Neurocognitive dysfunctioning and the impact of comorbid depression and anxiety in patients with somatic symptom and related disorders: a cross-sectional clinical study

Vroege, Lars de; Timmermans, A.; Kop, Willem J.; Feltz-Cornelis, Christina M. van der

doi:10.1017/s0033291717003300

Cited by 29 publications

(25 citation statements)

References 48 publications

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“…These findings are interesting because firstly, while impaired sustained attention, as reflected by increased SDRT on CPT, has not been reported in patients with IBS, this has been reported in patients with somatic symptom and related disorders, a group of conditions characterized by medically unexplained symptoms with high anxious and depressive comorbidity, and nosologically strongly overlapping with functional gastrointestinal disorders . This finding of impaired sustained attention is compatible with previous studies suggesting deficits in the “top‐down” cortical control of attention in IBS contributing to descending pain facilitation.…”

Section: Discussionsupporting

confidence: 89%

“…The lack of correlation in these patients with IBS of cognitive parameters and measures of anxiety and depression is in contrast to previous studies showing associations between anxiety and depressive symptoms and sustained attention, and executive function in non‐IBS samples . Our findings, however, appeared to be consistent with a recent study on a large clinical sample of patients of somatic and related disorders, where attentional and executive dysfunction were not associated with anxiety symptoms . In the case of sustained attention, that it did not correlate with bowel symptoms and chronicity, and also predicted IBS diagnosis independent of anxiety, depressive, and somatic symptoms suggested a more exclusive role as a trait associated with IBS.…”

Section: Discussionsupporting

confidence: 53%

“…16,46,47 Our findings, however, appeared to be consistent with a recent study on a large clinical sample of patients of somatic and related disorders, where attentional and executive dysfunction were not associated with anxiety symptoms. 35 In the case of sustained attention, that it did not correlate with bowel symptoms and chronicity, and also predicted IBS diagnosis independent of anxiety, depressive, and somatic symptoms suggested a more exclusive role as a trait associated with IBS. A caveat though, was that none of our recruited patients met criteria for depression, and exclusion of severely anxious patients may have annihilated inherent correlations found between anxiety/depressive symptoms and cognitive dysfunction.…”

Section: Ta B L E 5 Regression Analysis Of Cognitive Parameters On Ibmentioning

confidence: 89%

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Nature and specificity of altered cognitive functioning in IBS

Wong

Mak

Yuen

et al. 2019

Neurogastroenterology Motil

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Background It is unknown whether cognitive dysfunction found in patients with irritable bowel syndrome (IBS) was attributable to the different subtypes, ongoing pathophysiological processes, trait characteristics, or psychiatric comorbidity. Methods Forty Rome‐III patients with IBS (20 diarrhea‐predominant [IBS‐D] and 20 constipation‐predominant [IBS‐C]) and 40 age‐, sex‐, education‐matched healthy controls were systematically recruited and compared on their cognitive function with continuous performance test (CPT), Wisconsin Card Sorting Test (WCST) and emotional Stroop test. Beck Anxiety Inventory (BAI), Beck Depression Inventory‐II (BDI‐II), Patient Health Questionnaire‐15 (PHQ‐15) and a structured bowel symptom questionnaire were performed to measure anxiety, depressive, somatization, and bowel symptoms, respectively. Psychiatric diagnoses were ascertained with SCID‐I (Structured Clinical Interview for DSM‐IV Axis I Disorders). Key Results Patients with IBS showed significantly increased standard deviation of reaction time (SDRT) (P = .003) on CPT, increased failure to maintain set (FMS) (P=.002), and percentage of perseverative errors (P = .003) on WCST. SDRT did not correlate with illness chronicity or bowel symptoms. FMS correlated with bowel symptom severity. In logistic regression models controlled for BAI, BDI‐II, and PHQ‐15, SDRT (AOR = 1.08, P = .025), but not FMS (P = .25) or percentage of perseverative errors (P = .24), significantly differentiated IBS from controls. Cognitive function was not significantly different between IBS‐C and IBS‐D (P > .05), or between pure IBS (n = 22) and IBS with generalized anxiety disorder (GAD) (n = 17) (P > .05). Conclusions & Inferences Patients with IBS showed attentional and executive function impairment irrespective of subtypes but otherwise heterogeneous in terms of its state‐trait correlations and overlap with anxiety comorbidity.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 53%

Section: Ta B L E 5 Regression Analysis Of Cognitive Parameters On Ibmentioning

confidence: 89%

See 1 more Smart Citation

Nature and specificity of altered cognitive functioning in IBS

Wong

Mak

Yuen

et al. 2019

Neurogastroenterology Motil

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“…In China, the data were collected as part of a cross sectional study ( 39 ) in the general hospital setting. In the Netherlands, the data were collected as part of routine clinical care in the Clinical Centre of Excellence of Body Mind and Health ( 8 , 40 – 42 ).…”

