Psychosocial stress affects the change of mental distress under dermatological treatment-A prospective cohort study in patients with psoriasis.

Psoriasis is a chronic-inflammatory, immune-mediated disease leading to a state of increased systemic inflammation. Mental comorbidities often occur in the patients and may additionally affect the therapy outcome. Currently, it is unknown whether the disease severity, psychosocial stress or health-related quality of life determines the manifestation of anxiety/depression, or vice versa, in psoriasis.

Mental distress of physicians in the outpatient care throughout the COVID-19 pandemic: emotional and supportive human relations matter - Cross-sectional results of the VOICE-study.

Background: The aim of this cross-sectional study was to evaluate the course of self-reported mental distress and quality of life (QoL) of physicians, working in the outpatient care (POC). Outcomes were compared with a control group of physicians working in the inpatient care (PIC), throughout the Corona Virus Disease (COVID)-19 pandemic. The impact of risk and protective factors in terms of emotional and supportive human relations on mental distress and perceived QoL of POC were of primary interest.

Rates and predictors of mental health care utilisation in patients following a prolonged stay on intensive care unit: a prospective cohort study.

Objectives: An acute critical illness and secondary complications may necessitate a prolonged treatment on an intensive care unit (ICU). As long-term consequences, ICU survivors may suffer from both physical and psychological sequelae. To improve the aftercare of these patients, the present study aimed to assess the use of mental healthcare and associated factors following prolonged ICU stay.

Cortisol response under low intensity exercise during cognitive-behavioral therapy is associated with therapeutic outcome in panic disorder-an exploratory study.

Objectives: Patients with Panic Disorder (PD) show an abnormal stress-induced functioning of the Hypothalamic-Pituitary-adrenal (HPA)-axis. Different protocols for stress induction are of rather low relevance for the psychotherapeutic treatment. In practice, interoceptive exposure is often realized as Low Intensity Exercise (LIE), as compared to an incremental cycle exercise test to exhaustion.

Childhood Trauma and Psychosocial Stress Affect Treatment Outcome in Patients With Psoriasis Starting a New Treatment Episode.

Objective: Traumatic childhood experiences and psychosocial stress may predispose the evolvement of somatic diseases. Psoriasis is a multifactorial chronic inflammatory skin disease that often associates with current and past stress. Both may entail pathological alterations in major stress axes and a balance shift in the level of T helper type 1 (Th1) and 2 (Th2) cytokines, affecting the development and course of psoriasis.

Single assessment of delirium severity during postacute intensive care of chronically critically ill patients and its associated factors: post hoc analysis of a prospective cohort study in Germany.

Objectives: To assess the delirium severity (DS), its risk factors and association with adverse patient outcomes in chronically critically ill (CCI) patients.

Design: A prospective cohort study.

Setting: A tertiary care hospital with postacute intensive care units (ICUs) in Germany.

Impact of post-traumatic stress symptoms on the health-related quality of life in a cohort study with chronically critically ill patients and their partners: age matters.

Background: Survivors of an acute critical illness with continuing organ dysfunction and uncontrolled inflammatory responses are prone to become chronically critically ill. As mental sequelae, a post-traumatic stress disorder and an associated decrease in the health-related quality of life (QoL) may occur, not only in the patients but also in their partners. Currently, research on long-term mental distress in chronically critically ill patient-partner dyads, using appropriate dyadic analysis strategies (patients and partners being measured and linked on the same variables) and controlling for contextual factors, is lacking.

Neural Responses to Faces of Attachment Figures and Unfamiliar Faces: Associations With Organized and Disorganized Attachment Representations.

The neural response to faces of attachment figures compared with unfamiliar faces still remains elusive. In particular, the modulation of the neural response by the organized (secure, insecure) compared with disorganized attachment representation of the subject investigated is unknown. For the present study, 38 healthy participants (age range, 21-71 years) were recruited.

Predictors of Major Depressive Disorder following Intensive Care of Chronically Critically Ill Patients.

Objective: Major depressive disorder (MDD) is a common condition following treatment in the Intensive Care Unit (ICU). Long-term data on MDD in chronically critically ill (CCI) patients are scarce. Hence, the primary aim of the present study was to investigate the frequency and predictors of MDD after intensive care of CCI patients.

Self-reported fatigue following intensive care of chronically critically ill patients: a prospective cohort study.

Background: Protracted treatment on intensive care unit (ICU) sets the patients at increased risk for the development of chronic critical illness (CCI). Muscular and cardio-respiratory deconditioning are common long-term sequelae, going along with a state of chronic fatigue. At present, findings regarding the frequency, long-term course, and associated factors of self-reported fatigue following ICU treatment of CCI patients are lacking.

Fatigue in chronically critically ill patients following intensive care - reliability and validity of the multidimensional fatigue inventory (MFI-20).

Background: Fatigue often occurs as long-term complication in chronically critically ill (CCI) patients after prolonged intensive care treatment. The Multidimensional Fatigue Inventory (MFI-20) has been established as valid instrument to measure fatigue in a wide range of medical illnesses. Regarding the measurement of fatigue in CCI patients, the psychometric properties of the MFI-20 have not been investigated so far.

Risk Factors of Delayed Onset Posttraumatic Stress Disorder in Chronically Critically Ill Patients.

The main aim of this study was to investigate factors associated with a delayed-onset posttraumatic stress disorder (PTSD) after the intensive care unit (ICU) treatment of patients with a chronic critical illness (CCI). Patients (n = 97) with critical illness polyneuropathy or critical illness myopathy were interviewed via the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. The diagnosis of the acute stress disorder was assessed within 1 month (t1), the diagnosis of PTSD at 3 (t2) and 6 (t3) months after transfer from the acute care ICU to the post-acute ICU.

