Functional somatic symptoms (FSS) are characterized by persistent somatic symptoms without identifiable organic abnormalities that lead to decreased quality of life (QOL). Japanese traditional medicine (Kampo medicine) is widely used to treat FSS; however, its generational benefits remain unclear. This study evaluated Kampo medicine treatment in patients with FSS, with a sub-analysis stratified by generation. This retrospective observational study included adult patients with FSS who visited our outpatient department between July 2020 and March 2023. Comprehensive QOL was evaluated at baseline and 6 months using the EuroQol 5-dimension 5-level (EQ-5D-5L) utility value, the EuroQol Visual Analog Scale (EQ VAS), and the 12-item Short-Form Health Survey (SF-12) three-component summary (Physical [PCS], Mental [MCS], and Role/Social [RCS]). Changes were compared with the established minimal clinically important difference (MCID) thresholds (EQ-5D-5L, 0.05; EQ VAS, 5; SF-12,3). Additionally, patients were stratified into working-age (< 65 years) and older (≥ 65 years) groups for analysis. Statistical significance for QOL scores was set at p < 0.01 after Bonferroni correction. Of the 79 included patients, 58 were of working age group and 21 were of older groups, respectively. For the overall population, the EQ-5D-5L utility value and EQ VAS scores improved significantly from baseline to 6 months (both p < 0.001, respectively), and the median changes exceeded the MCID thresholds (0.058 and 7, respectively). The SF-12 showed significant improvements in PCS (Δmedian 3.2, p = 0.001) and MCS (Δmedian 2.8, p = 0.002), though MCS did not reach the MCID threshold. Subgroup analysis revealed distinct generational patterns: the working-age group showed significant and clinically meaningful improvements in EQ VAS score (Δmedian 6, p < 0.001) and PCS (Δmedian 3.9, p = 0.0011). Conversely, the older group demonstrated a significant and clinically meaningful improvement in MCS (Δmedian 4.4, p = 0.002), whereas no significant changes were observed in EQ-5D-5L measures or PCS. This study suggests that Kampo treatment may improve the QOL of patients with FSS by providing comprehensive, personalized care. Integrating this approach into modern practice, while considering the patient’s life stage, could offer a potential therapeutic avenue. Not applicable.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women, often accompanied by metabolic disturbances such as insulin resistance (IR). Although emerging evidence suggests a link between PCOS and mental health disorders, the specific role of insulin resistance in depression and anxiety among affected women remains insufficiently understood. This study aimed to investigate the association between depression, anxiety, and insulin resistance in women with PCOS. This three-group cross-sectional comparative study was conducted among 274 women (aged 18–45 years) between June and December 2025 at a tertiary gynecology clinic and an infertility center in Ahvaz, Iran. Participants were divided into three groups: PCOS with insulin resistance (PCOS + IR; n = 87), PCOS without insulin resistance (PCOS-IR; n = 87), and healthy controls (n = 100). PCOS was diagnosed based on the Rotterdam criteria. Insulin resistance was defined as HOMA-IR > 2.5. Depression and anxiety symptoms were assessed using the Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI), respectively. Data were analyzed using one-way ANOVA, ANCOVA (adjusting for age, BMI, waist circumference, and socioeconomic status), and chi-square tests, followed by Bonferroni post-hoc comparisons. Effect sizes were reported as partial eta-squared (η²p). The three groups were comparable regarding education level, employment status, spouse’s occupation, and parity (p > .05). However, significant differences were observed in age, body mass index (BMI), waist and hip circumference, blood pressure, and socioeconomic status (all p < .001). After adjustment for age, BMI, waist circumference, blood pressure, and socioeconomic status (hip circumference was excluded due to multicollinearity), depressive symptom scores differed significantly across groups (F(2, 265) = 10.59, p < .001, η²p = .074 indicating a medium effect size). Post-hoc analysis revealed that the PCOS + IR group had significantly higher depression scores than both the PCOS − IR group (Adjusted Mean Difference = 5.81, SE = 1.29, p < .001, 95
To examine the associations of patient and family member pain-related fear beliefs with early mobilization function after thoracic surgery, estimate the statistical indirect association involving perceived overprotection, and test the interaction between patient and family member fear beliefs. A preoperative-postoperative two-timepoint paired prospective design was adopted. A total of 180 patient-family member pairs were initially recruited from the thoracic surgery department of a tertiary hospital between March 2025 and October 2025. Fifteen patients were excluded after postoperative transfer to the ICU, leaving 165 pairs for postoperative follow-up, of which 157 with complete core variables were included in the main analysis. One day before surgery, the Fear of Pain Questionnaire-9 (FPQ-9) was administered to patients and family members. On postoperative day 3, the Tampa Scale for Kinesiophobia-11 (TSK-11), Perceived Overprotection Scale-6 (POP-6), Numeric Rating Scale (NRS), and a 2-minute walk test (2MWT) were completed. Hierarchical regression, bootstrap mediation analysis (5,000 resamples), and interaction testing were used to examine adjusted associations, statistical indirect associations, and the interaction between patient and family member FPQ-9. Patient FPQ-9 (25.64 ± 7.59) was significantly higher than Family FPQ-9 (22.69 ± 7.04, p < 0.001), and the two scores were positively correlated (r = 0.280, p < 0.001). The TSK-11 score was 27.92 ± 4.99, with 77.1
