Risk factors for worsening of somatic symptom burden in a prospective cohort during the COVID-19 pandemic

Aims: Little is known about risk factors for both Long COVID and somatic symptoms that develop in individuals without a history of COVID-19 in response to the pandemic. There is reason to assume an interplay between pathophysiological mechanisms and psychosocial factors in the etiology of symptom persistence. This study investigates specific risk factors for somatic symptom deterioration in a cohort of German adults with and without prior SARS-CoV-2 infection. Method(s): German healthcare professionals underwent SARS-CoV-2 IgG antibody testing and completed self-rating questionnaires at baseline and 21 months later between April 2020 and February 2022. Differences in variables between the time points were analyzed and a regression analysis was performed to predict somatic symptom deterioration at follow-up. Result(s): Seven hundred fifty-one adults completed both assessments. Until follow-up, n = 58 had contracted SARS-CoV-2 confirmed by serology. Between baseline and follow-up, signs of mental and physical strain increased significantly in the sample. Symptom expectations associated with COVID-19 and a self-reported history of COVID-19, but not serologically confirmed SARS-CoV-2 infection, significantly predicted somatic symptom deterioration at follow-up. A further predictor was baseline psychological symptom burden. Conclusion(s): This study supports a disease-overarching biopsychosocial model for the development of burdensome somatic symptoms during the COVID-19 pandemic and supports research findings that symptom burden may be more related to the psychosocial effects of the pandemic than to infection itself. Future studies on Long COVID should include SARS-CoV-2 negative control groups and consider symptom burden prior to infection in order to avoid an overestimation of prevalence rates.Copyright © 2023

Medical Rehabilitation and Infectious Diseases in Children

Today, medical rehabilitation is undergoing significant transformation. The new system built around the biopsychosocial model includes assessment of physical constraints and rehabilitation diagnosis, determination of rehabilitation potential, formulation of goals and objectives of individual interventions, development of rehabilitation plans, and progress evaluation. All of these rehabilitation components can be implemented using a personalized, problem-oriented, multidisciplinary approach, which is now being actively introduced into clinical practice. The current pandemic of the novel coronavirus infection has demonstrated that medical rehabilitation is crucial for convalescents. However, its principles and techniques have not been fully elaborated yet. This review describes the current state of medical rehabilitation of children with or after infectious diseases and identifies its avenues and prospects.Copyright © 2022 Obstetrics, Gynecology and Reproduction. All rights reserved.

Social models in leg care: understanding Lindsay Leg Club volunteering

Background: This qualitative exploratory research was the first study to explore Leg Club volunteering through focusing specifically on volunteers' narratives. Aim(s): The aim was to understand volunteers' motivations and experiences and to outline the crucial steps for maintaining volunteers' positive trajectory towards providing social support. Method(s): A qualitative study based on semi-structured interviews with volunteers from UK Leg Clubs was undertaken. Interview transcripts were analysed using a constructivist reflexive thematic analysis. Result(s): I recruited 16 volunteers from three UK Leg Clubs. The study explained the motivations for volunteering (started as members or companions;retired individuals with a strong sense of purpose;emotional, social and mental health reasons), experiences of volunteering (satisfaction from helping;meaningful social connections;personal growth) and volunteers' objectives (desire to recruit more volunteers;concerns about long-term capacity to return to pre-pandemic activities). Conclusion(s): The study outlines the conditions necessary for Leg Club volunteers' continued success in the social dimension of leg care. Declaration of Interest: Dr Anna Galazka is a volunteer project consultant for the Lindsay Leg Club Foundation. The research was funded by Cardiff Business School Research and Scholarship Seedcorn Funding Scheme.Copyright © 2023, OmniaMed Communications Ltd. All rights reserved.

