Journal of Psychosomatic Research最新文献

{"title":"Psychological well-being and the effects of supportive coaching during SPECT myocardial perfusion imaging in patients with suspected ischemic heart disease","authors":"T. Roovers ,&nbsp;I.A.C. Vermeltfoort ,&nbsp;J.W. Widdershoven ,&nbsp;W.J. Kop","doi":"10.1016/j.jpsychores.2025.112355","DOIUrl":"10.1016/j.jpsychores.2025.112355","url":null,"abstract":"<div><h3>Background</h3><div>Diagnostic procedures for ischemic heart disease are common, but the consequences for the patient's psychological well-being are not well understood. The current study investigates changes in negative affect as a measure of psychological well-being during myocardial perfusion imaging (MPI-SPECT) and whether supportive coaching during diagnostic testing improves well-being, reduces symptom burden, and increases patient satisfaction.</div></div><div><h3>Methods</h3><div>Patients undergoing MPI-SPECT were randomly assigned to a supportive coaching intervention group or a care-as-usual control group. Negative affect was assessed at nine time-points throughout the 2-day diagnostic MPI visits. Anginal and adenosine-related symptoms were evaluated during cardiac stress testing (CST) and patient satisfaction at completion of MPI-SPECT. Data were analyzed using regression analysis, <em>t</em>-tests, and linear mixed models.</div></div><div><h3>Results</h3><div>A total of 149 patients were randomized (mean age = 68.5 [SD = 9.6] years, 41.6 % women; 74 intervention and 75 control condition). Negative affect changed significantly throughout the MPI procedure (F(8, 244.098) = 8.689, <em>p</em> &lt; .001), with the highest level occurring during the peak phase of CST. Negative affect was associated with higher concurrent anginal (β = 0.285, <em>p</em> = .001) and adenosine-related symptoms (β = 0.252, <em>p</em> = .004) during CST. No significant benefits of supportive coaching were found for well-being or symptoms, inducibility of ischemia, or patient satisfaction (all <em>p</em>-values &gt; .200).</div></div><div><h3>Conclusion</h3><div>Negative affect during MPI-SPECT is associated with cardiac symptoms during CST. No benefits were found of the short-term supportive coaching intervention during the MPI-SPECT procedure. Patient well-being might be improved by providing support during the entire diagnostic phase for ischemic heart disease rather than just during the MPI-SPECT procedure.</div><div>Trial registration #<span><span>NCT05896982</span><svg><path></path></svg></span>.</div><div>Open science statement/Preregistration: Medical Ethics Committee METC-Brabant NL81600.028.22 / P2234.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"197 ","pages":"Article 112355"},"PeriodicalIF":3.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression as a mediator in the relationship between adverse childhood events, pelvic pain, and pelvic organ prolapse: A cross-sectional study using structural equation modeling","authors":"Dina M. Mahjoob ,&nbsp;Gommert A. van Koeveringe ,&nbsp;Desiree M.J. Vrijens ,&nbsp;Marco H. Blanker ,&nbsp;Grietje E. Knol-de Vries","doi":"10.1016/j.jpsychores.2025.112352","DOIUrl":"10.1016/j.jpsychores.2025.112352","url":null,"abstract":"<div><h3>Background</h3><div>Adverse childhood events (ACEs) have been linked to chronic pain, yet their relationship with pelvic floor symptoms, including pelvic pain and pelvic organ prolapse (POP), is less understood. This study investigates whether depressive symptoms mediate the association between ACEs and pelvic floor symptoms.</div></div><div><h3>Method</h3><div>A secondary analysis of a population-based cohort (age ≥ 16 years) was conducted. Participants completed validated questionnaires assessing ACEs, POP symptoms, and depressive symptoms, while pelvic pain was determined by a study-specific questionnaire. Structural equation modeling (SEM) and path analysis were used to assess direct and indirect relationships, stratified by sex.