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

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

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

PURPOSE: The purpose of this study was to identify the effects of emotional labor, compassion fatigue and occupational stress on the somatization of nurses in hemodialysis units. METHODS: The sample consisted of 139 nurses in hemodialysis units from a tertiary hospital, a general hospital, a dialysis clinic, and a care hospital in G province. Data were analyzed using frequencies, percentages, means and standard deviations, t-test, ANOVA, Duncan test, Pearson's correlation and hierarchical multiple regression. RESULTS: There were significant correlations of the experience of emotional labor, compassion fatigue and occupational stress with the somatization of nurses in hemodialysis units. Factors influencing somatization intention were ‘emotional labor’ (β=.37, p<.001), which explained 28% of the variance (F=10.00, p<.001). CONCLUSION: The results of this study indicate that the factor influencing the somatization of nurses in hemodialysis units was emotional labor. Therefore, strategies to decrease emotional labor of nurses in hemodialysis units are required.
Compassion Fatigue* ; Dialysis ; Empathy* ; Hospitals, General ; Intention ; Renal Dialysis* ; Somatoform Disorders ; Tertiary Care Centers

This study investigated the relationship between depression, somatization, anxiety, personality, and laryngopharyngeal reflux (LPR). We prospectively analyzed 231 patients with symptoms with LPR using the laryngopharyngeal reflux symptom index and the reflux finding score. Seventy nine (34.2%) patients were diagnosed with LPR. A significant correlation was detected between the presence of LPR and total scores on the Patient Health Questionnaire-9 (5.6±5.3 vs. 4.0±4.6, p=0.017) and the 7-item Generalized Anxiety Disorder Scale (4.3±4.9 vs. 3.0±4.5, p=0.041). LPR was significantly more frequent in those with depression than in those without (45.6% vs. 27.0%, p=0.004). A multivariate analysis confirmed a significant association between the presence of LPR and depression (odds ratio, 1.068; 95% confidence interval, 1.011–1.128; p=0.019). Our preliminary results suggest that patients with LPR may need to be carefully evaluated for depression.
Anxiety ; Anxiety Disorders ; Depression* ; Humans ; Laryngopharyngeal Reflux* ; Multivariate Analysis ; Prospective Studies ; Somatoform Disorders

Most common peripheral neuropathy around foot and ankle is diabetic neuropathy, but there are another cause of peripheral neuropathy, such as rheumatoid arthritis, metabolic disease, genetic disease, toxic material, and so on. The main symptom of peripheral neuropathy is pain. The disturbance of sensory and balancing, weakness of muscle, deformity of foot and neuropathic arthropathy are also the symptoms of the peripheral neuropathy. History taking is most important to identify the cause of peripheral neuropathy. Neurological exam have to include the pin prick test, vibration test, 10 g-monofilamant test and ankle reflex test. Simple radiography is essential to observe the deformities or neuropathic arthropathy at foot and ankle. The presence of peripheral neuropathy, involvement and severity can be identified from nerve conduction study. The study of occlusive arteritis is essential for diabetic neuropathy. The medical treatment of associated disease is important but the pain of peripheral neuropathy should be controlled simultaneously. Medicine include the antidepressants, anticonvulsants, opioids and topical agents. The surgical treatment of peripheral neuropathy include lengthening of Achilles tendon, correction of deformity, the total contact cast and arthrodesis. Surgical decompression of specific nerve might helpful in pain control of peripheral neuropathy.
Achilles Tendon ; Analgesics, Opioid ; Ankle* ; Anticonvulsants ; Antidepressive Agents ; Arteritis ; Arthritis, Rheumatoid ; Arthrodesis ; Congenital Abnormalities ; Decompression, Surgical ; Diabetic Neuropathies ; Diagnosis ; Foot* ; Metabolic Diseases ; Neural Conduction ; Peripheral Nervous System Diseases* ; Radiography ; Reflex ; Somatoform Disorders* ; Vibration

