Dissociative amnesia is comorbid with somatic symptom disorder (SSD), yet this link is not well-understood. Clinical studies indicate that childhood trauma, especially sexual abuse and emotional abuse, are primary causal factors in the etiology of SSD. This paper provides evidence that dissociative amnesia is an explanatory variable between childhood trauma and SSD. As many or more trauma victims develop amnesia and somatic complaints as those who develop post-traumatic stress disorder (PTSD), but SSD and dissociative amnesia receive much less attention. This leaves clinicians and patients without effective intervention and sometimes causes misdiagnosis. PTSD’s neuroendocrinological cascade, from peritraumatic perception to psychobehavioral endpoints is well-mapped, and it informs an opponent-process for dissociative amnesia and SSD, allowing a better conceptualization of a primary cause of SSD - trauma. The novel trauma-amnesia-pain (T-A-P) neuroendocrinological map presented here is a mirror process of the tonic immobility-PTSD pathway initiated by the hypothalamus-pituitary-adrenal (HPA) axis. Dissociative amnesia-SSD develops through the same HPA axis pathway, with PTSD essentially being a downregulated cortisol response and T-A-P an upregulated cortisol response. Copious evidence has now emerged from neurological, physiological, and clinical studies of animals and people regarding the role controllable stress/trauma plays in the etiology of both amnesia and analgesia. T-A-P also validates the decision to consolidate pain disorder, somatization disorder, and functional somatic disorder under one nosological category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. The implications of this theory are important for both prevention and effective intervention with trauma-induced SSD.

Psychotherapy is effective in treating various types of mental disorders. However, the biological processes underlying its therapeutic efficacy in the relief of depression and anxiety remain unclear. An approach to investigating these therapeutic mechanisms derives from an understanding of disease pathogenesis, in which the dysfunction of brain-derived neurotrophic factor (BDNF) is strongly implicated. This study provides a review of various studies investigating the link between the efficacy of talking therapies in anxiety and depression and the measures of BDNF variability, the latter determined by plasma and serum BDNF concentrations, BDNF gene polymorphisms, and DNA methylation. Despite the few intriguing findings supporting the underlying hypothesis that reduced BDNF function results in poor response, many studies are limited by inadequate methodology and poor control of confounding factors. Thus, opportunities remain for further well-designed investigations, particularly utilizing the little-studied epigenetic factor of BDNF gene methylation.

Insomnia is the most prevalent sleep disorder with significant implications for mental and physical health. While traditionally understood through a biomedical lens, increasing evidence highlights the role of psychosomatic factors in its onset and perpetuation. This narrative review explores the relationship between psychological and somatic influences on insomnia, examining the underlying mechanisms, diagnostic challenges, and treatment strategies. We discuss neurobiological pathways, including the hypothalamic-pituitary-adrenal axis and neurotransmitter imbalances, alongside psychological factors such as anxiety, hyperarousal, and cognitive distortions. Somatic symptoms, particularly chronic pain, and other physical conditions are also regarded as integral contributors to insomnia. Diagnosis of psychosomatic insomnia requires a comprehensive approach that incorporates both psychological and physical assessments, utilizing a combination of clinical interviews, standardized questionnaires, and differential diagnostic techniques. Treatment strategies are discussed in this paper with an emphasis on cognitive-behavioral therapy for insomnia, pharmacological interventions, and integrative approaches that address the multifaceted nature of the disorder. The review also highlights the importance of lifestyle modifications and the potential role of alternative therapies in managing insomnia. A rounded understanding of psychosomatic influences is crucial for effective diagnosis and treatment of insomnia. Future research should focus on personalized therapeutic approaches and further interpreting the complex interconnections between mind and body in the pathophysiology of insomnia. This perspective has the potential to enhance clinical practice and improve outcomes for individuals suffering from this challenging disorder.

The Aboriginal population comprises 3.3% of the total Australian population, and youth represent 19% of this segment. In general, the Aboriginal inhabitants of Australia experience discrimination, limited access to education, and low socioeconomic conditions, and exhibit high mental disorder rates. The rate of suicide attempts by the Indigenous people of Victoria increased by 75% in 2021. This study examined the possible risk factors associated with suicides committed by Indigenous youth in Victoria. It focused on the health profiles of Victorian Aboriginal individuals, identified stakeholders who could help improve their mental well-being, addressed the needs and issues related to Aboriginal mental health, and examined substance abuse in this population segment. Finally, recommendations are offered to mitigate the studied problem. Rising suicide rates represent an urgent concern because they reflect the diminished mental health conditions of a society, particularly among its marginalized populations. It is crucial to develop an integrated suicide prevention act that takes into account the biological, psychological, social, cultural, and spiritual determinants of this population.

Sleep problems are common and significantly impact health and well-being. Diet, particularly protein intake, may affect sleep, yet the precise relationship remains unclear. This study investigates the association between protein consumption and sleep problems while considering potential confounders and gender differences, using data from the National Health and Nutrition Examination Survey. Our cross-sectional analysis included 18,077 women (51.3%) and 17,175 men (48.7%), averaging 45.9 years (standard deviation = 17.7). Protein consumption was assessed through 24-h dietary recall interviews and sleep problems were assessed through the question: “Have you ever told a doctor or other health professional that you have trouble sleeping?” Using binary logistic regression models, we found that 24.6% of individuals reported sleep problems. A statistically significant association emerged between protein consumption and the likelihood of experiencing sleep problems across quartiles of protein intake. Specifically, individuals in the highest quartile of protein consumption had the lowest odds of sleep problems compared to those in the lowest quartile, even after adjusting for various demographic and lifestyle factors (P < 0.001). Gender-stratified analysis revealed a persistent association between protein intake and sleep problems, with a stronger effect observed in females (P < 0.002) compared to males (P = 0.337). Overall, our findings suggest that higher protein consumption is independently associated with reduced odds of sleep problems. This underscores the importance of adequate protein intake for promoting better sleep outcomes and highlights potential implications for public health interventions and clinical practice.