</div></div><div><h3>Results</h3><div>Complete data were available for 552 males and 780 females. Depression mediated the relationship between ACEs and pelvic pain in both sexes, as well as between ACEs and POP in females. In females, ACEs were associated with pelvic pain (<em>p</em> = 0.020), with depression partially mediating this relationship (<em>p</em> = 0.001, R² = 0.116, moderate effect). In males, ACEs were not directly associated with pelvic pain (<em>p</em> = 0.196), but a significant indirect effect was observed through depression (<em>p</em> = 0.023), indicating full mediation (R² = 0.042, small effect). For POP, ACEs had no direct effect (<em>p</em> = 0.722), but depression significantly mediated the relationship (<em>p</em> = 0.001, R² = 0.161, moderate effect). Findings from SEM and path analysis were comparable.</div></div><div><h3>Conclusion</h3><div>This study highlights the association between ACEs, pelvic pain and POP in adulthood. Depression emerged as a key mediator in these relationships, with differences observed between males and females.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"197 ","pages":"Article 112352"},"PeriodicalIF":3.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of complete decongestive therapy for patients with lower limb lymphedema: A descriptive phenomenological study","authors":"Yucheng Yin,&nbsp;Jie Lin,&nbsp;Lixia Yang,&nbsp;Yuanyuan Zhao,&nbsp;Lili Zhu,&nbsp;Luya Pu,&nbsp;Dongmei Han","doi":"10.1016/j.jpsychores.2025.112351","DOIUrl":"10.1016/j.jpsychores.2025.112351","url":null,"abstract":"<div><h3>Background</h3><div>Lower limb lymphedema can cause significant physical and psychological distress. Complete decongestive therapy is recognized as the gold standard for non-surgical management of this condition. However, the lived experiences of patients undergoing complete decongestive therapy have been largely overlooked in existing research.</div></div><div><h3>Objectives</h3><div>To explore the experiences of individuals with lower limb lymphedema undergoing complete decongestive therapy.</div></div><div><h3>Methods</h3><div>A total of 18 eligible participants with lower limb lymphedema, aged 39–72 years, were recruited through purposive sampling from a hospital in China. One-on-one in-depth interviews were conducted to collect qualitative data. Nvivo12.0 was used for data encoding and management, and Colaizzi's descriptive analysis framework was employed for data interpretation.</div></div><div><h3>Results</h3><div>Four major themes and thirteen subthemes were generated from the data analysis: (a) Physical discomfort, (b) Increased confidence, (c) Emotional distress, and (d) Need for support.</div></div><div><h3>Conclusion</h3><div>People undergoing complete decongestive therapy for lower limb lymphedema experience complex physical, emotional, and psychological challenges. Interventions to enhance the complete decongestive therapy experience should focus on five key areas: health education, psychological support, advancements in medical devices, the establishment of consultation platforms, and addressing self-care difficulties among individuals living alone.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"197 ","pages":"Article 112351"},"PeriodicalIF":3.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validating the 15-item stress anxiety depression scale (SAD-15) using Rasch analysis","authors":"Kaj Sparle Christensen","doi":"10.1016/j.jpsychores.2025.112349","DOIUrl":"10.1016/j.jpsychores.2025.112349","url":null,"abstract":"<div><h3>Background</h3><div>Stress, anxiety, and depression frequently co-occur in primary care, complicating accurate diagnosis and treatment. Existing screening tools typically evaluate each condition separately, which can be time consuming and inefficient. The 15-item Stress Anxiety Depression scale (SAD-15) was designed as a brief instrument to assess all three conditions simultaneously. This study examines its structural validity using Rasch measurement theory.</div></div><div><h3>Methods</h3><div>Data from 222 general practice patients were analyzed to assess the clinimetric properties of the SAD-15 and its subscales. Rasch analyses included tests for dimensionality, item and person fit, person separation reliability, local item dependency, differential item functioning (DIF), scale targeting, and identification of cut-off scores using the WHO-5 Well-Being Index as the criterion standard.