Psychosomatic medicine
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Psychosomatic medicine · Sep 2011
Randomized Controlled TrialInteracting effects of trait anger and acute anger arousal on pain: the role of endogenous opioids.
Elevated trait anger (TRANG; heightened propensity to experience anger) is associated with greater pain responsiveness, possibly via associations with deficient endogenous opioid analgesia. This study tested whether acute anger arousal moderates the impact of TRANG on endogenous opioid analgesia. ⋯ Results indicate that hyperalgesic effects of TRANG are most prominent when acute anger is aroused and suggest that endogenous opioid mechanisms contribute.
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Negative expectations deriving from the clinical encounter can produce negative outcomes, known as nocebo effects. Specifically, research on the nocebo effect indicates that information disclosure about potential side effects can itself contribute to producing adverse effects. Neurobiological processes play a role in the nocebo effect, and this article provides a selective review of mechanistic research on the nocebo effect. ⋯ Nocebo effects adversely influence quality of life and therapy adherence, emphasizing the need for minimizing these responses to the extent possible. Evidence further indicates that the informed consent process in clinical trials may induce nocebo effects. This article concludes with ethical directions for future patient-oriented research and routine practice.
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Psychosomatic medicine · Sep 2011
Increased risks of acute organ dysfunction and mortality in intensive care unit patients with schizophrenia: a nationwide population-based study.
To investigate the risks of acute organ dysfunction and death in intensive care unit (ICU) patients with schizophrenia. ⋯ Among ICU patients, schizophrenic patients were sicker, having a higher risk of acute organ dysfunction and death.
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Psychosomatic medicine · Jul 2011
Ecological momentary assessment of maternal cortisol profiles over a multiple-day period predicts the length of human gestation.
Biobehavioral models of prenatal stress highlight the importance of the stress-related hormone cortisol. However, the association between maternal cortisol levels and the length of human gestation requires further investigation because most previous studies have relied on one-time cortisol measures assessed at varying gestational ages. This study assessed whether ecological momentary assessment (EMA) of cortisol sampling improves the ability to predict the length of human gestation. In addition, associations between EMA-based measures of psychological state (negative affect) with cortisol levels during pregnancy were assessed. ⋯ Our findings support the ecological validity of repeated ambulatory assessments of cortisol in pregnancy and their ability to improve the prediction of adverse birth outcomes.
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Psychosomatic medicine · Jul 2011
Association between generalized anxiety disorder and asthma morbidity.
Generalized anxiety disorder (GAD) is common among people with asthma, but its association with asthma morbidity remains unexplored. This study examined cross-sectional associations between GAD and asthma control, quality of life, and self-efficacy. ⋯ GAD is associated with worse asthma morbidity independent of age, sex, smoking, and asthma severity; however, comorbid major depressive disorder and low asthma self-efficacy may account for many of these associations. Only breathlessness and the frequency of bronchodilator use were uniquely associated with GAD. Future research should examine whether treatment of GAD can affect asthma outcomes.