The lived experience of older, independent residents during the COVID-19 pandemic

The growing older population confronting the risks of the COVID-19 pandemic have a story to tell of their experiences that may influence the way society confronts future pandemics. Little research has been done on older adults in independent living communities and their experiences with the COVID-19 pandemic. This study aimed to fill that gap using the biopsychosocial model as a framework to guide the exploration of the research question addressing the lived experiences of older, independent residents during the COVID-19 pandemic. Using a basic qualitative analysis design, a purposive sample of 10 participants from a continuing care retirement community were recruited by flyer for telephone interviews. Participant inclusion criteria were they must be 65 years old or older, lived at the facility since the onset of the COVID-19 pandemic, display no self-reported cognitive disability, and be fluent in English. The interview questions were developed from the literature review, theoretical framework, and pilot tests. Each interview was transcribed verbatim, coded in vivo, and sorted by codes before being analyzed thematically. Results indicated that participants were resilient and grateful while at the same time suffering from loneliness and grief. A surprising result was that the majority of participants responded in the negative to questions about depression and anxiety, known as the positivity effect. The implications for positive social change are twofold;the findings can be used (a) for the prospective development of marketing applications in health that take advantage of the positivity effect evidenced by older adults and (b) to develop a greater understanding of the older adult and improve communication with this cohort. . (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Long-COVID syndrome: physical-mental interplay in the spotlight.

Patients suffering from Long-COVID syndrome experience a variety of different symptoms on a physical, but also on a psychological and social level. Previous psychiatric conditions such as depression and anxiety have been identified as separate risk factors for developing Long-COVID syndrome. This suggests a complex interplay of different physical and mental factors rather than a simple cause-effect relationship of a specific biological pathogenic process. The biopsychosocial model provides a foundation for understanding these interactions and integrating them into a broader perspective of the patient suffering from the disease instead of the individual symptoms, pointing towards the need of treatment options on a psychological as well as social level besides biological targets. This leads to our conclusion, that the biopsychosocial model should be the underlying philosophy of understanding, diagnosing and treating patients suffering from Long-COVID syndrome, moving away from the strictly biomedical understanding suspected by many patients, treaters and the media while also reducing the stigma still associated with the suggestion of a physical-mental interplay.

Dynamic modeling of experience sampling methodology data reveals large heterogeneity in biopsychosocial factors associated with persistent fatigue in young people living with a chronic condition.

OBJECTIVE: To evaluate associations between self-reported biopsychosocial factors and persistent fatigue with dynamic single-case networks. METHODS: 31 persistently fatigued adolescents and young adults with various chronic conditions (aged 12 to 29 years) completed 28 days of Experience Sampling Methodology (ESM) with five prompts per day. ESM surveys consisted of eight generic and up to seven personalized biopsychosocial factors. Residual Dynamic Structural Equation Modeling (RDSEM) was used to analyze the data and derive dynamic single-case networks, controlling for circadian cycle effects, weekend effects, and low-frequency trends. Networks included contemporaneous and cross-lagged associations between biopsychosocial factors and fatigue. Network associations were selected for evaluation if both significant (α < 0.025) and relevant (ß ≥ 0.20). RESULTS: Participants chose 42 different biopsychosocial factors as personalized ESM items. In total, 154 fatigue associations with biopsychosocial factors were found. Most associations were contemporaneous (67.5%). Between chronic condition groups, no significant differences were observed in the associations. There were large inter-individual differences in which biopsychosocial factors were associated with fatigue. Contemporaneous and cross-lagged associations with fatigue varied widely in direction and strength. CONCLUSIONS: The heterogeneity found in biopsychosocial factors associated with fatigue underlines that persistent fatigue stems from a complex interplay between biopsychosocial factors. The present findings support the need for personalized treatment of persistent fatigue. Discussing the dynamic networks with the participant can be a promising step towards tailored treatment. TRIAL REGISTRATION: No. NL8789 (http://www.trialregister.nl).

Sexual function among women with vaginismus: a biopsychosocial approach.

