Introduction Negative treatment expectations are central to nocebo effects and shape symptom perception as a transdiagnostic mechanism relevant to persisting physical symptoms. Little is known about how such expectations form, how they respond to threatening treatment information across somatic and visceral pain domains, and which dispositional factors moderate this process. Methods Using data from the randomized NOVIS trial, 101 healthy participants (52 females; 18–36 years) completed a multiple-threat pain paradigm involving visceral (rectal distension) and somatic (cutaneous heat) stimuli. Participants received either negative information (nocebo: 50% probability of a pain-enhancing infusion) or neutral information (control) regarding an intravenous treatment that was always saline. Generalized expectations of symptom worsening and side effects, as well as symptom-specific pain expectations, were assessed prior to treatment. Bayesian cumulative probit and linear models estimated the effects of treatment information and moderation by pain catastrophizing, somatosensory amplification, and negative affect. Results Negative information induced expectations of symptom worsening and side effects. Effects on symptom-specific expectations were modality-dependent: anticipated unpleasantness increased for somatic but not visceral pain. Pain catastrophizing and somatosensory amplification were associated with elevated negative expectations independent of treatment information. Somatosensory amplification, pain catastrophizing, and trait negative affect each moderated the effect of negative information on somatic pain unpleasantness expectations. Conclusion Nocebo-related expectations differed between generalized and symptom-specific expectations and depended on symptom modality and psychological vulnerability. Individuals with heightened bodily vigilance, catastrophizing, and negative affect, may be particularly vulnerable to nocebo effects as a psychological mechanism implicated in persisting physical symptoms. Trial registration number German Clinical Trials Register (DRKS) – ID: 00024410
Background Patients with schizophrenia have an elevated burden of type 2 diabetes mellitus (T2DM), but the relationship between psychiatric symptom domains of schizophrenia and glycemic status has been less well established. This study aimed to investigate the association of clinical factors with HbA1c in this population, particularly focusing on Brief Evaluation of Psychosis Symptom Domains (BE-PSD), a symptom scale easy to use in routine clinical practice. Method This retrospective observational study included patients aged 18 years or older with schizophrenia or schizoaffective disorder admitted to the psychiatric ward of Ashikaga Red Cross Hospital between April 2021 and November 2025. A linear mixed-effects model was fitted with HbA1c as the dependent variable, clinical factors including the five BE-PSD symptom domains as fixed effects, and a random intercept for patient ID. Results The primary analysis included 369 admissions of 249 patients. Of the 249 patients, 44 (17.7%) had a history of T2DM. Older age (p = 0.0013), higher body mass index (p = 0.028), and greater BE-PSD mania/excitement symptoms (p = 0.038) were significantly associated with higher HbA1c. Mania/excitement symptoms were not associated with HbA1c in the sensitivity analyses. Conclusions Older age, higher body mass index, and greater BE-PSD mania/excitement symptoms were associated with higher HbA1c, although the mania/excitement association was not statistically significant in the sensitivity analyses and should be interpreted as exploratory. Further studies are necessary to establish the relationship between symptoms of schizophrenia and glycemic status, and to examine whether BE-PSD can help characterize symptom-metabolic relationships in routine care.
Background The neurophysiological abnormality in patients with functional movement disorders (FMDs) is not clear. We aimed to study the neurophysiological abnormality in these patients using transcranial magnetic stimulation (TMS). Methods We enrolled 30 patients with FMD and 31 healthy controls (HC) in the study. Basic demographic and clinical details were recorded. The severity of motor symptoms was evaluated using the Psychogenic (Functional) Movement Disorder (PMD) Scale. The hospital Anxiety and depression rating scale (HADS) was used for assessing anxiety and depression. The motor cortex contralateral to the affected side was stimulated using a figure-of-eight coil connected to a Magstim 2002 stimulator, and motor evoked potential was recorded from the first dorsal interossei muscle. The parameters recorded included resting motor threshold (RMT), central motor conduction time (CMCT), contralateral silent period (cSP), short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF). Results The mean age of the patients (30.96 ± 14.02 years) was comparable to that of healthy controls (33.35 ± 9.04 years). Functional tremor (FT) was the most common phenomenology observed (50%), followed by dystonia (26.6%) and myoclonus (10%). There was a significant reduction in ICF in patients with FMD compared to HC. Also, in patients with FT, ICF was significantly reduced (0.21 ± 0.2) compared to HC (1.25 ± 0.22, p < 0.001). The SICI did not differ between patients (0.25 ± 0.23) and HC (0.34 ± 0.23, p = 0.13). No significant correlation was found between PMD score, HADS score and the TMS parameters. Conclusions Patients with FMD have reduced ICF, suggesting an abnormality in the glutamatergic neurotransmission.
