[Risks and health problems caused by the use of video terminals].

PubMed

Tamez González, Silvia; Ortiz-Hernández, Luis; Martínez-Alcántara, Susana; Méndez-Ramírez, Ignacio

2003-01-01

To evaluate the association between video display terminal (VDT) use and health hazards, occupational risks, and psychosocial factors, in newspaper workers. A cross-sectional study was conducted in 1998 in a representative sample (n = 68) drawn from a population of 218 VDT operators in Mexico City. Data were collected using a self-administered questionnaire. Data were confirmed by performing physical examinations. The research hypothesis was that both the current and cumulative use of VDT are associated with visual, musculoskeletal system, and skin illnesses, as well as with fatigue and mental or psychosomatic disorders. Occupational health hazards were assessed (visual problems, postural risks, sedentary work, computer mouse use, excessive heat, and overcrowding), as well as psychosocial factors related to work organization (psychological demands, work control, and social support). Prevalence ratios were adjusted for confounding variables like age, sex and schooling. Women were more likely than men to have upper extremity musculoskeletal disorders (MSD), dermatitis, and seborrheic eczema. VDT use was associated with neuro-visual fatigue, upper extremity MSD, dermatitis, and seborrheic eczema. Computer mouse use and postural risks were significantly associated with health problems. Psychosocial factors were mainly associated with mental problems, psychosomatic disorders, and fatigue. Intense use of video screens has been found to cause musculoskeletal disorders of the hand. The diversification of tasks and control of labor processes itself had a protective effect against psychosomatic disorders and pathological fatigue.

The Psychosomatic Disorders Pertaining to Dental Practice with Revised Working Type Classification

PubMed Central

2014-01-01

Psychosomatic disorders are defined as disorders characterized by physiological changes that originate partially from emotional factors. This article aims to discuss the psychosomatic disorders of the oral cavity with a revised working type classification. The author has added one more subset to the existing classification, i.e., disorders caused by altered perception of dentofacial form and function, which include body dysmorphic disorder. The author has also inserted delusional halitosis under the miscellaneous disorders classification of psychosomatic disorders and revised the already existing classification proposed for the psychosomatic disorders pertaining to dental practice. After the inclusion of the subset (disorders caused by altered perception of dentofacial form and function), the terminology "psychosomatic disorders of the oral cavity" is modified to "psychosomatic disorders pertaining to dental practice". PMID:24478896

The psychosomatic disorders pertaining to dental practice with revised working type classification.

PubMed

Shamim, Thorakkal

2014-01-01

Psychosomatic disorders are defined as disorders characterized by physiological changes that originate partially from emotional factors. This article aims to discuss the psychosomatic disorders of the oral cavity with a revised working type classification. The author has added one more subset to the existing classification, i.e., disorders caused by altered perception of dentofacial form and function, which include body dysmorphic disorder. The author has also inserted delusional halitosis under the miscellaneous disorders classification of psychosomatic disorders and revised the already existing classification proposed for the psychosomatic disorders pertaining to dental practice. After the inclusion of the subset (disorders caused by altered perception of dentofacial form and function), the terminology "psychosomatic disorders of the oral cavity" is modified to "psychosomatic disorders pertaining to dental practice".

What Do Patients Think about the Cause of Their Mental Disorder? A Qualitative and Quantitative Analysis of Causal Beliefs of Mental Disorder in Inpatients in Psychosomatic Rehabilitation.

PubMed

Magaard, Julia Luise; Schulz, Holger; Brütt, Anna Levke

2017-01-01

Patients' causal beliefs about their mental disorders are important for treatment because they affect illness-related behaviours. However, there are few studies exploring patients' causal beliefs about their mental disorder. (a) To qualitatively explore patients' causal beliefs of their mental disorder, (b) to explore frequencies of patients stating causal beliefs, and (c) to investigate differences of causal beliefs according to patients' primary diagnoses. Inpatients in psychosomatic rehabilitation were asked an open-ended question about their three most important causal beliefs about their mental illness. Answers were obtained from 678 patients, with primary diagnoses of depression (N = 341), adjustment disorder (N = 75), reaction to severe stress (N = 57) and anxiety disorders (N = 40). Two researchers developed a category system inductively and categorised the reported causal beliefs. Qualitative analysis has been supplemented by logistic regression analyses. The causal beliefs were organized into twelve content-related categories. Causal beliefs referring to "problems at work" (47%) and "problems in social environment" (46%) were most frequently mentioned by patients with mental disorders. 35% of patients indicate causal beliefs related to "self/internal states". Patients with depression and patients with anxiety disorders stated similar causal beliefs, whereas patients with reactions to severe stress and adjustment disorders stated different causal beliefs in comparison to patients with depression. There was no opportunity for further exploration, because we analysed written documents. These results add a detailed insight to mentally ill patients' causal beliefs to illness perception literature. Additionally, evidence about differences in frequencies of causal beliefs between different illness groups complement previous findings. For future research it is important to clarify the relation between patients' causal beliefs and the chosen treatment.

What Do Patients Think about the Cause of Their Mental Disorder? A Qualitative and Quantitative Analysis of Causal Beliefs of Mental Disorder in Inpatients in Psychosomatic Rehabilitation

PubMed Central

Magaard, Julia Luise; Schulz, Holger; Brütt, Anna Levke

2017-01-01

Background Patients’ causal beliefs about their mental disorders are important for treatment because they affect illness-related behaviours. However, there are few studies exploring patients’ causal beliefs about their mental disorder. Objectives (a) To qualitatively explore patients’ causal beliefs of their mental disorder, (b) to explore frequencies of patients stating causal beliefs, and (c) to investigate differences of causal beliefs according to patients’ primary diagnoses. Method Inpatients in psychosomatic rehabilitation were asked an open-ended question about their three most important causal beliefs about their mental illness. Answers were obtained from 678 patients, with primary diagnoses of depression (N = 341), adjustment disorder (N = 75), reaction to severe stress (N = 57) and anxiety disorders (N = 40). Two researchers developed a category system inductively and categorised the reported causal beliefs. Qualitative analysis has been supplemented by logistic regression analyses. Results The causal beliefs were organized into twelve content-related categories. Causal beliefs referring to “problems at work” (47%) and “problems in social environment” (46%) were most frequently mentioned by patients with mental disorders. 35% of patients indicate causal beliefs related to “self/internal states”. Patients with depression and patients with anxiety disorders stated similar causal beliefs, whereas patients with reactions to severe stress and adjustment disorders stated different causal beliefs in comparison to patients with depression. Limitations There was no opportunity for further exploration, because we analysed written documents. Conclusions These results add a detailed insight to mentally ill patients’ causal beliefs to illness perception literature. Additionally, evidence about differences in frequencies of causal beliefs between different illness groups complement previous findings. For future research it is important to clarify the relation between patients’ causal beliefs and the chosen treatment. PMID:28056066

Research paradigms in psychosomatic medicine with special emphasis on whiplash - cervical hyperextension flexion injury (CHFI).

PubMed

Merskey, Harold

2003-01-01

There have been a number of attempts, particularly in the last five decades to understand the origins of pain in terms of psychological or psychosomatic patterns. These include psychoanalytic explanations relying on hysterical mechanisms, and psychophysiological proposals. The occurrence of pain in the course of psychiatric illness and its remission after the illness, has long been known and is not a controversial issue. However, the reported explanations of pain without overt and obvious prior psychiatric illness have largely failed to convince a significant portion of the professional establishment. These explanations have very often coincided with the interests of insurance companies, whether those insurance companies were providing medical benefits, disability insurance or workers' or accident compensation. Critical examination of the evidence generated by insurance company related research indicates profound weaknesses in it.

Psychosomatic medicine and cybernetics.

PubMed

Ishikawa, H

1979-01-01

In our daily psychosomatic medicine clinics, we have adopted four principles from Wiener's cybernetics and von Bertalanffy's general system theory. We use the polygraphic method for the diagnosis of psychosomatic disease (black box principle). For the control of psychosomatic symptoms, we use the biofeedback method (feedback principle). We use systematic desensitization to relieve social stresses which cause psychosomatic disease (open and closed system principle). And lastly, transactional analysis, which corresponds to the information and energy principle.

Are adolescents with high self-esteem protected from psychosomatic symptomatology?

PubMed

Piko, Bettina F; Varga, Szabolcs; Mellor, David

2016-06-01

This study investigated the role of self-esteem, social (need to belong, loneliness, competitiveness, and shyness), and health (smoking, drinking) behaviors in Hungarian adolescents' psychosomatic symptoms. Our sample of 490 students (ages 14-19 years) from Debrecen (Hungary) completed the questionnaires. Besides descriptive statistics, correlation and multiple regression analyses were applied to test interrelationships. Frequency analysis revealed that fatigue was the most commonly experienced psychosomatic symptom in this sample, followed by sleeping problems and (lower) back pain. Girls reported experiencing more symptoms. Multiple regression analyses suggested that (1) need to belong, shyness, and competitiveness may serve as social behavioral risk factors for adolescents' psychosomatic symptomatology, whereas (2) self-esteem may play a protective role. The role of social and health behaviors was modified when analyzed by gender: the psychosomatic index score was positively related to smoking and shyness among girls, and need to belong among boys. Self-esteem provided protection for both sexes. We conclude that problems with social relationships (namely, unmet need to belong, competitiveness, and shyness) may lead to psychosomatic health complaints, whereas self-esteem may serve as a protection. Findings suggest that social skills training and strengthening self-esteem should be an important part of children's health promotion programs in schools to improve their psychosomatic health and well-being. • Despite being free of serious physical illness, many adolescents often report subjective health complaints, such as psychosomatic symptoms • As children in this life stage develop independence and autonomy, new types of social relationships, and identity, their social needs and skills also change What is new: • Need to belong, shyness, and competitiveness may serve as social behavioral risk factors for adolescents' psychosomatic symptomatology, whereas self-esteem may play a protective role • The role of social and health behaviors may vary by gender.

Previous experiences with illness and traumatic experiences: a specific risk factor for hypochondriasis?

PubMed

Weck, Florian; Neng, Julia M B; Göller, Kathrin; Müller-Marbach, Alexis M

2014-01-01

Previous experiences with illness and traumatic experiences are considered as important risk factors for the development of health anxiety and hypochondriasis. However, empirical research is insufficient and lacks adequate comparison groups. Therefore, we sought to determine whether experiences with illness and traumatic experiences are really specific risk factors for hypochondriasis. In the current study, patients with the diagnosis of hypochondriasis (n = 80), patients with a primary anxiety disorder (n = 80), and healthy controls (n = 83) were investigated regarding their previous experiences with illness (self and other) and traumatic childhood experiences. We found that patients with hypochondriasis reported a higher level of experience with illness and with traumatic childhood experiences than healthy controls. However, no differences were found between patients with hypochondriasis and those with an anxiety disorder, regarding their level of experience with illness and traumatic experiences. Previous experiences with illness and traumatic childhood experiences did not prove to be specific risk factors for the development of hypochondriasis. The importance of both experiences with illness and traumatic experiences as risk factors, as considered in the Diagnostic and Statistical Manual and in established cognitive-behavioral models, does not seem to be supported empirically. Further research should therefore also consider other potential risk factors discussed in the literature. © 2013 Published by Academy of Psychosomatic Medicine on behalf of Academy of Psychosomatic Medicine.

Somatic expressions of grief and psychosomatic illness in the works of William Shakespeare and his coevals.

PubMed

Heaton, Kenneth W

2012-10-01

To find out if Shakespeare, famed for his insights into human nature, is exceptional in how much his characters express grief through somatic symptoms and signs, and by physical illness. The texts of all large-scale works currently attributed to Shakespeare (39 plays, 3 long narrative poems) were systematically searched for bodily changes and for evidence of grief as dominating the character's emotional state at the time. The findings were compared with those from a search of 46 works, similar in genre, by 15 prominent playwrights active at the same time as Shakespeare. In Shakespeare 31 different grief-associated symptoms or signs were found, in 140 instances. They are present in all but two of his plays and long poems and involve most systems of the body. With non-Shakespearean writers there were 26 kinds, 132 instances. Twenty-two changes are common to both groups, including fainting, death (sudden or after a decline), and wrinkled face, and symptoms such as malaise, fatigue, awareness of the heart-beat, and anorexia. Ten somatic expressions of grief were found only in Shakespeare, including hyperventilation, hair turning white and premature childbirth. Four were found only in his contemporaries but were trivial or unconvincing. Deaths and non-fatal illnesses are prevalent in Shakespeare. Grieving Shakespearean characters exhibit many somatic symptoms and signs and a wide range of psychosomatic illnesses. This panoply of psychosomatic phenomena may be an artistic artefact but it also confirms that Shakespeare's empathy with grieving humanity was unrivalled. Copyright © 2012 Elsevier Inc. All rights reserved.

[Psychosomatic pain in the field of gynecology. Stages of the formation of psychosomatic reactions and symptoms with examples of cases (author's transl)].

PubMed

Poettgen, H

1976-12-01

1. Understanding disease in the context of a hermeneutic of the ill person's life history forces us to abandon the old understanding of causality which is represented by the model of body-soul polarity. The real onset of an illness has a biographic pre-history. Long latent periods may occur before and between "functio laesa" and actual damage to the involved organ. On the basis of psychosomatic case histories, we can conclude that the future-orientation of an individual's life, that for which man must make decisions, is also that which causes the crises situation for those who are suffering. 2. Psychosomatic medicine cannot simply be included in an already existing medical discipline such as, for example, perinatology can be included in gynecology or pediatrics. It implies a whole new understanding of illness and, above all, it requires a new attitude on the part of the physician. The patient must be allowed to cooperate in his self-realization; the physician himself becomes the medicine. 3. An attempt was made to illustrate the concept of "organ language" on the basis of 6 brief examples from psychosomatic gynecology. Here only the most important information was presented. According to the concept of "organ language", the soma and psyche of the suffering person can represent and interpret each other reciprocally. It also becomes obvious that conflicts at various strata of being can use one and the same physical symptom if a common denominator is present (e.g., defence overagainst a danger, a disease or a role). This type of teleological nosology implies a new dimension for the consideration a disease, namely, the question of the meaning of suffering. 4. The examples cited are almost exclusively found in the understanding of sexuality in the broadest sense of the word. The threat of individuation as the final personality organization resulting from inadequate realization of the individual's own sex determination (Friedrichs) is present. 5. The sixth example clearly illustrates that sexuality is not what it is commonly considered to be. Rather, it permeates all state of personality and extends beyond them into areas of cultural and intellectual life. Whether or not a woman engages in sexual activity is not important (as had originally been thought). What is important is her attitude toward her own sex, toware her sexual activity and, therefore, also toward her partner and the environment. True sexual activity means infinitely more than just the automatic physiological act. In total self-abandonment to the "Thou", perfect sexual love becomes a knowing penetration of being. Genesis 4:1 states: "Now Adam knew Eve his wife...". The Hebrew word for "know" (yada') means both to know and to beget. Through the mystery of this word, something of the perfection, of the "participation mystique" in the work of creation becomes transparent in the perfect sexual union of two human beings!

The indissociable unity of psyche and soma: a view from the Paris Psychosomatic School.

PubMed

Aisenstein, Marilia

2006-06-01

Depending on whether or not psyche/soma is seen as singular or dual, one may construct different systems explaining man and the world, life and death. In the author's view, the discoveries of psychoanalysis offer a perfectly cogent and unique solution to the famous mind/body problem. In transferring the duality psyche/soma on to the duality of drives, psychoanalysis places the origin of the thought process in the body. In Beyond the pleasure principle, Freud discusses the drastic effect of a painful somatic illness on the distribution and modalities of the libido. He provides a starting point for the Paris Psychosomatic School's psychoanalytical approach to patients afflicted with somatic illnesses. To illustrate the technical implications of this theory the author relates two clinical cases.

Physical and psychosomatic health outcomes in people bereaved by suicide compared to people bereaved by other modes of death: a systematic review.

PubMed

Spillane, Ailbhe; Larkin, Celine; Corcoran, Paul; Matvienko-Sikar, Karen; Riordan, Fiona; Arensman, Ella

2017-12-12

Little research has been conducted into the physical health implications of suicide bereavement compared to other causes of death. There is some evidence that suicide bereaved parents have higher morbidity, particularly in terms of chronic illness. This systematic review aims to examine the physical and psychosomatic morbidities of people bereaved by a family member's suicide and compare them with family members bereaved by other modes of death. MEDLINE, EMBASE, CINAHL, and PsycINFO were searched from 1985 to February 2016. The search was re-run in March 2017. Peer-reviewed English language articles comparing suicide-bereaved family members to non-suicide bereaved family members on measures of physical or psychosomatic health were eligible for inclusion. Cohort, cross-sectional, case-control and cohort-based register studies were eligible for inclusion. A modified version of the Newcastle Ottawa Scale was used for quality assessment. Results were synthesised using narrative synthesis. The literature search located 24 studies which met the inclusion criteria. Seven studies found statistically significant associations between physical health and suicide bereavement. Five of the studies found that suicide-bereaved family members were more likely to experience pain, more physical illnesses and poorer general health. They were also at increased risk of cardiovascular disease, hypertension, diabetes and chronic obstructive pulmonary disease. In contrast, another study in Denmark found that those bereaved by suicide had a lower risk of a number of physical health disorders, including cancers, diabetes, cardiovascular and chronic lower respiratory tract disorders compared to those bereaved by other causes of death. Additionally, a further study conducted in the United States found that suicide-bereaved children visited a GP less frequently than non-suicide bereaved children. Review findings are relevant for clinicians working with people bereaved by suicide as they highlight that such clients are at increased risk of several adverse physical health outcomes. Future research should examine health risk behaviours of suicide-bereaved and non-suicide bereaved family members as they may confound the association between exposure and outcome. The review protocol has been registered on PROSPERO, registration number CRD42016030007 .

[Patients with ICD-10 disorders F3 and F4 in psychiatric and psychosomatic in-patient units - who is treated where? : Allocation features from the PfAD study].

PubMed

Bichescu-Burian, D; Cerisier, C; Czekaj, A; Grempler, J; Hund, S; Jaeger, S; Schmid, P; Weithmann, G; Steinert, T

2017-01-01

In Germany, in-patient treatment of patients with depressive, neurotic, anxiety, and somatoform disorders (ICD-10 F3, F4) is carried out in different settings in psychiatry and psychosomatics. Which patient characteristics determine referral to one or the other specialty is a crucial question in mental health policy and is a matter of ongoing controversy. However, comparative data on patient populations are widely lacking. In the study of Treatment Pathways of Patients with Anxiety and Depression (PfAD study), a total of 320 patients with ICD-10 F3/F4 clinical diagnoses were consecutively recruited from four treatment settings (psychiatric depression ward, psychiatric crisis intervention ward, psychiatric day hospitals, or psychosomatic hospital units; 80 participants per setting) and investigated. In all treatment settings, patients with considerable severity of illness and chronicity were treated. Female gender, higher education, and higher income predicted referral to psychosomatic units; male gender, transfer from another hospital or emergency hospitalization, co-morbidity with a personality disorder, higher general psychiatric co-morbidity, and danger to self at admission predicted referral to psychiatric unit. Patients in psychosomatic units had neither more psychosomatic disorders nor more somatic problems. There is considerable overlap between the clientele of psychiatric and psychosomatic units. Referral and allocation appears to be determined by aspects of severity and social status.

Stress, Coping, and Infectious Illness: Persistently Low Natural Killer Cell Activity as a Host Risk Factor.

DTIC Science & Technology

1988-03-14

increased incidence of acute, infectious illnesses, such as upper respiratory infections and infectious mononucleosis , as well as outbreaks of herpes... infectious mononucleosis . Psychosomatic Medicine, 41. 445-466. Kemeny, M., Cohen, F., and Zegams, L., (1986). The relationship of coping strategies to...follow-up period in order to identify predictors of infectious illness over time. As in the preliminary work, we are finding that approximately 1/3 of

[Gerontopsychosomatic consultation/liaison service in inpatient acute geriatrics : Effects of trust and support on patient-nurse interaction].

PubMed

Lindner, Reinhard

2018-06-01

Geriatric and psychosomatic medicine follow a biopsychosocial paradigm. Despite this similar "Menschenbild" in general, collaboration between geriatrics and psychosomatics is still rare. This comparative interventional study aims to find possible effects of psychosomatic work in geriatrics on the interaction between patients and nursing staff and contentment of patients with treatment in general. In the period of one year 238 geriatric patients (return rate 22.2%) of the intervention ward (psychosomatic consultation-/liaison service) and the control ward (TAU) were investigated with an anonymized questionnaire. Two questions were evaluated, concerning the patients trust in the nurses and their experience of being able to speak with them about their anxieties and concerns. This is interpreted as an indicator for the advancement of patients' contentment with treatment. In comparison with the control ward during the intervention the answers to both questions showed an increasing trust in the nurses and an increasing experience of speaking about anxieties and concerns with the nurses. This is evaluated as some evidence for the promotion of the patients' contentment with the treatment CONCLUSION: A psychosomatic consultation-/liaison service in geriatric medicine generates a positive effect on the relationship between patients and nursing staff, especially concerning trust and acceptance in existential situations of illness and limitation in hospital.

Medically unexplained symptoms as a threat to patients' identity? A conversation analysis of patients' reactions to psychosomatic attributions.

PubMed

Burbaum, Christina; Stresing, Anne-Maria; Fritzsche, Kurt; Auer, Peter; Wirsching, Michael; Lucius-Hoene, Gabriele

2010-05-01

Interactions between patients suffering from medically unexplained symptoms (MUS) and their physicians are usually perceived as difficult and unsatisfactory by both parties. In this qualitative study, patients' reactions to psychosomatic attributions were analyzed on a micro-level. 144 consultations between consultation-and-liaison (CL) psychotherapists and inpatients with MUS, who were treated according to a modified reattribution model, were recorded. Linguists and psychologists evaluated these consultations by applying conversation and positioning analysis. When introducing a psychosomatic attribution, therapists use discursive strategies to exert interactional pressure on the patient; while simultaneously using careful and implicit formulations. Three linguistic patterns could be found in which patients subtly refute, drop or undermine the psychosomatic attribution in their reply. Moreover, in this context patients position themselves as somatically ill or justify their own life situation. The results suggest that patients interpret psychosomatic attributions and even subtle suggestions from the psychotherapists as face-threatening 'other-positionings'. When implementing the reattribution model, it should be taken into account that interactional resistance might be a necessary step in the process of the patient's understanding. Nevertheless therapists should introduce reattribution in a patient-centered rather than persuasive way and they should openly address patients' fears of being stigmatized. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

The treatment of patients with medically unexplained physical symptoms in China: a study comparing expectations and treatment satisfaction in psychosomatic medicine, biomedicine, and traditional Chinese medicine.

PubMed

Fritzsche, Kurt; Xudong, Zhao; Anselm, Kathrin; Kern, Stephanie; Wirsching, Michael; Schaefert, Rainer

2011-01-01

Little is known about treatment for patients with medically unexplained symptoms (MUS) in China. This study investigates the treatment expectations and treatment satisfaction of patients with MUS in psychosomatic medicine, biomedicine, and Traditional Chinese Medicine (TCM). In a cross-sectional survey, n = 96 (10.3%) out of 931 participating patients were screened positive for multiple somatoform symptoms. These patients answered questionnaires concerning symptom duration, number of doctor visits, functional impairment, emotional distress, treatment expectations, treatment satisfaction, and empathy in the consultation. The physicians filled in a questionnaire about applied or recommended treatment. Most of the patients from psychosomatic medicine wanted psychotherapy. In TCM, 55% of the patients had already received TCM treatment and most of them wanted to continue TCM treatment. Patients in biomedicine did not express clear expectations; most of them had had no previous treatment. A combination of treatment methods was most prevalent in biomedicine in comparison to psychosomatic medicine and TCM. The outcome from the patients' point of view was significantly better in TCM than in psychosomatic medicine and biomedicine. Psychosomatic medicine's strength was the empathetic physician-patient interaction. From a biopsychosocial perspective, these results suggest that various treatment approaches with various emphases can be effective depending on the patient's complaints, his illness beliefs, and what the physician offers. The results will be verified in a larger multicenter longitudinal study.

Pediatric Psychosomatic Medicine: Creating a Template for Training

PubMed Central

Walker, Audrey; Pao, Maryland; Nguyen, Ngoc

2012-01-01

There is a critical public health problem in the United States today, the problem of childhood psychiatric disorders in youngsters with physical illnesses. Currently there is a pressing need for well-trained pediatric psychosomatic medicine practitioners as well as advanced training in the field. Yet, this training does not currently exist. This article will present the innovative Montefiore Medical Center/Albert Einstein College of Medicine (MMC/AECOM) program as a model for a training curriculum, clinical training experience, and clinical research training setting in this important and rapidly expanding area of need in pediatric mental health. PMID:22658325

Psychological factors affecting medical condition: a new proposal for DSM-V.

PubMed

Fava, Giovanni A; Fabbri, Stefania; Sirri, Laura; Wise, Thomas N

2007-01-01

The DSM category of "psychological factors affecting medical condition" had virtually no impact on clinical practice. However, several clinically relevant psychosomatic syndromes have been described in the literature: disease phobia, persistent somatization, conversion symptoms, illness denial, demoralization, and irritable mood. These syndromes, in addition to the DSM definition of hypochondriasis, can yield clinical specification in the category of "psychological factors affecting medical condition" and eliminate the need for the highly criticized DSM classification of somatoform disorders. This new classification is supported by a growing body of research evidence and is in line with psychosomatic medicine as a recognized subspecialty.

[Frequency and consequences of financial problems in patients undergoing outpatient psychosomatic treatment].

PubMed

Wagner, Stefanie; Münster, Eva; Beutel, Manfred E

2010-01-01

About seven million people in Germany are affected by overindebtedness and insolvency. Being severely in debt is a very stressful situation that can result in social marginalisation, reducted overall activity, and physical and mental illness. The present study investigated the frequency of financial problems and their effects on physical and mental disorders at a university psychosomatic clinic. The study included a total of 659 patients. Their mental status was assessed with the Symptom Checklist (SCL-90-R), their physical status with the Gießener Beschwerdebogen (GBB). 37 percent of the subjects reported experiencing financial problems. We found that subjects with financial problems reported more physical and mental disorders than those without financial problems. Furthermore, therapists more often recommended that patients with financial problems receive inpatient therapy than patients without financial problems. The study suggests that financial problems should be included in any anamnesis, therapeutic recommendation, and actual therapy of patients in psychosomatic treatment.

[The future of psychosomatic medicine in West Germany--an illusion?].

