Page 68 - JCBP-2-2

Journal of Clinical and
Basic Psychosomatics Psychosomatic medicine in 2023

Dong et al. have contributed to the advancement group (35 patients) undergoing only CBT and systematic
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of understanding regarding the psychophysiological desensitization. The effectiveness of the treatment was
stress sources associated with human gastric diseases. assessed using the Shy Bladder Syndrome Scale (SBS) and
The study uncovered that the stomach directly receives the Self-rating Anxiety Scale (SAS) before and after the
acetylcholinergic inputs from the dorsal motor nucleus of 10-week treatment period. The results demonstrated that
the vagus (AChDMV), a process regulated by serotonergic the combination of Yangxin Tongquan decoction with
neurons in the dorsal raphe nucleus (5-HTDRN). Utilizing CBT yielded a positive impact on the treatment of avoidant
microendoscopic calcium imaging and multi-electrode paruresis, with no notable adverse effects reported.
electrophysiological recording, the researchers observed
that chronic stress, which is associated with reduced gastric 2.5. Psychosomatic endocrinology
function, inhibits the 5-HTDRN→AChDMV→stomach Epidemiological evidence indicates a bidirectional
circuit. In both male and female mice, artificial activation relationship between type 2 diabetes and depression, yet
of this circuit reversed gastric dysfunction induced their causal link and underlying mechanisms remain
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by chronic stress. These findings suggest that the unclear. Maina et al. discovered that depression serves
5-HTDRN→AChDMV→stomach axis acts as a key driver as a risk factor for type 2 diabetes through Mendelian
in stress-related gastric dysfunction. The study reveals a randomization analysis, establishing a positive causal
recently discovered brain–gastric pathway implicated in relationship between them, with 37% of the effect mediated
the adverse effects of stress on gastric function, paving the through body mass index. Through multiphenotype
way for further exploration into the connections between genome-wide association studies (GWAS), which aim
the brain and visceral organs. to pinpoint genetic markers contributing to the risk
of developing a condition by comparing the DNA of
Vanuytsel et al. have pointed out the potential individuals with and without the condition, combined
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connection between aberrant pain transmission and with expression quantitative trait locus analysis, the study
immune responses in individuals suffering from identified seven shared genetic loci between both diseases.
functional dyspepsia (FD) and IBS in their review of These loci pinpoint gene regions associated with insulin
the pathophysiological mechanisms associated with secretion and inflammation. The study not only offers
functional gastrointestinal disorders. However, while new insights into the interaction between type 2 diabetes
this association is acknowledged, the underlying causes and depression but also emphasizes the importance of
remain a hot topic for further investigation. Furthermore, considering their interplay in the treatment and research
therapeutic options aimed at mitigating immune activation of both conditions.
in these disorders are currently limited. Addressing these
challenges necessitates a collaborative effort involving 2.6. Psychosomatic rheumatology
experts from various fields, including immunologists, Fibromyalgia (FM), characterized by widespread pain
neurogastroenterologists, neuroscientists, microbiologists, exacerbated by negative emotions, involves cognitive–
psychologists, bioinformaticians, and others. Such emotional processes related to pain perception, one of
interdisciplinary collaboration is essential for advancing which is pain-related catastrophizing that amplifies pain
the clinical management of these challenging conditions. perception. Psychosomatic treatments, such as CBT,

2.4. Psychosomatic urology may aid in improving FM symptoms by reducing pain-
related catastrophizing, although its neural basis remains
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Liang et al. investigated the efficacy and safety of uncertain. Lee et al. explored the impact of CBT on FM.
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combining Chinese herbal Yangxin Tongquan decoction In their study, 98 participants were divided into groups,
with cognitive behavioral therapy (CBT) for the treatment with some receiving 8 weeks of CBT and others receiving
of avoidant paruresis, a prevalent condition in urology and FM education as a control. The results demonstrated that
psychosomatic medicine. CBT is a form of psychotherapy CBT was more effective in reducing the intensity of pain,
that aims to improve mental health by changing problematic pain interference, and symptom impact compared to
patterns of thinking or behavior. It is a structured, time- control. Furthermore, additional research revealed that
limited, and goal-oriented approach that helps individuals CBT modulates connections between the ventral posterior
identify and challenge distorted or negative thoughts while cingulate cortex and other brain regions within the default
fostering the adoption of more realistic and positive ones. mode network. These findings indicate that CBT provides
In this study, 68 patients were enrolled and divided into clinical benefits to FM patients by reducing the intensity
a treatment group (33 patients) receiving the decoction of pain-related symptoms and altering brain network
alongside CBT and systematic desensitization and a control connections.

Volume 2 Issue 2 (2024) 3 https://doi.org/10.36922/jcbp.2601