</div></div><div><h3>Results</h3><div>Initial analysis of the full SAD-15 revealed poor overall fit due to local item dependency. However, when analyzed as three composite scores, the scale and subscales demonstrated excellent Rasch model fit, unidimensionality, acceptable item and person fit, and high person separation reliability (PSI 0.77–0.93). No DIF was observed across gender or age groups. The scales were well-targeted, and ROC analysis yielded optimal cut-offs of 17 for the total scale, 7 for stress, and 5 for both anxiety and depression subscales.</div></div><div><h3>Conclusions</h3><div>The SAD-15 shows potential as an initial screening tool for simultaneously assessing stress, anxiety, and depression in primary care. Its composite structure supports its use as a first step before condition-specific diagnostics. Further validation in clinical populations and over time is recommended.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"197 ","pages":"Article 112349"},"PeriodicalIF":3.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of unipolar major depression in prostate cancer patients undergoing androgen deprivation therapy: The impact of age, treatment duration and prostate cancer stage","authors":"Amy L. Holtman ,&nbsp;Sabine van Leersum ,&nbsp;Karen S. van den Berg ,&nbsp;Lea M. Dijksman ,&nbsp;Whitney M. Freeze ,&nbsp;Matthijs J.V. Scheltema ,&nbsp;Jarmo C.B. Hunting ,&nbsp;Johanna M. Hegeman","doi":"10.1016/j.jpsychores.2025.112350","DOIUrl":"10.1016/j.jpsychores.2025.112350","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer is the most common malignancy among men. Androgen deprivation therapy (ADT), a common treatment for prostate cancer, may contribute to an increased risk for depression. This study examines the prevalence of unipolar major depression in patients undergoing ADT and potential risk factors.</div></div><div><h3>Method</h3><div>A cross-sectional study was conducted among prostate cancer patients receiving ADT (<em>n</em> = 217). The presence of depression was screened with the Inventory of Depressive Symptomatology Self Report (IDS-SR). Patients with IDS-SR scores above the cutoff point were invited for a semi-structured clinical interview to diagnose depression. For non-interviewed patients the individual items of the IDS-SR were analyzed to assess whether core criteria of the DSM-5 were present. Multivariable analyses were performed to evaluate the association between the risk factors (age, ADT duration and prostate cancer stage) and the IDS-SR score as well as the presence of depression.</div></div><div><h3>Results</h3><div>Of all patients, 35 % scored above the cutoff point of the IDS-SR and 8.3 % were diagnosed with major depression. Furthermore, among the included patients, age, ADT duration and prostate cancer stage were not significantly associated with the IDS-SR score, neither with the presence of depression.</div></div><div><h3>Conclusion</h3><div>The 8.3 % prevalence of unipolar major depression highlights the importance of being vigilant about a comorbid depression in prostate cancer patients undergoing ADT. However, due to a lack of power, we were unable to identify specific risk factors within this patient group.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"197 ","pages":"Article 112350"},"PeriodicalIF":3.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early maladaptive schemas in functional movement disorders: A cross-sectional study","authors":"G. Carle-Toulemonde ,&nbsp;M. Houot ,&nbsp;E. Roze ,&nbsp;F. Mesrati ,&nbsp;T. Gendre ,&nbsp;R. Levy ,&nbsp;B. Degos ,&nbsp;B. Garcin","doi":"10.1016/j.jpsychores.2025.112348","DOIUrl":"10.1016/j.jpsychores.2025.112348","url":null,"abstract":"<div><h3>Background</h3><div>Early maladaptive schemas (EMS) are predisposing psychological factors for various disorders but raised little concern in Functional Movement Disorders (FMD). We aimed to assess the intensity of EMS in patients with FMD compared to Parkinson's Disease (PD) or Organic Dystonia (OD). We analysed their association with the severity of motor symptoms, anxiety, depression, dissociative symptoms and childhood trauma events.