PubMed

Meyer, A E

1990-01-01

Due to historical developments the structure and function of German Psychosomatics is unique in the world. Hence, to predict its future is difficult. There is the intimate conjunction of psycho-somatics with psychotherapy and the mandatory teaching of this combination to medical students, so that every medical school has to have a corresponding department and that most of these are psychoanalytically orientated. Medical care insurances finance psycho-therapy to a degree unknown in any other country. Then, in excess of the 700 beds for psychosomatics/psychotherapy in university and communal hospitals, the FRG provides another 4000 beds which are legally, financially and geographically separated from the former. Epidemiological data show that in spite of the above average out-patient financing many patients in need are not treated psychotherapeutically until their working capacity is reduced by which they become subject to another (and separate) legal system: The law of rehabilitation the measures of which are financed by the federal or state pension funds. At this late stage only in-patient psychosomatic treatment has some chance of rehabilitation. Hence, in cooperation with private entrepreneurs or non-profit organizations the above-mentioned over 4000 additional beds were provided. Two examples show that the effects of psychotherapy with somatic illness (myocardial infarction and metastatic cancer) are remarkable but discrete and their full impact can only been seen after several years. These features probably explain the habitual underestimation of psychotherapy in medicine.

Anxiety and psychosomatic symptoms in palliative care: from neuro-psychobiological response to stress, to symptoms' management with clinical hypnosis and meditative states.

PubMed

Satsangi, Anirudh Kumar; Brugnoli, Maria Paola

2018-01-01

Psychosomatic disorder is a condition in which psychological stresses adversely affect physiological (somatic) functioning to the point of distress. It is a condition of dysfunction or structural damage in physical organs through inappropriate activation of the involuntary nervous system and the biochemical response. In this framework, this review will consider anxiety disorders, from the perspective of the psychobiological mechanisms of vulnerability to extreme stress in severe chronic illnesses. Psychosomatic medicine is a field of behavioral medicine and a part of the practice of consultation-liaison psychiatry. Psychosomatic medicine in palliative care, integrates interdisciplinary evaluation and management involving diverse clinical specialties including psychiatry, psychology, neurology, internal medicine, allergy, dermatology, psychoneuroimmunology, psychosocial oncology and spiritual care. Clinical conditions where psychological processes act as a major factor affecting medical outcomes are areas where psychosomatic medicine has competence. Thus, the psychosomatic symptom develops as a physiological connected of an emotional state. In a state of rage or fear, for example, the stressed person's blood pressure is likely to be elevated and his pulse and respiratory rate to be increased. When the fear passes, the heightened physiologic processes usually subside. If the person has a persistent fear (chronic anxiety), however, which he is unable to express overtly, the emotional state remains unchanged, though unexpressed in the overt behavior, and the physiological symptoms associated with the anxiety state persist. This paper wants highlight how clinical hypnosis and meditative states can be important psychosocial and spiritual care, for the symptom management on neuro-psychobiological response to stress.

On our need to move beyond folk medicine: A commentary on Karen Gubb's paper, "Psychosomatics today: a review of contemporary theory and practice".

PubMed

Gottlieb, Richard M

2013-02-01

In her thoughtful review and synthesis, Karen Gubb overstimates the breadth of resurgent interest among psychoanalysts in psychosomatic medicine. Such a modest revival as there has been reflects primarily the activity of a few authors and editors. Still, after several decades of inactivity following the intense excitement about this subject during the 1940s and 1950s, there has been some renewal of interest, primarily in Europe and among a small group in the United States. The golden age of psychoanalytic psychosomatics came to an end with the failure to find evidence in support of the promising but overly simplistic specificity theories, especially those of Franz Alexander. If we were going to better understand the complex relations between bodily states (including illnesses) and mental phenomena new theories and modes of investigation would be required. Many apparently new theories have been put forward over the past few decades. Of these, Gubb focuses her attention on two that relate somatic illness to failures in linguistic or symbolic elaboration, that is, to failures in the working over or binding of somatic excitations by the mental apparatus. These theories share the attractive feature that they seem consistent with the claim that psychosomatically ill patients are impaired in their language capacities, being unable to put feelings into words (alexithymia) and unable to move to abstract from concrete thinking (pensée opératoire). While apparently new, when closely examined these theories turn out to be but minor variations of one of Freud's own fundamental theories of mind/body, the one explicated in The Interpretation of Dreams and based upon the neurological model of the reflex arc as known in the 19th century. We know too much today about neuronal functioning, brain operations, and the importance of our subtle interactions with others to be satisfied with a superannuated scientific model. If we analysts are to lay claim to a science beyond a quaint folk medicine we need to create new models that are at consistent with our own more advanced findings and those of our neighboring disciplines.

[Interaction of mental health and forced married migrants in Germany].

PubMed

Kizilhan, Jan

2015-11-01

The study examines the interaction of the forced married migrants and the frequency of the psychological illness. Forced-married and not forced-married migrants are compared concerning her psychological illness in psychosomatic clinics in Germany. Forced-married women reported significantly more about psychological illness and have undertaken on average at least four times a suicide attempt. Forced-married women suffer lifelong from this event and need, with taking into account cultural migration-specific aspects, special support in the psychosocial consultation and medical-therapeutic treatment. © Georg Thieme Verlag KG Stuttgart · New York.

Psychiatric Patient History Taking and Nomenclature,

DTIC Science & Technology

1981-01-01

these can prove most important in diagnosing developmental disorders such as mental retardation and infantile autism. Age at turning over, crawling...psychological stress factors have been identified in asthma, doudenal ulcer, and other so-called "psychosomatic" illnesses. Even diabetes can be greatly

Metapsychological and clinical issues in psychosomatics research.

PubMed

Press, Jacques

2016-02-01

The author starts by treating the general epistemological problems inherent to research and emphasizes that all investigation takes place between two poles: a creative pole and one that is defensive in relation to the unknown and formlessness. In the psychosomatic field, an additional difficulty resides in the western dualistic vision of the relationship between psyche and soma which influences our way of thinking about the body as well as about otherness. The author continues by exploring Pierre Marty's psychosomatic model. Its psychosomatic monism is revolutionary but incomplete and creates a distance with the other, the somatizing patient, resulting in a medically oriented nosology symptomatic of the impossibility to think about some of the most important aspects of counter-transference. With the help of clinical material, the author considers these unthought aspects and some of their theoretical implications, particularly the way of understanding the negative often so prevalent with these patients. Based on these reflections as well as Freud's on beyond the pleasure principle and Winnicott's theorization on the fear of breakdown, the author suggests some directions for research. Somatic illness might occur when the attempts at filling the cracks created by a breakdown are unsuccessful. Copyright © 2015 Institute of Psychoanalysis.

[The psychosomatics of chronic back pain. Classification, aetiology and therapy].

PubMed

Henningsen, P

2004-05-01

An overview is given on the current classification, description and treatment of chronic pain with causally relevant psychological factors. It is based on the "practice guidelines on somatoform disorders" and on a thematically related meta-analysis. The classificatory problems, especially of the demarcation of somatoform and other chronic pain, are presented. Additional descriptive dimensions of the relevant psychosocial factors are: pain description, other organically unexplained pain- and non-pain-symptoms, anxiety and depression, disease conviction and illness behaviour, personality and childhood abuse. A modified psychotherapy for (somatoform) chronic pain is outlined. Finally, this aetiologically oriented psychosomatic-psychiatric approach is compared to psychological coping models for chronic pain.

Scientific Research and Corporate Influence: Smoking, Mental Illness, and the Tobacco Industry

PubMed Central

Hirshbein, Laura

2012-01-01

Mentally ill individuals have always smoked at high rates and continue to do so, despite public health efforts to encourage smoking cessation. In the last half century, the tobacco industry became interested in this connection, and conducted and supported psychiatric and basic science research on the mental health implications of smoking, long before most mental health professionals outside the industry investigated this issue. Initially, representatives of tobacco industry research organizations supported genetics and psychosomatic research to try to disprove findings that smoking causes lung cancer. Tobacco industry research leaders engaged with investigators because of shared priorities and interests in the brain effects of nicotine. By the 1980s, collaborative funding programs and individual company research and development teams engaged in intramural and extramural basic science studies on the neuropharmacology of nicotine. When mental health researchers outside the industry became interested in the issue of the mentally ill and smoking in the mid-1990s, they increasingly explained it in terms of a disease of nicotine addiction. Both the idea that smoking/nicotine does something positive for the mentally ill and the conclusion that it is the result of nicotine dependence have the potential to support corporate agendas (tobacco or pharmaceutical). PMID:21596723

Scientific research and corporate influence: smoking, mental illness, and the tobacco industry.

PubMed

Hirshbein, Laura

2012-07-01

Mentally ill individuals have always smoked at high rates and continue to do so, despite public health efforts to encourage smoking cessation. In the last half century, the tobacco industry became interested in this connection, and conducted and supported psychiatric and basic science research on the mental health implications of smoking, long before most mental health professionals outside the industry investigated this issue. Initially, representatives of tobacco industry research organizations supported genetics and psychosomatic research to try to disprove findings that smoking causes lung cancer. Tobacco industry research leaders engaged with investigators because of shared priorities and interests in the brain effects of nicotine. By the 1980s, collaborative funding programs and individual company research and development teams engaged in intramural and extramural basic science studies on the neuropharmacology of nicotine. When mental health researchers outside the industry became interested in the issue of the mentally ill and smoking in the mid-1990s, they increasingly explained it in terms of a disease of nicotine addiction. Both the idea that smoking/nicotine does something positive for the mentally ill and the conclusion that it is the result of nicotine dependence have the potential to support corporate agendas (tobacco or pharmaceutical).

Mental Health in the Perspectives of Biological Evolution and Cultural Change.

ERIC Educational Resources Information Center

Reynolds, V.

1979-01-01

Outlines and discusses characteristics of an ethological perspective on mental illness, which emphasizes the evolutionary background of humanity, his recent background since the agricultural and industrial revolutions, and the physiological and psychosomatic factors of the human species in dealing with stress. (CS)

Stress, Coping, and Infectious Illness: Persistently Low Natural Killer Cell Activity as a Host Risk Factor

DTIC Science & Technology

1990-12-20

and infectious mononucleosis , as well as outbreaks of herpes simplex (Ishigami, 1919; Hinkle and Plummer, 1952; McClelland, Alexander, and Marks, 1982...Evans, A., and Neiderman, J., (1979). Psychosocial risk factors in the development of infectious mononucleosis . Psychosomatic Medicine, 41, 445-466...34Stress, Coping, and Infectious Illness: Persistently Low Natural Killer Cell Activity as a Host Ri-k Fa.ctor" 2. PERSONAL AUTHOR(S) Sandra M. Lev

Peer Victimization and Perceived Life Satisfaction among Early Adolescents in the United States

ERIC Educational Resources Information Center

Valois, Robert F.; Kerr, Jelani C.; Huebner, E. Scott

2012-01-01

Background: Peer victimization among adolescents has been linked to increased psychological stress, psychosomatic illness, anxiety, depression, lower self-esteem, suicide ideation and poor physical health. Purpose: This study explored associations between peer victimization and adolescents' perceptions of life satisfaction. Methods: Public middle…

The buffering effect of tangible social support on financial stress: influence on psychological well-being and psychosomatic symptoms in a large sample of the adult general population.

PubMed

Åslund, Cecilia; Larm, Peter; Starrin, Bengt; Nilsson, Kent W

2014-09-28

Financial stress is an important source of distress and is related to poor mental and physical health outcomes. The present study investigated whether tangible social support could buffer the effect of financial stress on psychological and psychosomatic health. Two separate postal surveys were sent to random samples in five counties in Sweden in 2004 and 2008, with a total of 84 263 respondents. The questionnaires included questions about financial stress, tangible social support, psychosomatic symptoms, and psychological well-being (General Health Questionnaire-12). Individuals with high financial stress and low tangible social support had six to seven times increased odds ratios for low psychological well-being and many psychosomatic symptoms. By contrast, individuals with high financial stress and high tangible social support had only two to three times increased odds ratios for low psychological well-being and three to four times increased odds ratios for many psychosomatic symptoms, suggesting a buffering effect of tangible social support. Consistent with the buffering hypothesis, there were significant interactions between financial stress and social support, particularly in relation to low psychological well-being. Social support had its strongest effect at high levels of financial stress. The question whether the altering of our social networks may improve physical health is important for the prevention of ill health in people experiencing financial stress. Strengthening social networks may have the potential to influence health-care costs and improve quality of life.

Personality and Stress-Resistance Across Professional Groups.

ERIC Educational Resources Information Center

Kobasa, Suzanne C.

Knowledge of the influence of situational variables and the importance of interaction between person and situation requires a more complex view of illness than that held by many practitioners of psychosomatic medicine, who attribute causality solely to internal and isolated personality traits. Personality was studied, therefore, as a conditioner…

Should Psychiatrists Resurrect the Body?

PubMed

Benning, Tony B

2016-01-01

The current article interrogates the mind-body dualism that characterizes modern psychiatry and contends that the dualism is manifested by the relative neglect by psychiatrists of the body, or soma. The article argues that the state of affairs has several consequences, including psychiatrists' underappreciation of the somatic manifestations of mental disorders and of the therapeutic potential of somatic or body-based therapies. Empirical data attest to the association of a range of mental illnesses with somatic pathologies, as does the fact that a range of somatic therapies, including yoga and t'ai chi, are increasingly being shown to be efficacious in the treatment of a range of mental illnesses. The current article contextualizes contemporary Western psychiatry's relative neglect of the body by drawing on some historical as well as cross-cultural perspectives. Although their overall effect has been minimal, various theoretical perspectives in Western psychiatry, including Jungian thought, psychoanalytical psychosomatics, Reichian and related schools, and the phenomenological tradition, have sought to overcome psychiatry's mind-body dualism. Neither has psychiatry incorporated the values of various non-Western schools of medicine that maintain a far more integrated conceptualization of the relationship between mind and body than is seen in modern Western psychiatry. The field of psychosomatics could potentially influence general psychiatry to reverse its bifurcated mind-body relationship, but that field's increasingly narrow mandate and organizational separation from general psychiatry conspire to militate against the latter's incorporation of psychosomatic medicine's conceptual advances or pragmatic insights in any convincing or enduring manner.

Childhood Sexual Abuse and Psychosomatic Symptoms in Irritable Bowel Syndrome

ERIC Educational Resources Information Center

Ross, Colin A.

2005-01-01

Irritable bowel syndrome is characterized by chronic gastrointestinal symptoms without a demonstrable physical cause. In a subgroup of patients, irritable bowel syndrome may be part of a cluster of psychosomatic symptoms related to childhood sexual abuse. To investigate this possibility, the Dissociative Disorders Interview Schedule (DDIS), the…

The role of traditional Japanese medicine (Kampo) in the practice of psychosomatic medicine: the usefulness of Kampo in the treatment of the stress-related symptoms of women, especially those with peri-menopausal disorder.

PubMed

Ushiroyama, Takahisa

2013-10-22

A serious problem currently plaguing the medical field is the widening gap between academic medicine, which studies the features and causes of illness, and the medical care that patients desire. An example of this gap can be observed in the practice of psychotherapy, which is effective only for certain patients. Kampo medicine that combines the advantages of Western medicine with those of traditional Japanese medicine is currently undergoing a revival in the healthcare sector. The therapeutic policies underlying Kampo medicine are based on the physical constitution and current symptoms of each patient. For this reason, Kampo medicine is referred to as "tailor-made medicine" and has properties similar to "mind and body" or psychosomatic medicine. Some women exhibit multiple undefined stress-related symptoms during the peri-menopausal period. In order to accurately diagnose and provide patient-specific treatment, physicians should not only investigate the various stress factors in patients' lives but should also provide a Sho, or a Kampo diagnosis. The therapeutic approach in Kampo medicine is aimed at harmonizing the mind, body, and spirit; this practice involves the use of narrative and holistic medication that treats the entire being of the patient, resulting in an increased number of specialized treatment plans.There are many Kampo prescriptions tailored to treat women who exhibit various stress-related symptoms. Both Kampo and psychosomatic medicine are based on the principles of narrative-based medicine, and by integrating these two medical systems, an ideal system can be devised to better cope with the various needs of patients. This new medical system established by integrating and harmonizing Western and Eastern medicine can be used for the treatment of women with stress-related symptoms.

The Influence of Psychological Factors in Meniere's Disease

PubMed Central

Orji, FT

2014-01-01

Many physicians have observed that psychological factors play a significant role in the course of Meniere's disease (MD), with Meniere's patients being subject to anxiety and tension states. A lot of research attentions from a psychological point of view have been directed at MD, with earlier researchers focusing on psychosomatic causes of the illness as well as its somatopsychic result. However, the question whether MD is caused by psychological factors or whether the psychological manifestation in MD is as a result of the illness is still unresolved. The aim of this study is to provide an overview of interaction that exists between physical and emotional factors in the development of MD and its impact on the quality of life of the sufferers. A structured literature search was carried out, with no restrictions to the dates searched. A vicious circle of interaction seems to exist between the somatic organic symptoms of MD and resultant psychological stress. The frightening attacks of vertigo seem likely to produce and increase the level of anxiety thereby worsening the emotional state and the resultant anxiety provokes various symptoms probably through disorders of the autonomic nervous system occasioned by the increased levels of stress-related hormones. PMID:24669323

"Don't crack under pressure!"--Do leisure time physical activity and self-esteem moderate the relationship between school-based stress and psychosomatic complaints?

PubMed

Gerber, Markus; Pühse, Uwe

2008-10-01

Stressful experiences occupy a central role in most etiological models of developmental psychopathology. Stress alone, however, insufficiently explains negative health outcomes. This raises the question why some children and adolescents are more vulnerable to the development of psychopathological symptoms than others. The primary purpose of this research was to demonstrate whether leisure time physical activity and self-esteem protect against stress-induced health problems. The findings are based on a cross-sectional study of 407 Swiss boys and girls (M=14.01 years). All variables are self-reported. Analyses of covariance were applied to test for main and moderator effects. The findings suggest that school-based stress and psychosomatic complaints are important issues during adolescence. The results show that a higher level of psychosomatic complaints accompanies stress. Surprisingly, psychosomatic complaints and physical activity were unrelated. Likewise, no association was found between physical activity and stress. In contrast, students with high self-esteem reported significantly less complaints and a lower extent of perceived stress. Finally, the results do not support the stress-moderation hypothesis. Neither physical activity nor self-esteem buffered against the detrimental effects of school-based stress on psychosomatic health. The findings lend support to previous research with German-speaking samples but are in marked contrast to Anglo-Saxon studies, which generally support the role of physical activity as a moderator of the health-illness relationship. In this investigation, developmental features and methodological limitations may have accounted for the insignificant results.

[Steadfast--effectiveness of a cognitive-behavioral self-management program for patients with somatoform vertigo and dizziness].

PubMed

Tschan, Regine; Eckhardt-Henn, Annegret; Scheurich, Vera; Best, Christoph; Dieterich, Marianne; Beutel, Manfred

2012-01-01

The aim of the study was to evaluate a psychotherapeutic intervention for somatoform vertigo regarding illness perception, severity and psychopathology.Patients underwent a waiting-list control group design (n=10 control group; n=14 intervention group with diagnostics at baseline, post-intervention, 3- and 12-month follow-up). Psychometric assessments comprised the Illness Perception Questionnaire, Vertigo Symptom and Handicap Questionnaire, Hospital Anxiety and Depression Scale, and Physical Health Questionnaire.The intervention group improved in personal control (p=0.046; d=0.46), and coherency (p=0.087; d=0.42). Illness beliefs in organic deteriorations could be corrected towards psychosomatic attributions.Steadfast decreased dysfunctional illness representations and increased patient empowerment. © Georg Thieme Verlag KG Stuttgart · New York.

More on Darwin's illness: comment on the final diagnosis of Charles Darwin.

PubMed

Sheehan, William; Meller, William H; Thurber, Steven

2008-06-20

Without the possibility of confirmatory exhumation, diagnostic inferences about Darwin's illness must remain speculative. A diagnosis of Darwin's aggregate symptoms must account for not only gastrointestinal distress but also his predominant and excessive retching and the conglomerate of other heterogeneous symptoms. We opine that Crohn's disease, posited as the 'final diagnosis', is not sufficient for subsuming his pleiomorphic symptomatology. An additional proposal is outlined that may help to explain his presentation with heterogeneous symptoms. It incorporates constitutional vulnerabilities, psychosomatic influences and Pavlovian conditioning as explanatory variables.

Evidence of psychosomatic influences in compensated and decompensated tinnitus.

PubMed

Stobik, Corinna; Weber, Rainer K; Münte, Thomas F; Walter, Marc; Frommer, Jörg

2005-06-01

The purpose of this study was to evaluate the role and interaction of individual factors on decompensated tinnitus. Subjects consisted of 53 adult patients with chronic tinnitus. They were selected and assigned to two groups, compensated (n = 28) and decompensated (n = 25), according to the results of an established tinnitus questionnaire. Both groups were evaluated and compared. The patients with decompensated tinnitus suffered from more pronounced social disabilities, were more prone to depression, and used less effective techniques to cope with their illness. They showed a higher degree of somatic multimorbidity, with particularly strong correlations between tinnitus and the incidence of cardiovascular diseases and hypoacusis. As a consequence, in the psychosomatic tinnitus therapy, greater attention should be given to the treatment of the somatic complaints in addition to psychological and psychosocial aspects.

Caring for homeless persons with serious mental illness in general hospitals.

PubMed

Bauer, Leah K; Baggett, Travis P; Stern, Theodore A; O'Connell, Jim J; Shtasel, Derri

2013-01-01

The care of homeless persons with serious mental illness remains a common and challenging problem in general hospital settings. This article aims to review data on homelessness and its psychiatric comorbidities, and to expand the skills of providers who encounter homeless individuals in general hospital settings. Literature review reveals patient, provider, and systems factors that contribute to suboptimal health outcomes in homeless individuals. Diagnostic rigor, integrated medical and psychiatric care, trauma-informed interventions, special considerations in capacity evaluations, and health care reform initiatives can improve the treatment of homeless persons with serious mental illness. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

The Link between Emotion Identification Skills and Socio-Emotional Functioning in Early Adolescence: A 1-Year Longitudinal Study

ERIC Educational Resources Information Center

Ciarrochi, Joseph; Heaven, Patrick C. L.; Supavadeeprasit, Sunila

2008-01-01

Amongst adults, low emotion identification skill (EIS) relates to poor emotion regulation strategies, higher rates of anxiety and depression, and higher rates of somatic illness and disease [Taylor, G. J., & Bagby, R. M. (2004). New trends in alexithymia research. "Psychotherapy and Psychosomatics", 73, 68-77]. Little research has examined EIS in…

The modern hippocratic tradition. Some messages for contemporary medicine.

PubMed

Marketos, S G; Skiadas, P K

1999-06-01

Hippocrates (5th century B.C.), the most prominent physician of antiquity, was born in the small Greek island of Kos, which is near the coast of Asia Minor. Before his era, medicine was practiced as an empirical art and had a religious nature. Hippocratic medicine represents the landmark for the evolution of Western medicine. This "father" of rational medicine assimilated the accumulated knowledge of the past and formed a diagnostic system based on clinical observation and logical reasoning. The great physician attributed diseases to natural causes, believed in the healing power of nature, and gave special emphasis to the prevention and prognosis of illnesses. He treated patients as psychosomatic entities (a holistic medical approach) in relation to their natural environment. In his treatises, Hippocrates defined the ethical principles guiding medical practice. His entire work was inspired by humanistic ideals and an undeviating dedication to the patient. Modern medicine can derive valuable lessons from the Hippocratic tradition. For the coming 21st century, medicine more than ever senses the need to combine the concepts of humanistic values and the Hippocratic messages with the technologic "imperative" (power). This bond is necessary to the improvement of medicine in the future because, currently, the enormous biomedical technology so far has contributed little to the traditionally human fields of psychosomatic and functional disturbances, posing new dilemmas and threatening scientific problems.

“Psychosomatic consultation in the workplace” – a new model of care at the interface of company-supported mental health care and consultation-liaison psychosomatics: design of a mixed methods implementation study

PubMed Central

2012-01-01

Background Mental health issues are gaining in importance in society and the economic system. At the same time, the accessibility and stigmatisation of the mental health care system in Germany can obstruct help-seeking behavior and delay early psychotherapeutic interventions. Therefore, new models of care are being established at the interface of company-supported health promotion and conventional health insurance sponsored outpatient care for people developing mental illnesses. Two large industrial companies, in cooperation with two psychosomatic clinics, have recently established a model of “psychosomatic consultation in the workplace“. This new model of care offers the opportunity for a first psychotherapeutic door to door consultation with occupational medicine within the industrial workplace. The main empirical goals of this study are: 1) Describing the differences between patients who use this new diagnostic and therapeutic offer within the industrial workplace vs. patients who visit a conventional regional outpatient clinic, especially in regard to symptom duration and severity, work ability, and demographic characteristics, and 2) A first evaluation of how patients may benefit more from this new model of care compared to those first seen by standard outpatient care. In the qualitative part of the study, occupational physicians, psychosomatic therapists, involved personnel and select employees of the involved companies will be asked to comment on their experiences with this new approach. Methods/Design The implementation study will take place in Ulm and in Stuttgart, with each site looking at one regional conventional psychosomatic outpatient clinic and one psychosomatic consultation offer within the workplace. 70 consecutive patients in each setting will be recruited (overall n = 280). For the cross-sectional study and pre-post comparison we will use established and validated survey instruments (PHQ, SF-12, WAI, MBI, IS) as well as standardized questions about health care use. For data analysis, we will use uni- and multivariate analytical methods. Qualitative data analysis (expert interviews) will be carried out using Mayring’s content analysis method. Discussion The results of this study have the potential to provide evidence-based knowledge about an innovative model of psychotherapeutic outpatient care and to further promote tailored solutions for early psychotherapeutic interventions within the worksite. Trial Registration DRKS00003184 PMID:22974257

New strategies in the assessment of psychological factors affecting medical conditions.

PubMed

Sirri, Laura; Fabbri, Stefania; Fava, Giovanni A; Sonino, Nicoletta

2007-12-01

In this article, we examine research that may lead to a better assessment of psychological factors affecting medical conditions. We performed a review of the psychosomatic literature using both Medline and manual searches. We selected papers that were judged to be relevant to new strategies of assessment, with particular reference to the use of the Diagnostic Criteria for Psychosomatic Research. We assessed 8 areas concerned with the assessment of psychological factors in the setting of medical disease: hypochondriasis, disease phobia, persistent somatization, conversion symptoms, illness denial, demoralization, irritable mood, and Type A behavior. A new subclassification of the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-V]; not yet published) category of psychological factors affecting physical conditions appears to be feasible and may provide the clinician with better tools for identifying psychological distress.

[Follow-up Care in the Field of Medical Rehabilitation Concerning Psychosomatic Indications Based on the New Conceptual Framework of the German Pension Insurance].

