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Pesquisa : C23.888.541 [Categoria DeCS]
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[PMID]:29301428
[Au] Autor:Barkil-Oteo A; Abdallah W; Mourra S; Jefee-Bahloul H
[Ad] Endereço:From the Department of Psychiatry, Yale University, New Haven, Conn.; the Department of Psychiatry, Howard University Hospital, Washington, DC; the Department of Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles; and the Department of Psychiatry, UMass Medical School, Worcester, Mass.
[Ti] Título:Trauma and Resiliency: A Tale of a Syrian Refugee.
[So] Source:Am J Psychiatry;175(1):8-12, 2018 Jan 01.
[Is] ISSN:1535-7228
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ansiedade
Depressão
Exposição à Violência/psicologia
Psicoterapia/métodos
Refugiados/psicologia
Inibidores da Captação de Serotonina/administração & dosagem
Transtornos de Estresse Pós-Traumáticos
Síncope
[Mh] Termos MeSH secundário: Adulto
Ansiedade/diagnóstico
Ansiedade/terapia
Depressão/diagnóstico
Depressão/psicologia
Feminino
Seres Humanos
Sintomas Inexplicáveis
Dor/etiologia
Dor/psicologia
Processos Psicoterapêuticos
Campos de Refugiados
Resiliência Psicológica
Autogestão/métodos
Apoio Social
Transtornos de Estresse Pós-Traumáticos/complicações
Transtornos de Estresse Pós-Traumáticos/diagnóstico
Transtornos de Estresse Pós-Traumáticos/psicologia
Síncope/etiologia
Síncope/psicologia
Síria
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Serotonin Uptake Inhibitors)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1176/appi.ajp.2017.17030358


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[PMID]:28450466
[Au] Autor:Yon K; Habermann S; Rosenthal J; Walters KR; Nettleton S; Warner A; Lamahewa K; Buszewicz M
[Ad] Endereço:Research Department of Primary Care and Population Health, UCL, London, UK.
[Ti] Título:Improving teaching about medically unexplained symptoms for newly qualified doctors in the UK: findings from a questionnaire survey and expert workshop.
[So] Source:BMJ Open;7(4):e014720, 2017 04 27.
[Is] ISSN:2044-6055
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Medically unexplained symptoms (MUS) present frequently in healthcare, can be complex and frustrating for clinicians and patients and are often associated with overinvestigation and significant costs. Doctors need to be aware of appropriate management strategies for such patients early in their training. A previous qualitative study with foundation year doctors (junior doctors in their first 2 years postqualification) indicated significant lack of knowledge about this topic and appropriate management strategies. This study reviewed whether, and in what format, UK foundation training programmes for newly qualified doctors include any teaching about MUS and sought recommendations for further development of such training. DESIGN: Mixed-methods design comprising a web-based questionnaire survey and an expert consultation workshop. SETTING: Nineteen foundation schools in England, Wales and Northern Ireland PARTICIPANTS: Questionnaire administered via email to 155 foundation training programme directors (FTPDs) attached to the 19 foundation schools, followed by an expert consultation workshop attended by 13 medical educationalists, FTPDs and junior doctors. RESULTS: The 53/155 (34.2%) FTPDs responding to the questionnaire represented 15 of the 19 foundation schools, but only 6/53 (11%) reported any current formal teaching about MUS within their programmes. However, most recognised the importance of providing such teaching, suggesting 2-3 hours per year. All those attending the expert consultation workshop recommended case-based discussions, role-play and the use of videos to illustrate positive and negative examples of doctor-patient interactions as educational methods of choice. Educational sessions should cover the skills needed to provide appropriate explanations for patients' symptoms as well as avoid unnecessary investigations, and providing information about suitable treatment options. CONCLUSIONS: There is an urgent need to improve foundation level training about MUS, as current provision is very limited. An interactive approach covering a range of topics is recommended, but must be delivered within a realistic time frame for the curriculum.
