abstract sthat mention "chronic fatigue syndrome"
http://bit.ly/r5zv4b
i.e.
http://www.psychosomatic.org/AnMeeting/PastEvents/meeting2011/2011APSabstra=
cts.pdf
American Psychosomatic Society
69th ANNUAL SCIENTIFIC MEETING
MARCH 9 - 12, 2011
San Antonio Marriott Rivercenter
San Antonio, Texas USA
Meeting Abstracts
=93Biobehavioral Processes and Health: Understanding Mechanisms,
Implementing Interventions=94
209) Abstract 1116
HYPOTHALAMIC-PITUITARY-ADRENAL DYNAMICS IN
FUNCTIONAL SOMATIC DISORDERS: A SYSTEMS
APPROACH TO ASSESSING ALLOSTASIS
Kirstin E. Aschbacher, Ph.D., Psychiatry, University of California San
Francisco, San Francisco, CA, Emma K. Adam, PhD, Human
Development and Social Policy, Northwestern University, Evanston, IL,
Margaret E. Kemeny, PhD, Psychiatry, University of California San
Francisco, San Francisco, CA, Leslie J. Crofford, MD, Department of
Internal Medicine, University of Kentucky, Lexington, KY, Mark
Demitrack, MD, Neuronetics, Inc., Malvern, PA, Amos Ben-Zvi, PhD,
Chemical and Materials Engineering, University of Alberta, Edmonton,
AB, Canada
A dynamic systems approach was used to investigate potential
alterations in the behavior of the Hypothalamic-Pituitary-Adrenal (HPA)
system in 36 patients with functional somatic disorders (chronic fatigue
syndrome (CFS) and/or fibromyalgia (FM)) and 36 matched healthy
controls. An HPA system with high steady state gain (i.e., characterized
by heightened cortisol responses to adrenocorticotropic hormone
(ACTH) and/or blunted feedback control) may contribute to the
pathophysiology of functional disorders. Blood plasma was assayed for
cortisol and ACTH every 10 minutes between 11pm and 9am. The
dynamic model was specified with an ordinary differential equation
using three dynamic parameters: 1) ACTH-adrenal signaling, 2)
inhibitory feedback signaling, and 3) an error term representing external
influences. Model parameter estimates were calculated for each
individual (i.e., a personalizedsystem model), and subjected to group
difference comparisons using paired t-tests. Relative to
individually-matched healthy controls, patients with CFS exhibited
marked increases in ACTH-adrenal signaling (t(13)=3D 3.01, p<0.01) and
borderline increases in feedback signaling (t(13)=3D2.05,p=3D0.06), while
patients with FM (with or without concomitant chronic fatigue)
exhibited significant decreases in feedback signaling
(t(21)=3D-2.69,p=3D0.01). Compared to healthy controls, patients had a tren=
d
toward a higher steady state gain (t(35)=3D1.77,p=3D.09)) and lower mean
ACTH (t(35)=3D-1.71,p=3D.10)). This is the first study to use a
=91personalized=92 dynamic systems model to assess patient-control
differences in a disorder of unclear etiology. Results are broadly
consistent with an =91excitable=92 (high gain) HPA system among patients,
which could potentially be a risk or maintaining factor in the disorder.
Moreover, personalized HPA "system behavioral phenotypes" that map
onto diagnostic symptom clusters, may help understand the
pathophysiological mechanisms underlying disorders of function, even
in the context of comorbidity. System dynamics may constitute a novel
marker of allostasis, and its role in chronic disease.