</div></div><div><h3>Methods</h3><div>We sent the Young Schema Questionnaire Short Form 3 (YSQ-S3, French version) by mail to patients who had participated in a previous study. Eighteen schemas from the YSQ-S3 were compared between the 3 groups using linear and linear mixed models. Their associations were analysed with the scores of the modified Abnormal Involuntary Movement Scale (AIMS), the Hospital Anxiety and Depression Scale (HADS), the Composite International Diagnostic Interview questionnaire (CIDI) and the Somatoform Dissociation Questionnaire (SDQ-20).</div></div><div><h3>Results</h3><div>32 patients with FMD, 28 patients with PD, 20 patients with OD filled the questionnaire. The Excessive Responsibility and High Standards schema domain score was significantly higher in the FMD group (MDE ± SE: FMD vs PD: 13.00 ± 3.52, <em>p</em> = 0.005; FMD vs OD: 17.34 ± 3.90, <em>p</em> &lt; 0.001). The Self-Sacrifice schema scores were significantly more intense in the FMD group (group*schema: p &lt; 0.001 and Cohen's f2 = 0.07; MDE ± SE: patients vs PD: 6.59 ± 1.30, p &lt; 0.001; FMD vs OD: 9.57 ± 1.43, p &lt; 0.001). No association was found between YSQ-S3 scores and age, gender, educational level, AIMS, HADS, CIDI, and SDQ-20.</div></div><div><h3>Conclusions</h3><div>Higher intensity of self-sacrifice schema scores was reported in patients with FMD, suggesting that it may be a significant predisposing and/or perpetuating factor in FMD.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"196 ","pages":"Article 112348"},"PeriodicalIF":3.3,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosomatic comorbidity in endometriosis: A multi-center, cross-sectional study identifying an underestimated factor in current medical support","authors":"Aylin Candan ,&nbsp;Alexandra Kohl Schwartz ,&nbsp;Kurt Birchler ,&nbsp;Brigitte Leeners","doi":"10.1016/j.jpsychores.2025.112346","DOIUrl":"10.1016/j.jpsychores.2025.112346","url":null,"abstract":"<div><h3>Objective</h3><div>Endometriosis affects approximately 10 % of women and is associated with chronic pelvic pain, fatigue, infertility, and impaired quality of life. This study explores the association between psychosomatic diseases/ symptoms and endometriosis.</div></div><div><h3>Methods</h3><div>A multi-center study involving 422 women with endometriosis and 422 age-matched control women was conducted in Switzerland, Germany, and Austria. Data was collected using a self-administered questionnaire covering socio-demographic information, health history including psychosomatic diseases, and endometriosis symptoms. Information on endometriosis was extracted from the patients' medical charts. <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> NCT 02511626.</div></div><div><h3>Results</h3><div>Psychosomatic diseases/ symptoms but not physiological diseases were associated with a diagnosis of endometriosis. Women with endometriosis reported significantly higher frequencies of pain disorders (migraine/headache (very) often 25.12 %/12.33 %, back pain 32.46 %/16.83 %, chest pain 14.93 %/4.26 %, stomach pain 19.67 %/7.11 %, all <em>p</em>-values &lt;0.001), disturbed mental health (irritability 22.98 %/10.50 %, mood swings 34.59 %/9.48 %, depressive mood 17.33 %/2.81 %, feelings of anxiety 8.29 %/1.42 %, all p-values &lt;0.001), sleeping disorders (33.18 %/11.84 %, <em>p</em> &lt; 0.001), neck tension (50.94 %/34.60 %, <em>p</em> &lt; 0.001), teeth grinding (18.72 %/9.24 % <em>p</em> &lt; 0.04), appetite loss (6.16 %/2.37 %, <em>p</em> &lt; 0.02), digestive problems (31.99 %/11.13 %, p &lt; 0.001), diarrhea (15.17 %/4.50 %, p &lt; 0.001), asthma (3.55 %/0.71 %, p &lt; 0.001), and breathing difficulties (6.16 %/1.19 %, <em>p</em> &lt; 0.10) than did control women. The frequency (≥several times/day 30.47 %/10.58 %, <em>p</em> = 0.013) of endometriosis-related pain was greater in women with psychosomatic comorbidity.</div></div><div><h3>Conclusions</h3><div>The study supports a strong association between psychosomatic comorbidity and endometriosis. Pathophysiological mechanisms of this association should be further evaluated to better understand endometriosis development. Endometriosis should be treated with a holistic, multidisciplinary approach, combining physical and psychological aspects to enhance patient outcomes and quality of life.