Evidence is accumulating that some patients infected with SARS-CoV-2 develop persistent fatigue and cognitive dysfunction that meets the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (post-COVID-19 ME/CFS). However, no established treatment exists for this condition, and reports of patients who have recovered remain limited. Because the pathophysiologic mechanisms underlying the disabling symptoms of post-COVID-19 ME/CFS are not yet fully understood, I adopted a multifaceted treatment approach that considers disease severity, functional level, illness beliefs and coping behaviors, social support systems, comorbidities, secondary issues, and phase of recovery. This report describes a high-school student with post-COVID-19 ME/CFS who was, at one point, unable to attend school but ultimately recovered through this comprehensive, multiperspective treatment strategy. A 17-year-old girl was referred to my department for severe fatigue that developed after SARS-CoV-2 infection. Despite receiving treatments at other medical facilities, she was still bedridden for more than half of each day. I treated the patient from multiple perspectives, including (1) instruction on eating habits and supplements; (2) instruction on physical activities; (3) instruction on managing cognitive fatigue; (4) environmental adjustment; (5) pharmacotherapy with midodrine, ibudilast, and the traditional Japanese herbal medicines hochuekkito and tokishakuyakusan; (6) facilitation of therapeutic interoceptive awareness; (7) adjustment of disrupted diurnal sleep-wake rhythms; (8) conditioning exercise; (9) instructions for safe recovery; and (10) nurturing self-efficacy. These interventions were introduced progressively, tailored to the patient’s phase of recovery. Approximately one year after her initial consultation, the patient made a full recovery, entered university, and is now enjoying university life. This case report describes, in detail, the evaluation and multifaceted treatment of a 17-year-old high-school student with post-COVID-19 ME/CFS who had been unable to attend school but who ultimately recovered and was able to attend university.
Smartphone addiction in young adults produces a convergent triad of sensorimotor dysregulation, insomnia, and psychological stress. Despite this multidimensional burden, no published intervention has simultaneously addressed all three dimensions using a structured, physiotherapy-integrated, protocol-driven approach, a critical gap that the present study addresses through PhysioYoga. PhysioYoga is a therapeutic fusion of evidence-based physiotherapy techniques, including proprioceptive exercises and PNF-style sensorimotor facilitation, and yogic practices, including asanas, pranayama, and Shavasana. Its feasibility and preliminary efficacy have not previously been evaluated in this population. This study aimed to evaluate the feasibility, including recruitment rate, session adherence, and retention, as well as the preliminary pre-post changes associated with a structured online PhysioYoga protocol on sleep quality and perceived stress in smartphone-addicted young adults, within a sensorimotor integration-informed conceptual framework. The SAS-SV was employed as a validated screening instrument to confirm smartphone addiction at enrolment, using an inclusion threshold of score ≥ 31, thereby ensuring sample homogeneity. Given the 4-week single-arm feasibility design, SAS-SV was not designated as a post-intervention outcome. The study was specifically designed to evaluate the downstream health consequences of smartphone addiction, namely insomnia and perceived stress. Assessment of SAS-SV change as a primary outcome is recommended for the planned fully powered randomised controlled trial. This single-arm pre-post feasibility study enrolled 20 participants aged 18 to 30 years who met validated criteria for smartphone addiction, with an SAS-SV score ≥ 31, and poor sleep quality, with a PSQI score > 5. The sample size of 20 was selected in accordance with standard precedent for single-arm feasibility studies, which conventionally enroll 15 to 30 participants to assess protocol delivery, adherence, and retention rather than to achieve formal statistical power. A 4-week online PhysioYoga intervention was delivered via secure video conferencing, with three 60-minute sessions per week for a total of 12 sessions, across seven structured segments. Primary outcomes were PSQI global and component scores and PSS score, assessed pre- and post-intervention using the Wilcoxon signed-rank test in IBM SPSS version 29. The study demonstrated a 100