-------------
283) Abstract 1127
COGNITIVE COMPLAINTS IN SUBJECTS WITH
UNEXPLAINED FATIGUE EXPLAINED BY MENTAL EFFORT
Tamara E. Lacourt, MSc, Jan H. Houtveen, PhD, Lorenz J. van
Doornen, PhD, Clinical and Health Psychology, Utrecht University,
Utrecht, Netherlands, Cobi J. Heijnen, PhD, Laboratory for
Neuroimmunology, University Medical Center Utrecht, Utrecht, The
Netherlands
Concentration and attention difficulties are frequently reported
symptoms in chronic fatigue syndrome (CFS). However, the objective
performance of CFS patients in test situations has often been shown
within the normal range. The latter may be due to a compensatory
influence of effort investment. Studies using brain scanning techniques
to approach this issue show inconsistent results. However, tasks used in
these studies differed in presentation mode, required attention span, and
difficulty. Increased mental effort may only be found under specific task
demands using a well validated measure of mental effort. For this reason
we choose to measure pupil dilation during task performance under
fatiguing conditions in a self reported fatigued and a non-fatigued group.
Methods From a sample of 34 undergraduates a fatigued (n=3D11; 8
females) and a non-fatigued (n =3D 20; 15 females) group was selected
based on scores on a validated fatigue questionnaire (CIS-20; mean
scores 85.91 and 48.80 respectively). First, reaction times (RT) and pupil
dilation (using an eye-scanning device) were assessed in response to a
Stroop task (2 conditions: congruent and incongruent) and an n-back
task (4 conditions: 0-4 back). Next, the n-back task was repeated several
times to induce fatigue. Finally, RT and pupil dilation assessment during
the n-back task was repeated. Self-reports of momentary fatigue were
assessed throughout the session.
Results Preliminary results show that fatigue inducement was
successful: reported momentary fatigue significantly increased in both
groups (p<.0001). RT's and errors made during the tasks did not differ
between groups (all p-values >.05), indicating that performance was the
same in both groups. Pupil dilation during the Stroop task was larger in
the difficult (incongruent) condition in both groups (p<.0001), but no
difference was found between groups either in the congruent condition
(p=3D.34) or the incongruent condition (p=3D.33). Results on pupil dilation
during the n-back task are pending. These results will provide additional
insights in different task demands and fatigue inducement.
---------
Abstract 1437
COMORBIDITY OF ANXIETY AND NEUROPSYCHIATRIC
DISORDERS
Tuong-Vi Nguyen, MD, Psychiatry, McGill University, Montreal, QC,
Canada, Sok S. Lee, BA, Medicine, Boston University School of
Medicine, Boston, California, Nancy C. Low, FRCP, Psychiatry, McGill
University, Montreal, QC, Canada
Purpose of the study: Few studies to date have focused specifically on
the role of family- or gender-related factors in the comorbidity between
anxiety and neuropsychiatric disorders. Yet this may contribute to a
better understanding of the mechanisms underlying this comorbidity.
The purpose of this study is therefore to examine: (1) the comorbidity
between anxiety and neuropsychiatric disorders (2) mechanisms of
comorbidity by contrasting a) the familial and non-familial forms of
anxiety disorders and b) gender-specific associations.
Methods: Using a
nationally-representative, population-based sample (n=3D36 984) to whom
a structured psychiatric diagnostic interview [WHO-Composite
International Diagnostic Interview (CIDI)] was administered, this study
examined lifetime prevalence of migraine, epilepsy, fibromyalgia and
chronic fatigue syndrome in subjects with a lifetime history of panic
disorder or social phobia. The prevalence of medical disorders was then
compared in a) those with and without a family history of anxiety
disorders and b) separately in males and females. Chi-square testing and
logistic regression models yielding odds ratios (OR) were conducted,
controlling for age, sex, marital status, education and lifetime history of
mood disorders (p<0.05).
Results: Panic disorder was associated with
migraine (OR=3D1.8 95%CI: 1.5-2.2), fibromyalgia (OR=3D1.9 95%CI:
1.2-3.0) and chronic fatigue syndrome (OR=3D1.9 95%CI: 1.2-3.0). Social
phobia was associated with migraine (OR=3D1.6 95%CI: 1.4-1.9) and
fibromyalgia (OR=3D1.5 95%CI: 1.02-2.1). Epilepsy was associated with
social phobia in males (OR=3D2.6 95%CI: 1.1-6.2), but not in females. In
males with social phobia, family history of social fear was strongly
associated with epilepsy (OR=3D8.6 95%CI: 2.0-38.4).