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"196 ","pages":"Article 112346"},"PeriodicalIF":3.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personality nuances and mortality risk: A coordinated analysis of four longitudinal samples","authors":"Yannick Stephan ,&nbsp;Angelina R. Sutin ,&nbsp;René Mõttus ,&nbsp;Martina Luchetti ,&nbsp;Páraic O'Súilleabháin ,&nbsp;Antonio Terracciano","doi":"10.1016/j.jpsychores.2025.112347","DOIUrl":"10.1016/j.jpsychores.2025.112347","url":null,"abstract":"<div><h3>Objective</h3><div>Personality nuances constitute the most specific level of the personality trait hierarchy and are often operationalized by individual questionnaire items. We examine whether these items are related to mortality to identify which specific personality characteristics are most related to length of life.</div></div><div><h3>Method</h3><div>Participants (<em>N</em> &gt; 22,000) from the Health and Retirement Study, the Midlife in the United States Study, the National Social Life, Health, and Aging Project, and the National Health and Aging Trends Study completed 26-, 25-, 21- or 10-item measures of the Big Five personality traits using the Midlife Development Inventory. Mortality was tracked between 6 and 28 years.</div></div><div><h3>Results</h3><div>Across most samples and meta-analyses, higher neuroticism domain and item scores were related to a higher mortality risk, whereas higher extraversion, agreeableness, and conscientiousness domain and item scores were associated with a lower mortality risk. Less consistent associations were found for the openness domain and items. The extraversion item “active” had the strongest association with lower mortality risk (pooled hazard ratios [HR] = 0.79, 95 %CI = 0.73–0.85), followed by “lively” (extraversion), “organized”, “responsible”, “hardworking”, and “thorough” (conscientiousness), and “helpful” (agreeableness) (HRs range from 0.87 to 0.91). These associations were partially accounted for by clinical, behavioral, and psychological factors.</div></div><div><h3>Conclusion</h3><div>This research deconstructs the five broad domains to identify the nuances most related to longevity. Specific personality items have replicable associations with mortality but little incremental predictive power compared to the corresponding domain. Still, the aggregated predictive value of items was stronger compared to the five broad personality domains.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"196 ","pages":"Article 112347"},"PeriodicalIF":3.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with new onset of depression and anxiety symptoms differ by sex in the COPDGene study","authors":"Kirsten Voorhies ,&nbsp;Jess G. Fiedorowicz ,&nbsp;Abebaw M. Yohannes ,&nbsp;Gregory L. Kinney ,&nbsp;Dawn L. DeMeo ,&nbsp;Elizabeth A. Regan ,&nbsp;James D. Crapo ,&nbsp;Edwin K. Silverman ,&nbsp;Christoph Lange ,&nbsp;Karin F. Hoth ,&nbsp;Sharon M. Lutz","doi":"10.1016/j.jpsychores.2025.112345","DOIUrl":"10.1016/j.jpsychores.2025.112345","url":null,"abstract":"<div><h3>Objective</h3><div>Examine clinical and demographic variables associated with new onset depression and anxiety symptoms and assess moderation by sex in COPDGene, a cohort study of current and former smokers at risk for or with chronic obstructive pulmonary disease (COPD).</div></div><div><h3>Methods</h3><div>In the COPDGene study, 2653 adults had the hospital anxiety (HADS-A) and depression (HADS-D) scales available at phase 2 and 3, as well as clinical and demographic variables available at 2 and non-elevated HADS at phase 2. We defined new onset depression symptoms as HADS-D elevated at phase 3 (HADS-D ≥ 8) versus no new onset as HADS-D not elevated at either phase (HADS-D &lt; 8). New onset anxiety symptoms were defined identically using HADS-A. We used logistic regression models among all participants and stratified by sex and assessed sex interactions for variables associated with the outcome for only one sex.