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PubMed2002

Multidimensional fatigue, somatic symptoms and depression.

OBJECTIVES: Assess the moderating role of somatization on depression in the perception of fatigue for a healthy adult population. DESIGN: Correlational survey. METHODS: Several fatigue questionnaires, a mental health inventory, somatic complaints and demographic data were collected from a targeted, randomly selected adult sample (N = 278). RESULTS: Depression levels were positively and significantly related to all aspects of fatigue except fatigue that responds to rest and sleep (i.e. tiredness). When high levels of depression were coupled with somatization, fatigue complaints were more severe. CONCLUSIONS: Even within a non-patient population, somatization and depression had interactive effects on fatigue. Somatization increased fatigue level for the relatively dysphoric individuals.

Journal Article↗
PubMed1991

Somatization: a perspective from self psychology.

Somatization is a complex phenomenon that occurs in many forms and diverse settings. It is not necessarily pathological and may be found in a variety of psychiatric disorders. Much of the psychiatric literature has focused on patients with conversion disorders and hypochondriasis. Psychoanalytic theories regarding such conditions were largely based upon concepts of drive, conflict, and defense. The perspective from self psychology, with its emphasis on subjective experience and the sense of self, may further enhance the psychoanalytic understanding of somatization. Individuals with disturbances in the stability and organization of the self may present with somatic symptoms and disturbances in emotional awareness. Somatization in such cases may be the experiential manifestation of a disturbance in the cohesion of the self and/or may result from defensive operations to ward off affect. The latter may be prominent when affective arousal triggers the psychological threat of fragmentation. Somatization may diminish in such individuals when a self-object relationship is formed that bolsters and consolidates the sense of self. The integration of affect into ongoing subjective experience may also be an important aspect of psychoanalytic treatment in such patients.

Adult↗
PubMed2002

Suicidal ideation and somatic symptoms of patients with mind/body distress in a Japanese psychosomatic clinic.

To examine associations of suicidal ideation with somatic symptoms, 863 outpatients were studied in a psychosomatic clinic in Japan. All subjects were diagnosed according to the third and fourth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R and DSM-IV). They completed the Cornell Medical Index Questionnaire to assess suicidal ideation and 15 major somatic symptoms. Mood states were rated using the Profile of Mood States (POMS). In the study, 266 patients (31%) reported suicidal ideation. The age- and sex-adjusted odds ratios (typically in the range of 1.5 to 2.5) of somatic symptoms for suicide ideation showed significant differences (all ps < .05) for 13 of 15 symptoms. The total number of somatic symptoms predicted suicidal ideation (p < .05), controlling for the significant effects of sex, education, marital status, and the POMS Depression scale scores through multiple regression analysis. Evaluation of somatic symptoms might be important to assess suicidal ideation in a psychosomatic medicine population.

Adult↗
PubMed2000

Frequency of somatic MEN1 gene mutations in monoclonal parathyroid tumours of patients with primary hyperparathyroidism.

OBJECTIVES: Investigation of small numbers of parathyroid tumours by X-chromosome inactivation analysis suggests that the majority of them are monoclonal lesions most likely caused by a somatic mutation. Somatic mutations in the MEN1 gene located on chromosome 11q13 have recently been identified in 12-17% of solitary parathyroid tumours in patients with sporadic primary hyperparathyroidism, and they may be the precipitating genetic defect leading to monoclonal cell proliferation in these tumours. DESIGN: To determine the prevalence of MEN1 gene mutations in monoclonal parathyroid neoplasias we investigated 33 parathyroid tumours of patients with primary hyperparathyroidism for clonality and mutations in the MEN1 gene. METHODS: X-chromosome inactivation analysis was used to assess the clonal status of the tumours, direct sequencing of the complete coding region was applied to identify mutations in the MEN1 gene. RESULTS: Twenty-eight female patients (26 patients with solitary adenoma, 2 patients with hyperplasia) were informative for the polymorphism of the androgen receptor on the X-chromosome and could be tested for inactivation pattern. Nineteen of twenty-six (73%) solitary adenomas were monoclonal. Somatic mutations in the MEN1 gene were identified in nine cases. Six of them were found in the relatively large second exon of the MEN1 gene (A49D, 193del36, 402delC, 482del22, 547delT, W126X). One was found in exon 5 (904del9), one in exon 7 (Y327X) and one in exon 9 (R415X). Of the monoclonal tumours, 5 out of 19 (26%) harboured a somatic MEN1 gene mutation. CONCLUSIONS: In summary, 73% of the solitary parathyroid adenomas were monoclonal. In 26% of the monoclonal tumours a somatic MEN1 gene mutation has been identified. However, for 74% of monoclonal tumours of the parathyroids the underlying genetic defects are still not known.

