and total jaw function restricted score was 2.56(1.47, 4.15) respectively. Patients with mild depression or above accounted for 59.6%(84/141), patients with mild anxiety or above accounted for 56.7%(80/141), 46.1%(65/141) patients had somatization symptoms. Statistical differences (P<0.05) were determined between TMD group and control group in various scores of jaw function, oral behavior grading, depression, anxiety, and physical symptoms. Physical symptoms had significantly statistical difference between different diagnostic classification(P<0.05). Meanwhile, among the different chronic pain levels in the TMD group, there were statistical differences in the various scales of mandibular dysfunction, depression, anxiety, and somatization. In the TMD group, other significant differences were noticed between males and females in terms of the average score of mouth opening, verbal and facial communication, the total score of mandibular dysfunction as well as physical symptoms (P<0.05). Conclusions: Compared with the healthy people, patients with TMD had more abnormal oral behaviors, different restriction of the mandibular functional activities. At the same time, depression, anxiety, and somatization were more serious. Patients with osteoarthritis and subluxation of temporomandibular joint were more likely to suffer physical symptoms. TMD patients suffering from pain had more severe mandibular dysfunction and symptoms of depression, anxiety, and somatization.
Adult ; Depression/diagnosis* ; Facial Pain ; Female ; Humans ; Male ; Mandible ; Somatoform Disorders ; Temporomandibular Joint Disorders/diagnosis* ; Temporomandibular Joint Dysfunction Syndrome

We present a 33-year-old male patient with cerebellar ataxia. He was first considered to have a psychiatric conversion disorder but finally found to have chromosomal deletion in 7q31.2-31.32 involving Ca2⁺-dependent activator protein for secretion (CADPS) gene. When a targeted gene sequencing using next-generation sequencing panel and chromosomal microarray analysis were performed, an 8.6 Mb deletion within chromosome 7q31.2-31.32 was discovered. Deletion of CADPS gene in the 7q31.2-31.32 was suggested as the causative factor of cerebellar ataxia. Functional levels evaluated by Berg balance scale and modified Barthel index were improved via comprehensive rehabilitation including balance training and a dopamine agonist medication. To the best of our knowledge, this is the first report of chromosomal deletion in 7q31.2-31.32 including CADPS gene detected in patients with cerebellar ataxia.
Adult ; Cerebellar Ataxia ; Chromosome Disorders ; Conversion Disorder ; Dopamine Agonists ; Humans ; Male ; Microarray Analysis ; Rehabilitation

OBJECTIVES: The purpose of this study was to investigate the effect of body dissatisfaction on Smartphone addiction and to determine the relative magnitudes of specific mediation effect of personality characteristics.METHODS: One hundred and fifteen young and healthy participants completed the Smartphone Addiction Scale, Body Dysmorphic Disorder Examination-Self Report, and NEO Five-Factor Inventory. By using Indirect SPSS macros, multiple-mediation analyses were performed.RESULTS: Body dissatisfaction had a significant total, direct and indirect effect on Smartphone addiction. Indirect effect of Body dissatisfaction on Smartphone addiction was significantly mediated via personality characteristics (Neuroticism, Conscientiousness, and Openness).CONCLUSION: These results suggest the importance of evaluating both patients' personality characteristics and body dissatisfaction for managing Smartphone addiction. Consequently, they will be useful in the prevention and treatment of Smartphone addiction.
Body Dysmorphic Disorders ; Healthy Volunteers ; Negotiating ; Smartphone