Effects of Mental Stress Induction on Heart Rate Variability in Patients with Panic Disorder.

Reduced heart rate variability (HRV) constitutes a widely used marker of cardiac autonomic inflexibility which has been linked to disorders such as panic disorder (PD). To date, the pathophysiological mechanisms whereby panic leads to attenuated HRV are not fully elucidated. We aimed to investigate the hypothesis that PD patients show pathological reactivity both in response to interoceptive and psychosocial stress in comparison to healthy individuals.

Predictors of posttraumatic stress and quality of life in family members of chronically critically ill patients after intensive care.

Background: Prolonged mechanical ventilation for acute medical conditions increases the risk of chronic critical illness (CCI). Close family members are confronted with the life-threatening condition of the CCI patients and are prone to develop posttraumatic stress disorder affecting their health-related quality of life (HRQL). Main aim of the present study was to investigate patient- and family-related risk factors for posttraumatic stress and decreased HRQL in family members of CCI patients.

Predisposition or side effect of the duration: the reactivity of the HPA-axis under psychosocial stress in panic disorder.

Background: Panic disorder (PD) has been associated with an altered reactivity of the hypothalamic–pituitary–adrenocortical (HPA) system under psychosocial stress. Until now it remains unclear whether a diminished cortisol release is an early risk factor predisposing for PD or a consequence of PD. In order to unravel this point, the present study compares the cortisol secretion between patients with a recent onset and a chronic course of PD.

Salivary alpha-amylase response following repeated psychosocial stress in patients with panic disorder.

Background: This study examined autonomic responses (salivary alpha-amylase, sAA; heart rate, HR) to repeated psychosocial stress as a candidate mechanism linking autonomic hyper-arousal and sensitization to the occurrence of panic disorder (PD).

Methods: Thirty-three patients with PD and 34 healthy controls were exposed to the Trier Social Stress Test (TSST) twice on consecutive days.

Results: sAA changes were comparable between PD and controls on both testing days with overall decreasing sAA responses (delta) on day two.

Stress disorders following prolonged critical illness in survivors of severe sepsis.

Objectives: To examine the frequency of acute stress disorder and posttraumatic stress disorder in chronically critically ill patients with a specific focus on severe sepsis, to classify different courses of stress disorders from 4 weeks to 6 months after transfer from acute care hospital to postacute rehabilitation, and to identify patients at risk by examining the relationship between clinical, demographic, and psychological variables and stress disorder symptoms.

Design: Prospective longitudinal cohort study, three assessment times within 4 weeks, 3 months, and 6 months after transfer to postacute rehabilitation.

Setting: Patients were consecutively enrolled in a large rehabilitation hospital (Clinic Bavaria, Kreischa, Germany) admitted for ventilator weaning from acute care hospitals.

Chewing after stress: psychosocial stress influences chewing frequency, chewing efficacy, and appetite.

Background: Psychosocial stress is accompanied by an increase in the activity of the hypothalamic-pituitary-adrenocortical (HPA)-axis and by an increase in food intake. At present, no studies have been conducted to examine the impact of a potent laboratory stress test on the chewing frequency.

Methods: Thirty-one healthy participants (14 females, mean age 27.

Altered olfactory processing of stress-related body odors and artificial odors in patients with panic disorder.

Background: Patients with Panic Disorder (PD) direct their attention towards potential threat, followed by panic attacks, and increased sweat production. Onés own anxiety sweat odor influences the attentional focus, and discrimination of threat or non-threat. Since olfactory projection areas overlap with neuronal areas of a panic-specific fear network, the present study investigated the neuronal processing of odors in general and of stress-related sweat odors in particular in patients with PD.

Pre-hospital discharge testing of defibrillator without anesthesia: effects on psychological symptoms during clinical follow-up.

Objective: After the implantation of an implantable cardioverter-defibrillator (ICD), patients often fear therapeutic shock. The extent to which the experience of pre-hospital discharge (PHD) testing without anesthesia after ICD implantation, under observation by a physician, affects shock-related anxiety symptoms on follow-up has not been investigated as yet.

Methods: In a prospective, randomized controlled trial, 44 patients with a primary prevention indication for an ICD were randomly assigned to experience PHD testing without anesthesia (n = 23) or with anesthesia (n = 21).

Blunted salivary and plasma cortisol response in patients with panic disorder under psychosocial stress.

Background: Panic disorder (PD) has been associated with an altered activity of the hypothalamic-pituitary-adrenal-cortical (HPA) axis. Recent findings from a patient sample with PD with secondary depression on psychotropic medication using salivary cortisol as outcome measure suggest a non-responsiveness of the HPA-axis under acute psychosocial stress. Salivary cortisol does not necessarily reflect the total plasma cortisol due to interfering variables.

Cortisol response to repeated psychosocial stress.

Psychosocial stress plays a major role in the etiology and the course of mental disorders that often show an altered activation of the hypothalamus-pituitary-adrenal (HPA) axis. The Trier Social Stress Test (TSST) reliably activates the HPA axis and reflects real life stress exposure. However, habituation may confound the results of clinical trials that apply TSST.

Dissociation between ACTH and cortisol response in DEX-CRH test in patients with panic disorder.

Background: Panic disorder (PD) has been associated with the altered circadian rhythm of the hypothalamic-pituitary-adrenocortical (HPA) axis. The findings regarding the stress-specific functioning of the HPA-system are inconsistent. It is also unclear whether the HPA-system response after the Corticotropin-Releasing-Hormone (CRH) challenge becomes altered.