[Mh] Termos MeSH primário: Educação de Graduação em Medicina/métodos
Corpo Clínico Hospitalar/educação
Sintomas Inexplicáveis
[Mh] Termos MeSH secundário: Currículo
Seres Humanos
Médicos
Inquéritos e Questionários
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180201
[Lr] Data última revisão:
180201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1136/bmjopen-2016-014720


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[PMID]:27772559
[Au] Autor:Kohlmann S; Gierk B; Hilbert A; Brähler E; Löwe B
[Ad] Endereço:Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Clinic Hamburg Eilbek, Germany. Electronic address: s.kohlmann@uke.de.
[Ti] Título:The overlap of somatic, anxious and depressive syndromes: A population-based analysis.
[So] Source:J Psychosom Res;90:51-56, 2016 11.
[Is] ISSN:1879-1360
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The comorbidity of somatic, anxious and depressive syndromes occurs in half of all primary care cases. As research on this overlap of syndromes in the general population is scarce, the present study investigated the prevalence of the overlapping syndromes and their association with health care use. METHOD: A national general population survey was conducted between June and July 2012. Trained interviewers contacted participants face-to-face, during which, individuals reported their health care use in the previous 12months. Somatic, anxious and depressive syndromes were assessed using the Somatic Symptom Scale-8 (SSS-8), Generalized Anxiety Disorder-2 (GAD-2) and Patient Health Questionnaire-2 (PHQ-2) respectively. RESULTS: Out of 2510 participants, 236 (9.4%) reported somatic (5.9%), anxious (3.4%) or depressive (4.7%) syndromes, which were comorbid in 86 (3.4%) cases. The increase in the number of syndromes was associated with increase in health care visits (no syndrome: 3.18 visits vs. mono syndrome: 5.82 visits vs. multi syndromes: 14.16 visits, (F =149.10, p<0.00001)). Compared to each somatic (semi-partial r =3.4%), anxious (semi-partial r =0.82%) or depressive (semi-partial r =0.002%) syndrome, the syndrome overlap (semi-partial r =6.6%) explained the greatest part of variance of health care use ( R 11.2%, F =112.81, p<0.001.) CONCLUSIONS: The overlap of somatic, anxious and depressive syndromes is frequent in the general population but appears to be less common compared to primary care populations. To estimate health care use in the general population the overlap of somatic, anxious and depressive syndromes should be considered.
[Mh] Termos MeSH primário: Transtornos de Ansiedade/diagnóstico
Transtornos de Ansiedade/epidemiologia
Transtorno Depressivo/diagnóstico
Transtorno Depressivo/epidemiologia
Sintomas Inexplicáveis
Vigilância da População
[Mh] Termos MeSH secundário: Adulto
Idoso
Transtornos de Ansiedade/psicologia
Comorbidade
Transtorno Depressivo/psicologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Vigilância da População/métodos
Prevalência
Atenção Primária à Saúde/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171229
[Lr] Data última revisão:
171229
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:27772558
[Au] Autor:Konnopka A; König HH; Kaufmann C; Egger N; Wild B; Szecsenyi J; Herzog W; Schellberg D; Schaefert R
[Ad] Endereço:Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: a.konnopka@uke.de.
[Ti] Título:Cost-utility of a specific collaborative group intervention for patients with functional somatic syndromes.
[So] Source:J Psychosom Res;90:43-50, 2016 11.
[Is] ISSN:1879-1360
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Collaborative group intervention (CGI) in patients with functional somatic syndromes (FSS) has been shown to improve mental quality of life. OBJECTIVE: To analyse incremental cost-utility of CGI compared to enhanced medical care in patients with FSS. METHODS: An economic evaluation alongside a cluster-randomised controlled trial was performed. 35 general practitioners (GPs) recruited 300 FSS patients. Patients in the CGI arm were offered 10 group sessions within 3months and 2 booster sessions 6 and 12months after baseline. Costs were assessed via questionnaire. Quality adjusted life years (QALYs) were calculated using the SF-6D index, derived from the 36-item short-form health survey (SF-36). We calculated patients' net-monetary-benefit (NMB), estimated the treatment effect via regression, and generated cost-effectiveness acceptability curves. RESULTS: Using intention-to-treat analysis, total costs during the 12-month study period were 5777EUR in the intervention, and 6858EUR in the control group. Controlling for possible confounders, we found a small, but significant positive intervention effect on QALYs (+0.017; p=0.019) and an insignificant cost saving resulting from a cost-increase in the control group (-10.5%; p=0.278). NMB regression showed that the probability of CGI to be cost-effective was 69% for a willingness to pay (WTP) of 0EUR/QALY, increased to 92% for a WTP of 50,000EUR/QALY and reached the level of 95% at a WTP of 70,375EUR/QALY. Subgroup analyses yielded that CGI was only cost-effective in severe somatic symptom severity (PHQ-15≥15). CONCLUSION: CGI has a high probability to be a cost-effective treatment for FSS, in particular for patients with severe somatic symptom severity.