PURPOSE: The purpose of this study was to investigate how college students' perceived stress, cognitive stress, and somatization affect their heart rate variability (HRV). METHODS: This study is a cross-sectional survey research on 191 university students, registered at the G University. The perceived stress scale (PSS) and cognitive stress response scale, were used to assess level of stress. The somatization symptom scale of the Symptom Check List 90 (SCL-90), was used to assess level of somatization caused by stress. To assess heart rate variability (HRV), we conducted a five-minute test using a pulse wave analyzer, to analyze short-term HRV. RESULTS: The SCL-90 somatization score had relatively high positive correlation (p<.001) with cognitive stress, but low positive correlation (p<.001) with perceived stress. Cognitive stress response had low negative correlation (p<.001) with 1nSDNN and 1nRMSSD among HRV parameters. Perceived stress was not correlated with HRV. Multiple regression analysis showed that variables of perceived stress, cognitive stress, and somatization symptoms, could not explain HRV. By contrast, one of the HRV indicators, 1nSDNN, was affected by age, gender, and aggressive-hostile thought, the latter being a subscale of the cognitive stress response scale. CONCLUSION: This study suggests that stress evaluation for people in early adulthood will be more effective, if the evaluation examines cognitive stress and heart rate variability.
Cross-Sectional Studies ; Heart Rate ; Heart ; Humans ; Mental Fatigue ; Somatoform Disorders

Neurologic symptoms that develop unconsciously and are incompatible with known pathophysiologic mechanisms or anatomic pathways belong to Conversion Disorder (CD). CD diagnosis is based on the clinical history and the exclusion of physical disorders causing significant distress or social and occupational impairment. In a subgroup of CD, called functional weakness (FW), symptoms affecting limbs may be persistent, thus causing a permanent or transient loss of limb function. Physiotherapy, pharmacotherapy, hypnotherapy and repetitive transcranial magnetic stimulation (rTMS) have been proposed as treatment strategies for FW-CD. Herein, we report a 30 year-old male, presenting with lower limb functional paraparesis, having obtained positive, objectively, and stable effects from a prolonged r-TMS protocol associated to a multidisciplinary approach, including psychological and sexuological counseling, and monitored by gait analysis. We postulate that our rTMS protocol, combined with a multidisciplinary approach may be the proper treatment strategy to improve FW-CD.
Brain* ; Conversion Disorder ; Counseling ; Diagnosis ; Drug Therapy ; Extremities ; Gait ; Humans ; Hypnosis ; Lower Extremity ; Male ; Neurologic Manifestations ; Paraparesis* ; Transcranial Magnetic Stimulation

OBJECTIVE: Health anxiety can be defined by concern about health in the absence of a pathology. The Health Anxiety Questionnaire (HAQ) based on the cognitive-behavioral model can be useful for evaluating the severity and the structure of health anxiety. This study aims to verify the reliability and validity of Korean version of HAQ (K-HAQ). METHODS: For reliability, test-retest reliability and internal consistency were analyzed. For construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. Receiver Operating Characteristic (ROC) analysis was performed to identify the optimal cut-off score. RESULTS: Cronbach’s alpha was 0.92, and r value of test-retest reliability was 0.84. In the EFA, 4- and 5-factor model showed cumulative percentile of variance of 60% or more. In the CFA, the 4-factor model was found to be the most appropriate and simplest (χ²=397.33, df=187, CFI=0.909, TLI=0.888, RMSEA=0.077). In the ROC analysis, the cut-off score was 20 points. CONCLUSION: It is expected that K-HAQ can be helpful to evaluate the severity of health anxiety and make therapeutic plans because K-HAQ can help explore the cognitive, emotional, and behavioral structure of health anxiety by each factor.
Anxiety* ; Hypochondriasis ; Pathology ; Reproducibility of Results* ; ROC Curve

BACKGROUND AND OBJECTIVES: This study investigated the relationship between reflux symptom index (RSI) and psychiatric problems such as depression, somatization, and anxiety. SUBJECTS AND METHOD: We prospectively analyzed 231 patients with symptoms with laryngopharyngeal reflux (LPR) using the RSI and the reflux finding score. RESULTS: Seventy nine patients (34.2%) were diagnosed with LPR. A significant correlation was detected between the RSI and depression (18.4±8.3 vs. 12.3±7.0, p < 0.001), anxiety (19.5±8.5 vs. 13.0±7.3, p < 0.001), and somatization (19.2±9.1 vs. 13.6±7.5, p < 0.001). A multivariate analysis confirmed a significant association between heartburn and depression [odds ratio (OR): 1.241, 95% confidence interval (CI): 1.003–1.537, p=0.047], choking and anxiety (OR: 1.747, 95% CI: 1.297–2.352, p < 0.001), and choking and somatization (OR: 1.707, 95% CI: 1.248–2.336, p=0.001). CONCLUSION: Our preliminary results suggest that patients with high RSI may need to be carefully evaluated for psychiatric problems.
Airway Obstruction ; Anxiety ; Depression ; Heartburn ; Humans ; Laryngopharyngeal Reflux ; Methods ; Multivariate Analysis ; Prospective Studies ; Somatoform Disorders