BACKGROUND: Vaginismus is known as a type of sexual pain disorder. Regarding the multifactorial nature of vaginismus, the biopsychosocial model is one of the best models to describe this sexual disorder. AIM: The present research was conducted to study the determinants of sexual function in women with and without vaginismus based on the biopsychosocial model. METHODS: This case-control study was conducted in Iran on 420 women with and without primary vaginismus who met the inclusion criteria. All eligible people were included in the research once their eligibility was verified and their informed permission was acquired; convenience and purposive sampling techniques were used continually. Data collection tools included the demographic and obstetric information form and multiple published scales and questionnaires. Structural equation modeling with LISREL 9.2 software (Scientific Software International) was used to evaluate the determinants of the sexual function of vaginismus. OUTCOMES: Participants rated their determinants of sexual function based on the biopsychosocial model. RESULTS: The mean ages of the case and control groups were 27.67 and 28.44 years, respectively. The direct, indirect, and total effects of the dimensions of sexual health on sexual function and the diagnostic score of vaginismus of the women with vaginismus were significant (P < .001). Furthermore, based on the results, the diagnostic score of vaginismus in women with vaginismus was significantly affected by the direct, indirect, and cumulative impacts of vaginal penetration cognition and fear of sex (P = .016, P = .005). Women with and without vaginismus were able to accept the models' excellent fit. CLINICAL IMPLICATIONS: This study helps inform health planners and policy makers about the sexual function of women with vaginismus, the factors related to this disorder, and the multidimensional nature of this sexual problem. STRENGTHS AND LIMITATIONS: This study attempted to offer a more comprehensive and complete view of present knowledge via surveying different aspects of sexual health and by means of valid and reliable tools and path analysis. The study's merits include the use of the biopsychosocial model to evaluate sexual function in women with vaginismus, the use of a variety of questionnaires to compare women with and without vaginismus, and the size of the sample. The research was limited by the fact that electronic sampling was conducted because of the COVID-19 epidemic. CONCLUSION: Based on the findings of the present study for the group of women with vaginismus, the direct, indirect, and overall effects of the majority of dimensions of sexual health were significantly correlated with sexual function and vaginismus.

Disability protection according to the bio-psycho-social model

The essay proposes an analysis of the achievements but also of the persistent criticalities that distinguish the condition of disabled people. The measures contained in the Italian RRNP and the Disability Delegation Act of 22 December 2021 n. 227 will be analyzed, as a result of a renewed focus on people with disabilities following the Sars-Cov-2 pandemic, to verify whether these tools meet the expectations generated over the years by the new approach to disability. © 2023, Societa Editoriale Federalismi s.r.l.. All rights reserved.

Evolution of paradigms in the study of depression: from a unitary concept to a biopsychosocial model and interdisciplinary approaches

The review is devoted to the consideration of the history of paradigms in the study of depressive disorders in terms of modern understanding of depression in psychiatry and clinical and medical psychology and its correlation with the biopsychosocial model in medicine. The review also contains works devoted to the study of the prevalence and comorbidity of depressive disorders and their relationship with suicidal behavior. The existing limitations in the study of depressive disorders in psychiatry and clinical psychology and the issues of interdisciplinary integration and interdisciplinary barriers are considered in detail. The review includes publications indexed in the Web of Science, Scopus, Russian Science Citation Index, and PubMed databases. Depression is a major medical and psychological problem due to its widespread prevalence in the general population, in primary care, among patients with various chronic somatic symptom disorders who receive treatment in community and specialized hospitals and clinics, and among clients of psychological centers and social services. In 1996, the Harvard T.H. Chan School of Public Health, based on the materials of the World Health Organization (WHO) and the World Bank, published estimates and prognosis for the prevalence of depressive disorders around the world. According to their data, depression in 1990 was ranked 4th in terms of the severity of the leading causes of the burden of the disease, and according to the baseline scenario of development, by 2020 it should have been ranked 2nd after coronary artery disease. The review is focused on the need to revise the baseline scenario of development and start a new discussion on the study of depressive disorders under new conditions, such as the psychological state of society during the COVID-19 pandemic and lockdown, as well as on the eve of healthcare transition to the 11th Revision of the International Classification of Diseases. © 2022 Siberian State Medical University. All rights reserved.

[Chronic pain in elderly people during the COVID-19 pandemic]. / Chronische Schmerzen im Seniorenalter vor dem Hintergrund der COVID-19-Pandemie.

BACKGROUND: International studies have shown negative effects of the COVID-19 pandemic on mood and levels of distress. Correlations between the pandemic and higher levels of pain as well as greater pain-related disability have also been found; however, studies report ambiguous results about whether elderly people cope differently with the pandemic and its effects. METHODS: The University Hospital of Würzburg offers multimodal pain therapy for older adults. The current study performed a retrospective analysis of routine data measured during an interdisciplinary multimodal assessment. We compared n = 75 patients taking part in the therapy during 2018 and 2019 to n = 42 patients assessed in 2020-2021. We measured pain, mental distress and physical functioning using the German Pain Questionnaire, clinical diagnosis, and geriatric tests of physical fitness. RESULTS: Both subgroups did not differ in demographic characteristics, neither did we find significant differences regarding pain intensity, pain-related disability, and mental health; however, patients before the pandemic reported a higher number of days on which they felt limited due to pain. In the physical performance test, we even found significantly better results during the COVID-19 pandemic. DISCUSSION: The current data do not support an aggravation of pain or mental and physical well-being. Possible explanations could be better resilience in elderly people due to their experience of life, financial security or less change in their daily life.