Section: Methodsmentioning

confidence: 99%

Comparison of the Factor Structure of the Patient Health Questionnaire for Somatic Symptoms (PHQ-15) in Germany, the Netherlands, and China. A Transcultural Structural Equation Modeling (SEM) Study

et al. 2018

Self Cite

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Background: Persistent somatic symptoms are associated with psychological distress, impaired function, and medical help-seeking behavior. The Patient Health Questionnaire (PHQ)-15 is used as a screening instrument for somatization and as a monitoring instrument for somatic symptom severity. A bifactorial model has been described, with one general factor and four orthogonal specific symptom factors. The objective of the present study was to assess and to clarify the factor structure of the PHQ-15 within and between different countries in Western Europe and China.Method: Cross-sectional secondary data analysis performed in three patient data samples from two Western European countries (Germany N = 2,517, the Netherlands N = 456) and from China (N = 1,329). Confirmatory factor analyses (CFA), and structural equation modeling (SEM) analysis were performed.Results: The general factor is found in every sample. However, although the outcomes of the PHQ-15 estimate severity of somatic symptoms in different facets, these subscales may have different meanings in the European and Chinese setting. Replication of the factorial structure was possible in the German and Dutch datasets but not in the dataset from China. For the Chinese dataset, a bifactorial model with a different structure for the cardiopulmonary factor is suggested. The PHQ-15 could discern somatization from anxiety and depression within the three samples.Conclusion: The PHQ-15 is a valid questionnaire that can discern somatization from anxiety and depression within different cultures like Europe or China. It can be fitted to a bifactorial model for categorical data, however, the model can only be recommended for use of the general factor. Application of the orthogonal subscales in non-European samples is not corroborated by the results. The differences cannot be ascribed to differences in health care settings or by differences in concomitant depression or anxiety but instead, a cultural factor involving concepts of disease may play a role in this as they may play a role in the translation of the questionnaire. Further research is needed to explore this, and replication studies are needed regarding the factorial structure of the PHQ-15 in China.

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“…On the other hand, poorer working memory performance is related to higher anxiety levels in those with clinical anxiety disorders (Waechter et al, ). Working memory deficits have been associated with clinical anxiety disorders: poor updating and generalized anxiety disorder (Zainal & Newman, ), general working memory performance and somatic symptoms (de Vroege, Timmermans, Kop, & van der Feltz‐Cornelis, ), social anxiety (Moriya, ), and post‐traumatic stress disorder (Nejati, Salehinejad, & Sabayee, ).…”

Section: Anxiety Disorders and Working Memorymentioning

confidence: 99%

Effects of working memory training on emotion regulation: Transdiagnostic review

Barkus

2020

PsyCh Journal

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Working memory training is widely used transdiagnostically to improve cognition. However, more recently, studies using working memory training packages have targeted emotion-regulation outcomes to determine whether far transfer effects can be achieved.A narrative review is conducted of studies that have used standardized computerized working memory training packages across healthy volunteers, affect, anxiety, post-traumatic stress disorder (PTSD), and eating disordered populations with emotion-regulation outcomes.Working memory training has been used in children, adolescents, and adults to improve emotion regulation. Many studies have reported gains in mood as well as emotion-regulation strategies following working memory training, regardless of clinical indication and whether near transfer gains were achieved in cognitive domains. Significant emotion-regulation outcomes include: state and trait anxiety, rumination, brooding, positive appraisal, decreasing maladaptive emotion-regulation strategies, and decreasing intrusive thoughts. It is speculated that these far transfer outcomes from working memory training are possible due to the cognitive and neural overlap between cognitive and affective working memory, and emotion regulation. Working memory training could improve cognitive efficiency, which, in turn, increases the availability of cognitive resources during times when emotion regulation is taxed. Future studies need to consider the role of participant expectancy in predicting outcome measure performance, and including subjective and objective outcomes is paramount to study design. Furthermore, sample sizes require additional attention, given that the current review highlights that individual differences in non-clinical and clinical populations influence the outcomes from working memory training. Working memory training offers a possibility for improving emotion regulation transdiagnostically.

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Neurocognitive dysfunctioning and the impact of comorbid depression and anxiety in patients with somatic symptom and related disorders: a cross-sectional clinical study

Cited by 29 publications

References 48 publications

Nature and specificity of altered cognitive functioning in IBS

Nature and specificity of altered cognitive functioning in IBS

Comparison of the Factor Structure of the Patient Health Questionnaire for Somatic Symptoms (PHQ-15) in Germany, the Netherlands, and China. A Transcultural Structural Equation Modeling (SEM) Study

Effects of working memory training on emotion regulation: Transdiagnostic review

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