Conclusions:
Results link multiple neuropsychiatric comorbidities with anxiety
disorders, even after controlling for mood disorders and psychosocial
covariates. The gender-specific association of the familial form of social
phobia with epilepsy warrants further investigation. It may indicate the
possibility of sex-specific transmission of a common vulnerability for
both disorders.
-----------
Abstract 1189
PREVALENCE OF FUNCTIONAL SOMATIC SYNDROMES IN
AN APPARENTLY HEALTHY POPULATION
Susanne Fischer, M.Sc., Jens Gaab, PhD, Ulrike Ehlert, PhD, Urs M.
Nater, PhD, Psychology, University of Zurich, Zurich, Switzerland
Background and aim: Functional somatic syndromes (FSS) are defined
by a constellation of symptoms for which no medical explanation can be
identified. Previous epidemiological studies in students were accounting
for only one FSS or merely assessing medically unexplained conditions
on a symptom level. The objective of our study was to estimate
prevalence rates for 15 FSS in a sample of Swiss students.
Methods: A
total of 3054 apparently healthy students from various Swiss universities
were recruited. To assess prevalence rates, we developed and
administered an electronic screening questionnaire encompassing 71
items on various bodily symptoms. An additional 150 questions based
on international research diagnostic criteria were presented in case of
fulfilling a specific combination of complaints characteristic for one of
the syndromes. Subjects meeting the minimum of symptoms required for
a diagnosis were subsequently directed to a list of items addressing
differential diagnoses. Furthermore, information on comorbid
psychiatric conditions was obtained using the Patient Health
Questionnaire.
Results: Among the participants, 2241 (73.4%) were
women and 813 (26.6%) were men. Mean age was 25.87 (SD =3D 5.61).
Two hundred and ninety students (9.5%) were diagnosed with at least
one FSS. One hundred and twelve (3.7%) had premenstrual syndrome,
57 (1.9%) functional dyspepsia, 40 (1.3%) hyperventilation syndrome,
39 (1.3%) irritable bowel syndrome, 34 (1.1%) premenstrual dysphoric
disorder, 26 (0.9%) tension-type headache, 19 (0.6%)
temporomandibular disorders, 14 (0.5%) functional chest pain, 11
(0.4%) whiplash associated disorders, 6 (0.2%) chronic pelvic pain, 2
(0.1%) globus, 2 (0.1%) chronic low back pain, 2 (0.1%) fibromyalgia,
one (< 0.1%) chronic fatigue syndrome and one (< 0.1%) multiple
chemical sensitivity. Compared with subjects without any FSS,
participants with at least one FSS reported more somatoform disorders,
major depressive disorder, panic disorder or other anxiety disorders (all
p < 0.01).
Conclusion: Our findings indicate that FSS are relatively
prevalent in a sample of apparently healthy young individuals.
Psychiatric comorbidity seems to be high. Future studies should include
longitudinal designs examining mechanisms of FSS manifestation.
---------------------------------------------
Send posts to CO-CURE@listserv.nodak.edu
Unsubscribe at http://www.co-cure.org/unsub.htm
Co-Cure Archives: http://listserv.nodak.edu/archives/co-cure.html
---------------------------------------------
Co-Cure's purpose is to provide information from across the spectrum of
opinion concerning medical, research and political aspects of ME/CFS and/or
FMS. We take no position on the validity of any specific scientific or
political opinion expressed in Co-Cure posts, and we urge readers to
research the various opinions available before assuming any one
interpretation is definitive. The Co-Cure website <www.co-cure.org> has a
link to our complete archive of posts as well as articles of central
importance to the issues of our community.
---------------------------------------------