Adenoma↗
PubMed2005

Differential reprogramming of somatic cell nuclei after transfer into mouse cleavage stage blastomeres.

Mammalian somatic cell cloning requires factors specific to the oocyte for reprogramming to succeed. This does not exclude that reprogramming continues during the zygote and cleavage stages. The capacity or role of zygotic and cleavage stages to reprogram somatic cell nuclei is difficult to assess due to the limited development of somatic cell nuclei transplanted into cytoplasts of these stages. Alternatively, tetraploid embryos have been used to study reprogramming and can be assessed for their contribution to extra-embryonic lineages. When mouse cumulus cell nuclei transgenic for Oct4-green fluorescent protein (GFP) were injected into intact two- and four-cell stage blastomeres, manipulated embryos developed into blastocysts with expression of Oct4-GFP as observed in embryos produced by nuclear transfer into metaphase II oocytes. However, only the latter contributed to extra-embryonic tissues in day 10.5 conceptuses, with the exclusion of the somatic genome in cells originating from transfer into blastomeres already at 5.5 days post conception. Somatic nuclei transferred into cleavage stage blastomeres reinitiated expression of an embyronic-specific transgene, but lacked the extent of reprogramming required for contribution to postimplantation development, even when complemented by an embryonic genome.

Animals↗
PubMed2003

Comparative study of anxiety, depression, somatization, functional disability, and illness attribution in adolescents with chronic fatigue or migraine.

OBJECTIVE: To compare adolescents with migraine, unexplained profound chronic fatigue of >6 months duration, and normal school controls on measures of anxiety, depression, somatization, functional disability, and illness attribution. METHODS: Adolescents referred to Children's Hospital and Regional Medical Center for behavioral treatment of migraine (n = 179) or evaluation of chronic fatigue (n = 97) were compared with a group of healthy controls of similar age and sex from a middle school (n = 32). Subjects completed the Spielberger State-Trait Anxiety Inventory-Trait Form, the Children's Depression Inventory, the Childhood Somatization Inventory, and estimated the number of school days missed in the past 6 months because of illness. Migraine and fatigued subjects completed an illness attribution questionnaire. RESULTS: Subjects in the 3 groups were 56% to 70% female and ranged from 11 years old to 18 years old with a mean age of 14.0 +/- 2.0. Forty-six of the 97 chronically fatigued adolescents met 1994 Centers for Disease Control and Prevention (CDC) criteria for chronic fatigue syndrome (CDC-CFS), while 51 had idiopathic chronic fatigue syndrome (I-CFS) that did not meet full CDC criteria. Adolescents with migraine had significantly higher anxiety scores than those with I-CFS or controls and higher somatization scores than controls. Adolescents with CDC-CFS had significantly higher anxiety scores than those with I-CFS or controls, and higher depression and somatization scores than all other groups. There were significant differences between all groups for school days missed with CDC-CFS more than I-CFS more than migraine more than controls. Parents of adolescents with unexplained I-CFS had significantly lower attribution scores relating illness to possible psychological or stress factors than parents of adolescents with CDC-CFS or migraine. CONCLUSIONS: Adolescents referred to an academic center for evaluation of unexplained chronic fatigue had greater rates of school absenteeism than adolescents with migraine or healthy controls. Those meeting CDC-CFS criteria had higher anxiety scores than controls and higher depression and somatization scores than migraineurs or controls. Parents of adolescents with I-CFS were less likely to endorse psychological factors as possibly contributing to their symptoms than parents of adolescents with CDC-CFS or migraine.

Absenteeism↗
PubMed2005

The influence of somatic symptoms on the performance of elders in the Beck Depression Inventory (BDI).