Neuroticism, a personality trait linked to emotional instability and negative emotions, is associated with increased anxiety, depression, and poor mental health outcomes, particularly in individuals with psychiatric disorders. However, existing neuroticism scales often have too many items, are not tailored for psychiatric populations, and lack cultural adaptation for Chinese contexts. We aimed to develop a brief neuroticism scale with adequate reliability and validity for the Chinese population, including individuals with psychiatric disorders. The 14-item scale was developed based on the five-factor model and Eysenck’s personality theory. The scale, in the form of a questionnaire, was distributed to college students from Southeast University and patients from the Affiliated Zhongda Hospital of Southeast University. A total of 554 participants were recruited, and demographic information, the neurotic subscale of the Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI), Patient Health Questionnaire (PHQ-9), and generalized anxiety disorder (GAD-7) were collected along with the neuroticism scale. Correlation analysis, Cronbach’s alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were conducted to test and revise the scale. EFA indicated that the neuroticism scale consisted of four factors: Low self-esteem, excessive emotional sensitivity, unstable mood, and excessive worry. The Cronbach’s alpha was 0.926. CFA suggested a good fit of the scale structure (χ2/df =2.506, root mean square error of approximation =0.039, Tucker-Lewis index =0.947, comparative fit index =0.959, and standardized root mean square residual =0.032). The total scores of the neuroticism scale were positively related to those of PHQ-9, GAD-7, and NEO-FFI. The results indicate that the neuroticism scale exhibited a stable four-dimensional structure with good reliability and validity in the Chinese population. It is useful and time-saving for assessing neuroticism in individuals with psychiatric disorders.

Suicidal ideation (SI) is a strong predictor of suicide risk. High-density lipoprotein (HDL)-related inflammatory indicators, which combine HDL cholesterol (HDL-C) with other inflammation-related markers, provide a comprehensive assessment of the body’s inflammatory, immune, and metabolic states. However, limited research has examined the association between HDL-related inflammatory indicators and SI. This study analyzed data from 14,554 participants, including 588 individuals with SI, using information from the 2015 - 2023 National Health and Nutrition Examination Survey. SI was evaluated using the ninth item of the Patient Health Questionnaire-9. A weighted approach was applied to logistic regression, restricted cubic spline, and subgroup analyses to explore the relationship between six HDL-related inflammatory indicators and SI. In addition, weighted quantile sum regression was employed to account for the interactions among inflammatory markers and their influence on the outcomes. Among the various single-marker models, only high-sensitivity C-reactive protein/HDL-C (CHR) consistently demonstrated a significant linear association with SI. In Model 3 of the logistic regression analysis, the odds ratio with a 95% confidence interval was 1.11 (1.02, 1.21). Mixture analyses further identified CHR as the primary factor contributing to the increased prevalence of SI. This study provides the first epidemiological evidence linking multiple novel inflammatory markers to SI, identifying CHR as the most critical factor. Further prospective studies are needed to confirm this causal relationship.

Results of neuroimaging can provide information concerning the cause of functional motor disorders. In this paper, we review the most important of these neuroimaging investigations indicating changes in activation patterns in several brain regions relevant to motor control. A new combined treatment approach has demonstrated more promising results than previous attempts where either psychological or physiotherapeutic interventions have been used. When physiotherapy focusing on relearning appropriate movement patterns is combined with psychodynamic psychotherapy, including personally adapted psychoeducation, the results are convincing and most often long-lasting. Few cases with relapse show remission after undergoing only a few additional sessions of this new treatment modality. Three cases presented in this paper illustrate such courses post-treatment, lending credence to the potential existence of a dialectic interaction between mind and brain processes. The cases underline the importance of a therapeutic alliance and the ability of the therapist to let painful emotional material emerge and be understood, all based on confidence between the patient and the treating team.

Serotonin syndrome is a potentially life-threatening condition caused by increased serotonergic activity. Although this condition is commonly associated with certain antidepressants, this report describes a case of serotonin syndrome induced by the combined use of metaxalone and phentermine with duloxetine and bupropion. Our patient developed serotonin syndrome following the administration of metaxalone for severe back spasms. Symptoms resolved following the discontinuation of these medications, provision of supportive care, and administration of lorazepam and cyproheptadine. This case report adds to the existing literature, as studies on metaxalone-induced serotonin syndrome are currently limited. This case report also highlights the importance of monitoring polypharmacy, especially when prescribing less common medications such as metaxalone as well as weight-loss medications such as phentermine.

Healthcare workers must be vaccinated regularly. However, vaccination-related side effects can lead to sick leaves and decreased willingness to be vaccinated. Negative expectations can cause nocebo effects, potentially increasing the rates of adverse events (AEs). Herein, we evaluated the relationship between concerns regarding the vaccination course and the prevalence rate of AEs after the first and second doses of mRNA vaccines in 982 healthcare workers from the Nuremberg Hospital. Most of our participants were women (78%). Fatigue and headache were the most common systemic AEs. Healthcare workers who were worried about the vaccination process reported significantly more AEs after the first vaccine dose than those who were not worried (80% vs. 68%, P < 0.05). Thus, strategies to minimize concerns could reduce vaccination-related side effects and improve willingness to be vaccinated.