[Mh] Termos MeSH primário: Comportamento Cooperativo
Análise Custo-Benefício/métodos
Intervenção Médica Precoce/economia
Clínicos Gerais/economia
Sintomas Inexplicáveis
Qualidade de Vida
[Mh] Termos MeSH secundário: Adulto
Intervenção Médica Precoce/métodos
Feminino
Custos de Cuidados de Saúde
Seres Humanos
Masculino
Meia-Idade
Qualidade de Vida/psicologia
Anos de Vida Ajustados por Qualidade de Vida
Inquéritos e Questionários
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRAGMATIC CLINICAL TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171229
[Lr] Data última revisão:
171229
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:27772554
[Au] Autor:Maatz A; Wainwright M; Russell AJ; Macnaughton J; Yiannakou Y
[Ad] Endereço:Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, Zurich CH-8032, Switzerland. Electronic address: anke.maatz@puk.zh.ch.
[Ti] Título:What's 'difficult'? A multi-stage qualitative analysis of secondary care specialists' experiences with medically unexplained symptoms.
[So] Source:J Psychosom Res;90:1-9, 2016 11.
[Is] ISSN:1879-1360
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The term 'difficult' is pervasively used in relation to medically unexplained symptoms (MUS) and patients with MUS. This article scrutinises the use of the term by analysing interview data from a study of secondary care specialists' experiences with and attitudes towards patients suffering from MUS. DESIGN: Qualitative design employing semi-structured open-ended interviews systematically analysed in three stages: first, data were analysed according to the principles of content analysis. The analysis subsequently focused on the use of the term 'difficult'. Iterations of the term were extracted by summative analysis and thematic coding revealed its different meanings. Finally, alternative expressions were explored. SETTING: Three NHS trust secondary care hospitals in North-East England. PARTICIPANTS: 17 senior clinicians from seven medical and two surgical specialities. RESULTS: Unsolicited use of the term 'difficult' was common. 'Difficult' was rarely used as a patient characteristic or to describe the therapeutic relationship. Participants used 'difficult' to describe their experience of diagnosing, explaining, communicating and managing these conditions and their own emotional reactions. Health care system deficits and the conceptual basis for MUS were other facets of 'difficult'. Participants also reported experiences that were rewarding and positive. CONCLUSIONS: This study shows that blanket statements such as 'difficult patients' mask the complexity of doctors' experiences in the context of MUS. Our nuanced analysis of the use of 'difficult' challenges preconceived attitudes. This can help counter the unreflexive perpetuation of negative evaluations that stigmatize patients with MUS, encourage greater acknowledgement of doctors' emotions, and lead to more appropriate conceptualizations and management of MUS.
[Mh] Termos MeSH primário: Sintomas Inexplicáveis
Médicos/normas
Pesquisa Qualitativa
Atenção Secundária à Saúde/normas
Especialização/normas
[Mh] Termos MeSH secundário: Adulto
Assistência à Saúde
Inglaterra/epidemiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Médicos/psicologia
Atenção Secundária à Saúde/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171229
[Lr] Data última revisão:
171229
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:28860288
[Au] Autor:French FH
[Ad] Endereço:E-mail: fionahfrench@hotmail.com.
[Ti] Título:Helpful strategies for GPs seeing patients with MUPS.
[So] Source:Br J Gen Pract;67(662):398, 2017 09.