BACKGROUND: The Beck Depression Inventory (BDI) has been widely used to assess the prevalence of depressive symptomatology in clinical and non-clinical samples. On elders, however, the Beck Depression Inventory total score can be influenced by the increased scores on somatic and performance subscale due to the impact of ageing process itself and clinical diseases. PURPOSE: To verify if there are differences between answers of adults and elders for the BDI Somatic and Performance subscale. METHODS: Five hundred and fifty six subjects were interviewed. Two hundred and seventeen were adults (between 18 and 59 years old) and 339 were elders (> or = 60 years). Adults and elders with terminal diseases or dementia were excluded. The convenience sampling method was used. RESULTS: Elders answered significantly with higher scores in the Somatic and Performance subscale compared to adults (p < 0.001). Female gender and educational level were also associated to higher scores in the Somatic subscale. No differences between both age groups were found in the Cognitive-Affective subscale (p = 0.332). CONCLUSIONS: Positive answers in the BDI Somatic and Performance subscale must be carefully assessed among elder subjects. The age factor, either by aging or due to several diseases, can bring signs that are not necessarily symptoms of major depression. Further studies are suggested.

Adolescent↗
PubMed2004

Production of bacterial blight resistant lines from somatic hybridization between Oryza sativa L. and Oryza meyeriana L.

Novel bacterial blight (BB) resistance gene(s) for rice was (were) introduced into a cultivated japonica rice variety Oryza sativa (cv. 8411), via somatic hybridization using the wild rice Oryza meyeriana as the donor of the resistance gene(s). Twenty-nine progenies of somatically hybridized plants were obtained. Seven somatically hybridized plants and their parents were used for AFLP (amplified fragment length polymorphism) analysis using 8 primer pairs. Results confirmed that these plants were somatic hybrids containing the characteristic bands of both parents. The morphology of the regenerated rice showed characters of both O. sativa and O. meyeriana. Two somatic hybrids showed highest BB resistance and the other 8 plants showed moderate resistance. The new germplasms with highest resistance have been used in the rice breeding program for the improvement of bacterial blight resistance.

Genetic Enhancement↗
PubMed2002

Somatic epidermal stem cells can produce multiple cell lineages during development.

It has been demonstrated that several types of somatic stem cells have the remarkable capacity to differentiate into other types of tissues. We demonstrate here that stem cells from the skin, the largest organ of the body, have the capacity to form multiple cell lineages during development. Using our recently developed sorting technique, we isolated viable homogeneous populations of somatic epidermal stem and transient amplifying cells from the skin of 3-day old transgenic mice, who carried the enhanced green fluorescent protein transgene, and injected stem, TA, or unsorted basal epidermal cells into 3.5-day C57BL/6 blastocysts. Only the stem-injected blastocysts produced mice with GFP(+) cells in their tissues. We found GFP(+) cells in ectodermal, mesenchymal, and neural-crest-derived tissues in E13.5 embryos, 13-day-old neonates, and 60-day-old adult mice, proving that epidermal stem cells survived the blastocyst injection and multiplied during development. Furthermore, the injected stem cells altered their epidermal phenotype and expressed the appropriate proteins for the tissues into which they developed, demonstrating that somatic epidermal stem cells have the ability to produce cells of different lineages during development. These data suggest that somatic epidermal stem cells may show a generalized plasticity expected only of embryonic stem cells and that environmental (extrinsic) factors may influence the lineage pathway for somatic stem cells. Thus, the skin could be a source of easily accessible stem cells that are able to be reprogrammed to form multiple cell lineages.

Animals↗
PubMed1992

Somatic afferent stimulation-plasma corticosterone, luteinizing hormone (LH), and testosterone responses in aged male rats under anesthetization.

