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Qin GY, Han SS, Zhang YS, Ye YP, Xu CY. Effect of physical exercise on negative emotions in Chinese university students: The mediating effect of self-efficacy. Heliyon 2024; 10:e37194. [PMID: 39286123 PMCID: PMC11402780 DOI: 10.1016/j.heliyon.2024.e37194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 08/22/2024] [Accepted: 08/28/2024] [Indexed: 09/19/2024] Open
Abstract
Objective This study investigates the impact of physical activity on negative emotions among university students and examines the mediating influence of self-efficacy, aiming to furnish empirical insights and a theoretical framework to enhance and optimize the mental health of this population comprehensively. Methods Using the cluster random sampling method, 5341 university students were selected from three universities. The questionnaire included demographic information about university students, physical exercise behaviors, expressions of negative emotions such as depression and anxiety, and self-efficacy in physical exercise. The types of questionnaires included the Physical Activity Rating Scale (PARS-3), the General Self-Efficacy Scale (GSES), and the Depression Anxiety Stress Scales (DASS). Results 76.877 % of university students had low exercise. The detection rates of depression, anxiety and stress in negative mood were 77.041 %, 64.276 % and 47.931 %, respectively. There were significant differences in physical exercise and negative mood scores among university students of different genders and grades. University student. Negative emotions were significantly correlated with physical exercise and self-efficacy (P < 0.001). According to the regression model, physical exercise can significantly predict negative emotions and self-efficacy. The mediating effect of self-efficacy is evident. Conclusion Physical exercise among university students typically comprises light workouts, associated with a high prevalence of anxiety symptoms. Self-efficacy acts as a mediator in the effects of physical exercise on negative emotions within this group.
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Affiliation(s)
- Guo-You Qin
- Physical Education Institute, Hanjiang Normal University, Shiyan, 442000,China
| | - Shan-Shan Han
- Institute of Sports Science, Nantong University, Nantong 226019, China
| | - Yang-Sheng Zhang
- School of Physical Education, Nanjing Xiao zhuang University, Nanjing 210000,China
| | - Yu-Peng Ye
- School of physical education, Jing-gang-shan University, Ji'an 343009, China
| | - Chuan-Yi Xu
- Sports department, Guangxi University of Chinese Medicine, Nanning 530022,China
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2
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Schkoda S, Horman B, Witchey S, St Armour G, Nelson M, Gaeta E, Scott M, Patisaul HB. Sex-specific effects on elements of the social brain neural network in Wistar rats from perinatal exposure to FireMaster 550 or its components. Neurotoxicology 2024; 105:111-120. [PMID: 39241866 DOI: 10.1016/j.neuro.2024.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 09/03/2024] [Indexed: 09/09/2024]
Abstract
Developmental exposure to chemical flame retardants (FRs) has been linked to a variety of neurodevelopmental disorders and abnormal socioemotional behaviors in human and laboratory animal studies. We have previously shown in Wistar rats that gestational and lactational exposure to the FR mixture Firemaster 550 (FM 550) or its brominated or organophosphate ester (OPFR) components (at 2000 µg, 1000 µg, and 1000 µg oral to the dam respectively (absolute and not by bodyweight)) results in increased anxiety-like behaviors in females and decreased sociality in both sexes. Using their siblings, this study characterized sex and chemical specific targets of disruption in brain regions underlying each behavioral phenotype. Offspring were exposed across gestation and lactation then prepared for either immunohistochemistry or autoradiography at postnatal day 90 to quantify expression of serotonin, estrogen receptor α (ERα), and oxytocin receptor (OTR) in multiple brain regions. No effect of exposure was found in males for any biological target. In females, serotonin innervation was increased in the medial amygdala of FM 550 exposed animals while ERα expression in the bed nucleus of the stria terminalis (BNST) was reduced by FM 550 and OPFR. Evidence of disrupted OTR was observed in males, particularly the BNST but considered an exploratory finding given the small sample size. These results begin to shed light on the mechanisms by which developmental FR exposure alters socioemotional behaviors of relevance to neurodevelopmental disorders.
