Abstract:ZusammenfassungHaut-zu-Haut-Berührung stellt die ursprünglichste Sinneserfahrung von Mensch und Tier dar. Ein Mangel an Berührung in der Kindheit ist mit negativen Folgen für die psychosoziale und körperliche Gesundheit verbunden. Für die Entdeckung von Rezeptoren für Temperatur und Berührung im Körper wurde 2021 der Medizin-Nobelpreis verliehen. Klinische Studien belegen den Nutzen von professionellen Berührungstechniken zur Prävention und Therapie verschiedener Erkrankungen. Der breiten Anwendung einer profe… Show more
“…However, the patient’s consent to participate in exercise therapy could be hampered by the main features of MDD, such as severe fatigue, lack of interest, motivation loss, psychosomatic complaints, or comorbidity with physical diseases [ 83 ]. Others have therefore suggested the use of psychoregulatory massage therapies as complementary treatments for MDD, which have shown antidepressant, anxiolytic, analgesic, calming, and fatigue-reducing effects, probably via an interoceptive mechanism of action [ 84 – 90 ]. The frequent use of touch-based treatments in depressed patients may support their wider application [ 91 ].…”
Background
Fatigue is a core symptom of major depressive disorder (MDD) and is frequently refractory to antidepressant treatment, leading to unfavorable clinical/psychosocial outcomes. Dysfunctional self-reported interoception (i.e., maladaptive focus on the body’s physiological condition) is prevalent in MDD and could contribute to residual symptom burden of fatigue. Therefore, we explored (a.) cross-sectional correlations between both dimensions and investigated (b.) prospective associations between interoceptive impairments at admission and symptom severity of fatigue at the end of hospitalization.
Methods
This observational, exploratory study included 87 patients suffering from MDD who completed self-rating scales, the Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2), and the Multidimensional Fatigue Inventory (MFI-20), at the beginning and end of hospitalization. Bivariate correlations (r) and hierarchical regression analyses were performed.
Results
The cross-sectional analysis showed moderate to large negative correlations between the MAIA-2 and MFI-20 dimensions except for the Not-Distracting scale. Symptoms of general, physical, and mental fatigue at the end of hospitalization were predicted by reduced body Trusting (β = -.31, p = .01; β = -.28, p = .02; β = -.31, p = .00, respectively). Increased Body Listening (β = .37, p = .00), Not-Worrying (β = .26, p = .02), and diminished Attention Regulation (β = -.32, p = .01) predicted higher mental fatigue.
Conclusions
Diminished body confidence at baseline identified patients at risk for post-treatment fatigue and could therefore serve as a target for improving antidepressant therapy. Body-centered, integrative approaches could address treatment-resistant fatigue in MDD. However, clinicians may also consider the potential adverse effect of increased Body Listening and Not-Worrying on mental fatigue in psychotherapeutic and counselling approaches. Due to the exploratory nature of this study, the results are preliminary and need to be replicated in pre-registered trials with larger sample sizes.
“…However, the patient’s consent to participate in exercise therapy could be hampered by the main features of MDD, such as severe fatigue, lack of interest, motivation loss, psychosomatic complaints, or comorbidity with physical diseases [ 83 ]. Others have therefore suggested the use of psychoregulatory massage therapies as complementary treatments for MDD, which have shown antidepressant, anxiolytic, analgesic, calming, and fatigue-reducing effects, probably via an interoceptive mechanism of action [ 84 – 90 ]. The frequent use of touch-based treatments in depressed patients may support their wider application [ 91 ].…”
Background
Fatigue is a core symptom of major depressive disorder (MDD) and is frequently refractory to antidepressant treatment, leading to unfavorable clinical/psychosocial outcomes. Dysfunctional self-reported interoception (i.e., maladaptive focus on the body’s physiological condition) is prevalent in MDD and could contribute to residual symptom burden of fatigue. Therefore, we explored (a.) cross-sectional correlations between both dimensions and investigated (b.) prospective associations between interoceptive impairments at admission and symptom severity of fatigue at the end of hospitalization.
Methods
This observational, exploratory study included 87 patients suffering from MDD who completed self-rating scales, the Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2), and the Multidimensional Fatigue Inventory (MFI-20), at the beginning and end of hospitalization. Bivariate correlations (r) and hierarchical regression analyses were performed.