PubMed

Boes, N

2016-12-01

Mental disorders rank first amongst all causes for disability pensions and second in the field of medical rehabilitation. Especially alarming is the significantly lower age of entry of the mentally ill disability pensioners, compared to those with other indications. Mentally ill people often look back at a long history of diseases before getting in contact with the German pension insurance. In this regard the German pension insurance, which is obligated to effectively support people in order to keep them in working life until reaching the regular retirement age, is facing a big challenge, which stands right next to further demands, due to the demographic change, the increase of chronic diseases, multimorbidity, retirement age of 67 and changes in the working environment.With their activities in the field of medical rehabilitation the German pension insurance is aiming at the reintegration of people whose working capacity is endangered or reduced into the labor force or to prevent them from leaving it early. One of the main challenges notably in the field of mental diseases is to keep the success of the medical rehabilitation long-lasting. In this regard the post-rehabilitation provisions of the German pension insurances offer support according to § 31 I 1 Nr. 1 Social Insurance Code VI, if so required.On January 1st, 2016 the German pension insurance has adopted a new conceptual framework in the field of post rehabilitation which is presented in the following article, covering the range of psychosomatic indications. The aim of the new conceptual framework, which has to be implemented within the next three years, is to establish a nationwide, uniformed and preferably comprehensive follow-up care concept, which can be referred to by everyone, regardless which agency of the German pension insurance is in charge. © Georg Thieme Verlag KG Stuttgart · New York.

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

PubMed

Cosci, Fiammetta; Fava, Giovanni A

2016-08-01

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.

Are doctors who have been ill more compassionate? Attitudes of resident physicians regarding personal health issues and the expression of compassion in clinical care.

PubMed

Roberts, Laura Weiss; Warner, Teddy D; Moutier, Christine; Geppert, Cynthia M A; Green Hammond, Katherine A

2011-01-01

Compassion is an attribute central to professionalism and modern clinical care, yet little is known about how compassion is acquired and preserved in medical training. We sought to understand whether personal illness experiences are thought by residents to foster compassion. The authors surveyed 155 (71% response rate) second- and third-year residents at the University of New Mexico School of Medicine regarding their views of the relationship of personal life experience with illness to compassion and empathy for patients. Residents believe that experience with personal health issues enhances physician compassion for patients. Residents who report more personal health concerns, such as physical or mental health problems and family health problems, endorse the connection between direct experience with illness and empathy. Health care trainees' own illness experiences may increase compassionate patient care practices and foster empathy. Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

[Somatoform vertigo syndromes].

PubMed

Feuerecker, R; Dieterich, M; Eckhardt-Henn, A; Becker-Bense, S

2015-03-01

About 30 % of patients presenting to general practitioners complain of episodic or chronic vertigo or dizziness symptoms mostly with substantial impact on their daily living and activities. 30 to 50 % of the dizziness disorders are organically not sufficiently explained and are caused by mental or psychosomatic diseases. Somatoform dizziness syndromes can occur without a preceding vestibular disorder (e. g., primary somatoform dizziness) or they can develop in consequence of an organic vestibular disorder (secondary somatoform dizziness). However, it often takes months or even years until the correct diagnosis is made and an appropriate psychosomatic therapy can be initiated. Therefore, it is essential for the course of the disease that at an early stage not only careful interdisciplinary organic but also psychosomatic diagnostics are applied. © Georg Thieme Verlag KG Stuttgart · New York.

Electronic Support Groups: An Open Line of Communication in Contested Illness.

PubMed

Murphy, Michael; Kontos, Nicholas; Freudenreich, Oliver

Patients with functional somatic syndromes are often difficult to treat. The relationship between doctors and patients can be strained, which limits communication. Instead, patients often communicate with each other over the Internet in electronic support groups. This perspective summarizes studies of patient-to-patient communication over the Internet and uses the concept of contested illness to provide insights into the experiences of patients with functional somatic disorders. Conflict between a patient and their physician is a key feature of functional somatic syndromes. Physicians and patients do not have a shared understanding or appreciation of the patient's experiences. Patients with functional somatic syndromes often value their own embodied experience over medical knowledge. At the same time, they remain deeply invested in finding a "good doctor" who believes that the patient is suffering, agrees with their conception of the cause, and assents to the treatment as directed by the patient. Electronic support groups reinforce these beliefs. Patients may benefit from a compromising, collaborative approach that is realistic about the limitations of medical knowledge. However, physicians should not engage in unsafe treatment practices. Electronic support groups exist for a wide range of illnesses and the issues that rise to the surface in functional somatic syndromes likely occur to some extent with almost every patient. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Mechanisms in Chronic Multisymptom Illnesses

DTIC Science & Technology

2006-06-01

Psychiatry 2003;160:374–6. NEURAL ACTIVATIONS IN DEPRESSION AND CHRONIC PAIN 1583 21. Wolfe F, Ross K, Anderson J, Russell IJ. Aspects of fibromyalgia in...consequences in chronic musculoskeletal pain: a state of the art. Pain 2000;85:317–332.) S. A. MCLEAN et al. 784 Psychosomatic Medicine 67:783–790 (2005) tain...Report of the Moss International Working Group on medico-legal aspects of chronic widespread musculoskeletal pain complaints and fibromyal- gia. Scand

The relation of vocal fold lesions and voice quality to voice handicap and psychosomatic well-being.

PubMed

Smits, R; Marres, H; de Jong, Felix

2012-07-01

Voice disorders have a multifactorial genesis and may be present in various ways. They can cause a significant communication handicap and impaired quality of life. To assess the effect of vocal fold lesions and voice quality on voice handicap and psychosomatic well-being. Female patients, aged 18-65 years, who were referred to the outpatient clinic with voice problems were subsequently assessed. Laryngostroboscopic examination and acoustic voice analysis were carried out, and the patients were asked to fill in the Voice Handicap Index (VHI) and Symptom Check List-90 questionnaires. Eighty-two patients were included. In 43 patients (52.4%), a vocal fold lesion was observed. The VHI and psychosomatic well-being did not differ significantly between patients with and without a vocal fold lesion. The patients with a vocal fold lesion showed lower scores on the Dysphonia Severity Index (DSI) compared with those without a vocal fold lesion. However, the DSI was not correlated with voice handicap and psychosomatic well-being, except for the VHI physical subscale. Objective measurement does not necessarily correlate with the subjective appraisal of the patient's voice handicap and psychosomatic well-being. Furthermore, the criterion of the presence of a vocal fold lesion as the base of indemnity that is applied by health insurance institutions should be questioned. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

[Guideline-oriented inpatient psychiatric psychotherapeutic/psychosomatic treatment of anxiety disorders : How many personnel are need?].

PubMed

Bandelow, B; Lueken, U; Wolff, J; Godemann, F; Menzler, C W; Deckert, J; Ströhle, A; Beutel, M; Wiltink, J; Domschke, K; Berger, M

2016-03-01

The reimbursement of inpatient psychiatric psychotherapeutic/psychosomatic hospital treatment in Germany is regulated by the German personnel ordinance for psychiatric hospitals (Psych-PV), which has remained unchanged since 1991. The aim of this article was to estimate the personnel requirements for guideline-adherent psychiatric psychotherapeutic hospital treatment. A normative concept for the required psychotherapeutic "dose" for anxiety disorders was determined based on a literature review. The required staffing contingent was compared to the resources provided by the Psych-PV based on category A1. According to the German policy guidelines for outpatient psychotherapy, a quota of 25 sessions of 50 min each (as a rule plus 5 probatory sessions) is reimbursed. This approach is supported by studies on dose-response relationships. As patients undergoing inpatient treatment for anxiety disorders are usually more severely ill than outpatients, a contingent of 30 sessions for the average treatment duration of 5 weeks seems appropriate in order to fully exploit the costly inpatient treatment time (300 min per patient and week). In contrast, only 70 min are reimbursed according to the Psych-PV. The total personnel requirement for the normative concept is 624 min per patient and week. The Psych-PV only covers 488 min (78 %). Currently, the time contingents for evidence-based psychiatric psychotherapeutic/psychosomatic hospital care are nowhere near sufficient. In the development of future reimbursement systems this needs to be corrected.

Group supervision for healthcare professionals within primary care for patients with psychosomatic health problems: a pilot intervention study.

PubMed

Bullington, Jennifer; Cronqvist, Agneta

2018-03-01

In primary health care, efficacious treatment strategies are lacking for these patients, although the most prominent symptoms accounting for consultation in primary care often cannot be related to any biological causes. The aim was to explore whether group supervision from a specific phenomenological theory of psychosomatics could provide healthcare professionals treating patients with psychosomatic health issues within primary care a deeper understanding of these conditions and stimulate profession-specific treatment strategies. Our research questions were as follows: (i) What is the healthcare professionals' understanding of psychosomatics before and after the intervention? (ii) What are the treatment strategies for this group of patients before and after the intervention? The study was an explorative qualitative intervention pilot study. The six participants from a primary healthcare setting in a medium-sized city in Sweden participated in the study. A supervision group was formed, based on a mix of professions, age, gender and years of clinical experience. Supervision consisted of one 75-minutes meeting every month during the course of 6 months. Participants were interviewed before and after the supervision intervention. The study showed two distinct categories emerged from the data. One category of healthcare professionals espoused a psycho-educative approach, while the other lacked a cohesive approach. The supervision improved the second category of healthcare professionals' understanding of psychosomatics. The psycho-educative group did not change their understanding of psychosomatics, although they felt strengthened in their approach by the supervision. Profession-specific strategies were not developed. This pilot study indicates that a relatively short supervision intervention can aid clinicians in their clinical encounters with these patients; however, further research is necessary to ascertain the value of the specific phenomenologically based supervision intervention. © 2017 Nordic College of Caring Science.

'Actual neurosis' and psychosomatic medicine: the vicissitudes of an enigmatic concept.

PubMed

Hartocollis, Peter

2002-12-01

Out of the concept of neurasthenia, the main non-psychotic diagnosis of nineteenth-century psychiatry besides hysteria, and on the basis of psychophysiological problems of his own, self-diagnosed as neurasthenia, Freud developed the notion of 'actual neurosis', a 'contentless psychic state' manifested by various somatic symptoms and a depressive mood, which he attributed to a chemical factor associated with aberrant sexual practices and in particular masturbation. Rejected by post-Freudian analysts as such along with the diagnosis of neurasthenia, the concept of 'actual neurosis' has survived under various theoretical schemes that seek to explain psychosomatic illness and somatisation, in general, with its concomitant poverty of affects and dearth of fantasy life. In more recent years, the concept of 'actual neurosis' has resurfaced under the label of chronic fatigue syndrome, a medical entity thought to be an immunological deficiency, while in psychoanalysis Freud's idea of a contentless mental state has been replaced by that of unconscious fantasy and symbolisation at a pre-genital or pre-verbal level.

Bullying among school children: prevalence and association with common symptoms in childhood.

PubMed

Ramya, S G; Kulkarni, Mulrlidhar L

2011-03-01

To estimate the prevalence of bullying among girls and boys in school and examine its association with psychological and psychosomatic symptoms. 500 students aged between 8-14 yrs from 5 randomly selected schools as well as their parents and teachers were interviewed using a pretested questionnaire. Bullying was reported by 302(60.4%) of the 500 children interviewed. Bullying was seen to be more prevalent among boys than girls, the commonest forms being calling names and making fun of one's looks. Physical abuse was reported by 38 students. Only 65 (39%) parents knew that their children were being bullied. Bullied children were more likely to report symptoms such as headache, loose motions, fever and depression. Teachers were found to be ignorant of the whole issue. Bullying is a major problem among school children. Bullied children complained of psychosomatic symptoms which are potentially harmful for development. Teachers must be adequately trained to tackle this problem. Pediatricians should always consider bullying as a causative agent for illness and plan for appropriate interventions.

Insights into Chronic Functional Movement Disorders: The Value of Qualitative Psychiatric Interviews.

PubMed

Epstein, Steven A; Maurer, Carine W; LaFaver, Kathrin; Ameli, Rezvan; Sinclair, Stephen; Hallett, Mark

Patients with functional movement disorders (FMDs) are commonly seen by neurologists and psychosomatic medicine psychiatrists. Research literature provides scant information about the subjective experiences of individuals with this often chronic problem. To enhance our understanding of psychologic aspects of FMDs by conducting qualitative interviews of research subjects. In total, 36 patients with FMDs were recruited from the Human Motor Control clinic at the National Institutes of Health. Each subject participated in a qualitative psychiatric interview and a structured diagnostic psychiatric interview. Of our 36 subjects, 28 had current or lifetime psychiatric disorders in addition to conversion disorder and 22 had current disorders. Qualitative interviews provided rich information on patients' understanding of their illnesses and impaired cognitive processing of emotions. Our study supports the addition of open-ended qualitative interviews to delineate emotional dynamics and conceptual frameworks among such patients. Exploratory interviews generate enhanced understanding of such complex patients, above and beyond that gained by assessing DSM diagnostic comorbidities. Copyright © 2016 The Academy of Psychosomatic Medicine. All rights reserved.

Dreams of death: Von Weizsäcker's Dreams in so-called endogenic anorexia: a research note.

PubMed

Jackson, C; Beumont, P J; Thornton, C; Lennerts, W

1993-04-01

Viktor Von Weizsäcker's paper "Dreams in so-called endogenic Magersucht (anorexia," first published in the Deutsche Medizinische Wochenschrift in 1937 (translation in M. Kaufman & M. Heiman [1964]. Evolution of psychosomatic concepts: Anorexia nervosa: A paradigm (pp. 181-197), New York: International Universities Press, has been described as a noteworthy and historically important contribution to the recognition of anorexia nervosa as a psychosomatic illness. Von Weizsäcker analyzed the dreams of patients he was treating for "endogenous anorexia" (magersucht). He claimed that in the bulimic phase his patients experienced nightmares dealing with themes of death, but that in the anorectic phases of restricted eating more pleasant dreams dealt with themes of blissful contentment. The authors draw current attention to his work as another early example of the treatment of the theme of death and death symbolism in the literature on eating disorders, and suggest some reappraisal of von Weizsäcker's interpretations of his own material.

Teachers' Health.

PubMed

Scheuch, Klaus; Haufe, Eva; Seibt, Reingard

2015-05-15

Almost 800,000 teachers were working in Germany in the 2012-13 school year. A determination of the most common medical problems in this large occupational group serves as the basis for measures that help maintain teachers' health and their ability to work in their profession. We present our own research findings, a selective review of the literature, and data derived from the German statutory health insurance scheme concerning medical disability, long-term illness, and inability to work among teachers. Compared to the general population, teachers have a more healthful lifestyle and a lower frequency of cardiovascular risk factors (except hypertension). Like non-teachers, they commonly suffer from musculoskeletal and cardiovascular diseases. Mental and psychosomatic diseases are more common in teachers than in non-teachers, as are nonspecific complaints such as exhaustion, fatigue, headache, and tension. It is commonly said that 3-5% of teachers suffer from "burnout," but reliable data on this topic are lacking, among other reasons because the term has no standard definition. The percentage of teachers on sick leave is generally lower than the overall percentage among statutory insurees; it is higher in the former East Germany than in the former West Germany. The number of teachers taking early retirement because of illness has steadily declined from over 60% in 2001 and currently stands at 19%, with an average age of 58 years, among tenured teachers taking early retirement. The main reasons for early retirement are mental and psychosomatic illnesses, which together account for 32-50% of cases. Although German law mandates the medical care of persons in the teaching professions by occupational physicians, this requirement is implemented to varying extents in the different German federal states. Teachers need qualified, interdisciplinary occupational health care with the involvement of their treating physicians.

Specificity revisited and updated.

PubMed

Paulley, J W

1991-01-01

Typicality is probably a better representation of Alexander, Dunbar and others' conclusions than specificity, which was always too absolute a term. As such it became a valid cause of objection by opponents. No genuine attempts to repeat the original studies have been made and most of the original opposition to the concept is now acknowledged as invalid. Typicality (specificity) in psychosomatic disorders appears to be conferred by coping mechanisms acquired through interaction with mother and early surrogates in infancy and childhood as a means of reducing tensions and restoration of homeostatic emotional equilibrium. Psychosomatic medicine patients share one such mechanism, notably superstability/alexythymia, but contained within it are coping mechanisms typical for differing disorders. Examples are listed, and also mention of typicality of recurrently provocative life events/situations. Until typicality is appreciated, taught, learned and practised, success in management of psychosomatic disorders will be limited. The current bio-psycho-social approach is too imprecise.

[Psychosocial aspects of the change of life].

PubMed

Buddeberg, C

2000-10-01

In organ medicine the climacteric woman is frequently characterised by terms indicating a defect. The lack of hormones is viewed as an illness that requires treatment. The trend towards medicalizing the menopausal and postmenopausal years conflicts strongly with recent findings in psychosomatic research. Prospective studies show that pre- and postmenopausal complaints are considerably less severe than often described. Menopause represents a phase in life with an increased psychosocial vulnerability. This increased vulnerability and lowered resilience should be taken into account when treating menopausal women.

[Perspectives of psychoanalytic psychosomatics].

PubMed

Küchenhoff, J

2001-01-01

The paper discusses a variety of perspectives of psychoanalytic psychosomatics in the past, the present and the future. An epigenetic model of scientific development is introduced and developmental strains in psychosomatic medicine are evaluated according to the claims of the bio-psycho-social model. In historical terms, the psychological dimension of psychoanalytic psychosomatics has been the first strain to be elaborated; it is being extended still. The biological, somatic and bodily dimension of psychosomatic medicine was the next to be explored; during the last decade, this strain has found increasing interest, especially neurobiological research. Though the social dimension has not been neglected, it will be the main task for psychoanalytic psychosomatics to consider in the future. Likewise, a mandatory future challenge will be a more intensive discussion of the epistemological basis of psychosomatic medicine and psychoanalytic psychosomatics. The historical development of psychosomatic medicine is highlighted by examples drawn mainly from the history of Heidelberg Psychosomatic University Clinic that has its 50th anniversary in 2000.

[Psychosomatics in gastroenterology - statement of the Work Group for Psychosomatics in Gastroenterology of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS)].

PubMed

Auer, Peter Gunther; Enck, Paul; Häuser, Winfried; Stengel, Andreas; Storr, Martin; Langhorst, Jost

2018-06-01

The Association Psychosomatics in Gastroenterology of the DGVS aims to sharpen the profile of psychosomatic proportions in diagnostics, differential diagnostics and therapy of gastroenterological diseases, increasingly establish psychosomatic aspects in further education and clinical practice guidelines, deepen the cooperation with psychosomatic societies and strengthen the job satisfaction and mental health of gastroenterologists in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

The Art and Science of Learning, Teaching, and Delivering Feedback in Psychosomatic Medicine.

PubMed

Lokko, Hermioni N; Gatchel, Jennifer R; Becker, Madeleine A; Stern, Theodore A

2016-01-01

The teaching and learning of psychosomatic medicine has evolved with the better understanding of effective teaching methods and feedback delivery in medicine and psychiatry. We sought to review the variety of teaching methods used in psychosomatic medicine, to present principles of adult learning (and how these theories can be applied to students of psychosomatic medicine), and to discuss the role of effective feedback delivery in the process of teaching and learning psychosomatic medicine. In addition to drawing on the clinical and teaching experiences of the authors of the paper, we reviewed the literature on teaching methods, adult learning theories, and effective feedback delivery methods in medicine to draw parallels for psychosomatic medicine education. We provide a review of teaching methods that have been employed to teach psychosomatic medicine over the past few decades. We outline examples of educational methods using the affective, behavioral, and cognitive domains. We provide examples of learning styles together with the principles of adult learning theory and how they can be applied to psychosomatic medicine learners. We discuss barriers to feedback delivery and offer suggestions as to how to give feedback to trainees on a psychosomatic medicine service. The art of teaching psychosomatic medicine is dynamic and will continue to evolve with advances in the field. Psychosomatic medicine educators must familiarize themselves with learning domains, learning styles, and principles of adult learning in order to be impactful. Effective feedback delivery methods are critical to fostering a robust learning environment for psychosomatic medicine. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Consultation-Liaison Psychiatry Literature Database (2003 update). Part I: Consultation - Liaison Literature Database: 2003 update and national lists.

PubMed

Strain, James J; Strain, Jay J; Mustafa, Shawkat; Flores, Luis Ruiz Guillermo; Smith, Graeme; Mayou, Richard; Carvalho, Serafim; Chiu, Niem Mu; Zimmermann, Paulo; Fragras, Renerio; Lyons, John; Tsopolis, Nicholas; Malt, Ulrik

2003-01-01

Every day there are 10,000 scientific articles published. Since the Consultation-Liaison ("C-L") psychiatrist may be asked to consult on a patient with any medical illness, e.g., severe acute respiratory syndrome (SARS), malaria, cancer, stroke, amytrophic, lateral sclerosis, and a patient who may be on any medical drug, methods need to be developed to review the recent literature and have an awareness of key and essential current findings. At the same time, teachers need to develop a current listing of seminal papers for trainees and practitioners of this newest cross-over subspecialty of psychiatry-now called Psychosomatic Medicine. Experts selected because of their writings and acknowledged contributions to a specific clinical area or problem hope examined thousands of citations to choose those articles, chapters, books, or letters that they regard as most important to Psychosomatic Medicine. In addition, psychiatric specialists in six countries have provided their national Psychosomatic Medicine (Consultation-Liaison) lists as examples of what they regard as the most important teaching materials journals: Australia, Brazil, Greece, Mexico, Portugal, and Taiwan. It is our belief that a cogent, international, systematic review will provide the greatest success in creating a "regionally appropriate" teaching and consultation literature database with world-wide applicability. We review our current progress on this literature database and software, the technical system and data organization involved, the approach used to populate the literature system, and ongoing development plans to bring this system to the physician via mobile technologies.

[How is burnout treated? Treatment approaches between wellness, job-related prevention of stress, psychotherapy, and social criticism].

PubMed

Hillert, A

2012-02-01

The subjective illness burnout is often described as the combination of workload-related suffering and job dissatisfaction, thus, leading to depressive symptoms. Burnout is a serious model of personal illness perception, but not useful as a diagnosis term because of its lack of specification and reliability. In this respect, burnout therapy cannot be regarded as a specific form of psychotherapy or any other form of therapy, but rather a pragmatic procedure focusing on the burnout clients' needs. When applying scientific standards, the evidence of a more or less specific anti-burnout effect of such procedures involving relaxation, wellness, alternative medical approaches, and psychotherapy are between weak and non-existent. From a conceptual point of view, strategies focusing on relaxation and symptom-reduction can be distinguished from prospective, job-related stress management efforts. In clinical psychotherapeutic settings, aspects of both are usually combined in programs claimed to be integrative or holistic. However, whether these programs really enhance the individual therapeutic outcome has yet to be proved in controlled clinical trials. The efficacy of preventive anti-stress programs and of job-related therapeutic groups, offered complementary to common therapeutic programs in psychosomatic hospitals, have been demonstrated in several studies. Therapeutic information focusing on side effects of social and work-related changes on an individual's psychosomatic wellbeing are needed. The prominent term burnout may be helpful in the public discussion but is not useful in the conceptual framework of a rational, scientific-based procedure in this field.

Terror Weapons: The British Experience of Gas and Its Treatment in the First World War

PubMed Central

Jones, Edgar

2016-01-01

Chemical weapons accounted for only 1 per cent of the 750,000 British troops killed in the First World War and yet caused disproportionate casualties (estimated at 180,100). The considerable investment in the development of new toxins and methods of delivery was designed to maintain the elements of surprise and uncertainty as these accentuated their psychological effect. Soldiers were continually challenged on the battlefield by combinations of different types of agent designed to undermine their confidence in respirators, disorientate them, and erode their morale. At first, army doctors practised defensive medicine, invaliding their patients for protracted periods to the UK or base hospitals. By 1917, progressive study of the physical and psychological effects of different types of toxin allowed physicians to design new management strategies. Borrowing ideas from shell shock, specialist units were set up closer to the front line and medical officers taught to identify crucial points in the course of illness to accelerate recovery times and forestall the accretion of psychosomatic symptoms. PMID:27917027

Terror Weapons: The British Experience of Gas and Its Treatment in the First World War.

PubMed

Jones, Edgar

2014-07-01

Chemical weapons accounted for only 1 per cent of the 750,000 British troops killed in the First World War and yet caused disproportionate casualties (estimated at 180,100). The considerable investment in the development of new toxins and methods of delivery was designed to maintain the elements of surprise and uncertainty as these accentuated their psychological effect. Soldiers were continually challenged on the battlefield by combinations of different types of agent designed to undermine their confidence in respirators, disorientate them, and erode their morale. At first, army doctors practised defensive medicine, invaliding their patients for protracted periods to the UK or base hospitals. By 1917, progressive study of the physical and psychological effects of different types of toxin allowed physicians to design new management strategies. Borrowing ideas from shell shock, specialist units were set up closer to the front line and medical officers taught to identify crucial points in the course of illness to accelerate recovery times and forestall the accretion of psychosomatic symptoms.

[The state of outpatient psychotherapy in Germany].

PubMed

Zepf, Siegfried; Mengele, Ute; Hartmann, Sebastian

2003-01-01

This paper presents the results of a study of the state of adult outpatient psychotherapy in Germany after the PTG came into force. 1042 psychotherapists were questioned on certain issues. One result was that patients have to wait 4.6 months for psychotherapy and that every second patient asking for a diagnostic interview and possible treatment was refused. Of those who were given a diagnostic interview 35 % were not taken into treatment, although disturbances were diagnosed--such as tinnitus, pain, organic disturbances with psychic complications, suicidal tendencies, anorexia nervosa, addiction, psychosomatic illnesses, personality disorders, psychotic disorders--would normally demand psychotherapeutic treatment. Furthermore only 56 % of those patients who Löcherbach et al. considered needing and wanting psychotherapeutic treatment were actually in a G IV psychotherapy. Apart from this the possibility of getting psychotherapy as well as the kind of psychotherapy proved to be dependent on the kind of medical insurance. Different payments by the insurance companies caused longer waiting times for patients and determined the choice of psychotherapy by the psychotherapists.

A case of high noise sensitivity

NASA Astrophysics Data System (ADS)

Murata, M.; Sakamoto, H.

1995-10-01

A case of noise sensitivity with a five-year follow-up period is reported. The patient was a 34-year-old single man who was diagnosed as having psychosomatic disorder triggered by two stressful life events in rapid succession with secondary hypersensitivity to noise. Hypersensitivity to light and cold also developed later in the clinical course. The auditory threshold was within the normal range. The discomfort threshold as a measure of the noise sensitivity secondary to mental illness was measured repeatedly using test tone of audiometry. The discomfort threshold varied depending upon his mental status, ranging from 40-50 dB in the comparatively poorer mental state to 70-95 dB in the relatively good mental state. The features of noise sensitivity, including that secondary to mental illness, are discussed.

[Institutional Prevalence and Context of Severe Sleep Disorders in Psychosomatic Rehabilitation].