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Affiliation(s)
- Stacy Schkoda
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, United States
| | - Brian Horman
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, United States
| | - Shannah Witchey
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, United States
| | - Genevieve St Armour
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, United States; Center for Human Health and the Environment, North Carolina State University, Raleigh, NC 27695, United States
| | - Mason Nelson
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, United States
| | - Emily Gaeta
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, United States
| | - Madeline Scott
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, United States
| | - Heather B Patisaul
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, United States; Center for Human Health and the Environment, North Carolina State University, Raleigh, NC 27695, United States.
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3
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Karatayev O, Collier AD, Targoff SR, Leibowitz SF. Neurological Disorders Induced by Drug Use: Effects of Adolescent and Embryonic Drug Exposure on Behavioral Neurodevelopment. Int J Mol Sci 2024; 25:8341. [PMID: 39125913 PMCID: PMC11313660 DOI: 10.3390/ijms25158341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/10/2024] [Accepted: 07/17/2024] [Indexed: 08/12/2024] Open
Abstract
Clinical studies demonstrate that the risk of developing neurological disorders is increased by overconsumption of the commonly used drugs, alcohol, nicotine and cannabis. These drug-induced neurological disorders, which include substance use disorder (SUD) and its co-occurring emotional conditions such as anxiety and depression, are observed not only in adults but also with drug use during adolescence and after prenatal exposure to these drugs, and they are accompanied by long-lasting disturbances in brain development. This report provides overviews of clinical and preclinical studies, which confirm these adverse effects in adolescents and the offspring prenatally exposed to the drugs and include a more in-depth description of specific neuronal systems, their neurocircuitry and molecular mechanisms, affected by drug exposure and of specific techniques used to determine if these effects in the brain are causally related to the behavioral disturbances. With analysis of further studies, this review then addresses four specific questions that are important for fully understanding the impact that drug use in young individuals can have on future pregnancies and their offspring. Evidence demonstrates that the adverse effects on their brain and behavior can occur: (1) at low doses with short periods of drug exposure during pregnancy; (2) after pre-conception drug use by both females and males; (3) in subsequent generations following the initial drug exposure; and (4) in a sex-dependent manner, with drug use producing a greater risk in females than males of developing SUDs with emotional conditions and female offspring after prenatal drug exposure responding more adversely than male offspring. With the recent rise in drug use by adolescents and pregnant women that has occurred in association with the legalization of cannabis and increased availability of vaping tools, these conclusions from the clinical and preclinical literature are particularly alarming and underscore the urgent need to educate young women and men about the possible harmful effects of early drug use and to seek novel therapeutic strategies that might help to limit drug use in young individuals.
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Affiliation(s)
| | | | | | - Sarah F. Leibowitz
- Laboratory of Behavioral Neurobiology, The Rockefeller University, New York, NY 10065, USA; (O.K.); (S.R.T.)
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4
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Willsey HR, Seaby EG, Godwin A, Ennis S, Guille M, Grainger RM. Modelling human genetic disorders in Xenopus tropicalis. Dis Model Mech 2024; 17:dmm050754. [PMID: 38832520 PMCID: PMC11179720 DOI: 10.1242/dmm.050754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
Recent progress in human disease genetics is leading to rapid advances in understanding pathobiological mechanisms. However, the sheer number of risk-conveying genetic variants being identified demands in vivo model systems that are amenable to functional analyses at scale. Here we provide a practical guide for using the diploid frog species Xenopus tropicalis to study many genes and variants to uncover conserved mechanisms of pathobiology relevant to human disease. We discuss key considerations in modelling human genetic disorders: genetic architecture, conservation, phenotyping strategy and rigour, as well as more complex topics, such as penetrance, expressivity, sex differences and current challenges in the field. As the patient-driven gene discovery field expands significantly, the cost-effective, rapid and higher throughput nature of Xenopus make it an essential member of the model organism armamentarium for understanding gene function in development and in relation to disease.