Results
The cross-sectional analysis showed moderate to large negative correlations between the MAIA-2 and MFI-20 dimensions except for the Not-Distracting scale. Symptoms of general, physical, and mental fatigue at the end of hospitalization were predicted by reduced body Trusting (β = -.31, p = .01; β = -.28, p = .02; β = -.31, p = .00, respectively). Increased Body Listening (β = .37, p = .00), Not-Worrying (β = .26, p = .02), and diminished Attention Regulation (β = -.32, p = .01) predicted higher mental fatigue.
Conclusions
Diminished body confidence at baseline identified patients at risk for post-treatment fatigue and could therefore serve as a target for improving antidepressant therapy. Body-centered, integrative approaches could address treatment-resistant fatigue in MDD. However, clinicians may also consider the potential adverse effect of increased Body Listening and Not-Worrying on mental fatigue in psychotherapeutic and counselling approaches. Due to the exploratory nature of this study, the results are preliminary and need to be replicated in pre-registered trials with larger sample sizes.
“…Wir danken den Herausgebern und Autoren für den insgesamt gut recherchierten und auf dem Hintergrund der deutschen Leitlinie (LL) zur unipolaren Depression verfassten Artikel. Die Anlehnung an die LL führt leider auch zu einer bedauerlichen speziellen Ausblendung bei der Diskussion “… weiterer Therapieoptionen sowie Basismaßnahmen jenseits der Standardtherapien ….“ Dies betrifft die inzwischen doch recht starke Evidenz der antidepressiven Wirksamkeit manueller Therapieverfahren und insbesondere verschiedener Formen der Massage, mit der sich unsere Arbeitsgruppe seit vielen Jahren theoretisch und empirisch-klinisch beschäftigt 1 und die z. B. in einem neuen Buch zur therapieresistenten Depression ihren positiven Niederschlag gefunden hat 2 .…”
“…Denn wenn es zu zeitlichen verschobenen und dosisabhängigen Blockaden von Serotonin- und noradrenergen Transportern kommt, dann können daraus auch unterschiedliche dosisabhängige klinische Effekte resultieren. Insgesamt stellt sich die Evidenz für eine fehlende Dosis-Wirkungs-Beziehung bei den SNRI auf Basis dieser Metaanalyse als geringer dar als in den Metaanalysen zur Hochdosisbehandlung bei SSRI (keine bessere Wirksamkeit) oder bei den Fragestellungen zur Antidepressiva-Kombination oder dem Antidepressiva-Wechsel, welche u. a. durch die Arbeitsgruppe um Prof. Bschor in methodisch hervorragenden Metaanalysen ebenfalls untersucht wurde 1 , 2 .…”
“…There is a significant body of evidence showing that social support has positive effects on mood, mental health and wellbeing. [3,44,52,53] However, we are living in a world where our social interactions are increasingly occurring in virtual environments. Perhaps the need for closeness and social support, combined with the immediacy of the virtual world, has led to an explosion of searches on internet for videos that attempt to simulate close human interactions (e.g., role-play ASMR F I G U R E 1 Somatosensory and audio-visual affective stimulation associated with the primary caregiver during early affiliative interactions is integrated as part of a multimodal interoceptive mechanism, conveying affective and physiological regulatory information.…”
Section: Implications and Future Directionsmentioning
confidence: 99%
“…There is a significant body of evidence showing that social support has positive effects on mood, mental health and wellbeing. [ 3,44,52,53 ] However, we are living in a world where our social interactions are increasingly occurring in virtual environments. Perhaps the need for closeness and social support, combined with the immediacy of the virtual world, has led to an explosion of searches on internet for videos that attempt to simulate close human interactions (e.g., role‐play ASMR videos).…”
Section: Implications and Future Directionsmentioning
Autonomous sensory meridian response (ASMR) and affective touch (AT) are two phenomena that have been independently investigated from separate lines of research. In this article, I provide a unified theoretical framework for understanding and studying them as complementary processes. I highlight their shared biological basis and positive effects on emotional and psychophysiological regulation. Drawing from evolutionary and developmental theories, I propose that ASMR results from the development of biological mechanisms associated with early affiliative behaviour and self‐regulation, similar to AT. I also propose a multimodal interoceptive mechanism underlying both phenomena, suggesting that different sensory systems could specifically respond to affective stimulation (caresses, whispers and affective faces), where the integration of those inputs occurs in the brain's interoceptive hubs, allowing physiological regulation. The implications of this proposal are discussed with a view to future research that jointly examines ASMR and AT, and their potential impact on improving emotional well‐being and mental health.
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