</div></div><div><h3>Results</h3><div>Among males, COPD Assessment test (CAT) score was positively associated with new onset depression (<em>β</em> = 0.08, <em>p</em> = 1.9 × 10⁻⁵) and anxiety (<em>β</em> = 0.06, <em>p</em> = 1.4 × 10⁻³) symptoms. Among females, the modified Medical Research Council (mMRC) dyspnea was positively associated with new onset anxiety symptoms (<em>β</em> = 0.33, p = 1.4 × 10⁻³). We found sex by CAT score (<em>β</em> = −0.06, <em>p</em> = 0.02) and sex by mMRC dyspnea (β = 0.42, <em>p</em> = 5.1 × 10⁻³) interactions on new onset anxiety symptoms, and sex by CAT score interaction (<em>β</em> = −0.05, <em>p</em> = 0.04) on new onset depression symptoms.</div></div><div><h3>Conclusions</h3><div>These findings highlight the importance of understanding factors that increase risk for depression and anxiety among smokers at risk for or with COPD and are moderated by sex.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"197 ","pages":"Article 112345"},"PeriodicalIF":3.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of exercise training on motivation in patients with heart failure with preserved ejection fraction: Results from the randomized controlled Ex-DHF trial","authors":"Monika Sadlonova ,&nbsp;Christopher M. Celano ,&nbsp;Jeff Huffman ,&nbsp;Malte Jetzke ,&nbsp;Carlotta Derad ,&nbsp;Daniel Broschmann ,&nbsp;Anna Feuerstein ,&nbsp;Gerd Hasenfuss ,&nbsp;Kathleen Nolte ,&nbsp;Burkert Pieske ,&nbsp;Stephan Mueller ,&nbsp;Martin Halle ,&nbsp;Frank Edelmann ,&nbsp;Rolf Wachter ,&nbsp;Christoph Herrmann-Lingen","doi":"10.1016/j.jpsychores.2025.112344","DOIUrl":"10.1016/j.jpsychores.2025.112344","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) is a global public health issue. Over 50 % of symptomatic HF patients have HF with preserved ejection fraction (HFpEF), but to date, few pharmacotherapy treatments have been shown to improve morbidity and mortality in patients with HFpEF. Exercise training (ET) is an important component in the management of HFpEF since it improves exercise capacity, quality of life, and reduces HF hospitalizations. However, low motivation is a common barrier to adherence to ET.</div></div><div><h3>Methods</h3><div>In this secondary analysis of the Ex-DHF trial, we investigated whether a 12-month, structured, supervised ET intervention in HFpEF patients increases overall motivation, self-determined (intrinsic and identified) motivation, and non-self-determined (extrinsic and introjected) motivation, measured using the German Scale for Self-concordance of Sport- and Exercise-related Goals (SSK), compared to usual care (UC).</div></div><div><h3>Results</h3><div>We enrolled 322 participants (mean age 69.6 ± 7.3 years; 59.6 % women). ET was associated with significant improvements in overall motivation at 12 months (B = 0.78, 95 % CI 0.14–1.42, <em>p</em> = 0.017) compared with UC. Furthermore, ET led to significant increases in intrinsic (B = 0.57; 95 % CI 0.29–0.85, <em>p</em> &lt; 0.001) and identified motivation (B = 0.47, 95 % CI 0.21–0.73, p &lt; 0.001) at 12 months compared with UC, with no between-group differences in extrinsic or introjected motivation.</div></div><div><h3>Conclusions</h3><div>A 12-month ET intervention led to a significant increase in motivation in patients with HFpEF, with specific increases in self-determined motivation (intrinsic and identified). Given the key role of motivation in health behaviors, especially self-determined motivation types, supervised ET may have the potential to impact long-term adherence to ET in patients with HFpEF.</div></div><div><h3>Trial registration</h3><div>Ethics approval for this study was obtained from the Regional Committees for Medical Research Ethics of the Charité Medical Center Berlin, University Medical Center Göttingen, University of Würzburg, University of Leipzig Medical Center, and Technical University München. The study was registered after approval by the ethics committee at <span><span>http://www.isrctn.com</span><svg><path></path></svg></span>, on August 23, 2011. The registration number is ISRCTN86879094.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"196 ","pages":"Article 112344"},"PeriodicalIF":3.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}