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Affiliation(s)
- Helen Rankin Willsey
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
- Chan Zuckerberg Biohub - San Francisco, San Francisco, CA 94518, USA
| | - Eleanor G Seaby
- Genomic Informatics Group, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Annie Godwin
- European Xenopus Resource Centre (EXRC), School of Biological Sciences, University of Portsmouth, Portsmouth PO1 2DY, UK
| | - Sarah Ennis
- Genomic Informatics Group, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Matthew Guille
- European Xenopus Resource Centre (EXRC), School of Biological Sciences, University of Portsmouth, Portsmouth PO1 2DY, UK
| | - Robert M Grainger
- Department of Biology, University of Virginia, Charlottesville, VA 22904, USA
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5
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Traut P, Halbeisen G, Braks K, Huber TJ, Paslakis G. Sociodemographic and clinical features of men and women with eating disorders: a diagnosis-matched, retrospective comparison among inpatients. Front Psychiatry 2023; 14:1192693. [PMID: 37484681 PMCID: PMC10359980 DOI: 10.3389/fpsyt.2023.1192693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Eating disorders (EDs) are among the most severe mental disorders in women and men, often associated with high symptom burden and significant limitations in daily functioning, frequent comorbidities, chronic course of illness, and even high mortality rates. At the same time, differences between men and women with EDs remain poorly explored. Methods In this study, we compared 104 men to 104 diagnosis-matched women with EDs regarding sociodemographic and clinical features. Using latent class mixture modelling, we identified four distinct patient subgroups based on their sociodemographic features. Results Men with EDs had significantly higher odds than women to belong to a "single-childfree-working" class. Moreover, while there were few overall differences in ED-related symptoms and general psychopathology between men and women, single-childfree-working men with EDs presented with higher general psychopathology symptoms than men in the other classes. Discussion We discuss how considering sex and gender along with further sociodemographic differences in EDs may help to improve ED diagnosis and treatment.
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Affiliation(s)
- Philipp Traut
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
| | - Georg Halbeisen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
| | - Karsten Braks
- Centre for Eating Disorders, Klinik am Korso, Bad Oeynhausen, Germany
| | - Thomas J. Huber
- Centre for Eating Disorders, Klinik am Korso, Bad Oeynhausen, Germany
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
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6
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Göttgens I, Modderkolk L, Jansen C, Darweesh SKL, Bloem BR, Oertelt-Prigione S. The salience of gender in the illness experiences and care preferences of people with Parkinson's disease. Soc Sci Med 2023; 320:115757. [PMID: 36738652 DOI: 10.1016/j.socscimed.2023.115757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
RATIONALE In recent years, interest in sex characteristics and gender dimensions of Parkinson's disease (PD) has increased. Yet, much remains to be understood about how gender-related aspects specifically impact the illness and experiences of care in persons living with PD. OBJECTIVE The purpose of this study was to explore the salience of gender-related aspects in the illness experiences and care provision preferences of people with PD. METHODS A descriptive qualitative study including semi-structured life story interviews was conducted with men and women living with PD in the Netherlands. Between September 2020 and February 2021, forty people with PD (20 men and 20 women) participated in digital interviews of which thirty-one (18 men and 13 women) were included in the thematic analyses for this specific study. RESULTS Overall, most participants did not consider gender-related aspects salient towards their illness experiences. However, when prompted, a number of participants described several stereotypical views about gender as related to the visibility of PD, emotional experiences, help seeking, role patterns and physical appearance. While most men and women with PD did not express specific gender-related preferences for their healthcare providers, those that did, all preferred women as healthcare providers. These preferences were generally related to attributed feminine traits which are considered relevant in routine, particularly sensitive, physical examinations of people with PD. CONCLUSION This study demonstrates that although every person has a gender identity, the salience attributed to gender varies with illness experiences and in care provision preferences between people with PD. These findings highlight the need for precise and personalized methodologies to capture more nuanced insights into the impact of gender dimensions on PD. Furthermore, drivers behind gender-related preferences in care provision are multifactorial and warrant further investigation among people with PD.