PubMed

Linden, Michael

2015-07-01

In cases of burnout, chronic fatigue, depression, somatization, overtaxation, or impairment in wellbeing and work capacity, the cause can be sleep problems. Goal of the present study was to estimate the prevalence of sleep problems in psychosomatic inpatients. Included were 1325 unselected patients from a psychosomatic rehabilitation hospital. They filled in the SCL-90, the PSQI and were assessed in respect to their clinical, social and occupational status. At admission 13.4% of patients had a PSQI score of 5 at maximum (no sleep problem), 34.6% 6 to 10 (moderate sleep problem) und 52.1% over 10 (severe sleep problem). At discharge there was a reduction of sleep problems with 32.7% of patients over 10. Sleep problems were significantly associated with more severe mental problems, older age, women, lower socioeconomic status, and also incapacity to work or early retirement. Mental disorders can cause sleep problems and sleep problems mental disorders and incapacity to work, with a negative interaction. The high rate of severe sleep problems in rehabilitation patients shows that this problem is in need of special diagnostic and therapeutic attention. Also, the equipment of hospitals and the qualification of therapists should allow adequate care. © Georg Thieme Verlag KG Stuttgart · New York.

[Basic psychosomatic care in ophthalmology. Relevance, training and case examples].

PubMed

Brumm, G; Schnell, S

2016-02-01

The incidence of psychosomatic disorders and their impact on society are increasing. Many patients suffer from psychosomatic symptoms. Medical studies and most notably medical training for ophthalmologists do not sufficiently cover these topics and do not adequately prepare doctors for dealing with patients suffering from psychosomatic disorders. Training in basic psychosomatic care can be absolved by all physicians irrespective of specialization. The structure, benefits and importance of this professional training are explained. The curriculum of the German Medical Association forms the basis of training in basic psychosomatic care. The personal experiences of the authors after completing the training as well as case studies are presented. Training in basic psychosomatic care conveys practical skills for dealing with patients with psychosomatic symptoms, which are often not acquired during medical training for ophthalmologists, where technical procedures predominate. Thus the professional ability is broadened with an immediate positive effect not only on the physician-patient relationship but also on the professional and private environment. Training in basic psychosomatic care should be obligatory in the specialist training of ophthalmologists.

[Urology and Psychosomatics. A historical summary].

PubMed

Bernardy, Katrin; Köllner, V

2004-03-01

The investigation and description of psychosomatic interrelationships has a long tradition in the field of urology. At the beginning of last century, psychosomatic theories and therapies involving urologic questions were developed, some of which are still part of current therapeutic strategies. Numerous studies accentuated the need for a psychosomatic diagnostics and therapy of urologic diseases. The appreciation of psychosomatic urology is growing, a fact which is reflected in current urological teaching curricula.

The moderating effects of gender on the associations between multidimensional hostility and psychosomatic symptoms: a Chinese case.

PubMed

Weng, Chia-Ying; Lin, I-Mei; Jiang, Ding-Yu

2010-08-01

The purpose of this study was to examine the effects of gender on the relationship between multidimensional hostility and psychosomatic symptoms in Chinese culture. The participants in this study were 398 Chinese college students (40% female) recruited from Taiwan. Four dimensions of multidimensional hostility-hostility cognition, hostility affect, expressive hostility behavior, and suppressive hostility behavior-were measured by the Chinese Hostility Inventory. After controlling for the effects of depression and anxiety, the results of path analysis revealed that the multidimensional hostility predicted psychosomatic symptoms directly, and predicted psychosomatic symptoms indirectly through negative health behavior. Furthermore, gender moderated the relationships between multidimensional hostility and health outcomes. Expressive hostility exacerbated psychosomatic symptom in females but buffered it in males, while affective hostility exacerbated psychosomatic symptoms in males. Additionally, suppressive hostility behavior was correlated to psychosomatic symptoms indirectly through negative health behavior in females. Moreover, expressive hostility was correlated to psychosomatic symptoms indirectly through negative health behavior more in males than in females.

Effects of medical training scenarios on heart rate variability and motivation in students and simulated patients.

PubMed

Rieber, Nicole; Betz, Lisa; Enck, Paul; Muth, Eric; Nikendei, Christoph; Schrauth, Markus; Werner, Anne; Kowalski, Axel; Zipfel, Stephan

2009-06-01

Research regarding the experience of stress during medical training scenarios using standardised patients (SPs) has been primarily qualitative and has focused on the SPs. The purpose of this study was to quantitatively evaluate stress and motivation in both students and SPs during these scenarios by measuring heart rate variability (HRV) and administering the German version of the Questionnaire on Current Motivation (QCM). A total of 44 medical students (23 women, 21 men) participated in two medical history-taking training scenarios. In one scenario the SP role-played a patient with a somatic disease; in the other the SP played a patient with a psychosomatic disease, creating easy and difficult scenarios, respectively, for the student. Each student interviewed one of 11 SPs (five women, six men), using the same SP in both scenarios. Heart rate variability was measured during baseline periods and during the training scenarios in both students and SPs. Motivation was assessed before each training scenario. Heart rate variability was lower in both students and SPs during the scenarios compared with baseline values, but did not differ by scenario type. For students, motivation increased when the first scenario involved psychosomatic illness, but decreased when the first condition was somatic. For SPs motivation was consistent over time for scenarios involving psychosomatic disease, but decreased for somatic disease-related scenarios. The training scenarios induced stress in both students and SPs, as indicated by decreased HRV. Student motivation was high, indicating that SP scenarios represent a valid teaching method. Further studies in the natural setting of SP examinations are needed.

[Psychology and psychosomatics of the orthodontic treatment].

PubMed

Fábián, Gábor; Bálint, Mária; Fábían, Tibor Károly

2005-06-01

Psychosomatic problems related to orthodontic treatment are a special group of oral psychosomatic disorders. The most frequent complaints are related to aesthetics and occlusion. Most of the patients are children, adolescence or young adults, with special emotional problems. Authors reviewed the most important knowledge related to this specific field, but some general aspects of oral psychosomatics are also discussed.

Dysfunctional beliefs about symptoms and illness in patients with hypochondriasis.

PubMed

Weck, Florian; Neng, Julia M B; Richtberg, Samantha; Stangier, Ulrich

2012-01-01

The cognitive model and empirical research underline the importance of dysfunctional beliefs about bodily symptoms and illness in health anxiety and hypochondriasis. However, specificity of such beliefs has not yet been adequately demonstrated for patients with hypochondriasis. This study examined whether dysfunctional beliefs about bodily symptoms and illness are elevated in comparison to patients with anxiety disorders and, therefore, specific for patients with hypochondriasis. Patients with hypochondriasis (n = 38), patients with anxiety disorders (n = 40), and healthy controls (n = 42) completed the Symptom and Outcomes Scale (SOS) measuring participants' estimation of the likelihood of various symptoms being indicative of a particular illness. Additionally, participants' general psychopathology (Brief Symptom Inventory), depressive (Beck Depression Inventory-II), and anxiety symptoms (Beck Anxiety Inventory) were evaluated. In comparison to patients with anxiety disorders and healthy controls, patients with hypochondriasis estimated bodily symptoms to be more likely an indicator for a catastrophic illness. Patients with anxiety disorders took a middle position between patients with hypochondriasis and healthy controls. Regarding the estimation of the likelihood of symptoms indicating a minor illness, no differences were found between the three groups. Dysfunctional beliefs about symptoms and illness are important and specific for patients with hypochondriasis, which is in line with the cognitive model. In order to reduce misinformation about serious illnesses in patients with hypochondriasis, more attention should be paid to psychoeducational strategies. Copyright © 2012 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Burnout, psychosomatic symptoms and job satisfaction among Dutch nurse anaesthetists: a survey.

PubMed

Meeusen, V; VAN Dam, K; Brown-Mahoney, C; VAN Zundert, A; Knape, H

2010-05-01

To meet the increasing demand for healthcare providers, it is crucial to recruit and retain more nurse anaesthetists (NAs). The majority of NAs in the Netherlands are >45 years old, and retaining them in their jobs is very important. This study investigates the relationships among burnout, physical health and job satisfaction among Dutch NAs. Two thousand NAs working in Dutch hospitals were invited to participate in this online questionnaire. We tested the relationships among burnout, psychosomatic symptoms, sickness absence, perceived general health and job satisfaction. Nine hundred and twenty-three questionnaires were completed and analysed (46% response rate). Burnout and psychosomatic symptoms were negatively associated with job satisfaction, and predicted 27% of job satisfaction. Perceived general health was positively and sickness absence was negatively related to job satisfaction. Older NAs had a higher incidence of burnout than their younger counterparts. The results confirmed the importance of a healthy psychosocial work environment for promoting job satisfaction. To prevent burnout, further research is necessary to determine the factors causing stress. These findings may also apply to anaesthesiologists who share many tasks and work in close cooperation with NAs.

Translation and validation of Portuguese of a questionnaire for evaluation of psychosomatic symptoms in adults with atopic dermatitis*

PubMed Central

Boleira, Manuela; Lupi, Omar; Pires, Gisele Vianna; Dias, Gabriela; Seba, Amanda Jaccobson; Guimarães, Daniel Boleira Sieiro

2014-01-01

BACKGROUND atopic dermatitis is directly related to psychological stress, reduced quality of life and psychosomatic symptoms. The Psychosomatic Scale for Atopic Dermatitis is the only questionnaire developed specifically for assessment of psychosomatization in atopic dermatitis. OBJECTIVES the objective of this study was to cross-culturally adapt and validate a Brazilian-Portuguese version of the Psychosomatic Scale for Atopic Dermatitis. METHODS adaptation consisted of independent translation and backtranslation by three bilingual translators, followed by a pre-test. The Psychosomatic Scale for Atopic Dermatitis and the Dermatology Life Quality Index were self-administered to 47 patients with atopic dermatitis. Disease severity was evaluated using the Eczema Area and Severity Index. Factor analysis was used to identify the dimensions of the Brazilian Portuguese version of the Psychosomatic Scale for Atopic Dermatitis. Internal consistency and convergence validity were also analyzed. Reproducibility was assessed using the Kappa coefficient. RESULTS factor analysis revealed a two-dimensional structure: stress/laziness/insecurity (I) and maladjustment/social relationships (II), explaining 54.4% of total variance. All dimensions revealed excellent internal consistency. External construct validity was confirmed by positive correlations between the Psychosomatic Scale for Atopic Dermatitis and the Dermatology Life Quality Index. Test-retest reliability was excellent, with k>0.7 for all questions. CONCLUSIONS the Brazilian Portuguese version of the Psychosomatic Scale for Atopic Dermatitis demonstrated acceptable psychometric properties and can be used for the evaluation of psychosomatic symptoms in patients with atopic dermatitis and as a tool in clinical and epidemiological research. PMID:25184916

Past, Present, and Future of Psychosomatic Movements in an Ever-Changing World: Presidential Address.

PubMed

Herrmann-Lingen, Christoph

The American Psychosomatic Society was founded in 1942 and is celebrating its 75th anniversary in 2017. In recognizing the society's anniversary, this article provides a historical perspective on its history, the field of psychosomatic medicine in general, and anticipated future directions. Essay and narrative review of the literature on the historic development of psychosomatic concepts and their impact on medicine over time. Mind-body associations have been described in the medical literature for more than 3500 years. Early concepts of mind-body dualism and attempts to overcome them are found in classical Greek medicine. Psychosomatic thinking can be observed ever since, but only in the 20th century, a "psychosomatic movement" emerged in Europe and North America, aiming at humanizing medicine by introducing a holistic understanding of man into what was considered a widely reductionistic practice of medicine. This movement led to the inauguration of the American Psychosomatic Society during World War II and of national and international societies of psychosomatic medicine and its subspecializations thereafter. Psychosomatic medicine has its roots in the beginnings of medicine. During the past 75 years, it has made substantial contributions to the science and practice of medicine. The field has also changed in response to developments in medicine, technology, and society and is facing new challenges and opportunities that may require further adaptation of its concepts and practice.

[Culture sensitive analysis of psychosomatic complaints in migrants in Germany].

PubMed

Bermejo, Isaac; Nicolaus, Leonhard; Kriston, Levente; Hölzel, Lars; Härter, Martin

2012-05-01

To ensure an adequate health care of migrants, differentiated information on the association of cultural background and migration related factors and psychosomatic complaints are necessary. Cross-sectional questionnaire based survey regarding psychosomatic complaints of migrants from Turkey (n = 77), Italy (n = 95), and Spain (n = 67) and ethnic German resettled from the states of the former Soviet Union (n = 196). Questionnaires distributed by non-health specific counselling agencies of welfare associations. The cultural background was a relevant factor for psychosomatic complaints, showing higher complaints in Turkish and ethnic German resettled migrants, also compared to a sample of age corresponding Germans. In contrast, Spanish and Italian migrants showed a lower risk for psychosomatic complaints. Also gender, feeling unwell in Germany and fatalism showed a significant association with psychosomatic complaints. Migrants in Germany do not have per se a higher risk for psychosomatic complaints. A distinct differentiation by cultural background is necessary. © Georg Thieme Verlag KG Stuttgart · New York.

[Psychosomatics is "expensive"].

PubMed

Hnízdil, J; Savlík, J

2005-01-01

Experience shoves that number of diseases where recognition and treatment is without limits of classical medicine is rising, however it is fully within the competence of psychosomatic approach. It does not concern the classical classification into organic and functional defects, but it concerns the possibility of complex approach. The theorem of "diagnosis per exclusionem" is still valid, as well as it is true that the means of medicine end at its biological limitations. We consider stressing in our article that psychosomatic diseases or psychosomatic patients do not exist and psychosomatics is not and independent specialization. Psychosomatics is, as inseparable unity of psychic and somatic activities, each human being. Complex biopsychosocial (psychosomatic) approach is the way of thinking and work, which considers human in unrepeatable oneness and context of his life. It does not mean to underestimate objective biological findings and results of instrumentally investigation, but their implanting into the complex network of consequences of the patient's life in order to choose the most appropriate methods of the care of the individual in healthiness and disease.

[The new financial compensation system PEPP: an ethical analysis].

PubMed

Vollmann, J

2014-11-01

The new compensation system for psychiatric and psychosomatic institutions (German acronym: PEPP) not only constitutes a change in billing practices, but also necessitates an ethical investigation and analysis of possible consequences of the new legislation for those affected in practice. Following the presentation of the new PEPP and its consequences for psychiatric practice, problems and areas of conflict will be analyzed from an ethical perspective and discussed. Ethical conflicts exist in the following areas: (1) in the attempt to standardize inpatient care and invoicing for mental illnesses, (2) in poorer treatment for severely ill patients in view of degressive per diem rates, (3) in false incentives due to threshold values e.g. for 1:1 health professional-patient ratios in the case of coercive measures and (4) due to the inappropriate use of a supposed normative neutral quantitative economic model for a qualitative work area that often takes place in human border zones such as complex inpatient care of severely mentally ill patients. The ethical analysis of PEPP reveals that apart from the limited opportunities to improve efficiency, there is a considerable ethical risk of loss of quality in psychiatric inpatient care in particular for severely and chronically mentally ill patients.

Job satisfaction, job stress and psychosomatic health problems in software professionals in India

PubMed Central

Madhura, Sahukar; Subramanya, Pailoor; Balaram, Pradhan

2014-01-01

This questionnaire based study investigates correlation between job satisfaction, job stress and psychosomatic health in Indian software professionals. Also, examines how yoga practicing Indian software professionals cope up with stress and psychosomatic health problems. The sample consisted of yoga practicing and non-yoga practicing Indian software professionals working in India. The findings of this study have shown that there is significant correlation among job satisfaction, job stress and health. In Yoga practitioners job satisfaction is not significantly related to Psychosomatic health whereas in non-yoga group Psychosomatic Health symptoms showed significant relationship with Job satisfaction. PMID:25598623

[Drug abuse and eating disorders in women: symptoms of gender discomfort?

PubMed

Simões-Barbosa, Regina Helena; Dantas-Berger, Sônia Maria

2017-02-13

The article discusses drug abuse and eating disorders from the critical gender and healthcare perspectives, postulating that subjective suffering can be expressed in the body through psychosomatic illnesses. From this perspective, craving for drugs or superfluous consumer goods, just as illness from self-imposed hunger in pursuit of an ideal of slimness, as in anorexia and bulimia, can be symptoms that expose the woman's suffering. A review in the fields of public health and feminist theories highlights the magnitude of the phenomena of medicalization and commodification of health in the psychiatrization of female discomfort. In the gender transition in capitalist societies, social demands for the performance of old and new women's roles accentuate feelings of inadequacy, expressed as the gender discomfort permeating drug abuse and eating disorders, analyzed as diseases of protest. The study proposes to reclaim the ideals of the Program for Comprehensive Women's Healthcare to deal with such challenges.

Temperament and character profiles of patients with chronic idiopathic urticaria

PubMed Central

Canan, Fatih; Karakaş, Ayşe Akman; Geçici, Nihal

2015-01-01

Introduction Psychosocial factors have been implicated as being important in the onset and/or exacerbation of urticaria. Aim To examine both personality factors of patients with chronic idiopathic urticaria (CIU) and the correlations between illness duration, severity of itching, urticaria activity score (UAS) and temperament-character dimensions. Material and methods A total number of 70 CIU patients and 60 healthy individuals were included in the study. The Temperament and Character Inventory (TCI) was administered individually. The relationship between UAS, illness duration and severity of pruritus and TCI subscales were evaluated. Results The CIU group had significantly higher scores of novelty seeking and lower scores of cooperativeness, reward dependence and self-directedness than the control group. Conclusions The current study shows that CIU patients have distinctive temperament and character dimensions when compared with the control group. We suggest that evaluation and treatment of CIU should also include psychosomatic approaches in clinical practice. PMID:26161056

[Psychosomatic treatment of otorhinolaryngological diseases].

PubMed

Marek, A

2009-11-01

The spectrum of psychosomatic diseases in the field of otorhinolaryngology covers reactive disorders brought on by excessive psychosocial demands, post-traumatic disorders following mental traumatization, purely psychological disorders brought on by personality development deficits or learnt false behavior, and multifactorial diseases with somatic correlatives and mental triggers. Psychosomatic medicine describes the interaction of physical and psychological processes. The central treatment method is psychotherapy. In Germany, the costs of psychodynamic psychotherapies and behavioral therapy are covered by the health insurance companies. The tasks of psychosomatic treatment in the field of otorhinolaryngology comprise differential diagnostics, basic psychosomatic treatment and the determination of differential indications for the respective forms of psychotherapy.

Lifestyles and psychosomatic symptoms among elementary school students and junior high school students.

PubMed

Isshiki, Yuriko; Morimoto, Kanehisa

2004-05-01

To examine the relationship between lifestyles and psychosomatic symptoms in children, we conducted a self-administered questionnaire survey of elementary school students and junior high school students in Japan. We designed an original questionnaire to investigate the lifestyles and psychosomatic symptoms of children. In 1997, responses to the questionnaires were elicited from public elementary school fourth grade students (then aged 9-10) and public junior high school seventh grade students (then aged 12-13). The survey was repeated annually for three years as the students advanced through school. For both boys and girls, each cross-sectional analysis revealed a strong relationship between lifestyle behaviors and psychosomatic symptoms. Psychosomatic, symptoms scores varied according to daily hours of sleep, eating of breakfast, having strong likes and dislikes of food, bowel habits, and daily hours of television watching. Both boys and girls with "good" lifestyle, behaviors evaluated by the HPI (Health Practice Index) showed lower scores for psychosomatic symptoms. These findings show that the lifestyle behaviors of children are significantly associated with psychosomatic symptoms and suggest that poor lifestyle behaviors are likely to increase physical and psychological health risks.

Association between psychosomatic symptoms and work stress among Taiwan police officers.

PubMed

Chueh, Ke-Hsin; Yen, Cheng-Fang; Lu, Luo; Yang, Mei-Sang

2011-04-01

The aim of the study was to explore the association between the severity of psychosomatic symptoms and perceived work stress among male police officers in southern Taiwan. By stratified random sampling, a total of 698 male police officers were recruited into this study (the response rate was 73.4%; 512 of 698). A structured self-administered questionnaire on demographic and working characteristics, the severity of psychosomatic symptoms, perceived work stress, and social support was used to collect data anonymously. The results of multiple regression analysis revealed that (1) the police officers who perceived high-work stress reported more severe psychosomatic symptoms than those who perceived low-work stress; and (2) perceived social support had a moderating effect on the association between severity of psychosomatic symptoms and perceived work stress. Perceived work stress is an indicator of psychosomatic symptoms in police officers. Strategies for reducing psychosomatic symptoms of police officers include police administrators taking into account the level of work stress as well as more attention being paid to the resources of social support. Copyright © 2011 Elsevier Taiwan LLC. All rights reserved.

From Evidence-based Medicine to Human-based Medicine in Psychosomatics.

PubMed

Musalek, Michael

2016-08-23

Human-based medicine (HbM), a form of psychiatry that focuses not only on fragments and constructs but on the whole person, no longer finds its theoretical basis in the positivism of the modern era, but rather owes its central maxims to the post-modernist ideal that ultimate truths or objectivity in identifying the final cause of illness remain hidden from us for theoretical reasons alone. Evidence-based medicine (EbM) and HbM are thus not mutually exclusive opposites; rather, despite superficial differences in methods of diagnosis and treatment, EbM must be integrated into HbM as an indispensable component of the latter. Probably the most important difference between EbM and HbM lies in the aims and methods of treatment. In HbM the goal is no longer simply to make illnesses disappear but rather to allow the patient to return to a life that is as autonomous and happy as possible. The human being with all his or her potential and limitations once again becomes the measure of all things. This also implies, however, that the multidimensional diagnostics of HbM are oriented not only towards symptoms, pathogenesis, process and understanding but also to a greater degree towards the patient's resources. Treatment options and forms of therapy do not put the disease construct at the centre of the diagnostic and therapeutic interest, but have as their primary aim the reopening of the possibility of a largely autonomous and joyful life for the patient.

Consultation-liaison psychiatry and psychosomatic medicine: the company they keep.

PubMed

Lipsitt, D R

2001-01-01

The objectives of this review are 1) to briefly describe the parallel historical developments of consultation-liaison (C-L) psychiatry and psychosomatic medicine [corrected]; 2) to analyze the extent to which the literature of C-L psychiatry and psychosomatic medicine relate to each other, given that both fields have evolved simultaneously in the history of psychiatry; and 3) to propose possible explanations for observed publication patterns in selected C-L resources and the journal Psychosomatic Medicine. The quasi-citation analysis includes two segments: 1) a review of selected key C-L psychiatry references to determine the extent to which classic articles from Psychosomatic Medicine are cited; and 2) an analysis of 60 years of Psychosomatic Medicine, sampling issues from the first 5 years of each decade and all issues of the year 2000 for articles of potential relevance to C-L psychiatry. References to Psychosomatic Medicine articles in C-L resources are tallied as percentages of total references in each source. Articles in Psychosomatic Medicine are assigned to one of three categories (A, B, or C) according to their perceived relevance to C-L psychiatry, from most (A) to least (C) relevant. The review of C-L sources ("basic" reading lists and reference lists of seminal articles and textbooks) revealed a wide range of Psychosomatic Medicine citations, from 0% to 27.4% (average, 7.5%). The survey of Psychosomatic Medicine sorted 1705 articles for their relevance to C-L psychiatry into category A (9.5-40.6%, average 21.3%), category B (70.4-86.3%, average 72.3%), and category C (0.7-12.1%, average 6.4%) for each half-decade for the past 60 years. The lowest number of category A articles appeared in the years 1970 to 1975, and the highest number appeared in 1950 to 1955; reciprocal results were found for category B articles. The lowest number of category C articles appeared in 1980 to 1985, and the highest number appeared in 1940 to 1945. For the six issues of 2000, the distributions of articles in categories A, B, and C are similar, continuing an upward trend beginning in 1975 of core (category A) articles. Explanations for publication patterns are speculatively related to various factors, such as a paucity of C-L research and researchers, the broad definition of C-L psychiatry, editorial policies, and the impact of World War II. Although C-L psychiatry and psychosomatic medicine have common roots, the reliance of the C-L literature on classic Psychosomatic Medicine articles has varied markedly, from none to about one-quarter of its references. Nevertheless, Psychosomatic Medicine has consistently published articles of theoretical and clinical interest to C-L psychiatrists, with more than 90% of published articles considered to be of high or moderate relevance to C-L psychiatry. A far higher percentage of articles in Psychosomatic Medicine would seem to be relevant to the field of C-L psychiatry than are cited in significant C-L literature. Psychosomatic Medicine's essential focus on empirical research may dissuade the more clinically oriented C-L psychiatrists.

[DGPPN compass of participation for vocational integration of persons with mental illnesses].

PubMed

Stengler, K; Rauschenbach, J; Riedel-Heller, S G; Becker, T; Steinhart, I; Gerlinger, G; Hauth, I

2016-11-01

Working and living for persons with mental illnesses are a major concern of rehabilitative psychiatry. In Germany the definition of rehabilitation for persons with mental illnesses is closely linked to different sectors of social welfare and to the strongly organized supply chain of prevention, acute treatment, rehabilitation and care. In successfully supporting people with mental health problems in terms of vocational integration, professionals face various obstacles. Besides finding the correct content, structural and organizational difficulties can also arise. The welfare system with its specific institutions and settings is complicated which often leads to delays in the onset of rehabilitation. Some essential reasons are insufficient knowledge about established options of rehabilitative treatment and about responsibilities related to participation in specialized training and further education for professional caregivers. Also information and (positive) experiences from pilot projects working in an inclusive, cross-sectional way and across different settings are practically unavailable in Germany. The presented compass of participation from the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) for vocational integration of persons with mental illnesses starts at this point: it provides guidelines for psychiatric and psychotherapeutic practitioners, general practitioners as well as for physicians working in residential or day care institutions with a psychiatric and psychotherapeutic background. Both the paper and planned online versions should help professionals to help people, particularly those with severe mental illnesses to navigate the system of services for vocational integration in Germany.

[Dissolving anxiety as an essential ingredient for any therapy].

PubMed

Radics, Judit

2014-06-01

Anxiety frequently develops in human life and it is usually useful for the organism. Anxiety helps accomodation to the social environment, however, it may be harmful when it is intensive and long-lasting. It can also cause psychosomatic diseases. Anxiety may present itself as mild or moderate stress, psychosomatic diseases or psychiatric disorders. In the general practice, about one third of the patients suffer from anxiety, but it is not easy to identify these patients because of the frequent somatic complaints which may cover anxiety symptoms. The prevalence of anxiety disorders is between 12.6% and 17.2% per year and, in a considerable proportion of patients, both anxiety and depression are present. Therapy of anxiety is complex including psychopharmacotherapy (antidepressants, anxiolytics, hypnotics), psychotherapy and life style changes.

