Psychosomatics
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Randomized Controlled Trial
Responsiveness of hypochondriacal patients with chronic low-back pain to cognitive-behavioral therapy.
Evidence has suggested that cognitive-behavioral therapy (CBT) is effective in reducing hypochondriacal symptoms, and another line of evidence has suggested that CBT is also effective in reducing pain and the psychological conditions associated with chronic low-back pain (CLBP). The purpose of this study was to examine the effectiveness of CBT among hypochondriacal patients with and without CLBP. ⋯ CBT was certainly effective among hypochondriacal patients without CLBP, but it appeared to be insufficient for hypochondriacal patients with CLBP. The core psychopathology of hypochondriacal CLBP should be clarified to contribute to the adequate management of hypochondriacal symptoms in CLBP patients.
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Heightened levels of inflammation may be associated with an increased risk of depression, particularly among those with inflammatory medical conditions. Although elevated rates of both systemic inflammation and depression have been documented among patients with end stage renal disease (ESRD), the link between these factors has received little empirical evaluation. The goal of this pilot study was to investigate the association between cytokine gene polymorphisms (that are known to influence pro- and anti-inflammatory cytokine production) and depressive symptoms among patients with ESRD. ⋯ These findings provide some support for cytokine theories of depression in the medically ill, and specifically for the protective role of anti-inflammatory processes. Further research is needed to confirm these preliminary results and to explore the possibility of identifying subtypes of depressed patients based on inflammatory profiles, and those who may benefit from anti-inflammatory therapies.