Characteristics that predict engagement in instant win games

While gambling problems have long been investigated in association with electronic gambling machines, recent attention has focused on engagement with instant lottery games. Instant win game engagement has been identified as one robust predictor of increased concurrent and subsequent problem gambling (see: Grusser et al., 2007;Short et al., 2015;Stark et al., 2021;Williams, Leonard, et al., 2021;Williams, Leonard, et al., 2021). This emergent finding contrasts with historical perceptions that lottery games are low risk. It is important to understand the individual characteristics of those who engage in instant lottery games, the potential harms associated with engagement, and the biopsychosocial profile of those at greatest risk for experiencing harms. This study sought to identify the characteristics that predict engagement versus non-engagement using a longitudinal data set, namely the AGRI National COVID Project online panel participant data (n = 3449), collected in Fall 2019 (baseline data for this study) and in Spring 2020 (during the nation-wide pandemic lockdown). Results indicate that, pre-pandemic factors including gender, employment status, household financial status, greater involvement in gambling, and elevated problem gambling scores, contributed significantly to the delineation of those who did - versus did not - engage in instant win games during the national lockdown. Additional research is required to understand both, the individual characteristics that lead to susceptibility for problems with instant win games, and the role of environmental factors including social and economic strain experienced during the COVID-19 pandemic in the manifestation of problems related with instant win game engagement.

Looking forward to a decade of the biopsychosocial model.

The topic of this article is the biopsychosocial model. My main contention is that - notwithstanding doubts as to what exactly it is, or indeed whether it is anything - there is a coherent account of it, in terms of both applications to particular health conditions and mechanisms with wide application. There is accumulating evidence from recent decades that psychosocial as well as biological factors are implicated in the aetiology and treatment of a large range of physical as well as mental health conditions. The original proposer of the biopsychosocial model, George Engel, back in 1977, was substantially correct about what he saw was on its way.

Self-care and Wellness Checks in Emergency Field Hospitals During COVID-19 Pandemic: A New Self-check Tool for Military Personnel and Civilians

The authors explore the impact of cumulative stress on United States (US) military service members (SM), including soldiers and medical personnel, deployed to serve in New York City (NYC) communities. Their mission was to assist in establishing emergency field hospitals during the COVID-19 pandemic. Causative biopsychosocial factors are presented, as well as the impact of wellness checks, which were utilized to monitor the mood and morale of frontline healthcare providers, military personnel, and infected patients in a 2,500-bed emergency field hospital and a 1,000-bed Naval hospital ship operating in the metropolitan NYC area. The authors introduce a self-care and wellness tool, which assesses five core domains (physical, mental, emotional, social, and spiritual) for the purpose of assessing and improving individual overall well-being during periods of heightened stress. This instrument could aid attending medical personnel in identifying patients at risk of suicide. Likewise, the utility of this self-care tool is applicable to both military SM and civilians, and includes soldiers and medical personnel.

The Biopsychosocial Impact of COVID-19 on Older Adults.

COVID-19 has spread rapidly around the world and taken over 2.6 million lives. Older adults experience disproportionate morbidity and mortality from the disease because increasing age and the presence of comorbidities are important predictors of negative outcomes. Lasting effects of COVID-19 have been described after recovery from the acute illness despite eradication of the virus from the body. The impact of COVID-19 on a person's biological health post-infection is observed in multiple systems including respiratory, cardiac, renal, haematological, and neurological. Psychological dysfunction following recovery is also prevalent. Social factors such as distancing and stay at home measures leave older adults isolated and food insecure; they also face intertwined financial and health risks due to the resulting economic shutdown. This study examines the effects of COVID-19 on older adults using the biopsychosocial model framework.

Medicine's metaphysical morass: how confusion about dualism threatens public health.