Our previous studies have demonstrated that somatic sensory stimulation can produce increases in secretions of corticosterone, luteinizing hormone (LH), and testosterone in young male Wistar rats of 13-22 weeks old even after emotional factors are eliminated by pentobarbital-anesthetizing of the subjects. In the present study, we examined the effects of somatic sensory stimulation on plasma corticosterone, LH, and testosterone using aged male Wistar rats (24-27 months old) under the same anesthetizing condition as employed in our previous studies. We compared the reflex responses in aged rats with those previously measured in young rats. Nociceptive mechanical stimulation of both hindpaws by pinching for 10 min significantly increased plasma corticosterone levels in aged rats. The magnitude and time-course of this response were equivalent to those in young rats. On the other hand, neither plasma LH nor testosterone levels were changed by nociceptive mechanical stimulation of the hindpaws of aged rats. This is in sharp contrast to the increase in both plasma LH and testosterone caused by the stimulation of young rats. These results indicate a functional dissociation induced by aging between the secretory responses of the anterior pituitary, testes on the one hand and the adrenal cortex on the other hand, to nociceptive somatic sensory stimulation. Aging does not alter corticosterone release from the adrenal cortex to nociceptive somatic sensory stimulation; however, LH secretion from the anterior pituitary and testosterone secretion from the testes to nociceptive somatic sensory stimulation are subject to dysfunction with aging.

Aging↗
PubMed1987

Masked depression: its interrelations with somatization, hypochondriasis and conversion.

Masked depression appears to be a common clinical phenomenon. Most depressions present with some somatic complaints in addition to affective and cognitive ones. About one half of all depressions seen by primary care physicians initially present predominantly or exclusively with somatic symptoms. Many of these depressions are not recognized or are misdiagnosed and mistreated. The possible reasons for this are discussed here. The phenomenon of somatization in depressions and other conditions is reviewed and the interface with other related clinical problems like hypochondriasis and conversion is delineated. It is hypothesized that the proportion of depressions that are masked is positively correlated to the patients' tendency to somatize and negatively correlated to the doctors' ability to recognize depressions that hide behind somatic complaints. Suggestions for the diagnosis and treatment of masked depressions are given.

Conversion Disorder↗
PubMed2001

Restricted emotional processing and somatic attribution in fibromyalgia.

OBJECTIVE: Medically unexplained symptoms or syndromes, such as fibromyalgia (FM), might be partly caused or sustained by a mechanism involving restricted emotional processing (REP) and the subsequent attribution of emotional arousal to somatic or syndrome-consistent causes. In this study, it was hypothesized that FM patients, compared to healthy individuals, would be higher on trait measures of REP (defensiveness and alexithymia), and would show affective-autonomic response dissociation, that is, higher standardized scores of heart rate responses than affective responses, during negative emotional stimulation. Additionally, FM patients were expected to attribute their bodily symptoms more to somatic than to psychological causes. METHOD: Emotional movie excerpts were shown to 16 female FM patients and 17 healthy women. Affective response and heart rate were monitored continuously, while symptoms and their causal attributions were measured before and after the excerpts. Repressor coping style and alexithymia were measured, along with negative affectivity and habitual attributions of somatic complaints. RESULTS: FM patients nearly all showed the relatively uncommon combination of high defensiveness and high anxiousness. Compared with healthy women FM patients were more alexithymic, showed a higher level of affective-autonomic response dissociation, and lower within-subject emotional variability. The groups showed opposite attributional patterns, with FM patients attributing symptoms less to psychological causes and more to somatic causes. There was no evidence of a shift in these attributions caused by the emotional stimuli. CONCLUSIONS: The results provide preliminary support for the hypotheses. Both at trait and at state level, FM showed restricted emotional processing on most of the parameters measured, and a high ratio of somatic to psychological symptom attribution, coupled with high negative affectivity.

Adult↗
PubMed2002

Screening for somatization and depression in Saudi Arabia: a validation study of the PHQ in primary care.