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Affiliation(s)
- Irene Göttgens
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands.
| | - Linda Modderkolk
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Sirwan K L Darweesh
- Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands; AG 10 Sex- and Gender-sensitive Medicine, Medical Faculty OWL, University of Bielefeld, Bielefeld, Germany.
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7
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Johnston MP, Wanat MJ. Mitigating the impact of adolescence isolation on the development of social anxiety: A potential role for oxytocin. Front Behav Neurosci 2022; 16:1038236. [PMID: 36311867 PMCID: PMC9608628 DOI: 10.3389/fnbeh.2022.1038236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/27/2022] [Indexed: 11/23/2022] Open
Abstract
Exposure to isolation can lead to the development of social anxiety disorder (SAD), which affects 13% of Americans. There are sex differences in the prevalence of anxiety disorders, as women experience higher rates of SAD relative to men. Importantly, isolation experienced during adolescence increases the likelihood of developing SAD in adulthood. Unfortunately, the current treatments for SAD are only effective in 50–65% of patients. As such, it is critical to identify therapeutic targets for the treatment and prevention of SAD, particularly in women. Here, we discuss the links between childhood isolation and adulthood SAD. Next, we examine the preclinical models used to study the impact of isolation on social anxiety-like behaviors in rodents. Increasing evidence from both clinical and pre-clinical studies suggests oxytocin signaling is a potential target to modify social anxiety-like behaviors. We present the evidence that sex hormones influence the oxytocin system. Finally, we highlight future directions for both clinical and pre-clinical studies to further evaluate the efficacy of oxytocin as a treatment for isolation-induced SAD.
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Affiliation(s)
- Morgan P Johnston
- Department of Neuroscience, Developmental, and Regenerative Biology, Neurosciences Institute, Brain Health Consortium, University of Texas San Antonio, San Antonio, TX, United States
| | - Matthew J Wanat
- Department of Neuroscience, Developmental, and Regenerative Biology, Neurosciences Institute, Brain Health Consortium, University of Texas San Antonio, San Antonio, TX, United States
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8
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Seeman MV. Sex/Gender differences in schizophrenia: Thinking back and thinking forward. Psychiatry Res 2022; 316:114738. [PMID: 35905691 DOI: 10.1016/j.psychres.2022.114738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/17/2022] [Accepted: 07/21/2022] [Indexed: 10/16/2022]
Abstract
This commentary summarizes my view of my life's work in psychiatry, which has mainly been devoted to my obsessive interest in sex and gender differences in schizophrenia. I summarize the influences that guided my research and I take the opportunity to make some personal recommendations to future researchers.
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Affiliation(s)
- Mary V Seeman
- Professor Emerita, Department of Psychiatry, University of Toronto, #605 260 Heath Street West, Toronto, Ontario, Canada, M5P 3L6.
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9
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González-Rodríguez A, Seeman MV, Díaz-Pons A, Ayesa-Arriola R, Natividad M, Calvo E, Monreal JA. Do Sex/Gender and Menopause Influence the Psychopathology and Comorbidity Observed in Delusional Disorders? J Clin Med 2022; 11:jcm11154550. [PMID: 35956165 PMCID: PMC9369646 DOI: 10.3390/jcm11154550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/23/2022] [Accepted: 08/02/2022] [Indexed: 12/04/2022] Open
Abstract
Background: While sex differences and gonadal hormone levels are taken seriously in the understanding and treatment of schizophrenia, their influence in the psychopathology of delusional disorders (DD) remains unknown. Methods: Our strategy was to conduct a narrative review of the effects of (a) sex/gender difference and (b) menopause on delusional content, affective and anxiety-related comorbidity, substance use disorders, cognition, aggressivity, and suicide risk in DD. Results: Because the literature is scarce, our results are tentative. We found that erotomania was more prevalent in women than in men, and especially in women with premenopausal onset. In contrast, jealous and somatic delusions were more commonly seen in DD women with postmenopausal onset. With respect to depressive comorbidity, women with premenopausal onset appear more vulnerable to depression than those with later onset. Age at menopause is reported to correlate positively with intensity of suicidal ideation. Anxiety symptoms may be related to estrogen levels. Men present with higher rates of substance use disorders, particularly alcohol use. Conclusions: Many male/female differences in DD may be attributable to sociocultural factors but menopause, and, therefore, levels of female hormones, influence symptom expression in women and mediate the expression of psychiatric comorbidities. Further research in this area promises to lead to improved individualized treatment.