[Is] ISSN:1478-5242
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Sintomas Inexplicáveis
Relações Médico-Paciente
Transtornos Somatoformes
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE
[do] DOI:10.3399/bjgp17X692273


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[PMID]:28617903
[Au] Autor:Okland TS; Gonzalez JR; Ferber AT; Mann SE
[Ad] Endereço:Department of Otolaryngology, University of Colorado School of Medicine, Aurora.
[Ti] Título:Association Between Patient Review of Systems Score and Somatization.
[So] Source:JAMA Otolaryngol Head Neck Surg;143(9):870-875, 2017 Sep 01.
[Is] ISSN:2168-619X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Somatization is a condition in which psychological distress is manifested by medically unexplained symptoms, and it is prevalent in all medical specialties, including otolaryngology. Recognition of somatization can be difficult, and there are limited methods available. Objectives: To determine whether patients with somatization respond differently to the review of systems (ROS) portion of the patient interview and whether the ROS can be used to identify patients with somatization. Design, Setting, and Participants: A retrospective review of medical records of 2120 consecutive consultations of English- or Spanish-speaking patients aged 18 to 89 years who presented to the otolaryngology clinic from January 1, 2014, to November 10, 2015, was conducted to compare how the ROS of patients with chief complaints associated with somatization (group B: globus sensation, dizziness, and tinnitus) differs from those with symptoms more often associated with objective findings (group A: nasal obstruction, hoarseness, and hearing loss); a total of 605 patients were included. Objective clinical findings after physical examination and related testing were reviewed and classified as either significant, marginal, or absent. Current or past psychiatric comorbidities were also examined. Main Outcomes and Measures: Number of affirmative responses on a standardized, 69-point ROS was recorded as a ROS score (ROSS). Objective clinical findings, symptoms, and psychiatric comorbidities were recorded. Results: Of the 605 patients included in the analysis, 346 (57.2%) were women, and the mean (SD) age was 51.6 (15.7) years. Among patients with medically unexplained symptoms (median, 11; range, 0-39), the ROSS was higher compared with those with objective clinical findings (median, 6; range, 0-31) (median difference, 4; 95% CI, 3 to 6). Group A (hoarseness, nasal obstruction, and hearing loss: median ROSS, 6, range, 0-41) exhibited lower ROSS than group B (dizziness, globus sensation, and tinnitus: median ROSS, 9; range, 0-39) (median difference, -2; 95% CI -3 to -1). Psychiatric comorbidity (median, 10; range, 0-41) was associated with higher ROSS than patients without psychiatric comorbidity (median, 5.5; range, 0 to 36) (median difference, 5; 95% CI, 3 to 6). Conclusions and Relevance: The manner in which patients respond to a standardized ROS differs in those with medically unexplained symptoms and in those with psychiatric disease. The ROS offers information beyond the actual systems review, and may be useful in the identification of somatization.
[Mh] Termos MeSH primário: Anamnese
Sintomas Inexplicáveis
Exame Físico
Transtornos Somatoformes/diagnóstico
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Transtornos Mentais/psicologia
Meia-Idade
Estudos Retrospectivos
Transtornos Somatoformes/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170616
[St] Status:MEDLINE
[do] DOI:10.1001/jamaoto.2017.0671


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[PMID]:28546393
[Au] Autor:Pryke R
[Ad] Endereço:Winyates Surgery, Redditch. E-mail: rachelgpryke@btinternet.com.
[Ti] Título:Why are MUS conflated with heartsink?
[So] Source:Br J Gen Pract;67(659):252, 2017 06.
[Is] ISSN:1478-5242
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Sintomas Inexplicáveis
[Mh] Termos MeSH secundário: Seres Humanos
Transtornos Somatoformes
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170527
[St] Status:MEDLINE
[do] DOI:10.3399/bjgp17X690989


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[PMID]:28416243
[Au] Autor:Bonvanie IJ; Kallesøe KH; Janssens KAM; Schröder A; Rosmalen JGM; Rask CU
[Ad] Endereço:University Medical Center of Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, Groningen, The Netherlands. Electronic address: i.j.bonvanie@umcg.nl.
[Ti] Título:Psychological Interventions for Children with Functional Somatic Symptoms: A Systematic Review and Meta-Analysis.
[So] Source:J Pediatr;187:272-281.e17, 2017 Aug.