What position on dualism does medicine require? Our understanding of that question has been dictated by holism, as defined by the biopsychosocial model, since the late twentieth century. Unfortunately, holism was characterized at the start with confused definitions of 'dualism' and 'reductionism', and that problem has led to a deep, unrecognized conceptual split in the medical professions. Some insist that holism is a nonreductionist approach that aligns with some form of dualism, while others insist it's a reductionist view that sets out to eradicate dualism. It's important to consider each version. Nonreductive holism is philosophically consistent and clinically unproblematic. Reductive holism, however, is conceptually incoherent-yet it is the basis for the common idea that the boundary between medical and mental health disorders must be vague. When we trace that idea through to its implementation in medical practice, we find evidence that it compromises the safety of patient care in the large portion of cases where clinicians grapple with diagnosis at the boundary between psychiatry and medicine. Having established that medicine must embrace some form of nonreductionism, I argue that Chalmers' naturalistic dualism is a stronger prima facie candidate than the nonreductive alternatives. Regardless of which form of nonreductionism we prefer, some philosophical corrections are needed to give medicine a safe and coherent foundation.

A community perspective of COVID-19 and obesity in children: Causes and consequences.

The pandemic of childhood obesity that has been increasing over the last decade has collided with the current pandemic of COVID-19. Enforced behavioural changes have resulted in a myriad of problems for children particularly in weight management. Restricted activity is the most obvious but many other aspects of life have exacerbated biological, psychosocial, and behavioral factors identified as risks for childhood obesity. Significant effort is required to turn around the prevailing tide of weight gain necessitating changes in personal and family behavior and diet, as well as high-level governmental and educational policy. Evidence-based, focused, long-term interventions which are adequately funded are required. Enthusiasm and optimism for change coupled with public engagement by utilization of new technology as well as traditional methods offers hope for change. Public health interventions in isolation are inadequate and bolder changes to central policies and social structure are needed for sustained change. This will allow some mitigation of the affects of COVID-19 but also reduce negative outcomes in future comparable situations.

Risk Factors and Effects of the Morbus: COVID-19 through the Biopsychosocial Model and Ecological Systems Approach to Social Work Practice.

Utilizing the biopsychosocial model and the ecological systems theory, this disquisition explores on the risk factors associated with the COVID-19 pandemic. The discourse shows the interconnectedness of biological, psychological, and social domains in expatiating on the COVID-19 pandemic. It calls for the need to strengthen the resilience of the global community in the face of health outbreaks such as COVID-19. It emphasizes on the perspectives that pandemics are managed before they emerge through building systems that are resilient. Thus, it appreciates the need for a therapeutic milieu as a building block to resilience. The article calls for the adoption of a developmental stance to analyzing health outbreaks and clinical issues. The adumbration shows the reciprocity effects of the health outbreak [macrocosms] and individual factors [microcosms]. To its end, the paper implies that COVID-19 is a call for integration toward effective health planning between social policy formulators, urban and rural planners, epidemiologists, development practitioners, clinicians, researchers to mention but a few. Ultimately, the paper calls for social workers to consider a developmental-clinical social work approach which helps foster "health in all policies" so as to build resilience against the morbus and limit the proliferation of diseases.

Rethinking the nature of the person at the heart of the biopsychosocial model: Exploring social changeways not just personal pathways.

Karunamuni et al.'s (2020) biopsychosocial-pathways (BPS-P) model provides an important framework for elaborating on Engel's (1977) biopsychosocial (BPS) model of health. In particular, the BPS-P model improves on Engel's by articulating and evidencing the multiple pathways between biological, psychological, and social influences on health and identifying mechanisms that might be implicated in these pathways. Yet its analytic treatment of these influences as "separate systems" means that, as with Engel's model, the BPS-P model is more a list of ingredients than an integrated whole. In this commentary, following Haslam et al.'s (2019) specification of a sociopsychobio model, we underscore the value of a synthetic appreciation of biology, psychology, and society as dynamically interdependent aspects of an integrated whole which is more than just the sum of its parts and the pathways between them. In particular, our alternative framework centres on an appreciation of people as social beings whose group memberships and associated social identities open up 'changeways' (not just pathways) that, as we have seen during the COVID-19 pandemic, can fundamentally restructure biology, psychology and society.