Use of a Novel Visual Metaphor Measure (PRISM) to Evaluate School Children's Perceptions of Natural Hazards, Sources of Hazard Information, Hazard Mitigation Organizations, and the Effectiveness of Future Hazard Education Programs in Dominica, Eastern Caribbean

NASA Astrophysics Data System (ADS)

Parham, M.; Day, S. J.; Teeuw, R. M.; Solana, C.; Sensky, T.

2014-12-01

This project aims to study the development of understanding of natural hazards (and of hazard mitigation) from the age of 11 to the age of 15 in secondary school children from 5 geographically and socially different schools on Dominica, through repeated interviews with the students and their teachers. These interviews will be coupled with a structured course of hazard education in the Geography syllabus; the students not taking Geography will form a control group. To avoid distortion of our results arising from the developing verbalization and literacy skills of the students over the 5 years of the project, we have adapted the PRISM tool used in clinical practice to assess patient perceptions of illness and treatment (Buchi & Sensky, 1999). This novel measure is essentially non-verbal, and uses spatial positions of moveable markers ("object" markers) on a board, relative to a fixed marker that represents the subject's "self", as a visual metaphor for the importance of the object to the subject. The subjects also explain their reasons for placing the markers as they have, to provide additional qualitative information. The PRISM method thus produces data on the perceptions measured on the board that can be subjected to statistical analysis, and also succinct qualitative data about each subject. Our study will gather data on participants' perceptions of different natural hazards, different sources of information about these, and organizations or individuals to whom they would go for help in a disaster, and investigate how these vary with geographical and social factors. To illustrate the method, which is generalisable, we present results from our initial interviews of the cohort of 11 year olds whom we will follow through their secondary school education.Büchi, S., & Sensky, T. (1999). PRISM: Pictorial Representation of Illness and Self Measure: a brief nonverbal measure of illness impact and therapeutic aid in psychosomatic medicine. Psychosomatics, 40(4), 314-320.

Use of a Novel Visual Metaphor Measure (PRISM) to Evaluate School Children's Perceptions of Natural Hazards, Sources of Hazard Information, Hazard Mitigation Organizations, and the Effectiveness of Future Hazard Education Programs in Dominica, Eastern Car

NASA Astrophysics Data System (ADS)

Parham, Martin; Day, Simon; Teeuw, Richard; Solana, Carmen; Sensky, Tom

2015-04-01

This project aims to study the development of understanding of natural hazards (and of hazard mitigation) from the age of 11 to the age of 15 in secondary school children from 5 geographically and socially different schools on Dominica, through repeated interviews with the students and their teachers. These interviews will be coupled with a structured course of hazard education in the Geography syllabus; the students not taking Geography will form a control group. To avoid distortion of our results arising from the developing verbalization and literacy skills of the students over the 5 years of the project, we have adapted the PRISM tool used in clinical practice to assess patient perceptions of illness and treatment (Buchi & Sensky, 1999). This novel measure is essentially non-verbal, and uses spatial positions of moveable markers ("object" markers) on a board, relative to a fixed marker that represents the subject's "self", as a visual metaphor for the importance of the object to the subject. The subjects also explain their reasons for placing the markers as they have, to provide additional qualitative information. The PRISM method thus produces data on the perceptions measured on the board that can be subjected to statistical analysis, and also succinct qualitative data about each subject. Our study will gather data on participants' perceptions of different natural hazards, different sources of information about these, and organizations or individuals to whom they would go for help in a disaster, and investigate how these vary with geographical and social factors. To illustrate the method, which is generalisable, we present results from our initial interviews of the cohort of 11 year olds whom we will follow through their secondary school education. Büchi, S., & Sensky, T. (1999). PRISM: Pictorial Representation of Illness and Self Measure: a brief nonverbal measure of illness impact and therapeutic aid in psychosomatic medicine. Psychosomatics, 40(4), 314-320.

Psychosomatic Medicine: The Scientific Foundation of the Biopsychosocial Model

ERIC Educational Resources Information Center

Novack, Dennis H.; Cameron, Oliver; Epel, Elissa; Ader, Robert; Waldstein, Shari R.; Levenstein, Susan; Antoni, Michael H.; Wainer, Alicia Rojas

2007-01-01

Objective: This article presents major concepts and research findings from the field of psychosomatic medicine that the authors believe should be taught to all medical students. Method: The authors asked senior scholars involved in psychosomatic medicine to summarize key findings in their respective fields. Results: The authors provide an overview…

Physical Symptoms of Stress, Depression, and Suicidal Ideation in High School Students.

ERIC Educational Resources Information Center

Herman, Sandra L.; Lester, David

1994-01-01

Examined depression among 97 adolescents with and without psychosomatic stress symptoms and explored relationship between psychosomatic stress symptoms and preoccupation with suicide. Found that occurrence of minor physical symptoms of stress, but not major psychosomatic disorders, was associated with depression. Physical symptoms were not…

Psychosomatic Medicine: A New Psychiatric Subspecialty

ERIC Educational Resources Information Center

Gitlin, David F.; Levenson, James L.; Lyketsos, Constantine G.

2004-01-01

Objective: Psychosomatic medicine, also known as consultation-liaison psychiatry, received approval as a subspecialty field of psychiatry by the American Board of Medical Specialties in the spring of 2003. This represents a crucial step in the development of the field of psychosomatic medicine and recognition by leaders in the fields of medicine…

Mental status in patients with chronic bacterial prostatitis

PubMed Central

Banyra, Oleg; Ivanenko, Olha; Nikitin, Oleg

2013-01-01

Introduction Chronic prostatitis is a widespread urological disease with a lengthy course and a propensity to frequent recurrences. Adequate response to anti–inflammatory therapy is lacking in a high percentage of patients, which causes them to seek medical advice from different doctors. Thus, the physicians are challenged to look for other reasons causing the pathological symptoms. Material and methods We have reviewed the patients with treatment–resistant chronic bacterial prostatitis (CBP) from the perspective of psychosomatic medicine. For the evaluation of primary mental status and treatment control we used standard approved questionnaires. All 337 CBP patients initially underwent therapy aimed at pathogen eradication. If psychopathological symptoms were evident and dominated over urological ones, the patients were referred to psychiatric evaluation and treatment. Results The frequency of concomitant psychosomatic disorders (PSD) in patients with CBP was 28.2% and neurotic disorders – 26.4%. Adequate multimodal anti–inflammatory therapy followed by a few sessions of psychotherapy decreased the manifestations of PSD in 30.5%, neurotic disorders in 51.7%, and premature ejaculation in 60.5% of patients with CBP. The addition of pharmacotherapy to psychotherapy is effective in treatment–resistant cases. However, after multimodal treatment, 31.5% of pts. with PSD and 13.5% of pts. with neurotic disorders still remain treatment–resistant and required in–depth long–term psychiatric care. Conclusions A significant portion of CBP patients were diagnosed with neurotic, psychosomatic, and/or depressive disorders. Antibacterial and anti–inflammatory therapy, when followed by appropriate psychotherapy and pharmacotherapy, significantly decrease the manifestations of mental disorders in CBP patients. PMID:24579003

[The treatment needs of migrant children according to child and adolescent psychiatrists from medical clinics and in private practice].

PubMed

Siefen, Georg; Kirkcaldy, Bruce; Adam, Hubertus; Schepker, Renate

2015-03-01

How does the German child and adolescent psychiatry system respond to the increasing number of migrant children and adolescents? Senior doctors from German child and adolescent psychiatric hospitals (Association of Medical Hospital Directors in Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Germany, BAG) completed a specially constructed questionnaire about the treatment needs of migrant children, while a «random, representative» sample of child and adolescent psychiatrists in private practice (German Professional Association for Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, BKJPP) was administered a slightly modified version. The 100 psychiatrists in private practice represented only about one-eighth of their group, whereas the 55 medical directors comprised a representative sample. One-third of the hospitals has treatments tailored to the specific needs of migrants. In both settings, however, competent interpreters were rarely found, despite the treatment problems arising from the understanding the illness by the parents, language problems, and the clinical knowledge of the patient. Cultural diversity is perceived as enriching. The migration background and the sex of child and adolescent psychiatrists influence the treatment of migrants. Facilitating the process of «cultural opening» in child and adolescent psychiatry involves enacting concrete steps, such as the funding of interpreter costs.

The "Ulysses syndrome": An eponym identifies a psychosomatic disorder in modern migrants.

PubMed

Bianucci, Raffaella; Charlier, Philippe; Perciaccante, Antonio; Lippi, Donatella; Appenzeller, Otto

2017-06-01

Due to civil wars, violence and persecutions, between 2015 and 2016, more than 1.4 million people, from the Middle East and Africa, fled their counties and migrated to Europe. The vast majority of migrants, who have already experienced enormous level of stressors, are faced with dangerous, often lethal, migratory journeys. Those who survive are exposed to adaptation stressors such as different languages, isolation, lack of work opportunities, diminished social status and a sense of failure in the new countries of residence. These are stressors that go far beyond the usual adaptation stresses to new cultures and migrants experience permanent crises with an imminent risk of developing the "Ulysses syndrome". As a consequence, many individuals often develop symptoms such as irritability, nervousness, migraine, tension headache, insomnia, tiredness, fear, loss of appetite and generalized ill-defined discomfort. If left untreated these symptoms, originally described by Hofer in the 17th century, may degenerate into a severe psychosomatic disorder leading to reactive depression. Here we expand the concept of Ulysses' syndrome and illustrate new initiatives aimed at reducing the level of stressors in migrants and at promoting their successful integration in their new countries. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Research on promotion of management of children with psychosomatic and psychosocial disorders in Japan.

PubMed

Ishizaki, Yuko; Kobayashi, Yohnosuke; Yamagata, Zentaro; Eto, Takashi; Hoshika, Akinori; Kano, Yukiko; Koeda, Tatsuya; Miike, Teruhisa; Oki, Junichi; Tanaka, Hidetaka; Watanabe, Hisako

2005-06-01

The number of children with psychosomatic and psychosocial disorders has been increasing in Japan. There are, however, few trained pediatricians who have adequate knowledge of the treatment needed. The Research Group on the Promotion of Management of Children with Psychosomatic and Psychosocial Disorders carried out the present study to (i) disseminate knowledge about psychosomatic and psychosocial disorders of children; and (ii) establish a community-based network model to ensure effective communication among relevant institutions. To disseminate knowledge of the psychosocial and psychosomatic disorders, the Research Group compiled the Handbook for Psychosomatic Disorders of Children and distributed it to pediatricians throughout Japan. A follow-up questionnaire survey was then carried out. Also, in order to examine the current status of the communication network between pediatricians and the related institutions, the Research Group conducted a questionnaire survey on general pediatricians. Sixty-five percent of the respondents indicated that they were actually using the Handbook. The topics in the Handbook that were most frequently referred to by the respondents were attention deficit hyperactivity disorders, school refusal, eating disorders, and orthostatic dysregulation. Thirty-seven percent of the participants indicated changes in their behavior towards psychosomatic and psychosocial problems. The results of the survey on communication networks found that the pediatricians generally collaborated with different institutions depending on the nature of the problems, such as school refusal and bullying, developmental disorders, child abuse and maltreatment, and others. Promotion of the Handbook would greatly contribute to improving the management of children with psychosomatic and psychosocial disorders, together with the construction of the basic network model for management of these children.

Does the Association with Psychosomatic Health Problems Differ between Cyberbullying and Traditional Bullying?

ERIC Educational Resources Information Center

Beckman, Linda; Hagquist, Curt; Hellstrom, Lisa

2012-01-01

The association between mental health problems and traditional bullying is well known, whereas the strength of the association in cyberbullying is less known. This study aimed to compare the association between mutually exclusive groups of bullying involvement and psychosomatic problems as measured by the PsychoSomatic Problems scale. The sample…

Multiple Chemical Sensitivity (MCS) - Scientific and Public-Health Aspects

PubMed Central

Schwenk, Michael

2004-01-01

Multiple Chemical Sensitivity (MCS) is a phenomenon which the ENT-doctor should be familiar with. It has its roots in the description of a syndrome in 1987. A worker spilled chemicals at his workplace and from then on he reacted highly sensitive to chemicals. Today, there are many people who explain their complaints with self-suspected MCS. Various pathopysiological models have been proposed, including toxicological, immunological or behaviorial models. But no-one could be proved so far. Since controlled provocation tests have also provided unclear results, an increasing number of doctors assumes today, that MCS reflects a psychic condition. In 1996, an expert team of the WHO has suggested the renaming of MCS to "idiopathic environmental illness" (IEI). However, other doctors still assume a chemical cause. Since there are neither straightforward diagnostic methods to proof MCS, nor reliable therapeutic concepts, treatment of MCS-patients is usually difficult. The MCS-debate (somatic vs psychic causes) seems to reflect the dilemma of the medical profession today, that somatic disorders of known origin can be well treated, whereas the increasing number of psychosomatic/ somatoform disorders is often resistant to medical help. The ENT-doctor should pay attention to changes of the nasal mucous membrane, nasal resistance and the sense of smell. Moreover he should know about the peculiarities of MCS-patients. The manuscript describes the present knowledge and state of discussion with special regard to the situation in Germany. PMID:22073047

Psychosomatic health impacts of power plants and computer aided risk management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pop-Jordanova, N.; Pop-Jordanov, J.; Boskovska, V.

1998-07-01

The concept ``psychosomatic'', initially introduced in the first half of this century, has recently being reconfirmed by the theory and practice of modern medicine. The psychosomatic disorders are generally defined as physical (somatic) diseases produced, in part, by psychological factors, primarily stress. The organs of cardiovascular, gastrointestinal, respiratory and endocrine system are being affected, as a result of innervation by the autonomic nervous system. In some of these diseases the psychological factors can play relatively essential role; these are named ``primary psychosomatic diseases'': essential hypertension, peptic ulcer, bronchial asthma, ulcerative colitis, neurodermatitis, rheumatoid arthritis and hyperthyroidism (the last two diseasesmore » were later replaced by eating disorders as bulimia and anorexia nervosa). In many other cases the psychological element is only one among several parallel factors; these are sometimes called ``secondary psychosomatic diseases''. As known from the psychosomatic medicine, the stressors are being refracted through the individual history of a person as through a prism, leading to a spectrum of possible reactions. The personality prism comprises heredity, early child experiences and actual conflict, while the resulting disorders, as a response of the human being, have the form of neuroses, disturbed behavior and psychoses from one side, and psychophysiological disorders and other psychosomatic diseases, including synergetic amplification, from the other side. The probability of each outcome depends primarily on the individual personality prism, as well as on the characteristics of the stressors.« less

[Psychosomatic symptoms as an expression of the deterioration of the health-related quality of life in adolescents].

PubMed

Fuentes Chacón, Rosa M; Simón Saiz, M José; Garrido Abejar, Margarita; Serrano Parra, M Dolores; Larrañaga Rubio, M Elisa; Yubero Jiménez, Santiago

2017-12-04

To analyze, in a population of adolescents in school, the relationship between psychosomatic symptoms and the perception of health-related quality of life (HRQoL), differentiating by gender and age group. Transversal study. Five Secondary Schools. Eight hundred and forty four adolescents between the ages of 15 and 18 in secondary school. HRQoL using KIDSCREEN-52 and psychosomatic symptoms with the psychosomatic problems scale (PSP). Girls and adolescents aged 17-18 years presented significantly higher psychosomatic symptoms, both groups also scored worse in all dimensions of HRQoL, although only the dimensions related to physical and mental wellness, mood and stress reached significance. All psychosomatic symptoms were inversely associated with the ten dimensions of KIDSCREEN-52. The regression models showed that sadness, concentrating difficulties and sleeping difficulties were the predictors of worse HRQoL in both sexes and age groups and these variables explained between 30 and 41% of the HRQoL variance of the adolescents. Psychosomatic symptoms are frequent especially in girls and in older adolescents and predictors of worse HRQoL. It is important to distinguish them from medical conditions to avoid unnecessary interventions. As expressions of emotional discomfort they must be evaluated and treated in an integral way because they interfere with daily life and increase the vulnerability proper of adolescence. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

[Psychosomatic basic care in the general hospital - an empirical investigation of the bio-psycho-social stress, treatment procedures and treatment outcomes from the vantage point of medical doctors].

PubMed

Fritzsche, Kurt; Schäfer, Inna; Wirsching, Michael; Leonhart, Rainer

2012-01-01

The present study investigates the psycho-social stress, the treatment procedures and the treatment outcomes of stressed patients in the hospital from the perspective of the hospital doctors. Physicians from all disciplines who had completed the course "Psychosomatic Basic Care" as part of their specialist training documented selected treatment cases. 2,028 documented treatment cases of 367 physicians were evaluated. Anxiety, depression and family problems were the most common causes of psychosocial stress. In over 40 % of the cases no information was found on the medical history. Diagnostic and therapeutic conversations took place with almost half the patients (45%). From the vantage point of the physicians patients receiving diagnostic and therapeutic conversations achieved significantly more positive scores with respect to outcome variables than patients without these measures. Collegial counseling was desired for more than half of the patients and took place mainly among the ward team. There were few significant differences in the views of surgical and nonsurgical physicians. Psychosomatic basic care in general hospitals is possible, albeit with some limitations. Patients undergoing psychosocial interventions have better treatment outcomes. Therefore, extending training to 80 hours for all medical disciplines seems reasonable.

Surveillance of psychosomatic disorders in internal medicine in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

PubMed

Shatri, Hamzah; Mudjaddid, E; Lapau, Buchari

2004-01-01

to examine certain characteristics of patients who suffer from psychosomatic disorders. We called data through medical report outpatient clinic of the Psychosomatic Division, Department of internal medicine, Cipto Mangunkusumo Central General Hospital/Faculty of Medicine of the University of Indonesia (FKUI/RSUPN-CM), Jakarta, Indonesia, in 1996. The data was processed manually and by computer from which table and graphic were obtained. The descriptive analysis was performed to the objective the study. the FPD patients consisted of those with vegetative imbalance (multiple psychosomatic syndrome) (30.2%), dyspepsia (20.8%), functional heart disease (11.3%) and others 1%-6%. All of SPD consisted of chronic disease, such as hypertension (38.3%), diabetes mellitus (29.8%), bronchial asthma (10.6%), coronary artery disease (6.4%), and others 2%-5%. According to DSM IV, among the psychosomatic patients, 52.7% met the criteria for anxiety, 29.3% for depression, 14.2% for mixed anxiety and depression, and 3.8% unclear. The psychosocial stressor groups were family problems (38%), physical conditions (16%), work-related problems (13.4%), marriage problems (8.4%) and others (1%-4%). The most common physical symptoms of psychosomatic disorders were functional. Common functional psychosomatic disorders were multiple psychosomatic syndrome, dyspepsia and functional heart disease. Structural disorders found were chronic diseases. There was no difference in prevalence between males and females. The most frequent functional disorders were more commonly found among those under 40 years of age, while those with structural disorders were more common among patients 40 years of age or more. The psychological diagnoses were anxiety and depression. The most frequent psychological stressors were family problems, medical conditions, work-related problems and marriage problems.

[Blended-learning in psychosomatics and psychotherapy - Increasing the satisfaction and knowledge of students with a web-based e-learning tool].

PubMed

Ferber, Julia; Schneider, Gudrun; Havlik, Linda; Heuft, Gereon; Friederichs, Hendrik; Schrewe, Franz-Bernhard; Schulz-Steinel, Andrea; Burgmer, Markus

2014-01-01

To improve the synergy of established methods of teaching, the Department of Psychosomatics and Psychotherapy, University Hospital Münster, developed a web-based elearning tool using video clips of standardized patients. The effect of this blended-learning approach was evaluated. A multiple-choice test was performed by a naive (without the e-learning tool) and an experimental (with the tool) cohort of medical students to test the groups' expertise in psychosomatics. In addition, participants' satisfaction with the new tool was evaluated (numeric rating scale of 0-10). The experimental cohort was more satisfied with the curriculum and more interested in psychosomatics. Furthermore, the experimental cohort scored significantly better in the multiple-choice test. The new tool proved to be an important addition to the classical curriculum as a blended-learning approach which improves students' satisfaction and knowledge in psychosomatics.

What kind of diagnosis in a case of mobbing: post-traumatic stress disorder or adjustment disorder?

PubMed

Signorelli, Maria Salvina; Costanzo, Maria Cristina; Cinconze, Maria; Concerto, Carmen

2013-06-11

Over the last decade a consistent increase in stress-related psychological consequences at the workplace, usually called 'mobbing', has been seen. It claimed physical, psychical and social distress as its victims, leading to an increased incidence of many illnesses, such as psychosomatic disorders (ache, high blood pressure, chronic fatigue and insomnia) and psychiatric disturbances (high level of anxiety, depression and suicidal attempts). It was recently demonstrated that mobbing is significantly widespread among healthcare workers, especially among female nurses. In this report, we illustrate the case of a nurse who, after a brilliant career, underwent mobbing at the workplace, showing depression, anxiety and sleep disorders that required hospitalisation and a substantial intervention.

The Role of Individual- and Macro-Level Social Determinants on Young Adolescents' Psychosomatic Complaints

ERIC Educational Resources Information Center

Ottova, Veronika; Erhart, Michael; Vollebergh, Wilma; Kokonyei, Gyongyi; Morgan, Antony; Gobina, Inese; Jericek, Helena; Cavallo, Franco; Valimaa, Raili; Gaspar de Matos, Margarida; Gaspar, Tania; Schnohr, Christina W.; Ravens-Sieberer, Ulrike

2012-01-01

This study examines the social determinants of psychosomatic complaints in young adolescents. Using data from the Health Behaviour in School-aged Children (HBSC) study, psychosomatic complaints are studied in 98,773 adolescents (11- and 13-year-olds; 48% 11-year-olds, 52% 13-year-olds; 52% females, 48% males) from 34 European countries.…

Abusive supervision, psychosomatic symptoms, and deviance: Can job autonomy make a difference?

PubMed

Velez, Maria João; Neves, Pedro

2016-07-01

Recently, interest in abusive supervision has grown (Tepper, 2000). However, little is still known about organizational factors that can reduce its adverse effects on employee behavior. Based on the Job Demands-Resources Model (Demerouti, Bakker, Nachreiner, & Schaufeli, 2001), we predict that job autonomy acts as a buffer of the positive relationship between abusive supervision, psychosomatic symptoms and deviance. Therefore, when job autonomy is low, a higher level of abusive supervision should be accompanied by increased psychosomatic symptoms and thus lead to higher production deviance. When job autonomy is high, abusive supervision should fail to produce increased psychosomatic symptoms and thus should not lead to higher production deviance. Our model was explored among a sample of 170 supervisor-subordinate dyads from 4 organizations. The results of the moderated mediation analysis supported our hypotheses. That is, abusive supervision was significantly related to production deviance via psychosomatic symptoms when job autonomy was low, but not when job autonomy was high. These findings suggest that job autonomy buffers the impact of abusive supervision perceptions on psychosomatic symptoms, with consequences for production deviance. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The rebirth of neuroscience in psychosomatic medicine, Part I: historical context, methods, and relevant basic science.

PubMed

Lane, Richard D; Waldstein, Shari R; Chesney, Margaret A; Jennings, J Richard; Lovallo, William R; Kozel, Peter J; Rose, Robert M; Drossman, Douglas A; Schneiderman, Neil; Thayer, Julian F; Cameron, Oliver G

2009-02-01

Neuroscience was an integral part of psychosomatic medicine at its inception in the early 20th century. Since the mid-20th century, however, psychosomatic research has largely ignored the brain. The field of neuroscience has burgeoned in recent years largely because a variety of powerful new methods have become available. Many of these methods allow for the noninvasive study of the living human brain and thus are potentially available for integration into psychosomatic medicine research at this time. In this first paper we examine various methods available for human neuroscientific investigation and discuss their relative strengths and weaknesses. We next review some basic functional neuroanatomy involving structures that are increasingly being identified as relevant for psychosomatic processes. We then discuss, and provide examples of, how the brain influences end organs through "information transfer systems," including the autonomic, neuroendocrine, and immune systems. The evidence currently available suggests that neuroscience holds great promise for advancing the goal of understanding the mechanisms by which psychosocial variables influence physical disease outcomes. An increased focus on such mechanistic research in psychosomatic medicine is needed to further its acceptance into the field of medicine.

Assessment of the need for psychosomatic care in patients with suspected cardiac disease.

PubMed

Kunschitz, Evelyn; Friedrich, Oliver; Schöppl, Christine; Weiss, Thomas W; Miehsler, Wolfgang; Sipötz, Johann; Moser, Gabriele

2017-04-01

The study aimed to assess the subjectively perceived need for additional general disease-oriented and psychotherapeutic care in patients with suspected cardiac disease and to investigate if the request for additional care is consistent with impairment of generic quality of life and the presence of psychosomatic risk factors. Patients referred for cardiac stress testing because of suspected cardiac disease completed the assessment of the demand for additional psychological treatment (ADAPT) questionnaire, an assessment tool for counselling demand in patients with chronic illness, the SF-36 quality of life and the hospital anxiety and depression scale (HADS) questionnaires. The questionnaires were administered to 233 patients (age: 54.5 ± 13.4, 57.5 % male). Exclusive demand for disease-oriented counselling was indicated by 45.1 %, demand for psychotherapeutic counselling (exclusive or combined with disease-oriented demand) by 33.9 %. Almost all patients with psychotherapeutic demand (96.3 %) expressed also request for disease-oriented counselling. Patients with exclusive demand for disease-oriented counselling showed significantly lower scores in the emotional and physical functioning and role domains of the SF-36 than the norm population. Patients demanding psychotherapeutic counselling reported significantly lower scores in all SF-36 domains than the norm population. Psychotherapeutic demand was strongly associated with positive indicators for mental distress: SF-36 MH (OR: 4.1), SF-36 MCS (OR: 5.9), HADS anxiety (OR: 3.9), and HADS depression (OR: 3.0). Our study shows that the patients' request for additional care reflects impairment of generic health status and psychological risk load. This indicates that the assessment of subjectively perceived demand allows to screen for patients who are in need of psychosomatic care and motivated to participate in additional counselling and therapy.

[The inner coherence of psychosomatic medicine].

PubMed

Herrmann-Lingen, Christoph

2012-01-01

The body-mind dualism of somatic medicine is resolved through the concept of psychosomatic medicine. More unspecific descriptions such as "integrative medicine" (which does not clarify what should be integrated) or the "holistic approach" (which comes close to esoterics) suggest the unity of mind, body and soul, although the term "psycho-somatic" still reflects dualistic thinking. The American Psychosomatic Society has been considering a name change for years, partially to rid itself of the dualistic label, but so far these efforts have not resulted in a viable alternative. Engel's concept of biopsychosocial medicine supposes a triangular array of the body, mind, and social environment, setting body and mind into a relationship with each other and with a third party. Based on the physician-patient relationship (Balint), psychosomatic medicine can be understood in a broader sense as "relationship medicine," covering not only the use of the interpersonal relationship as a medical agent, but also a science of medicine that puts mind, body, and social environment into a theoretical framework of interrelations, with the perspective of integrating the different system levels. The translation processes among the system levels are, for example, addressed by biosemiotics (v. Uexküll). Both clinical medicine and medical research, if they intend to be psychosomatic, need to take these theoretical concepts into account and utilize them practically for (team)work with patients. Together with a clear differentiation from other cultures of (para)medicine, this can serve to develop a "psychosomatic identity."