[Is] ISSN:1097-6833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To analyze the effectiveness of psychological treatments on symptom load and associated disability in children with functional somatic symptoms, and to explore potential moderators of effects. STUDY DESIGN: Cochrane, PubMed, PsycINFO, EMBASE, and CINAHL were searched for randomized controlled trials published in peer-reviewed journals. Randomized controlled trials studying the effect of a psychological treatment on symptom load and disability in children with functional somatic symptoms were selected. Data on symptom load, disability, and school absence directly post-treatment and at follow-up were extracted by 2 assessors. Studies were appraised with the Cochrane risk of bias tool. Standardized mean differences were pooled in a random-effects model. Heterogeneity in effect-sizes was explored by use of meta-regressions. PROSPERO Registration ID: CRD42015029667. RESULTS: Out of 4098 identified records, 27 studies were included in this review of which 21 were included in meta-analyses. Psychological treatments reduced symptom load (Hedges g = -0.61), disability (Hedges g = -0.42), and school absence (Hedges g = -0.51) post-treatment in children suffering from various functional somatic symptoms. Effects were maintained at follow-up. Type and duration of symptoms, age, and treatment dose did not explain heterogeneity in effect-sizes between studies. Effect-sizes should be interpreted with caution because of the variety in outcome measures, unexplained heterogeneity in found effects and potential publication bias. CONCLUSIONS: Psychological interventions reduce symptom load, disability, and school absence in children with functional somatic symptoms. Future research should clarify which patient and treatment characteristics modify outcomes.
[Mh] Termos MeSH primário: Sintomas Inexplicáveis
Psicoterapia/métodos
[Mh] Termos MeSH secundário: Adolescente
Criança
Gerenciamento Clínico
Feminino
Seres Humanos
Masculino
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE


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[PMID]:28371755
[Au] Autor:Bräscher AK; Raymaekers K; Van den Bergh O; Witthöft M
[Ad] Endereço:Johannes Gutenberg University Mainz, Department for Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Wallstraße 3, 55122 Mainz, Germany. Electronic address: abraesch@uni-mainz.de.
[Ti] Título:Are media reports able to cause somatic symptoms attributed to WiFi radiation? An experimental test of the negative expectation hypothesis.
[So] Source:Environ Res;156:265-271, 2017 07.
[Is] ISSN:1096-0953
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:People suffering from idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) experience numerous non-specific symptoms that they attribute to EMF. The cause of this condition remains vague and evidence shows that psychological rather than bioelectromagnetic mechanisms are at work. We hypothesized a role of media reports in the etiology of IEI-EMF and investigated how somatosensory perception is affected. 65 healthy participants were instructed that EMF exposure can lead to enhanced somatosensory perception. Participants were randomly assigned to watch either a television report on adverse health effects of EMF or a neutral report. During the following experiment, participants rated stimulus intensities of tactile (electric) stimuli while being exposed to a sham WiFi signal in 50% of the trials. Sham WiFi exposure led to increased intensity ratings of tactile stimuli in the WiFi film group, especially in participants with higher levels of somatosensory amplification. Participants of the WiFi group reported more anxiety concerning WiFi exposure than the Control group and tended to perceive themselves as being more sensitive to EMF after the experiment compared to before. Sensational media reports can facilitate enhanced perception of tactile stimuli in healthy participants. People tending to perceive bodily symptoms as intense, disturbing, and noxious seem most vulnerable. Receiving sensational media reports might sensitize people to develop a nocebo effect and thereby contribute to the development of IEI-EMF. By promoting catastrophizing thoughts and increasing symptom-focused attention, perception might more readily be enhanced and misattributed to EMF.
[Mh] Termos MeSH primário: Ansiedade/epidemiologia
Campos Eletromagnéticos/efeitos adversos
Sintomas Inexplicáveis
Sensibilidade Química Múltipla/psicologia
Tato
Tecnologia sem Fio
[Mh] Termos MeSH secundário: Adolescente
Adulto
Ansiedade/etiologia
Feminino
Alemanha/epidemiologia
Seres Humanos
Masculino
Distribuição Aleatória
Televisão
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171119
[Lr] Data última revisão:
171119
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE



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