OBJECTIVES: The author tried to find out reasons why and how hysteria(and conversion disorder) patient numbers, which were so prevalent even a few decades ago, have decreased and the phenotype of symptoms have changed. METHODS: The number of visiting patients diagnosed with conversion disorder and their phenotype of symptoms were investigated through chart reviews in a psychiatric department of a University hospital for the last 12 years. Additionally, the characteristics of conversion disorder patients visiting the emergency room for last 2 years were also reviewed. Those results were compared with previous research results even if it seemed to be an indirect comparisons. The research relied on Briquet P. and Charcot JM's established factors of the vicissitudes of hysteria(and conversion disorder) which has been the framework for more than one hundred and fifty years since hysteria has been investigated. RESULTS: The author found decreased numbers and changes of the phenotype of the hysteria patients(and conversion disorder) over the last several decades. The decreased numbers and changes of the symptoms of those seemed to be partly due to several issues. These issues include the development of the diagnostic techniques to identify organic causes of hysteria, repeated changes to the symptom descriptions and diagnostic classification, changes of the brain nervous functions in response to negative emotions, and the influence of human evolution. CONCLUSIONS: The author proposed that the evolutionary brain discord reaction theory explains the causes of disappearance of and changes to symptoms of hysteria(conversion disorder). Most patients with hysteria(conversion disorder) have been diagnosed in the neurological department. For providing more appropriate treatment and minimizing physical disabilities to those patients, psychiatrists should have a major role in cooperating not only with primary care physicians but with neurologists. The term 'hysteria' which had been used long ago should be revived and used as a term to describe diseases such as somatic symptom disorder, functional neurological symptoms, somatization, and somatoform disorders, all of which represent almost the same vague concept as hysteria.
Brain* ; Classification ; Conversion Disorder ; Emergency Service, Hospital ; Humans ; Hysteria ; Phenotype ; Physicians, Primary Care ; Psychiatry ; Somatoform Disorders

PURPOSE: The purpose of this study was to identify depression and its influencing factor of nurses among comprehensive nursing care service ward. METHODS: The research was cross-sectional descriptive study. The subjects of the study were 173 nurses of comprehensive nursing care service ward in Gyeonggi-do. Data collection was done using self-reported structured questionnaires asking about job stress, emotional labor, job burnout, somatic symptoms, turnover intention, depression and general characteristics from May 16 to June 3, 2016. Data were analyzed with SPSS/WIN 19.0 program. RESULTS: Mean scores of job stress were 159.15(range 43~215), emotional labor 30.90(range: 9~45), job burnout 59.45 (range: 0~132), somatic symptoms 24.03 (range: 12~60), turnover intention 5.61 (range 0~18) and depression 19.25 (range: 0~60) and reported as depression in 63.6%. Somatic symptoms (β=.26, p<.001), job burnout (β=.37, p<.001) had significant associations with depression and the most important variable was job burnout. CONCLUSION: It is necessary to apply the developed program to reduce job burnout in hospitals and to prevent and/or control depression. And also, it needs to improve working conditions and increase the nursing staff to reduce somatic symptoms for nurses among comprehensive nursing care service ward.
Data Collection ; Depression* ; Gyeonggi-do ; Humans ; Intention ; Nursing Care* ; Nursing Staff ; Nursing* ; Somatoform Disorders ; Stress, Psychological

OBJECTIVETo evaluate clinical effect and safety of floating needle therapy and duloxetine in treating patients with persistent somatoform pain disorder (PSPD).

METHODSTotally 108 PSPD patients were randomly assigned to the floating needle treatment group, the duloxetine treatment group, and the placebo treatment group, 36 in each group. Patients in the floating needle treatment group received floating needle therapy and placebo. Those in the duloxetine treatment group received duloxetine and simulated floating needle therapy. Those in the placebo treatment group received the placebo and simulated floating needle therapy. All treatment lasted for six weeks. Efficacy and adverse reactions were evaluated using Simple McGill pain scale (SF-MPQ) and Treatment Emergent Symptom Scale (TESS) before treatment and immediately after treatment, as well as at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Hamilton Depression Scale (HAMD, 17 items), Hamilton Anxiety Scale (HAMA) were assessed before treatment and at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Patients in the floating needle treatment group and the duloxetine treatment group with the total reducing score rate of SF-MPQ in Pain Rating index (PRI) ≥ 50% after 6 weeks' treatment were involved in the follow-up study.