Association of work-related factors with psychosocial job stressors and psychosomatic symptoms among Japanese pediatricians.

PubMed

Umehara, Katsura; Ohya, Yukihiro; Kawakami, Norito; Tsutsumi, Akizumi; Fujimura, Masanori

2007-11-01

A cross-sectional study was conducted to explore what work-related factors were associated with job stress among pediatricians in Japan, as determined by the demand-control-support model and psychosomatic symptoms. We sent an anonymous questionnaire to a random sample of 3,000 members selected from the nationwide register of the Japan Pediatric Society and received 850 responses (response rate, 28%). Data from the 590 respondents who worked more than 35 h per week as a pediatrician and had no missing responses in the questionnaire were analyzed. We measured workload-related variables (e.g. working hours, work schedule) and recovery-related variables (e.g. workdays with no overtime, days off with no work in the past month) as exposure variables, and psychosocial job stressors (the Brief Job Stress Questionnaire) and psychosomatic symptoms as outcome variables. Longer working hours per week was significantly associated with greater job demand, lower job control and more psychosomatic symptoms (p<0.05). After adjusting for working hours, more workdays with no overtime was significantly associated with lower job demand, greater job control and fewer psychosomatic symptoms (p<0.05). Our findings suggest that long working hours is a risk factor for job stressors and psychosomatic symptoms, and that workdays with no overtime is a protective factor which may facilitate recovery. Controlling working hours and encouraging non-overtime workdays may be important for reducing job stressors and psychosomatic symptoms among pediatricians in Japan.

Cyberchondria: Parsing Health Anxiety From Online Behavior.

PubMed

Doherty-Torstrick, Emily R; Walton, Kate E; Fallon, Brian A

2016-01-01

Individuals with questions about their health often turn to the Internet for information about their symptoms, but the degree to which health anxiety is related to online checking, and clinical variables, remains unclear. The clinical profiles of highly anxious Internet checkers, and the relationship to checking behavior itself, have not previously been reported. In this article, we test the hypothesis, derived from cognitive-behavioral models, that individuals with higher levels of illness anxiety would recall having experienced worsening anxiety after reassurance-seeking on the Internet. Data from 731 volunteers who endorsed engaging in online symptom-searching were collected using an online questionnaire. Severity of health anxiety was assessed with the Whiteley Index, functional impairment with the Sheehan Disability Scale, and distress recall during and after searching with a modified version of the Clinician׳s Global Impairment scale. Multiple regression analyses were conducted to determine variables contributing to distress during and after Internet checking. Severity of illness anxiety on the Whiteley Index was the strongest predictor of increase in anxiety associated with, and consequent to, online symptom-searching. Individuals with high illness anxiety recalled feeling worse after online symptom-checking, whereas those with low illness anxiety recalled relief. Longer-duration online health-related use was associated with increased functional impairment, less education, and increased anxiety during and after checking. Because individuals with moderate-high levels of illness anxiety recall experiencing more anxiety during and after searching, such searching may be detrimental to their health. If replicated in controlled experimental settings, this would suggest that individuals with illness anxiety should be advised to avoid using the Internet for illness-related information. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Organizational health and quality of life: survey among ambulance nurses in prehospital emergency care.

PubMed

Sili, A; Fida, Roberta; Vellone, E; Gianlorenzi, Alessandra; Alvaro, Rosaria

2011-01-01

The workplace plays a central role in causing stress and different kinds of syndromes and diseases. More generally, organizational procedures and practices could have an impact on nurses' quality of life. Although several studies have investigated this link, none of them considered nurses working in prehospital emergency care. To investigate the role of organizational health factors that affect the quality of life and psychosomatic complaints of ambulance nurses. Our sample included 411 ambulance nurses. Workers were administered two questionnaires to assess organizational health and quality of life. Descriptive and correlational analyses were used to test our assumptions. Several organizational health dimensions provided an explanation for the complaints reported by nurses working in prehospital emergency care in terms of quality of life and psychosomatic disorders. The results allowed identification of possible interventions focusing on specific duties and organizational aspects that would improve the quality of nurses' health.

Relevance of psychiatry in dermatology: Present concepts

PubMed Central

Basavaraj, K. H.; Navya, M. A; Rashmi, R.

2010-01-01

Skin is an organ that has a primary function in tactile receptivity and reacts directly upon emotional stimuli. Dermatological practice involves a psychosomatic dimension. A relationship between psychological factors and skin diseases has long been hypothesized. Psychodermatology addresses the interaction between mind and skin. It is divided into three categories according to the relationship between skin diseases and mental disorders. This article reviews different dermatological conditions under each of the three categories namely psychosomatic disorders, dermatological conditions due to primary and secondary psychiatric disorders. Dermatological conditions resulting from psychiatric conditions like stress/depression and those caused by psychiatric disorders are discussed. This review intends to present the relationship between the ‘skin’ and the ‘mind’ specifically from the dermatology point of view. The effects on the quality of life as a result of psychodermatological conditions are highlighted. A multidisciplinary approach for treatment from both dermatologic and psychiatric viewpoints are suggested. PMID:21180416

Relevance of psychiatry in dermatology: Present concepts.

PubMed

Basavaraj, K H; Navya, M A; Rashmi, R

2010-07-01

Skin is an organ that has a primary function in tactile receptivity and reacts directly upon emotional stimuli. Dermatological practice involves a psychosomatic dimension. A relationship between psychological factors and skin diseases has long been hypothesized. Psychodermatology addresses the interaction between mind and skin. It is divided into three categories according to the relationship between skin diseases and mental disorders. This article reviews different dermatological conditions under each of the three categories namely psychosomatic disorders, dermatological conditions due to primary and secondary psychiatric disorders. Dermatological conditions resulting from psychiatric conditions like stress/depression and those caused by psychiatric disorders are discussed. This review intends to present the relationship between the 'skin' and the 'mind' specifically from the dermatology point of view. The effects on the quality of life as a result of psychodermatological conditions are highlighted. A multidisciplinary approach for treatment from both dermatologic and psychiatric viewpoints are suggested.

Associations between psychosomatic symptoms in adolescence and mental health symptoms in early adulthood.

PubMed

Kinnunen, Pirjo; Laukkanen, Eila; Kylmä, Jari

2010-02-01

This longitudinal study explored associations between psychosomatic symptoms in adolescence and mental health symptoms in early adulthood. The baseline data were collected in 1996 from 14-year-old pupils (n = 235; 116 girls, 119 boys) at schools using a structured questionnaire that included a 14-item scale of psychosomatic symptoms. The follow-up data were collected in 2006 from the same persons at the age of 24 using the Symptom Checklist-90. Follow-up questionnaires were returned by 149 (63.4%) young adults (88 women and 61 men). Young adults who had many psychosomatic symptoms in adolescence suffered more often than the others from somatization and anxiety symptoms in early adulthood. In addition, women had more symptoms of depression and paranoid ideation, and men had more interpersonal sensitivity and psychotic symptoms. Psychosomatic symptoms in adolescence might be important signals of mental health and this should be taken seriously in school health and in general primary care.

[Psychosomatic aspects of stress].

PubMed

Okuse, S; Anzai, T

1992-03-01

We established the Bromocriptine test for the dopaminergic function of the hypothalamopituitary gland. The secretion patterns of plasma GH and PRL to 2.5 mg Bromocriptine, a dopamine receptor agonist, were classified into two types; a response type and a non-response type. The former showed an increase in plasma GH levels and suppression of PRL secretion; the latter showed no change in GH after Bromocriptine administration. The response type cases corresponded to psychosocial stress by neurotic and maladaptive behavior. The non-response type cases corresponded to psychosocial stress by alexithymic and over adaptive behaviors. Case Presentation 1. Essential Hypertension: a. 56-year old male, response type, blood pressure elevated by stress in daily life. Psychosomatic treatment: advice about blood pressure measurement at his home, brief psychotherapy and drug therapy. b. 53-year-old male, non-response type, type A behavior. Psychosomatic treatment: advice to increase awareness of body-mind relationships of his disorder, self-control training and drug therapy. 2. Gastric ulcers: a. 40-year-old male, response type, CMI IV region (Neurotic tendencies). Psychosomatic treatment: autogenic training and drug therapy. b. 28-year-old male, non-response type, high JAS scores(Over adaptative behavior). Psychosomatic treatment: advice to increase awareness of body-mind relationships of occurrence of his ulcers, to induce change in his perceptions of way of life, to encourage taking rest. 3. Technostress syndrome: a. 23-year-old female, response type, technoanxiety. Psychosomatic treatment: advice to make her take rest, and change in arrangements at her working place. b. 27-year-old male, non-response type, technodependent. Psychosomatic treatment: Fasting therapy. This therapy changed the non-response pattern to normal.

Problematic Internet use in Chinese adolescents and its relation to psychosomatic symptoms and life satisfaction

PubMed Central

2011-01-01

Background Problematic Internet use (PIU) is a growing problem in Chinese adolescents. Little is known about associations of PIU with physical and psychological health. This study was designed to investigate the prevalence of PIU and to test the relationships between PIU and psychosomatic symptoms and life satisfaction among adolescents in mainland China. Methods A cross-sectional survey was conducted comprising a large representative sample of 17 599 students in eight cities of China. PIU was assessed by the 20-item Young Internet Addiction Test (YIAT). The Multidimensional Sub-health Questionnaire of Adolescents and the Multidimensional Students' Life Satisfaction Scale were administered to obtain information on psychosomatic symptoms and life satisfaction. Demographics and Internet usage patterns were also collected. Logistic regression was used to assess the effects of PIU on psychosomatic symptoms and life satisfaction. Results Approximately 8.1% of subjects showed PIU. Adolescents with PIU were associated with males, high school students, urban, eastern and western areas, upper self-report family economy, service type mostly used for entertainment and relieving loneliness and more frequency of Internet use. Compared with normal Internet users, adolescents with PIU were more likely to suffer from psychosomatic symptoms (P < 0.001), including lack of physical energy (P < 0.001), physiological dysfunction (P < 0.001), weakened immunity (P < 0.001), emotional symptoms (P < 0.001), behavioural symptoms (P < 0.001) and social adaptation problems (P < 0.001). Adolescents with PIU had lower scores on total and all dimensions of life satisfaction (all P < 0.001). Adjusted for the demographic and Internet-related factors, there was positive significant relationship between PIU and psychosomatic symptoms, but negatively related to life satisfaction. Conclusions PIU is common among Chinese students, and PIU was significantly associated with psychosomatic symptoms and life satisfaction. Effective measures are needed to prevent the spread of this problem and interventions to prevent the effects of PIU on psychosomatic symptoms and life satisfaction should be conducted as early as possible. PMID:21995654

[A 20-year follow-up study of a sample of 50 pairs of twins with neurotic-psychosomatic disorders].

PubMed

Muhs, A; Schepank, H; Manz, R

1990-01-01

As part of a research project, examination was made of a sample of 50 pairs of twins (21 pairs of identical twins, 16 pairs of non-identical twins of the same sex, and 13 pairs of male-female twins [n = 100 test persons]) between 1963 and 1969 and again recently after a period of 20 years. The index twins were drawn from among the patients who made use of the services of an out-patient psychotherapeutic clinic, and they were determined to be either psychoneurotic, character neurotic, or psychosomatically ill. The question examined was again one of nature vs. nurture. Identical twins showed a significantly higher similarity with regard to the seriousness of their neuroses and the manifestation of neurotic symptoms than did non-identical twins. Noticeable similarities existed in cases of depressive disturbances, disturbances of oral and aggressive behavior, and disturbances of interpersonal contact. With regard to the influence of variables in the environment, we examined the effect of factors in early childhood on neurotic development. Lack of a reference person, a negative attitude on the part of parents toward the child, etc., frustration within and outside the family have an effect on the manifestation of neuroses and on the course of their development. The influence of early childhood factors on the degree of neurotic disorder is still to be noted in the current point prevalence.

[Effect of hypnosis and autogenic training on acral circulation and coping with the illness in patients with progressive scleroderma].

PubMed

Seikowski, K; Weber, B; Haustein, U F

1995-02-01

In 12 patients with systemic sclerosis the influence of hypnosis and autogenic training on the acral blood circulation and the coping with the disease was investigated in a pilot study. In the first step significant increases in the skin temperature of the finger (mean +/- SD: 3.9 +/- 1.2 degrees C) could be found after relaxation hypnosis. In the second step six patients (study group) gained experience with autogenic training. The other six patients served as control group. In the study group, the skin temperature of the fingers (short-term effect) was significantly higher than in the control group (1.9 +/- 1.0 degrees C). Long-term effects of the autogenic training (mean acral rewarning time, duration and course of the Raynaud attacks, acral lesions of the hands, psychosomatic status of complaints, type of relation to the disease as precondition for coping with the disease) were not found within the relatively short follow-up period of 4 months. Two patients, however, reported that they could shorten the duration of Raynaud attacks by autogenic training. In our patients heterogenicity and an increased score of multiple psychosomatic complaints were registered at the outset. As far as the type of relation to the disease is concerned, the patients could be assessed as almost adapted. Hypnosis and autogenic training can be recommended as complementary therapy in systemic sclerosis.

[Establishing ward-independent, intensive treatment concept in a psychiatric hospital : A model project within the new German remuneration system].

PubMed

Noeker, M; Juckel, G

2017-03-01

Model projects according to § 64b of the Social Code V in the context of the new remuneration system in psychiatry and psychosomatics, offer great possibilities to improve the treatment of people with mental illnesses. This article presents the model project of the University Hospital Bochum, which is essentially characterized by improved transition through the internal hospital sections so that patients can be quickly transferred from inpatient and daycare sections to high frequency outpatient sections with ward-independent therapies (SUL), including outreach home treatment. The SUL is also intended to facilitate preadmission crises, to significantly reduce duration of inpatient treatment and to maximize post-inpatient continuity of treatment.

What kind of diagnosis in a case of mobbing: post-traumatic stress disorder or adjustment disorder?

PubMed Central

Signorelli, Maria Salvina; Costanzo, Maria Cristina; Cinconze, Maria; Concerto, Carmen

2013-01-01

Over the last decade a consistent increase in stress-related psychological consequences at the workplace, usually called ‘mobbing’, has been seen. It claimed physical, psychical and social distress as its victims, leading to an increased incidence of many illnesses, such as psychosomatic disorders (ache, high blood pressure, chronic fatigue and insomnia) and psychiatric disturbances (high level of anxiety, depression and suicidal attempts). It was recently demonstrated that mobbing is significantly widespread among healthcare workers, especially among female nurses. In this report, we illustrate the case of a nurse who, after a brilliant career, underwent mobbing at the workplace, showing depression, anxiety and sleep disorders that required hospitalisation and a substantial intervention. PMID:23761569

Looking out and looking in: some reflections on 'body talk' in the consulting room.

PubMed

Wiener, J

1994-07-01

In this paper, I use illustrations from analytic work with one patient to suggest that we reconsider and extend the meaning which we give to the term 'psychosomatic'. It should include patients who come for analysis with severe anxieties about their bodies which may not necessarily take the form of an actual organic bodily illness. Using contemporary analytic thinking in this field, I have tried to look at what we mean by the term 'psychosomatic' and to make some attempt to differentiate it from the term 'hysteria'. Hysterical symptoms may sometimes mask earlier and more profound psychosomatic troubles, but may need to be analysed before the core split between psyche and soma may be approached. A useful way of bypassing difficult overlaps in diagnostic terminology when thinking about the way in which patients use the body in the consulting room, can be to make a distinction between body talk and body language. Body talk I have described as a primitive mode of communication which is a precursor to actual talking and which for some patients can come to be a substitute for talking, thinking and reflecting. When this happens, it suggests a very early fundamental rupture between body and mind where certain deintegration/reintegration experiences have inhibited growth and the body continues to function in an archetypal fashion. I hypothesize that body talk is a consequence of the kind of preverbal communication between mother and baby where there may have been a bad fit in terms of vitality affects. In later life, this can manifest itself in the form of 'body' or psychosomatic problems which cannot be put into words but are often recognizable through the quality of the interpersonal transference dynamics. Body language, on the other hand, is an essential and unique component in every patient's communication about him or herself. Our sense impressions of a patient can teach us much about the psychic meaning of body-based responses through observing with our eyes, our nose, as well as through our ears. Whilst we may all regress into body talk when under stress, body language may be said to be more integrated at all points with verbal communications and therefore it suggests some capacity to symbolize. In the transference/countertransference dynamics, there is less evidence of discomfort or dissonance between what the patient is 'saying' and what they seem to be 'doing', than there was in the earlier body talk.

[Relationship Between The Use of Psychosomatic Rehabilitation and Regional Capacities for Medical and Psychotherapeutic Treatment of Mental Disorders in Westphalia].

PubMed

Köckerling, Elena; Breckenkamp, Jürgen; Hesse, Bettina

2018-05-14

Regional disparities in mental health care are well known and become apparent in inadequate treatment capacities and long waiting time for psychotherapeutic treatment. Hence, the authors assume that there is a shift from curative to rehabilitative care. Accordingly, the purpose of this study was to analyze the relationship between regional treatment capacities and the use of psychosomatic rehabilitation on behalf of the German Statutory Pension Insurance Westphalia (i. e. DRV Westfalen) in 2013. Regional data on medical and psychotherapeutic care within the purview of DRV Westfalen were drawn from public databases. Data on application and approval processes in psychosomatic rehabilitation as well as data on demographic and insurance-related traits, such as periods of insurance, were provided by DRV Westfalen for 2013. Logistic 2-level models were conducted. Regional data showed that poor medical care was associated with a significantly higher chance of applying for rehabilitation. The demographic and insurance-related traits of the applicants were significantly related both with the application for and approval of psychosomatic rehabilitation. Persons with a discontinuous work biography in 2013 had a higher chance for application for and approval of psychosomatic rehabilitation. No significant correlation of regional treatment capacities and the approval of applications for psychosomatic rehabilitation could be found. The results show that decisions on applications for psychosomatic rehabilitation basically depend on the personal health situation of the applicants. An increased application and approval rate in areas with poor medical care can be interpreted as compensatory means which indicate a need for improvement in regional care of mental disorders. © Georg Thieme Verlag KG Stuttgart · New York.

Type D personality is a risk factor for psychosomatic symptoms and musculoskeletal pain among adolescents: a cross-sectional study of a large population-based cohort of Swedish adolescents

PubMed Central

2013-01-01

Background Type D personality, or the “distressed personality”, is a psychosocial factor associated with negative health outcomes, although its impact in younger populations is unclear. The purpose of this study was to investigate the prevalence of Type D personality and the associations between Type D personality and psychosomatic symptoms and musculoskeletal pain among adolescences. Methods A population-based, self-reported cross-sectional study conducted in Västmanland, Sweden with a cohort of 5012 students in the age between 15–18 years old. The participants completed the anonymous questionnaire Survey of Adolescent Life in Västmanland 2008 during class hour. Psychosomatic symptoms and musculoskeletal pain were measured through index measuring the presence of symptoms and how common they were. DS14 and its two component subscales of negative affectivity (NA) and social inhibition (SI) were measured as well. Results There was a difference depending on sex, where 10.4% among boys and 14.6% among girls (p = < 0.001) were defined as Type D personality. Boys and girls with a Type D personality had an approximately 2-fold increased odds of musculoskeletal pain and a 5-fold increased odds of psychosomatic symptoms. The subscale NA explained most of the relationship between Type D personality and psychosomatic symptoms and musculoskeletal pain. No interaction effect of NA and SI was found. Conclusions There was a strong association between Type D personality and both psychosomatic symptoms and musculoskeletal pain where adolescent with a type D personality reported more symptoms. The present study contributes to the mapping of the influence of Type D on psychosomatic symptoms and musculoskeletal pain among adolescents. PMID:23336535

Bullied children and psychosomatic problems: a meta-analysis.

PubMed

Gini, Gianluca; Pozzoli, Tiziana

2013-10-01

A previous meta-analysis showed that being bullied during childhood is related to psychosomatic problems, but many other studies have been published since then, including some longitudinal studies. We performed a new meta-analysis to quantify the association between peer victimization and psychosomatic complaints in the school-aged population. We searched online databases up to April 2012, and bibliographies of retrieved studies and of narrative reviews, for studies that examined the association between being bullied and psychosomatic complaints in children and adolescents. The original search identified 119 nonduplicated studies, of which 30 satisfied the prestated inclusion criteria. Two separate random effects meta-analyses were performed on 6 longitudinal studies (odds ratio = 2.39, 95% confidence interval, 1.76 to 3.24) and 24 cross-sectional studies (odds ratio = 2.17, 95% confidence interval, 1.91 to 2.46), respectively. Results showed that bullied children and adolescents have a significantly higher risk for psychosomatic problems than non-bullied agemates. In the cross-sectional studies, the magnitude of effect size significantly decreased with the increase of the proportion of female participants in the study sample. No other moderators were statistically significant. The association between being bullied and psychosomatic problems was confirmed. Given that school bullying is a widespread phenomenon in many countries around the world, the present results indicate that bullying should be considered a significant international public health problem.

Psychosocial functioning in consultation-liaison psychiatry patients: influence of psychosomatic syndromes, psychopathology and somatization.

PubMed

Porcelli, Piero; Bellomo, Antonello; Quartesan, Roberto; Altamura, Mario; Iuso, Salvatore; Ciannameo, Ida; Piselli, Massimiliano; Elisei, Sandro

2009-01-01

This study investigated whether the Diagnostic Criteria for Psychosomatic Research (DCPR) were able to predict psychosocial functioning in addition to psychiatric diagnoses and somatization in consultation-liaison psychiatry (CLP) patients. A consecutive sample of 208 CLP patients were recruited and assessed for sociodemographic and medical data, psychopathology (SCID), psychosomatic syndromes (DCPR structured interview) and somatization (SCL-90-R SOM scale and multisomatoform disorder, MSD). The main endpoints were the mental and physical components of psychosocial functioning (SF-36). A total of 185 (89%) patients had any psychiatric diagnosis, 51 (25%) had MSD positive criteria, 176 (85%) had any DCPR syndrome, and 105 (51%) had multiple DCPR syndromes. Although psychiatric and psychosomatic syndromes were variously associated with psychosocial functioning, hierarchical regression and effect size analyses showed that only DCPR syndromes, particularly demoralization and health anxiety, with somatization but not DSM-IV psychopathology independently predicted poor psychosocial functioning. The presence of psychosomatic syndromes, assessed with DCPR criteria, and high levels of somatization had larger effect size and were independent predictors of the mental and physical components of psychosocial dysfunction, over and above psychopathology. The DCPR classification can provide CLP professionals with a set of sensitive diagnostic criteria for a comprehensive clinical evaluation of psychosomatic syndromes that might play a significant mediating role in the course and the outcome of medical patients referred for psychiatric consultation. Copyright 2009 S. Karger AG, Basel.

[Symptoms, disease models and treatment experiences of patients in psychosomatic rehabilitation with and without a history of migration].

PubMed

Gruner, Andrea; Oster, Jörg; Müller, Gottfried; von Wietersheim, Jörn

2012-01-01

Previous studies have shown that psychosomatic rehabilitation treatments were less successful for patients with a migration background. These findings should be explored further with the help of interviews. The main aim of this study was to compare patients with and without a migration background with regards to social-demographic variables, disease model, symptoms, and the course and result of a psychosomatic rehabilitation treatment. 75 patients with and 75 without a migration background were analysed. Half-structured interviews were carried out at admission, discharge and three months after discharge from treatment. Patients with a migration background were "sicker" at the beginning of the rehabilitation. Especially men with a migration background benefit less from the treatment and often did not feel "at the right place" in the psychosomatic rehabilitation. Patients with a migration background have a more negative view of their work performance than patients without a migration background. Patient with a migration background should receive more information about psychosomatic disease models and different treatment methods prior to their rehabilitation therapy.

DNR versus DNT: clinical implications of a conceptual ambiguity: a case analysis.

PubMed

Martin, Robert D; Cohen, Mary Ann; Weiss Roberts, Laura; Batista, Sharon M; Hicks, Dan; Bourgeois, James

2007-01-01

Psychiatrists who practice psychosomatic medicine are routinely called upon to help resolve ethical dilemmas that arise in the care of patients near the end of their lives. Psychosomatic-medicine psychiatrists may be of unique value in these situations because of the clinical insights that we bring to the care of the dying patient. In particular, our subspecialty brings expertise related to the evaluation of decisional capacity of patients who are faced with accepting or declining end-of-life clinical interventions, such as resuscitation and intubation. In this first entry in a new bioethics case series in Psychosomatics, we will lay the groundwork for examining a complex patient case and provide an illustrative analysis of the end-of-life care issues that may be addressed by psychiatrists who practice psychosomatic medicine.

Psychosomatic approaches to obstetrics, gynaecology and andrology--a review.

PubMed

Lal, Mira

2009-01-01

This review aims to clarify the scope and clinical importance of psychosomatic approaches to obstetrics, gynaecology and andrology. This gradually expanding sub-specialty covers a wide domain of complex disease conditions that can be managed more effectively if the various biological, psychological and social aspects are recognised at the start and concurrent treatment initiated. The current need to practise biopsychosocial management of disease conditions is highlighted along with a description of what this would involve. The nine-field psychosomatic approach, which can be applied to everyday clinical encounters, has been illustrated. Clinical applications of the psychosomatic approach are discussed for various conditions including chronic pelvic pain, eating disorders, tokophobia, post-traumatic stress disorder, depression, menstrual disorders, infertility, bereavement and testicular cancer. Cultural considerations and the need for further research are also briefly discussed.

Mental stress as consequence and cause of vision loss: the dawn of psychosomatic ophthalmology for preventive and personalized medicine.

