Epigenetic Interactions and the Brain-Body Communication

McEwen, Bruce S.

doi:10.1159/000449150

Cited by 36 publications

(27 citation statements)

References 51 publications

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“…To name exemplary biological and psychosocial examples, genetic factors contribute to the vulnerability for FSS/bodily distress, as well as for chronic pain in general, but only to a limited extent, explaining up to 30% of the variance - epigenetic mechanisms most likely are at least as important here [38,48]. There is evidence for a genetic tendency to develop bodily distress distinct from that for anxiety and depression [49,50].…”

Section: Etiologymentioning

confidence: 99%

Management of Functional Somatic Syndromes and Bodily Distress

Henningsen

Zipfel²,

Sattel³

et al. 2018

Psychother Psychosom

242

182

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Functional somatic syndromes (FSS), like irritable bowel syndrome or fibromyalgia and other symptoms reflecting bodily distress, are common in practically all areas of medicine worldwide. Diagnostic and therapeutic approaches to these symptoms and syndromes vary substantially across and within medical specialties from biomedicine to psychiatry. Patients may become frustrated with the lack of effective treatment, doctors may experience these disorders as difficult to treat, and this type of health problem forms an important component of the global burden of disease. This review intends to develop a unifying perspective on the understanding and management of FSS and bodily distress. Firstly, we present the clinical problem and review current concepts for classification. Secondly, we propose an integrated etiological model which encompasses a wide range of biopsychosocial vulnerability and triggering factors and considers consecutive aggravating and maintaining factors. Thirdly, we systematically scrutinize the current evidence base in terms of an umbrella review of systematic reviews from 2007 to 2017 and give recommendations for treatment for all levels of care, concentrating on developments over the last 10 years. We conclude that activating, patient-involving, and centrally acting therapies appear to be more effective than passive ones that primarily act on peripheral physiology, and we recommend stepped care approaches that translate a truly biopsychosocial approach into actual management of the patient.

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Section: Etiologymentioning

confidence: 99%

Management of Functional Somatic Syndromes and Bodily Distress

Henningsen

Zipfel²,

Sattel³

et al. 2018

Psychother Psychosom

242

182

View full text Add to dashboard Cite

show abstract

“…In psychosomatic practice, when the cumulative exposure to stressors exceeds coping resources, allostatic overload ensues, which may precipitate disease states or otherwise aggravate existing somatic and mental disorders [4]. Evidence indicates that gene-environment interactions and epigenetic mechanisms may influence resilience to stress [5]. Therefore, genetic factors may influence resilience to stress in patients with physical long-term conditions (LTCs) in the context of a financial crisis.…”

Section: Tablementioning

confidence: 99%

Resilience Mediates the Influence of a Polymorphism in the Serotonin Transporter Gene on the Relationship between the Burden of Chronic Illness and Depression

Delis

Carvalho²,

Poulia³

et al. 2017

Psychother Psychosom

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“…The concept of allostasis emphasizes that healthy functioning requires continual adjustments to the internal physiological milieu [8]. Allostatic load reflects the cumulative effects of stressful experiences on daily life.…”

mentioning

confidence: 99%

“…Allostatic load reflects the cumulative effects of stressful experiences on daily life. When the cost of chronic exposure to fluctuating or heightened neural or neuroendocrine responses exceeds the coping resources of an individual, allostatic overload ensues [8]. Clinical criteria for the determination of allostatic overload have been developed [9].…”

mentioning

confidence: 99%