OBJECTIVES: The purpose of this study was to compare psychological test profiles of psychiatric outpatients with high and low depression/suicide ideation and to identify predictor variables for depression/suicide ideation. METHODS: Component scores of the Personality Assessment Inventory (PAI) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were compared using t-tests. Discriminant analysis was conducted for predictor variables of depression/suicide ideation. RESULTS: Regarding PAI profiles, somatic complaints (SOM), anxiety (ANX), anxiety-related disorder (ARD), depression (DEP), paranoia (PAR), borderline features (BOR), antisocial features (ANT), mania (MAN) drug problems (DRG) scores were significantly elevated in high depression and high suicide ideation groups. Concerning MMPI-2 profiles, the scores of hypochondriasis (Hs), depression (D), hysteria (Hy), psychopathic deviate (Pd), paranoia (Pa), psychasthenia (Pt), schizophrenia (Sc), social introversion (Si) were significantly elevated in these same groups. The PAI and MMPI-2 profile shapes were remarkably similar between high depression and high suicide ideation groups. Therefore, in terms of psychological profile, depression and suicidal ideation seemed to reflect the same construct. However, in discriminant analysis, significant predictors for depression were found to be Pt and D Sc from MMPI-2, while those for suicide ideation were found to be Pa and Sc, suggest subtle differences. CONCLUSION: The superficial characteristics of depression and suicide ideation groups reflected by the psychological test profiles seemed similar, but the determining factors may differ. Thus, the psychological interventions for these two groups may have to follow different routes considering these subtle differences.
Anxiety ; Bipolar Disorder ; Depression ; Discriminant Analysis ; Humans ; Hypochondriasis ; Hysteria ; Introversion (Psychology) ; Minnesota ; Outpatients ; Paranoid Disorders ; Personality Assessment ; Psychological Tests ; Schizophrenia ; Suicidal Ideation ; Suicide

Munchausen syndrome is a rare factitious disorder in which a person repeatedly and deliberately acts as if he or she has a physical or mental illness when he or she is not really sick. These patients distort their medical history, undergoing dangerous diagnostic and therapeutic procedures, often resulting in misdiagnosis. Management of this syndrome requires collateral history taking, sound clinical approach, exclusion of organicity, and addressing psychological issues. We report a 54-year-old female, who underwent orthopedic surgery 13 times. She was always unsatisfied with her surgical outcomes, and underwent additional surgical treatment of the shoulder, elbow, wrist, and knee joint. She repeatedly complained of joint pain, which was much more exaggerated than expected from her examination results. Therefore, we considered artificial arthrosis for a differential diagnosis of unclear arthrosis, and paid special attention when she exhibited odd behaviors.
Arthralgia ; Diagnosis, Differential ; Diagnostic Errors ; Elbow ; Female ; Humans ; Knee Joint ; Middle Aged ; Munchausen Syndrome ; Orthopedics ; Shoulder ; Wrist

Steroid withdrawal syndrome (SWS) following steroid dependence is becoming a common clinical condition. It may be associated with body image disorder. Though selective serotonin reuptake inhibitors (SSRIs) are found to be effective SWS associated depression, data for this clinical condition is limited. We present a case of SWS associated with body image disorder which improved with mirtazapine. Mirtazapine might be better option than SSRIs in this subgroup of patients for its noradrenergic property and better gastrointestinal profile. More research should explore its efficacy in this clinical condition.
Body Dysmorphic Disorders ; Depression* ; Humans ; Serotonin Uptake Inhibitors