Biological phenotypes underpin the physio-somatic symptoms of somatization, depression, and chronic fatigue syndrome

Anderson, G, Berk, M and Maes, M 2014, Biological phenotypes underpin the physio-somatic symptoms of somatization, depression, and chronic fatigue syndrome, Acta Psychiatrica Scandinavica, vol. 129, no. 2, pp. 83-97, doi: 10.1111/acps.12182.

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Title Biological phenotypes underpin the physio-somatic symptoms of somatization, depression, and chronic fatigue syndrome
Author(s) Anderson, G
Berk, MORCID iD for Berk, M orcid.org/0000-0002-5554-6946
Maes, M
Journal name Acta Psychiatrica Scandinavica
Volume number 129
Issue number 2
Start page 83
End page 97
Total pages 15
Publisher Blackwell Publishing
Place of publication London, UK
Publication date 2014
ISSN 0001-690X
1600-0447
Keyword(s) Depression
Chronic fatigue syndrome
Somatization
Inflammation
Cytokines
Serotonin
Tryptophan
Tryptophan catabolite
Autoimmunity
Summary Objective
Somatization is a symptom cluster characterized by ‘psychosomatic’ symptoms, that is, medically unexplained symptoms, and is a common component of other conditions, including depression and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This article reviews the data regarding the pathophysiological foundations of ‘psychosomatic’ symptoms and the implications that this has for conceptualization of what may more appropriately be termed physio-somatic symptoms.

Method
This narrative review used papers published in PubMed, Scopus, and Google Scholar electronic databases using the keywords: depression and chronic fatigue, depression and somatization, somatization and chronic fatigue syndrome, each combined with inflammation, inflammatory, tryptophan, and cell-mediated immune (CMI).

Results

The physio-somatic symptoms of depression, ME/CFS, and somatization are associated with specific biomarkers of inflammation and CMI activation, which are correlated with, and causally linked to, changes in the tryptophan catabolite (TRYCAT) pathway. Oxidative and nitrosative stress induces damage that increases neoepitopes and autoimmunity that contribute to the immuno-inflammatory processes. These pathways are all known to cause physio-somatic symptoms, including fatigue, malaise, autonomic symptoms, hyperalgesia, intestinal hypermotility, peripheral neuropathy, etc.

Conclusion

Biological underpinnings, such as immune-inflammatory pathways, may explain, at least in part, the occurrence of physio-somatic symptoms in depression, somatization, or myalgic encephalomyelitis/chronic fatigue syndrome and thus the clinical overlap among these disorders.
Language eng
DOI 10.1111/acps.12182
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2014, Blackwell Publishing
Persistent URL http://hdl.handle.net/10536/DRO/DU:30060275

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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Created: Thu, 06 Feb 2014, 09:08:09 EST by Barb Lavelle

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