PubMed

Sabel, Bernhard A; Wang, Jiaqi; Cárdenas-Morales, Lizbeth; Faiq, Muneeb; Heim, Christine

2018-06-01

The loss of vision after damage to the retina, optic nerve, or brain has often grave consequences in everyday life such as problems with recognizing faces, reading, or mobility. Because vision loss is considered to be irreversible and often progressive, patients experience continuous mental stress due to worries, anxiety, or fear with secondary consequences such as depression and social isolation. While prolonged mental stress is clearly a consequence of vision loss, it may also aggravate the situation. In fact, continuous stress and elevated cortisol levels negatively impact the eye and brain due to autonomous nervous system (sympathetic) imbalance and vascular dysregulation; hence stress may also be one of the major causes of visual system diseases such as glaucoma and optic neuropathy. Although stress is a known risk factor, its causal role in the development or progression of certain visual system disorders is not widely appreciated. This review of the literature discusses the relationship of stress and ophthalmological diseases. We conclude that stress is both consequence and cause of vision loss. This creates a vicious cycle of a downward spiral, in which initial vision loss creates stress which further accelerates vision loss, creating even more stress and so forth. This new psychosomatic perspective has several implications for clinical practice. Firstly, stress reduction and relaxation techniques (e.g., meditation, autogenic training, stress management training, and psychotherapy to learn to cope) should be recommended not only as complementary to traditional treatments of vision loss but possibly as preventive means to reduce progression of vision loss. Secondly, doctors should try their best to inculcate positivity and optimism in their patients while giving them the information the patients are entitled to, especially regarding the important value of stress reduction. In this way, the vicious cycle could be interrupted. More clinical studies are now needed to confirm the causal role of stress in different low vision diseases to evaluate the efficacy of different anti-stress therapies for preventing progression and improving vision recovery and restoration in randomized trials as a foundation of psychosomatic ophthalmology.

[General psychosomatics in children and adolescents].

PubMed

Begovac, Ivan; Votava-Raić, Ana

2004-01-01

The purpose of this study is a review of contemporary knowledge from the field of children and adolescent psychosomatics by using standard textbooks and journals. Data are chosen according to their importance and easy reference for a clinical study and scientific research. Psychosomatics can be defined as medicine of mutual relationships in the widest sense. It seems that factors of bio-psycho-social area participate in etiology and pathogenesis, i.e. complex genetic, developmental, psychodynamic, neuroanatomical, psychoneurophysiological, neurobiochemical, psychoneuroimmunological, psychoneuroendocrinal, familiar, social and probably other factors. Children and adolescent psychiatry, pediatrics are mutually complementary. In the medical-psychosomatic field there is consideration in the form of spatial-operative models that have to be amended through the concepts of unconscious and preconscious as well as through a temporal-systematic perspective. A team approach will be applied in a therapy.

[Stumbling-blocks: initiating a psychosomatic pain clinic].

PubMed

Heger, S; Lieberz, K

2000-12-01

Despite psychosocial factors playing an important role in the course of chronic pain disorder, there is a noticeable imbalance between demand and availability of psychosomatic care for these patients. This led us to establish a psychosomatic pain clinic within the framework of our outpatient clinic at the Department of Psychosomatic Medicine and Psychotherapy at the Central Institute of Mental Health, Mannheim, Germany. A recent study aimed at the evaluation of sociodemographic variables, state of chronification, symptom load and psychiatric comorbidity. Additionally we wanted to determine whether existing conditions at our hospital can be considered suitable for those patients. During the clinic's first year we assessed 40 consecutive patients based on a psychosomatic interview as well as a set of psychometric questionnaires (BDI, STAI, SCL-90-R). To detect differences between pain patients and psychotherapy inpatients, we compared the two groups in terms of sociodemographic variables and symptom load. Most pain patients were in advanced states of chronification, showing extensive psychiatric comorbidity, particularly anxiety and depressive syndromes. Drug addiction was found more infrequently. Use of the before mentioned questionnaires prevented us from underestimating existing anxiety syndromes. Pain patients differed substantially from psychotherapy inpatients in terms of age, education, family status and symptom load. Our examination routine effectively demonstrated the special needs of chronic pain patients. As there is significant demand for psychosomatic intervention in those patients, earlier referral appears highly desirable. As pain patients differ also greatly from the remaining hospital population, specialized therapeutic concepts must be developed.

Unhealthy behaviour modification, psychological distress, and 1-year survival in cardiac rehabilitation.

PubMed

Gostoli, Sara; Roncuzzi, Renzo; Urbinati, Stefano; Morisky, Donald E; Rafanelli, Chiara

2016-11-01

Cardiac rehabilitation (CR) is considered the recommended secondary prevention treatment for cardiovascular diseases (CVD), in terms of health behaviours and, secondarily, better cardiac outcomes promotion. However, the role of psychiatric and psychosomatic distress on the efficacy of CR is unclear. This research aimed to evaluate the impact of CR on unhealthy behaviour modification and cardiac course, considering the moderating role of depression, anxiety, and psychosomatic syndromes. A longitudinal design between and within groups was employed. The assessment was repeated four times: at admission to CR (T1), at discharge (T2), 6 (T3) and 12 months following CR completion (T4). One hundred and eight patients undergoing CR versus 85 patients with CVD not referred to CR, underwent psychiatric, psychosomatic, and health behaviour assessment. The assessment included the Structured Clinical Interview for DSM-IV (depression and anxiety), the interview based on Diagnostic Criteria for Psychosomatic Research, GOSPEL Study questionnaire (health behaviours), Pittsburgh Sleep Quality Index, and 8-item Morisky Medication Adherence Scale. Cardiac rehabilitation was associated with maintenance of physical activity, improvement of behavioural aspects related to food consumption, stress management, and sleep quality. On the contrary, CR was not associated with weight loss, healthy diet, and medication adherence. Depression and psychosomatic syndromes seem to moderate the modification of specific health-related behaviours (physical activity, behavioural aspects of food consumption, stress management, and pharmacological adherence). In CR settings, an integrated assessment including both psychiatric and psychosomatic syndromes is needed to address psychological factors associated with unhealthy behaviour modification. Statement of contribution What is already known on this subject? Cardiac rehabilitation (CR) is considered a class 1A treatment recommendation and the most cost-effective model of secondary prevention to reduce cardiovascular events. There is evidence about the association between psychological distress and both unhealthy behaviour and cardiac course. Depression and psychosomatic distress, such as type A behaviour and demoralization, are frequently associated with CVD course. However, the role of psychiatric and psychosomatic distress in CR is not well known. What does this study add? CR exerted a protective effect on physical activity and a positive effect on eating behaviour, stress management, and quality of sleep. CR did not show any particular effect on smoking, overweight/obesity, dietary habits, medication adherence, and patients' 1-year survival. Findings from this study suggest the importance to consider specific psychological and psychosomatic aspects in affecting lifestyle. © 2016 The British Psychological Society.

The effects of shift work on physical and mental health.

PubMed

Vogel, Matthias; Braungardt, Tanja; Meyer, Wolfgang; Schneider, Wolfgang

2012-10-01

Occupational engagement is a pre-requisite for continuous income opportunities. Among the changing social circumstances work-related conditions play an increasingly eminent role in psychological and mental well-being. The public discusses the question of a possible association between the demands of modern work life and the increases of psychological, psychosomatic and cardiovascular disorders. Given the socioeconomic implications of psychiatric and psychosomatic suffering in the general population, there is a need to further elucidate the causes of their increasing incidence. From a medical point of view, any organization of work disrupting the phased circadian rhythms for bio-psycho-social processes and functioning of the individual are interesting against the background of clock genes and certain biological functions that are organized in a circadian fashion. The authors review the influence of shift work as a form of systematic desynchronization of inner clock systems on the endocrine, the physical, and the mental level. The significance of the findings in the field is discussed along with future directions of conclusive research.

[Female patients with fibromyalgia syndrome in somatic and psychosomatic rehabilitation center - an exploratory study on access routes and differences in patient characteristics].

PubMed

Ullrich, A; Glattacker, M; Sibold, M; Egle, U T; Ehlebracht-König, I; Geigges, W; Köllner, V; Kruse, M; Jäckel, W H

2013-10-01

Fibromyalgia syndrome (FMS) is characterized by e. g. chronic, multilocular pain, and mental health problems. In Germany, patients with FMS are treated in somatic and psychosomatic rehabilitation centers - specialized for rheumatic diseases (somatic) or psychosomatic diseases. The aim of this study is to identify the status quo of FMS patients' access routes to the rehabilitation system, and to identify their predictors for being assigned to one or the other indication group. Our cohort consists of 197 FMS patients from 3 psychosomatic (M=49.9 years) and 223 FMS patients (M=50.2 years) from 3 somatic rehabilitation centers. At the beginning of rehabilitation, patients filled out a questionnaire packet to identify their access routes to the rehabilitation centers and to record patients' disease-related, psychosocial and socio-demographic characteristics. To analyze the results we used descriptive calculations, calculated bivariate correlations, and conducted binary logistic regression analysis for the prediction of group membership. The access routes of FMS patients to a somatic or a psychosomatic rehabilitation center were often similar. Some items revealed significant group differences, i. e., a higher primary -rejection rate, longer waiting period between application for rehabilitation and its approval, and between the application itself and initiation of psychosomatic rehabilitation in comparison to somatic FMS patients. Prior experience of out-patient psychotherapy, and expectations ("psychological support") for the rehabilitation were predictive patient characteristics for the assignment into a psychosomatic rehabilitation center. Marriage, motivation, and expectations ("physical improvement" and "interaction with other patients") for the rehabilitation were predictive patient characteristics for the assignment in a somatic rehabilitation center. The predictors clarified 32% of the variance of group membership. Our results provide initial evidence of how FMS patients access the German rehabilitation system and which of their characteristics are responsible for being assigned to a particular rehabilitation setting. © Georg Thieme Verlag KG Stuttgart · New York.

Fifty moves a year: is there an association between joint physical custody and psychosomatic problems in children?

PubMed

Bergström, Malin; Fransson, Emma; Modin, Bitte; Berlin, Marie; Gustafsson, Per A; Hjern, Anders

2015-08-01

In many Western countries, an increasing number of children with separated parents have joint physical custody, that is, live equally much in their parent's respective homes. In Sweden, joint physical custody is particularly common and concerns between 30% and 40% of the children with separated parents. It has been hypothesised that the frequent moves and lack of stability in parenting may be stressful for these children. We used data from a national classroom survey of all sixth and ninth grade students in Sweden (N=147839) to investigate the association between children's psychosomatic problems and living arrangements. Children in joint physical custody were compared with those living only or mostly with one parent and in nuclear families. We conducted sex-specific linear regression analyses for z-transformed sum scores of psychosomatic problems and adjusted for age, country of origin as well as children's satisfaction with material resources and relationships to parents. Clustering by school was accounted for by using a two-level random intercept model. Children in joint physical custody suffered from less psychosomatic problems than those living mostly or only with one parent but reported more symptoms than those in nuclear families. Satisfaction with their material resources and parent-child relationships was associated with children's psychosomatic health but could not explain the differences between children in the different living arrangements. Children with non-cohabitant parents experience more psychosomatic problems than those in nuclear families. Those in joint physical custody do however report better psychosomatic health than children living mostly or only with one parent. Longitudinal studies with information on family factors before and after the separation are needed to inform policy of children's postseparation living arrangements. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

["There is no room for more"--case report of a Kurdish adolescent with an eating disorder in relation to family background of political persecution].

PubMed

Bräutigam, Barbara; Schnitker, Annette

2002-09-01

Migrant families make up almost 10% of the population of the German state of Schleswig-Holstein and a significant number of patients in the clinics for paediatrics. A casuistry shall show the specific problems and needs in the psychosomatic treatment of foreign children and adolescents, especially the problems of children of political refugees. In the Clinic for Paediatrics at the University of Lübeck a task group for migration and health has been formed which deals with the special needs of these patients. A better and more specific treatment of these patients shall prevent unnecessary long stays at the clinics, false diagnoses, wrong treatments, and the chronification of illnesses in the future.

[Oral pathology of pscyhosomatic origin. Review of the literature].

PubMed

Preda, E G; Pasetti, P; Caggiula, S; Nidoli, G; Boggio, E; Azzi, R

1990-01-31

Emotional stress is one of the etiologic or anyway predisposing factors involved in a lot of oral pathologies. In fact, relations between stress effects and frequent diseases such as gastric ulcer or ulcerous colitis are today wellknown by everyone. Theories about a relation between this kind of etiology and tumours are only reported by some Authors and are at the level of hypotheses. Mouth is very weak in these situations, owing to its great interest as primary erogenous zone, and for this reason we find frequently oral pathologies in relation with psychosomatic medicine. In this report we tried to give a good help to the study of these diseases and to find an easy classification to use (really it is an hard work to do due to the variety of this numerous illnesses).

[On the relationship of psychosomatic and mind-body medicine: integrative, complementary or alternative disciplines within an evolutionary approach?].

PubMed

Brunnhuber, Stefan; Michalsen, Andreas

2012-01-01

The text outlines the relation between psychosomatic medicine as an established medical discipline and the emerging concept of mind-body medicine from a historical, clinical and epistemological perspective. Limitations and contributions of both disciplines are discussed and the opportunities within the concept of Integrative Medicine are outlined. Whereas psychosomatic medicine is perceived as a form of transformation through a primarily verbal discoursive relationship, mind-body medicine claims healing through increased traditional techniques of the relaxation response, increased awareness, mindfulness, increasing des-identification and health-promoting lifestyle modification. It becomes clear that mind-body medicine seems to be epistemologically the broader theoretical framework, whereas in a clinical context the combination of both disciplines appears to be complementary and synergistic. The connection between psychosomatic medicine and mind-body medicine can make an important and exemplary contribution to the concept of Integrative Medicine. Copyright © 2012 S. Karger AG, Basel.

School-related stress and psychosomatic symptoms among school adolescents.

PubMed

Natvig, G K; Albrektsen, G; Anderssen, N; Qvarnstrøm, U

1999-11-01

Associations between psychosomatic symptoms and school-induced stress, and personal and social resources were analyzed among 862 Norwegian adolescents ages 13-15 years participating in the WHO project, "Health Promoting Schools." Stress-related factors were represented by the average of scores of 3-12 items. Both in combined and separate analyses of each psychosomatic symptom, increasing school distress, the most direct measure of stress experience, was associated with increased risk. A similar relationship was found with school alienation, though not significant for all symptoms. Social support from the teacher decreased the risk among girls, whereas social support from other pupils reduced the risk among both genders, but in particular among boys. No consistent associations were seen between psychosomatic complaints and general or school-related self-efficacy or decision control. In some analyses, however, these factors seemed to modify the association with school distress or school alienation.

[Interdisciplinary longitudinal curriculum "Medical psychology, psychotherapy and psychosomatics" (MPPP) at the University of Ulm].

PubMed

Allert, Gebhard; Gommel, Michael; Tamulionyté, Liudvika; Appelt, Matthias; Zenz, Helmuth; Kächele, Horst

2002-08-01

We report the clinical part of the longitudinal curriculum MPPP which was developed by the departments of Medical Psychology, Psychotherapy and Psychosomatic Medicine at the University of Ulm. The commitment and creativity of the participating students in their two undergraduate years inspired us to offer them an interest-guided curriculum for their six clinical semesters. Our paper reports the extensive results of two evaluations that we conducted during the clinical part of this new teaching-model. It became evident that we were successful in transferring continuous, intense and patient-centred psychosomatic and psychosocial contents. Yet the transfer of basic and methodological knowledge was not realised to the extent the students would have appreciated. The positive results of our project encouraged us to expand the concept of an interest-guided curriculum onto the whole academic education in psychotherapy and psychosomatic medicine at our university.

[Causal "cancer personality" attribution--an expression of maladaptive coping with illness?].

PubMed

Faller, H; Lang, H; Schilling, S

1996-01-01

In psycho-oncology, the concept of a "cancer-prone personality" has gained some attention. This notion means that persons who try to stay pseudo-normal in spite of severe life stress, suppress negative emotions, particularly anger, and sacrifice themselves for other people without uttering any personal demands, are at a high risk to develop cancer. However, it has been demonstrated by previous research that features of the cancer-prone personality could only be found if the ill person was convinced to suffer from cancer, irrespective of what the factual diagnosis was. Thus it can be concluded that at least some aspects of the so called cancer personality might be the results of coping with the belief of having cancer. The present study had the objective to describe causal attributions to psychosocial factors in cancer patients, and to find out if these were connected with emotional state and coping. N = 120 newly diagnosed lung cancer patients were included in the study. The instruments consisted of a semi-structured interview, a check-list of subjective causal factors, self-reports and interviewer ratings on emotional state and standardised questionnaires about depression and coping. Patients who made a psychosocial causal attribution proved to suffer from greater emotional distress, to be more depressed and less hopeful than other patients. This difference seemed to be mediated by a depressive way of coping with the illness (brooding, wrangling). Thus, an attribution of the illness to psychological factors seems indicative of a maladaptive way of coping with illness. This result is supported by similar findings of previous research. The question is put up to discussion if the psychosomatic concept of a cancer personality may reflect patients' subjective theories which in turn may be the expression of their depressive coping modes.

[Suggested personnel figures in psychotherapeutic and psychosomatic hospitals and departments providing routine care].

PubMed

Heuft, G; Senf, W; Janssen, P L; Pontzen, W; Streeck, U

1993-07-01

Though the existing independency of the psychotherapeutic and psychosomatic medicine in Germany there is the necessity of developing personnel clue numbers for this clinical specification. By the analytic method the required trade groups of the regular inpatient psychosomatic-psychotherapeutic treatment thus far and their engagement in time are investigated. In a 2. step the fields of business for physicians, psychologists, nurses, social workers, special-therapists and secretary/documentation as well as regular business for the consultation/liaison-service are defined. For a model station the concret personnel clue numbers of all named business groups are referred.

Evaluation of a Salutogenetic Concept for Inpatient Psychosomatic Treatment

PubMed Central

Loew, Thomas

2013-01-01

The increase of psychosomatic disorders due to cultural changes requires enhanced therapeutic models. This study investigated a salutogenetic treatment concept for inpatient psychosomatic treatment, based on data from more than 11000 patients of a psychosomatic clinic in Germany. The clinic aims at supporting patients' health improvement by fostering values such as humanity, community, and mindfulness. Most of patients found these values realized in the clinical environment. Self-assessment questionnaires addressing physical and mental health as well as symptom ratings were available for analysis of pre-post-treatment effects and long-term stability using one-year follow-up data, as well as for a comparison with other clinics. With respect to different diagnoses, symptoms improved in self-ratings with average effect sizes between 0.60 and 0.98. About 80% of positive changes could be sustained as determined in a 1-year follow-up survey. Patients with a lower concordance with the values of the clinic showed less health improvement. Compared to 14 other German psychosomatic clinics, the investigated treatment concept resulted in slightly higher decrease in symptoms (e.g., depression scale) and a higher self-rated mental and physical improvement in health. The data suggest that a successfully implemented salutogenetic clinical treatment concept not only has positive influence on treatment effects but also provides long-term stability. PMID:24159352

Dysfunctional illness perception and illness behaviour associated with high somatic symptom severity and low quality of life in general hospital outpatients in China.

PubMed

Zhang, Yaoyin; Fritzsche, Kurt; Leonhart, Rainer; Zhao, Xudong; Zhang, Lan; Wei, Jing; Yang, Jianzhong; Wirsching, Michael; Nater-Mewes, Ricarda; Larisch, Astrid; Schaefert, Rainer

2014-09-01

In primary care populations in Western countries, high somatic symptom severity (SSS) and low quality of life (QoL) are associated with adverse psychobehavioural characteristics. This study assessed the relationship between SSS, QoL and psychobehavioural characteristics in Chinese general hospital outpatients. This multicentre cross-sectional study enrolled 404 patients from 10 outpatient departments, including Neurology, Gastroenterology, Traditional Chinese Medicine [TCM] and Psychosomatic Medicine departments, in Beijing, Shanghai, Chengdu and Kunming. A structured interview was used to assess the cognitive, affective and behavioural features associated with somatic complaints, independent of their origin. Several standard instruments were used to assess SSS, emotional distress and health-related QoL. Patients who reported low SSS (PHQ-15<10, n=203, SOM-) were compared to patients who reported high SSS (PHQ-15≥10, n=201, SOM+). As compared to SOM- patients, SOM+ patients showed significantly more frequently adverse psychobehavioural characteristics in all questions of the interview. In hierarchical linear regression analyses adjusted for anxiety, depression, gender and medical conditions (SSS additionally for doctor visits), high SSS was significantly associated with "catastrophising" and "illness vulnerability"; low physical QoL was associated with "avoidance of physical activities" and "disuse of body parts"; low mental QoL was associated with "need for immediate medical help." In accordance with the results from Western countries, high SSS was associated with negative illness and self-perception, low physical QoL with avoidance behaviour, and low mental QoL with reassurance seeking in Chinese general hospital outpatients. Copyright © 2014 Elsevier Inc. All rights reserved.

Defense Mechanisms, Psychosomatic Symptomatology, and Conjugate Lateral Eye Movements

ERIC Educational Resources Information Center

Gur, Raquel E.; Gur, Ruben C.

1975-01-01

Subjects were classified into left movers, right movers, and bidirectionals according to the characteristic direction of their eye movements in response to questions. The three groups were compared on their preferential use of defense mechanisms and on the number of psychosomatic complaints. (Author)

Psychosomatic symptoms and stressful working conditions among Palestinian nurses: a cross-sectional study

PubMed Central

Jaradat, Yousef; Nijem, Khaldoun; Lien, Lars; Stigum, Hein; Bjertness, Espen; Bast-Pettersen, Rita

2016-01-01

Background: High levels of perceived stressful working conditions have been found to have an adverse effect on physical and mental health. Objectives: To examine the associations between self-reported stressful working conditions and Psychosomatic Symptoms (PSS), and to investigate possible gender differences. Methods: The present cross-sectional study comprises 430 nurses employed in Hebron district, Palestine. Self-reported stressful working conditions were recorded, and a Psychosomatic Symptoms Check list was used to assess prevalence of PSS. Findings: Median score on the psychosomatic symptom checklist for the group was 11, (range 1–21). Women reported more symptoms than men, with medians 11.6 and 10.0, respectively (p = .0001). PSS were associated with more self-reported stressful working conditions for both men (p < .0001) and women (p < .0001). The association was strongest among men. Conclusions: PSS were associated with high self-reported stressful working conditions, and this association was strongest among the men. PMID:27160155

Psychosomatic symptoms among Palestinian nurses exposed to workplace aggression.

PubMed

Jaradat, Yousef; Nielsen, Morten Birkeland; Bast-Pettersen, Rita

2018-06-01

The study examined associations between workplace aggression (WPA) and psychosomatic symptoms in Palestinian nurses. The 341 nurses, (62% females and 38% males), answered a WHO questionnaire and a psychosomatic symptoms checklist. A total of 27.3% of the nurses reported exposure to WPA of any kind within the last 12 months. After adjusting for covariates, female nurses exposed to WPA of any kind and those exposed to verbal aggression reported a higher symptom score: (1.5; 95% confidence interval [CI]: 0.3, 2.7), and (1.4; 95%CI 0.2, 2.6), respectively, than unexposed females. Male nurses exposed to bullying reported a higher symptom score: (3.2; 95%CI 1.0, 5.5) than unexposed males. Exposure to WPA was associated with higher occurrences of psychosomatic symptoms for both sexes. The female nurses reacted most strongly to verbal aggression or to WPA of any type, while bullying was associated with the male nurses' symptoms. © 2018 Wiley Periodicals, Inc.

Development and challenges of palliative care in Indonesia: role of psychosomatic medicine.

PubMed

Putranto, Rudi; Mudjaddid, Endjad; Shatri, Hamzah; Adli, Mizanul; Martina, Diah

2017-01-01

To summarize the current status of palliative care and the role of psychosomatic medicine in Indonesia. Palliative care is not a new issue in Indonesia, which has been improving palliative care since 1992 and developed a palliative care policy in 2007 that was launched by the Indonesian Ministry of Health. However, the progress has been slow and varied across the country. Currently, palliative care services are only available in a few major cities, where most of the facilities for cancer treatment are located. Psychosomatic medical doctors have advantages that contribute to palliative care because of their special training in communication skills to deal with patients from the standpoints of both mind and body. Palliative care services in Indonesia are established in some hospitals. Future work is needed to build capacity, advocate to stakeholders, create care models that provide services in the community, and to increase the palliative care workforce. Psychosomatic medicine plays an important role in palliative care services.

Transplantation okay--psyche okay? Reflections on psychosomatics in the field of organ transplantation.

PubMed

Storkebaum, Sibylle

2005-01-01

Transplantation puts a large burden on patients' psyche, before and after the operation. Psychosomatic care implicates helping patients to take a firm decision in favour of a new organ, of a new life. Incorporation of the graft, efficient doctor-patient-relations, pregnancy and sexuality, everything is possible but crucial to many patients. Psychosomatic knowledge and specified consulting help them and their families and even the doctors and nurses to cope with overwhelming emotions, fear and a lifelong danger of losing the organ. Transplantation means crossing borders, going into unknown psychic regions. And the recent rapid development of living liver transplantation does not facilitate things.

Attachment, Acculturation, and Psychosomatic Complaints among Hispanic American University Students

ERIC Educational Resources Information Center

Wang, Chiachih D. C.; Scalise, Dominick A.; Barajas-Munoz, I. Alejandro; Julio, Kathy; Gomez, Ayleen

2016-01-01

This study investigated adult attachment and acculturation frameworks of reported psychosomatic complaints related to perceived discrimination among a sample of Latino/Hispanic university students (N = 160). The model supported by the data suggests that attachment anxiety, acculturation toward the dominant cultural norms, and adherence to…

[Comparison of Psychosomatic Rehabilitation for German and Foreign Patients].

PubMed

Zollmann, P; Pimmer, V; Rose, A D; Erbstößer, S

2016-12-01

Aim: This study aims to comprehensively analyse the course of psychosomatic rehabilitation - from access to quantifiable rehabilitation outcomes. A comparison is made between 3 groups of patients: German citizens, patients of Turkish nationality or patients of foreign or unknown nationality. Methods: The data set used comprises routine data of the German Pension Insurance regarding psychosomatic rehabilitation from the so called Reha-Statistik-Database (RSD, database for rehabilitation statistics) over a period from 2007 to 2014. We included 128,165 compulsorily insured persons who underwent psychosomatic rehabilitation in 2012. Results: Among the patients in psychosomatic rehabilitation in 2012 5.8 % were of foreign nationality. Turkish patients were with 2.0 % the largest group, patients with another or unknown nationality or stateless patients constitute the additional group. The most common diagnoses for all groups were affective disorders and neurotic, somatoform and stress disorders. Differences between the groups can be demonstrated with regard to sociodemographics and employment status prior to rehabilitation: Patients of foreign nationality, and here especially Turkish patients, are on average younger, more often married and have less advanced vocational training than German patients. Accordingly, they work more often in less qualified jobs with lower wages. The health status prior rehabilitation, measured as days of sick leave, is also worse compared to German patients. In contrast to other indications there is no disadvantage regarding access to psychosomatic rehabilitation. On the contrary: the age-standardised uptake ratios of Turkish patients, especially of women, are markedly higher than in Germans. Treatment during psychosomatic rehabilitation is more or less identical. With regards to outcome of rehabilitation, reintegration into working life or transition into disability pension Turkish patients are less successful. As important influential variables for return to work (RTW) the following factors were identified: Employment duration in the last 12 months before the start of rehabilitation, the medically tested ability to work for the last employment, age and wage in the last year before the start of rehabilitation. Even after the inclusion of these variables in the logistic regression model, a direct influence of the Turkish citizenship has remained. Conclusion: In this study Turkish patients are a special group. This is especially true for Turkish women. They start from a lower baseline in comparison with their male compatriots, they have higher access to psychosomatic rehabilitation and the results of rehabilitation are less favourable. These findings may be attributable to the markedly worse health and employment status of the female Turkish patient group. Nevertheless, nationality itself remains to be a significant influencing factor. © Georg Thieme Verlag KG Stuttgart · New York.