OBJECTIVES: Somatization, the tendency to seek treatment for medically unexplained physical symptoms, is an important issue in primary care practice. This study examines the somatoform, depression, and anxiety modules of the Patient Health Questionnaire (PHQ), a screening instrument for the identification of somatoform and other mental disorders. We also utilized the PHQ to measure the prevalence of somatization and co-morbid depression in Saudi Arabian primary care patients. METHODS: This is a cross sectional study of 431 male and female Saudi Arabian primary care patients with a two stage design for purposes of validation of the somatoform, depression and anxiety modules of the PHQ. The self administered Patient Health Questionnaire was given to 431 primary care patients and, of this group, the first, consecutive 173 patients (40 percent) were interviewed by mental health professionals using the Structured Clinical Interview (SCID-R) as the criterion standard for validation of the PHQ in the Saudi population. The PHQ was then used to measure the prevalence of somatization and depression in the remaining 258 patients. RESULTS: The somatoform and depression modules of the PHQ were found to be valid in a Saudi population using the criterion standard of SCID based psychiatric interviews. Agreement between the PHQ and psychiatric interviews was (kappa = .65) for both somatoform disorders and depression but the anxiety module was weak in terms of sensitivity (.37) and agreement with the criterion standard (k = .37). Clinically significant rates of somatization (19.3 percent) and depression (20 percent) were identified in this population. CONCLUSIONS: The prevalence of somatization and co-morbid depression in a primary care population in Saudi Arabia is similar to published rates in the U.S. and worldwide. It is possible to screen primary care patients for mental disorders in international settings and the PHQ is valid instrument for that purpose.

Adolescent↗
PubMed1998

Validation of a self-report measure of somatic health.

The primary purpose was to assess the validity of a new self-report inventory of general somatic health status. In addition, we sought to examine the influence of social desirability and negative affectivity on health reports and to learn whether asking respondents to report concrete, memorable aspects of illness episodes such as seeing a doctor or staying home in bed for all or most of a day would enhance validity. The somatic component of the Cornell Medical Index was used as a criterion measure of health status because that Index has been shown to reflect medical records with great accuracy. Scores on the new health inventory correlated highly with the Cornell somatic scores, and this relationship was independent of negative affectivity and social desirability. The addition of the "concrete, memorable" aspects of illness accounted for no additional variance in the Cornell Index somatic scores beyond that accounted for by mere reporting of the presence of the symptom or illness. This study offers evidence supporting the validity of the Inventory of Health Status as a predictor of somatic health independent of social desirability and negative affectivity and also indicates that a simple indication of whether the patient had the symptoms is sufficient.

Adult↗
PubMed1999

MMPI screening scales for somatization disorder.

44 items on the MMPI were identified which appear to correspond to some of the symptoms in nine of the 10 groups on the Perley-Guze checklist for somatization disorder (hysteria). This list was organized into two scales, one reflecting the total number of symptoms endorsed and the other the number of organ systems with at least one endorsed symptom. Full MMPIs were then obtained from 29 women with primary affective disorder and 37 women with somatization disorder as part of a follow-up study of a consecutive series of 500 psychiatric clinic patients seen at Washington University. Women with the diagnosis of somatization disorder scored significantly higher on the somatization disorder scales created from the 44 items than did women with only major depression. These new scales appeared to be slightly more effective in identifying somatization disorder than the use of the standard MMPI scales for hypochondriasis and hysteria. Further development is needed.

Adult↗
PubMed2004

Children's somatization symptoms: correlations with trait anxiety, anxiety sensitivity, and learning experiences.

The objectives of this study were to examine associations between trait anxiety, anxiety sensitivity, and learning experiences, on the one hand, and children's somatization symptoms, on the other hand. A sample of 190 nonclinical children completed the trait anxiety scale of the State-Trait Anxiety Inventory for Children, the Childhood Anxiety Sensitivity Index, and the Children's Somatization Inventory, and were interviewed about learning experiences in relation to physical symptoms. Correlational and regression analyses indicated that trait anxiety, anxiety sensitivity, and parents' anxiety-encouraging behaviours in relation to somatic symptoms were significantly positively associated with somatization. These results indicate that there might be common vulnerability factors in childhood anxiety and somatization symptoms.

Adolescent↗
PubMed2002

Use of somatic cells from goat milk for dynamic studies of gene expression in the mammary gland.