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Affiliation(s)
- Alexandre González-Rodríguez
- Department of Mental Health, Mutua Terrassa University Hospital, Fundació Docència i Recerca Mutua Terrassa, University of Barcelona (UB), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 08221 Terrassa, Spain
- Correspondence:
| | - Mary V. Seeman
- Department of Psychiatry, University of Toronto, Toronto, ON M5P 3L6, Canada
| | - Alexandre Díaz-Pons
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, 39008 Santander, Spain
- Faculty of Psychology, National University of Distance Education (UNED), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, 39008 Santander, Spain
- Faculty of Psychology, National University of Distance Education (UNED), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Mentxu Natividad
- Department of Mental Health, Mutua Terrassa University Hospital, Fundació Docència i Recerca Mutua Terrassa, University of Barcelona (UB), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 08221 Terrassa, Spain
| | - Eva Calvo
- Department of Mental Health, Mutua Terrassa University Hospital, Fundació Docència i Recerca Mutua Terrassa, University of Barcelona (UB), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 08221 Terrassa, Spain
| | - José A. Monreal
- Department of Mental Health, Mutua Terrassa University Hospital, Fundació Docència i Recerca Mutua Terrassa, University of Barcelona (UB), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 08221 Terrassa, Spain
- Institut de Neurociències, Universitat Autònoma de Barcelona, 08221 Terrassa, Spain
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Papst L, Köllner V. Using machine learning to investigate earning capacity in patients undergoing psychosomatic rehabilitation-A retrospective health data analysis. Front Psychiatry 2022; 13:1039914. [PMID: 36339869 PMCID: PMC9630905 DOI: 10.3389/fpsyt.2022.1039914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/06/2022] [Indexed: 11/21/2022] Open
Abstract
Psychiatric disorders increasingly contribute to disability and early retirement. This study was conducted to investigate whether machine learning can contribute to a better understanding and assessment of such a reduced earning capacity. It analyzed whether impaired earning capacity is reflected in missing treatment effects, and which interventions drive treatment effects during psychosomatic rehabilitation. Analyses were based on routine clinical data encompassing demographics, diagnoses, psychological questionnaires before, and after treatment, interventions, and an interdisciplinary assessment of earning capacity for N = 1,054 patients undergoing psychosomatic rehabilitation in 2019. Classification of patients by changes in self-reported mental health and interventions predictive of changes were analyzed by gradient boosted model. Clustering results revealed three major groups, one of which was comprised almost exclusively of patients with full earning capacity, one of patients with reduced or lost earning capacity and a third group with mixed assessments. Classification results (Kappa = 0.22) indicated that patients experienced modestly divergent changes over the course of rehabilitation. Relative variable influence in the best model was highest for changes in psychological wellbeing (HEALTH-49). Regression analysis identified intervention A620 (physical exercise therapy with psychological goal setting) as most influential variable predicting changes in psychological wellbeing with a model fit of R 2 = 0.05 (SD = 0.007). Results suggest that disability due to psychiatric disorders does associate with distinct demographic and clinical characteristics but may be less clear-cut in a subgroup of patients. Trajectories of treatment response show moderately divergent paths between patient groups. Moreover, results support both physical exercise therapy as efficient intervention in reducing disability-associated impairments and the complementarity of a multimodal treatment plan.
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Affiliation(s)
- Lilia Papst
- Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité University Medicine Berlin, Berlin, Germany
| | - Volker Köllner
- Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité University Medicine Berlin, Berlin, Germany.,Department of Psychosomatics and Behavioural Psychotherapy, Rehabilitation Centre Seehof, Teltow, Germany
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