Pain-related fear and expectancy to movements-varying in similarity with the original painful and nonpainful movement-decrease during extinction in HC and FM. Yet, conditioned responses remain elevated in patients despite corrective feedback, indicating impaired extinction of generalization. Persistent excessive protective responses may contribute to preserving pain disability.

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Negative affective states elicit elevated somatic symptom reports in patients experiencing fibromyalgia and/or chronic fatigue syndrome. This symptom-enhancing effect is greater in patients having higher difficulty to identify feelings and higher absorption scores. The results are discussed in a predictive coding framework of symptom perception.

This study extended earlier findings in patients with medically unexplained dyspnea to patients with fibromyalgia and CFS. This suggests that altered symptom perception is a non-symptom-specific mechanism underlying functional somatic syndromes in general, particularly in patients with high levels of somatic symptom severity. The results are discussed in a predictive coding framework of symptom perception.

sensitivity at a cut-point of > 15/35 was 95% (95% CI: 74-100). The positive predictive value equalled 44% (95% CI: 29-60). CONCLUSION:In this group of Belgian CHC patients infected after substance use, antiviral treatment caused a considerable risk of depression. Seven vegetativedepressive symptoms of the Zung scale at wk 4 of treatment predicted 95% of all emerging depressions, at a price of 56% false positive test results. INTRODUCTIONFollowing the recent expert consensus, patients with chronic hepatitis C (CHC) should now receive interferon (IFN) and ribavirin regardless of psychiatric status, except in uncontrolled psychiatric disease [1][2][3] . As 23%-44% of patients treated with IFN develop depressive symptoms during treatment [4,5] and since, more patients are treated, interferon-induced psychiatric illness is likely to become an increasingly important clinical problem [4,[6][7][8][9][10][11][12][13][14] . IFN-induced depression appears to be a depressive disorder that is unusually responsive to antidepressant treatment. Approximately 80% of patients are responsive within 4 wk [15] . This high response rate may be related to the usually short duration of this illness when treatment is initiated, to the mild to moderate severity of illness in most cases [1] , but also to the mainly interferon-induced influences on the central nervous system [16] . Based on the results of a small scale study (n = 16), it has been hypothesised that vegetative symptoms are Abstract AIM: To study the predictive value of the vegetativedepressive symptoms of the Zung Depression Rating Scale for the occurrence of depression during treatment with peg-interferon α-2b of chronic hepatitis C (CHC) patients. METHODS:T h e pre dic t ive value of ve ge t at ivedepressive symptoms at 4 wk of treatment for the o c c u r r e n c e o f a s u b s e q u e n t d i a g n o s i s o f m a j o r depressive disorder (MDD) was studied in CHC patients infected after substance use in a prospective, multicenter treatment trial in Belgium. The presence of vegetative-depressive symptoms was assessed using the Zung Scale before and 4 wk after the start of antiviral treatment. RESULTS:Out of 49 eligible patients, 19 (39%) developed MDD. The area under the ROC curve of the vegetative Zung subscale was 0.73, P = 0.004. The

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Medically unexplained symptoms (MUS) are a considerable presenting problem in general practice. Alexithymia and difficulties with mental elaboration of bodily arousal are hypothesized as a key mechanism in MUS. In turn, this inability influences the embodied being and participating of these patients in the world, which is coined as ‘the lived body’ and underlies what is mostly referred to as body awareness (BA). The present article explores a more innovative hypothesis how hands-on bodywork can influence BA and serve as a rationale for a body integrated psychotherapeutic approach of MUS. Research not only shows that BA is a bottom-up ‘bodily’ affair but is anchored in a interoceptive-insular pathway (IIP) which in turn is deeply connected with autonomic and emotional brain areas as well as verbal and non-verbal memory. Moreover, it is emphasized how skin and myofascial tissues should be seen as an interoceptive generator, if approached in the proper manual way. This article offers supportive evidence explaining why a ‘haptic’ touch activates this IIP, restores the myofascial armored body, helps patients rebalancing their window of tolerance and facilitates BA by contacting their bodily inner-world. From a trans-disciplinary angle this article reflects on how the integration of bodywork with non-directive verbal guidance can be deeply healing and resourcing for the lived body experience in MUS. In particular for alexithymic patients this approach can be of significance regarding their representational failure of bodily arousal.

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