RESULTS(1) Compared with the same group before treatment, SF-MPQ score, HAMD score and HAMA total scores all decreased in all the three groups at the end of 1st, 2nd, 4th, and 6th week of treatment (P < 0.05, P < 0.01). Besides , each item of SF-MPQ significantly decreased immediately after treatment in the floating needle treatment group (P < 0.01). Compared with the placebo treatment group, SF-MPQ, HAMD, and HAMA total score in the floating needle treatment group significantly decreased after 1, 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). SF-MPQ score, HAMD score and HAMA total score in the duloxetine treatment group also significantly decreased after 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). (2) There were 3 patients (8.3%) who had adverse reactions in the floating needle treatment group, 17 (50.0%) in the duloxetine treatment group, and 7 (21.2%) in the placebo treatment group. Compared with the placebo treatment group, the incidence of adverse reaction increased in the duloxetine treatment group (χ² = 6.04, P < 0.05). Besides, it was higher in the duloxetine treatment group than in the floating needle treatment group (χ² = 14.9, P < 0.05). (3) There were 19 patients in the floating needle treatment group and 17 patients in the duloxetine treatment group involved in the follow-up study. Compared with 6 weeks after treatment, no significant difference was observed at 3 and 6 months after treatment in the score of SF-MPQ, HAMD, and HAMA in the floating needle treatment group and the duloxetine treatment group. No significant difference was observed between the two groups (P > 0.05). There were 5 patients (29.4%) who had adverse reactions in the duloxetine treatment group, and no adverse reactions were observed in the floating needle treatment group. The adverse reaction rate was significantly different between the two groups (χ² = 4.26, P < 0.05).

CONCLUSIONSFloating needle therapy and duloxetine were effective in treatment of patients with PSPD. However, floating needle therapy could relieve pain more rapidly than duloxetine, with obviously less adverse reactions.

Acupuncture Therapy ; methods ; Analgesics ; therapeutic use ; Anxiety Disorders ; Duloxetine Hydrochloride ; therapeutic use ; Follow-Up Studies ; Humans ; Needles ; Pain ; Pain Management ; methods ; Pain Measurement ; Psychiatric Status Rating Scales ; Somatoform Disorders ; therapy ; Treatment Outcome

OBJECTIVE: Brain-derived neurotrophic factor (BDNF), one of the most abundant and important neurotrophins, is known to be involved in the development, survival, maintenance, and plasticity of neurons in the nervous system. Some studies have suggested that BDNF may play a role in the pathophysiology of several psychiatric illnesses such as depression and schizophrenia. Similarly, it is likely that the alteration of BDNF may be associated with the neuro-modulation that contributes to the development of somatization disorder. METHODS: The purpose of this study was to determine whether there is an abnormality of plasma BDNF levels in patients with somatization disorder, and to analyze the nature of the alteration after pharmacotherapy using an enzyme-linked immunosorbent assay (ELISA). RESULTS: The plasma BDNF levels of the patients with a somatization disorder were significantly lower compared with those of the control volunteers (83.61±89.97 pg/mL vs. 771.36±562.14 pg/mL); moreover, the plasma BDNF levels of those patients who received an antidepressant were significantly increased after the treatment (118.13±91.45 pg/mL vs. 72.92±88.21 pg/mL). CONCLUSION: These results suggest that BDNF may play a role in the pathophysiology of somatization disorder.
Brain-Derived Neurotrophic Factor* ; Depression ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Humans ; Nerve Growth Factors ; Nervous System ; Neurons ; Plasma* ; Plastics ; Schizophrenia ; Somatoform Disorders* ; Volunteers