Post-COVID-19 Epidemic: Allostatic Load among Medical and Nonmedical Workers in China

<b><i>Background:</i></b> As the fight against the COVID-19 epidemic continues, medical workers may have allostatic load. <b><i>Objective:</i></b> During the reopening of society, medical and nonmedical workers were compared in terms of allostatic load. <b><i>Methods:</i></b> An online study was performed; 3,590 Chinese subjects were analyzed. Socio-demographic variables, allostatic load, stress, abnormal illness behavior, global well-being, mental status, and social support were assessed. <b><i>Results:</i></b> There was no difference in allostatic load in medical workers compared to nonmedical workers (15.8 vs. 17.8%; <i>p</i> = 0.22). Multivariate conditional logistic regression revealed that anxiety (OR = 1.24; 95% CI 1.18–1.31; <i>p</i> &#x3c; 0.01), depression (OR = 1.23; 95% CI 1.17–1.29; <i>p</i> &#x3c; 0.01), somatization (OR = 1.20; 95% CI 1.14–1.25; <i>p</i> &#x3c; 0.01), hostility (OR = 1.24; 95% CI 1.18–1.30; <i>p</i> &#x3c; 0.01), and abnormal illness behavior (OR = 1.49; 95% CI 1.34–1.66; <i>p</i> &#x3c; 0.01) were positively associated with allostatic load, while objective support (OR = 0.84; 95% CI 0.78–0.89; <i>p</i> &#x3c; 0.01), subjective support (OR = 0.84; 95% CI 0.80–0.88; <i>p</i> &#x3c; 0.01), utilization of support (OR = 0.80; 95% CI 0.72–0.88; <i>p</i> &#x3c; 0.01), social support (OR = 0.90; 95% CI 0.87–0.93; <i>p</i> &#x3c; 0.01), and global well-being (OR = 0.30; 95% CI 0.22–0.41; <i>p</i> &#x3c; 0.01) were negatively associated. <b><i>Conclusions:</i></b> In the post-COVID-19 epidemic time, medical and nonmedical workers had similar allostatic load. Psychological distress and abnormal illness behavior were risk factors for it, while social support could relieve it.

The clinical inadequacy of the DSM-5 classification of somatic symptom and related disorders: an alternative trans-diagnostic model

The Diagnostic and Statistical of Mental Disorders, Fifth Edition (DSM-5) somatic symptom and related disorders chapter has a limited clinical utility. In addition to the problems that the single diagnostic rubrics and the deletion of the diagnosis of hypochondriasis entail, there are 2 major ambiguities: (1) the use of the term “somatic symptoms” reflects an ill-defined concept of somatization and (2) abnormal illness behavior is included in all diagnostic rubrics, but it is never conceptually defined. In the present review of the literature, we will attempt to approach the clinical issue from a different angle, by introducing the trans-diagnostic viewpoint of illness behavior and propose an alternative clinimetric classification system, based on the Diagnostic Criteria for Psychosomatic Research.