Somatic cells are present in the milk throughout lactation and consist of leukocytes and epithelial cells exfoliated from the mammary epithelium. Our objective was to determine the efficacy of using somatic cells from goat milk for dynamic studies of gene expression in the mammary gland. Over a 4-wk interval, cells were isolated from daily morning milk samples and samples taken 30 min after milking. They were characterized by direct cell counts and by flow cytometry analysis after immunostaining with antibodies directed against cytokeratin and CD45, a common leukocyte antigen. Epithelial cell counts within the morning milk ranged from 15 to 45% of total milk somatic cells. After-milking samples contained twice as many cells as did morning milk samples. The RNA was extracted from the somatic cells of both types of milk samples with equivalent efficiency (a mean of 1.2 microg RNA/mL of milk). Four mRNA variants of the alpha-S1 casein gene were detected by Northern blot analysis and the amount of each mRNA in milk cells was related to protein concentration in milk. The comparison between mRNA from the mammary gland and from congruently collected milk cells showed that relative amounts of mRNA for each milk-protein (alpha-S1 and kappa-casein and alactalbumin) were conserved. In a third experiment, daily milk cell RNA preparations were extracted to assess the effect of growth hormone (GH) on mammary gene expression; four goats were separated into two groups in order to perform a switch-back design consisting of three treatment weeks: Control, GH-Control or GH-Control-GH. In this study, treatment of goats with GH increased milk yields by 5%. Throughout the control and GH treatments, the expression of the three milk-protein genes studied were highly and significantly correlated (r = 0.949 and r = 0.958, P < 0.001 for, respectively, alpha-S1 and kappa-casein and for alpha-S1 casein and alpha-lactalbumin). During GH treatment, the three milk-protein mRNA abundances increased with the same pattern. In conclusion, the opportunity to use milk somatic cells for RNA preparation and analysis provides a significant improvement over the use of biopsy samples in assessing gene activity in the mammary gland and allows easy and repetitive sampling without damaging mammary tissue. Furthermore, we propose that this method could be used to investigate the transcriptional status of the mammary gland of an animal in relation to its genotype, nutritional and pathologic status, and under influence by hormonal factors.

Animals↗
PubMed2006

Evaluation of milk somatic cells as a source of mRNA for study of lipogenesis in the mammary gland of lactating beef cows supplemented with dietary high-linoleate safflower seeds.

Our objectives were 2-fold: to determine the effect of dietary linoleate on milk fat composition and on transcript abundance of acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS), lipoprotein lipase (LPL), and stearoyl-CoA desaturase (SCD) mRNA in mammary tissue, and to evaluate milk somatic cell mRNA as a source of mammary tissue mRNA for these enzymes. Eighteen primiparous, crossbred beef cows (BW = 411 +/- 24 kg; BCS = 5.25) were offered Foxtail millet hay at 1.68% of BW daily and either a low-fat control (n = 9) or a high-linoleate (79% 18:2n-6), cracked safflower seed supplement (n = 9). Diets were isonitrogenous and isocaloric, and the linoleate diet contained 5.4% of DMI as fat. At slaughter (37 +/- 3 d postpartum), mammary tissue was sampled and immediately frozen in liquid N2 before being stored at -80 degrees C. Milk samples were obtained from the same mammary glands and immediately centrifuged at 1,200 x g to pellet somatic cells. A ribonuclease protection assay was used to quantify the mRNA in the mammary gland and milk somatic cells. Effects of diet, tissue, or their interaction were not observed for ACC (P = 0.28, 0.89, and 0.35, respectively), FAS (P = 0.38, 0.66, and 0.20, respectively), LPL (P = 0.09, 0.15, and 0.43, respectively), or SCD (P = 0.45, 0.19, and 0.29, respectively). Dietary effects on fatty acid profile of the milk fat suggested that linoleate supplementation might have decreased de novo lipogenesis while increasing uptake of dietary fatty acids; this effect was consistent with a trend toward greater LPL mRNA for linoleate-fed cows (P = 0.09). Correlations (r values) between mammary tissue and milk somatic cell data for each mRNA for the low-fat control diet were: ACC, 0.76 (P = 0.02); FAS, 0.69 (P = 0.04); LPL, 0.68 (P = 0.04); and SCD, 0.73 (P = 0.05), and for the linoleate diet were: ACC, 0.85 (P = 0.003); FAS, 0.75 (P = 0.02); LPL, 0.90 (P = 0.001); and SCD, 0.73 (P = 0.03). We conclude that milk somatic cells obtained from lactating beef cows can be used as a source of RNA to study nutritional regulation of mammary gland lipogenesis in cows fed dietary fat supplements.

Acetyl-CoA Carboxylase↗