[Emotional stress psychotherapy].

PubMed

Rozhnov, V E

1989-01-01

The concept of emotional stress psychotherapy (ESP) is based on the theoretical understanding of mental process as a system of cross-potentiating synergism of consciousness and the unconscious. Therefore, one can regard this kind of treatment as an appeal to the spiritual components of personality arousing its need of self-perfectioning. Owing to this, ESP turns the demands and higher interests creating a personality dominant to oppose the illness with ensuing depression and apathy. In a sense, this method is a qualitative contrast to S. Freud's psychoanalysis digging in the dark compartments of the soul. As a result of treatment of thousands of neurotic patients and those with psychosomatic disorders and alcoholism, the following techniques of ESP were elaborated: rational, shaped as a socratic dialogue; hypnosuggestive comprising individual or collective hypnosis, extremely loaded with emotions; autosuggestive like mental self-regulation and autogenic training filled with specific emotions.

Response of spinal myoclonus to a combination therapy of autogenic training and biofeedback.

PubMed

Sugimoto, Koreaki; Theoharides, Theoharis C; Kempuraj, Duraisamy; Conti, Pio

2007-10-12

Clinical evidence indicates that certain types of movement disorders are due to psychosomatic factors. Patients with myoclonic movements are usually treated by a variety of therapeutic agents. Autogenic training (AT), a recognized form of psychosomatic therapies, is suitable for certain types of neurological diseases. We describe a patient with myoclonus who failed to respond to conventional medical therapy. His symptoms were exaggerated by psychogenic factors, especially anger. A 42-year-old man was admitted to our hospital, Preventive Welfare Clinic, for severe paroxysmal axial myoclonus of the left shoulder and abdominal muscles. The initial diagnosis was "combination of spinal segmental myoclonus and propriospinal myoclonus". The myoclonic movements did not occur during sleep but were aggravated by bathing, alcohol drinking, and anger. Psychological examination indicated hostile attribution. Although considered not to be a case of psychogenic myoclonus, a "psychogenic factor" was definitely involved in the induction of the organic myoclonus. The final diagnosis was "combination of spinal segmental myoclonus and propriospinal myoclonus accompanied by features of psychosomatic disorders". The patient underwent psychosomatic therapy including AT and surface electromyography (EMG)-biofeedback therapy and treatment with clonazepam and carbamazepine. AT and EMG-biofeedback resulted in shortening the duration and reducing the amplitude and frequency of the myoclonic discharges. Psychosomatic therapy with AT and surface EMG-biofeedback produced excellent improvement of myoclonic movements and allowed the reduction of the dosage of conventional medications.

[Health pedagogy instead of consolation. Theological adjustment to illness by Philipp Melanchthon and Caspar Peucer].

PubMed

Bröer, R; Hofheinz, R

2001-01-01

Subject of this paper is the interpretation of disease as physical evil (malum physicum) by the university professors Philipp Melanchthon (1497-1560) and Caspar Peucer (1525-1602) at Protestant Wittenberg. Melanchthon and Peucer settled the problem of theodicy principally by theological strategies of moralization and compensation. In most cases, therefore, disease resulted from inadequate health behavior, especially drunkenness, furthermore from disdain for medicine and obstruction of divine healing. As a rule, natural factors (e.g. celestial bodies or human affections) only contributed to disease. In general it was caused by free will. In consequence the strategies of depotentiation and functionalization of disease became insignificant resulting in the accentuation of its evil nature. By way of compensation Melanchthon and Peucer stressed the Divine healing of disease. God created the natural remedies and later He created the medical arts by granting heroic virtue to the greatest doctors (Hippocrates, Galen, Avicenna). Moreover the divine Trinity could directly harmonize affections. Thus, God incited a psychosomatical healing within the human organism. As far as physical evil is concerned Lutheran pathology substituted medieval pessimism for therapeutical optimism. Melanchthon and Peucer strived to discipline the patients' behavior and to legitimate the medical arts by God. In this sense their pathology formed part of a program of social and religious stabilization. The academic medicine profited greatly from that program in later years.

The toxic mind: the biology of mental illness and violence.

PubMed

Van Winkle, E

2000-10-01

The continual suppression of emotions during fight or flight reactions results in atrophy and endogenous toxicosis in noradrenergic neurons. Diminished synaptic levels of norepinephrine are associated with depression. During periodic detoxification crises excess norepinephrine and other metabolites flood synapses. The norepinephrine overexcites postsynaptic neurons and causes symptoms ranging from mild anxiety to violent behavior. Some of the other metabolites, which may include dopamine, epinephrine, serotonin, gamma-aminobutyric acid, peptides, amino acids, and various metabolic waste products, are bound by noradrenergic receptors and alter neurotransmission. When they prevent norepinephrine from exciting postsynaptic neurons, depression returns. A mechanism is proposed for the binding of norepinephrine and for the effects of the other metabolites, many of which have been thought to be neurotransmitters. The diverse receptor proteins presumed to be specific for false neurotransmitters may instead encode specific memories. The shift in depressive and excitatory behavior is characteristic of nearly all nervous and mental disorders, including addictions, Alzheimer's disease, Parkinson's disease, and psychosomatic disorders. When toxins accumulate in regions of the brain that control specific activities, the symptoms observed will be related to those activities, giving rise to supposedly distinct disorders that represent the same detoxification process. Recovery can be facilitated by therapy and self-help measures that involve the releasing and redirecting of repressed emotions. Full text: http://homepages.nyu.edu/~er26/toxicmind.html [corrected].

Idiopathic Parkinson's disease and depression: a psychosomatic view.

PubMed Central

Todes, C J

1984-01-01

The link between idiopathic Parkinson's disease and depression is examined in the light of psychosomatic theory. A view of the condition is offered as a manifestation of chronic emotional disorder in an organic sense. Predisposition arises from bereavement and/or maternal failure in early emotional development. PMID:6707677

Bullying at School--An Indicator of Adolescents at Risk for Mental Disorders.

ERIC Educational Resources Information Center

Kaltiala-Heino, Riittakerttu; Rimpela, Matti; Rantanen, Paivi; Rimpela, Arja

2000-01-01

Surveys Finnish adolescents about bullying and victimization in relations to psychosomatic symptoms, depression, anxiety, eating disorders and substance use. Anxiety, depression, and psychosomatic symptoms were most frequent among bully-victims and equally common among bullies and victims. Argues that bullying should be seen as an indicator of…

Gender Differences in the Psychosomatic Reactions of Students Subjected to Examination Stress

ERIC Educational Resources Information Center

Kosmala-Anderson, Joanna; Wallace, Louise M.

2007-01-01

Introduction: The study investigated pre-examination anxiety and emotional control strategies as possible mediators of gender differences in self reported intensity and type of psychosomatic reactions to examination stress. Method: Sample comprised 150 male and 150 female high school senior students and university students who voluntarily…

[Psychosomatics in rheumatology].

PubMed

Eich, W; Blumenstiel, K; Lensche, H; Fiehn, C; Bieber, C

2004-04-01

Psychosocial factors influence the course and the outcome of chronic somatic diseases. This is also valid for rheumatic diseases like rheumatoid arthritis, spondyloarthropathies, systemic collagen vascular diseases, and fibromyalgia syndrome. The article summarises the evidence-based findings and it illustrates possibilities of psychosomatic treatment in rheumatic diseases by means of three case reports.

Operational Thinking at Adolescence in Relation to Psychosomatic Disorder.

ERIC Educational Resources Information Center

Anthony, E. James

1978-01-01

Relating disorders to Piaget's and Freud's developmental stages, it is proposed that, in the somatopsychic group, resomatization is associated with primitive modes of thinking and feeling; while in the psychosomatic group, resomatization is connected with an operational type of cognition and emotion. A case history is used as illustration.…

Disability in Relation to Different Peer-Victimization Groups and Psychosomatic Problems

ERIC Educational Resources Information Center

Beckman, Linda; Stenbeck, Magnus; Hagquist, Curt

2016-01-01

The purpose of this study was to examine the associations between disability, victims, perpetrators, and so-called "bully-victims" (someone reporting being both a victim and a perpetrator) of traditional, cyber, or combined victimization or perpetration and psychosomatic health among adolescents. Authors analyzed cross-sectional data…

[Consistency and inconsistency of psychosomatic symptoms in adolescents].

PubMed

Marocco Muttini, C

1994-03-01

The term psychosomatic is sometimes mistakenly used as a virtual synonym of "somatoform", whereas there is a structural difference between alexythymia and hysteria. In adolescent psychopathology, where the interpretation of phenomena follows a dynamic and relational pattern, it is difficult to draw a distinction between psychosomatosis and hysteria. Pathological expressivities are often transient and do not depend on the course of an illness, despite being linked to moments of juvenile crisis in which the structural and dynamic reorganisation of the personality accentuates some regressive aspects of defensive operations. The body and its changes represents a motor of development or crisis according to how stimuli and personal and relational experiences are integrated in the image of self, which is in turn an instrument of the structuring of the identity in as far as it represents real and imagined physical aspects, both conscious and unconscious. The importance of the body in the maturation process is such that from the quality of an adolescent's relationship with his or her own body it is possible to trace the modes of development and identify the severity and extent of a psychopathological condition. It follows that body-centered symptoms are among the most frequently found in adolescence. Negative counter-attitudes by the adult in relation to the insufficiently integrated sexual and aggressive impulses sometimes shown by adolescents further underline the need to search for a type of communication which is accepted and therefore compatible with the construction of an acceptable self-image; the body therefore becomes a language used in communicating with the adult to express unease.(ABSTRACT TRUNCATED AT 250 WORDS)

[Psychosomatic approach to patients with headache: alternative or integrated diagnoses?].

PubMed

De Giorgio, Giuseppina; Ruberto, Stefania; Firenze, Caterina; Quartesan, Roberto

2010-01-01

Each person has an inseparable body-mind unity, with psychic factors that can also manifest themselves through changes in the functions of the body, and with changing somatic states that contribute to mental experience. This explains why somatic symptoms fall within psychiatry. When a patient complains about physical symptoms, it is essentially an integrated, multidisciplinary diagnosis which is used to identify the various factors (biological and psychological) which worsen the disorder, and a psychiatric dimensional approach is used to integrate the descriptive symptomatic diagnosis with the psychostructural diagnosis. The same symptoms, in fact, may underlie different psychological dynamics that direct the treatment and determine the prognosis, as explained in three clinical cases that we described. The literature on headaches reports a high rate of co-morbidity between migraines and psychiatric disorders, but doesn't take into account the fact that often the symptom of headache is part of the disorder, even when it presents on its own. In conclusion, a holistic approach is needed for the patient to be diagnosed as having a "psychiatric" form of headache. A medical examination of the illness leading to a diagnoses is essential, according to the criteria of the International Classification of Headache Disease (ICHD-II). In clinical practice, we have integrated the descriptive diagnosis (ICHD-II mini-Plus) with the psychological (Diagnostic Criteria of Psychosomatic Research - DCPR) and psycho-structural (Kenberg's interview, Minnesota Multiphasic Personality Inventory - MMPI) diagnoses. The clarification of the dynamics underlying the definition of symptoms and the role played by psychological factors has influenced the identification of therapeutic objectives and in the identification of the most appropriate strategies.

[Psychosomatics in patients with hypertensive disease under conditions of occupational stress].

PubMed

Enikeev, A Kh; Zamotaev, Iu N; Kolomoets, N M

2008-01-01

The aim of the work--the investigation of peculiarities of psychosomatic relations in patients with different stages of hypertensive disease (HD) in conditions of direct occupation activity. The 225 workers from a number of large pharmaceutical industries, who was engaged in performance of the basic occupation activities in conditions of conveyor manufacture at the alternating working regimen, that seemed to be an origin of stresses. On grounds of blood pressure level the patients were selected into 3 groups. The 65 cases with border arterial hypertension (BAH) were included into the 1st group, 69 patients with stage 1 HB were included into the 2nd group and 61 patient--into the third group. The control group consisted of 30 health volunteers. The results of the study testify that occupational stress results in development of neurosis, stable sympathicotonia with formation of hyperkinetic and in consequent advance--hypokinetic type of circulation, gradual aggravation of changes from heart side, decrease of productiveness of mentality. One of causes of persistence of neurosis is a deficiency of a pragmatic information in conditions of complicate and strenuous process of occupational activity.

[Personality and somatic disorders].

PubMed

Darves-Bornoz, J-M

2018-06-08

In the title of this text, by somatic disorders we mean those physical illnesses clearly related to a non-psychiatric medical field, frequently termed psychosomatic illnesses and somatoform disorders. For forty years, a trend of thought has focused with pertinence on the psychological peculiarities in patients with severe somatic diseases. Moreover, causality was often supposed in the regularly mentioned association between personality features and somatoform disorders. However, the revival of the study of the earlier field of relationships between mind and body by Briquet, Charcot, Janet and Freud in his first period has led to the reassessment of the meaning of these observations. This reexamination is marked out by several assertions. Two of them work as preliminaries to argumentation: 1. existential wounds may produce long-lasting personality alterations; 2. existential wounds may produce somatoform disorders. These phenomena have been rediscovered over the last few years among assaulted subjects as well as war veterans in whom a frequent occurrence of somatizations has been, in addition, closely linked to the incidence of behavior or personality disorders. Two theses then emerge: 1. somatic diseases may produce long-lasting personality alterations; 2. until now no premorbid personality univocally predisposing to somatic diseases could be found. Indeed, during the 1980s a growing body of negative results coming from retrospective and prospective studies as well as anatomical comparisons have accumulated upon the potential role of certain personality factors in the incidence of somatic illnesses. This dialectic leads to the connection of two corollary assertions: 1. "pensée opératoire" and "alexithymia" in patients with somatic diseases may represent only an effect of the announcement or chronicity of the organic disease; 2. the old "dissociative hysteria" with somatic manifestations finds its substratum in existential wounds and not in pre-trauma personality. Indeed, on the one hand, recent publications do not allow the assertion to be confirmed that alexithymia and "pensée opératoire" predispose to somatizations. On the other hand, personality disorders in subjects with "dissociative hysteria" as well as their somatoform symptoms appear mainly as an effect of an existential wound and express in fact the Janetian concept of "a drop in Psychological Tension". Then, in spite of their differences, conversion and psychosomatic symptoms share the property of being a primitive response to existential wounds in which the subject cannot produce any appropriate psychic or behavioral response to his distress. Light is shed on these phenomena when put alongside the field of "fixed ideas" thought of by Pierre Janet as the recourse to archaic automatisms. Indeed, the experience which contradicts the vision of existence provokes an "unspeakable terror". It is mentally unrepresented or represented in too slight a way. In such cases, no previous personality prevails, but the resulting personality often appears modified, including when the breakdown of vision of the existence results from the diagnosis of an illness or its protracted course. Copyright © 2018 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Research on Somatization and Somatic Symptom Disorders: Ars longa, vita brevis.

PubMed

Dimsdale, Joel E

The new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition defines somatic symptom and related disorders as long-standing somatic symptoms that are associated with disproportionate thoughts, feelings, and behaviors, irrespective of whether or not a medical cause for these symptoms can be determined. In this Special Section of Psychosomatic Medicine, several articles address diagnostic issues and the central nervous system correlates of somatic symptom and related disorder and document new developments in its treatment.

[Improvement of Psychosomatic Rehabilitation after Prestationary Intervention].

PubMed

Sander, K; Winkler, G; Hofer, N; Hunatschek, S; Doerr, R

2016-12-01

Aim of the study: Improvement of psychosomatic rehabilitation efforts with prestationary intervention. Method: The study is designed as a prospective and randomisized interventon study including 317 in patients. Result: Most of the patients were women (69.4 %), the mean age was 50.2 years. As measured with the BDI-II patients with prestationary intervention improved more than patients without intervention. The motivation has not been changed significantly in both treatment arms. Various independent cofactors like long duration of unemployment, disablement and patients who apply to pension were identified. Conclusion: Finally a prestationary telephon interview improves the results of psychosomatic rehabilitation measured with BDI. © Georg Thieme Verlag KG Stuttgart · New York.

Psychosomatic Disorders and Mental Retardation in Children. The Langley Porter Child Psychiatry Series, Volume 3.

ERIC Educational Resources Information Center

Szurek, S.A.; Berlin, I.N.

The reciprocal relationship between the child's emotional state and physiological disturbances is explored, and the effect of emotional disturbance on varieties of mental retardation or on obvious brain damage resulting from genetic metabolic disorders is assessed. Psychosomatic disorders of childhood are discussed in six papers on genetic…

Correlates of the MMPI LB Scale in a College Population.

ERIC Educational Resources Information Center

Klein, Steven; Cross, Herbert J.

1984-01-01

Administered the Low Back Pain Scale (LB) of the Minnesota Multiphasic Personality Inventory and other measures to 123 college freshmen. Subjects with a psychosomatic disorder scored higher on LB. Females who reported problems with their mothers were more likely to have a psychosomatic disorder, suggesting different etiology between males and…

Epilogue: meditations on psychosomatic medicine.

PubMed

Cobb, S

1975-01-01

Presented are some personal views on the state of psychosomatic medicine as a science. It is suggested that the field needs more precision in language including exorcism of value judgments from certain dimensions, less circularity in stress-strain reasoning, more complex hypotheses, more emphasis on social support as a central variable and more acceptance of divergent research styles.

[Psychosomatic and psychotherapeutic outpatient care in Germany - Capacity profile based on data from the National Association of Statutory Health Insurance Physicians].

PubMed

Kruse, Johannes; Larisch, Astrid; Hofmann, Mareike; Herzog, Wolfgang

2013-01-01

At the centre of the study lay a representation of outpatient psychosomatic and psychotherapeutic care with a focus on different groups of medical and psychological therapists. The routine data of the National Association of Statutory Health Insurance Physicians (KBV) from the year 2008 were analyzed based on a systematic literature review (Medline, ISI, to November 2010). Neurologists and psychiatrists see the most patients (n = 3,172 vs n = 1,347 cases per practice), but they rarely provide services according to the directives for psychotherapy (4,4 %). However, specialists for psychosomatic medicine and psychotherapy (65 %), physicians providing only psychotherapy (66 %) and psychological psychotherapists (73 %) provide care mainly according to the directives for psychotherapy and therefore see fewer patients (170-190 cases per practice).Medical psychotherapists work more often on a psychodynamic basis, while psychological psychotherapists perform more often behavioral therapy. The treatment of patients with mental and psychosomatic disorders is based on three columns of care, which differ in their supply profile and each make a specific contribution to the treatment.

Contemporary perspectives on psychosomatics in Germany: A commentary on Karen Gubb's paper, "Psychosomatics today: a review of contemporary theory and practice".

PubMed

Frommer, Jörg

2013-02-01

Karen Gubb's (2013) review focuses on contemporary developments in psychoanalytic theory and practice in relation to psychosomatics, starting with some historical remarks, and Paris School with the Attachment approach. This paper examines the question of how the German scene fits into the issues raised in Gubb's discussion. From a historical point of view, psychosomatic thinking had already come into existence at the beginning of the twentieth century in internal medicine, influenced not only by Freud's ideas, but also by holistic philosophical approaches, anthropology, and semiotic systems theory as well. Psychosomatics is still under the influence of psychodynamic thinking, but as a required subject for all medical students, it is currently more involved in inpatient treatment settings than in psychoanalyses in the classical couch setting. Research projects using standardized questionnaires, neuroimaging, and other empirical methods have also proved that these treatments are as effective as therapy based on psychoanalytic concepts like alexithymia or the Attachment approach. In addition, qualitative methods have been implemented to grasp the fine-grained conscious and unconscious processes in the inner life of patients and in the verbal and nonverbal interaction phenomena of therapies. To sum up: Recent developments in psychoanalytic theory, which begin to overcome the differences among psychoanalytic schools in favor of re-erecting a common psychoanalytic understanding like that demonstrated in Gubb's article, fit together in bridging the gap between insights from classical psychoanalyses and results from empirical research.

Response of spinal myoclonus to a combination therapy of autogenic training and biofeedback

PubMed Central

Sugimoto, Koreaki; Theoharides, Theoharis C; Kempuraj, Duraisamy; Conti, Pio

2007-01-01

Introduction Clinical evidence indicates that certain types of movement disorders are due to psychosomatic factors. Patients with myoclonic movements are usually treated by a variety of therapeutic agents. Autogenic training (AT), a recognized form of psychosomatic therapies, is suitable for certain types of neurological diseases. We describe a patient with myoclonus who failed to respond to conventional medical therapy. His symptoms were exaggerated by psychogenic factors, especially anger. Case presentation A 42-year-old man was admitted to our hospital, Preventive Welfare Clinic, for severe paroxysmal axial myoclonus of the left shoulder and abdominal muscles. The initial diagnosis was "combination of spinal segmental myoclonus and propriospinal myoclonus". The myoclonic movements did not occur during sleep but were aggravated by bathing, alcohol drinking, and anger. Psychological examination indicated hostile attribution. Although considered not to be a case of psychogenic myoclonus, a "psychogenic factor" was definitely involved in the induction of the organic myoclonus. The final diagnosis was "combination of spinal segmental myoclonus and propriospinal myoclonus accompanied by features of psychosomatic disorders". The patient underwent psychosomatic therapy including AT and surface electromyography (EMG)-biofeedback therapy and treatment with clonazepam and carbamazepine. Results AT and EMG-biofeedback resulted in shortening the duration and reducing the amplitude and frequency of the myoclonic discharges. Conclusion Psychosomatic therapy with AT and surface EMG-biofeedback produced excellent improvement of myoclonic movements and allowed the reduction of the dosage of conventional medications. PMID:17931427

Results of a psychosomatic training program in China, Vietnam and Laos: successful cross-cultural transfer of a postgraduate training program for medical doctors

PubMed Central

2012-01-01

Background With the “ASIA-LINK” program, the European Community has supported the development and implementation of a curriculum of postgraduate psychosomatic training for medical doctors in China, Vietnam and Laos. Currently, these three countries are undergoing great social, economic and cultural changes. The associated psychosocial stress has led to increases in psychological and psychosomatic problems, as well as disorders for which no adequate medical or psychological care is available, even in cities. Health care in these three countries is characterized by the coexistence of Western medicine and traditional medicine. Psychological and psychosomatic disorders and problems are insufficiently recognized and treated, and there is a need for biopsychosocially orientated medical care. Little is known about the transferability of Western-oriented psychosomatic training programs in the Southeast Asian cultural context. Methods The curriculum was developed and implemented in three steps: 1) an experimental phase to build a future teacher group; 2) a joint training program for future teachers and German teachers; and 3) training by Asian trainers that was supervised by German teachers. The didactic elements included live patient interviews, lectures, communication skills training and Balint groups. The training was evaluated using questionnaires for the participants and interviews of the German teachers and the future teachers. Results Regional training centers were formed in China (Shanghai), Vietnam (Ho Chi Minh City and Hue) and Laos (Vientiane). A total of 200 physicians completed the training, and 30 physicians acquired the status of future teacher. The acceptance of the training was high, and feelings of competence increased during the courses. The interactive training methods were greatly appreciated, with the skills training and self-experience ranked as the most important topics. Adaptations to the cultural background of the participants were necessary for the topics of “breaking bad news,” the handling of negative emotions, discontinuities in participation, the hierarchical doctor-patient relationship, culture-specific syndromes and language barriers. In addition to practical skills for daily clinical practice, the participants wanted to learn more about didactic teaching methods. Half a year after the completion of the training program, the participants stated that the program had a great impact on their daily medical practice. Conclusions The training in psychosomatic medicine for postgraduate medical doctors resulted in a positive response and is an important step in addressing the barriers in providing psychosomatic primary care. The transferability of western concepts should be tested locally, and adaptations should be undertaken where necessary. The revised curriculum forms the basis of training in psychosomatic medicine and psychotherapy for medical students and postgraduate doctors in China, Vietnam and Laos. PMID:22929520

Results of a psychosomatic training program in China, Vietnam and Laos: successful cross-cultural transfer of a postgraduate training program for medical doctors.

PubMed

Fritzsche, Kurt; Scheib, Peter; Ko, Nayeong; Wirsching, Michael; Kuhnert, Andrea; Hick, Jie; Schüßler, Gerhard; Wu, Wenyuan; Yuan, Shen; Cat, Nguyen Huu; Vongphrachanh, Sisouk; Linh, Ngo Tich; Viet, Ngyuen Kim

2012-08-29

With the "ASIA-LINK" program, the European Community has supported the development and implementation of a curriculum of postgraduate psychosomatic training for medical doctors in China, Vietnam and Laos. Currently, these three countries are undergoing great social, economic and cultural changes. The associated psychosocial stress has led to increases in psychological and psychosomatic problems, as well as disorders for which no adequate medical or psychological care is available, even in cities. Health care in these three countries is characterized by the coexistence of Western medicine and traditional medicine. Psychological and psychosomatic disorders and problems are insufficiently recognized and treated, and there is a need for biopsychosocially orientated medical care. Little is known about the transferability of Western-oriented psychosomatic training programs in the Southeast Asian cultural context. The curriculum was developed and implemented in three steps: 1) an experimental phase to build a future teacher group; 2) a joint training program for future teachers and German teachers; and 3) training by Asian trainers that was supervised by German teachers. The didactic elements included live patient interviews, lectures, communication skills training and Balint groups. The training was evaluated using questionnaires for the participants and interviews of the German teachers and the future teachers. Regional training centers were formed in China (Shanghai), Vietnam (Ho Chi Minh City and Hue) and Laos (Vientiane). A total of 200 physicians completed the training, and 30 physicians acquired the status of future teacher. The acceptance of the training was high, and feelings of competence increased during the courses. The interactive training methods were greatly appreciated, with the skills training and self-experience ranked as the most important topics. Adaptations to the cultural background of the participants were necessary for the topics of "breaking bad news," the handling of negative emotions, discontinuities in participation, the hierarchical doctor-patient relationship, culture-specific syndromes and language barriers. In addition to practical skills for daily clinical practice, the participants wanted to learn more about didactic teaching methods. Half a year after the completion of the training program, the participants stated that the program had a great impact on their daily medical practice. The training in psychosomatic medicine for postgraduate medical doctors resulted in a positive response and is an important step in addressing the barriers in providing psychosomatic primary care. The transferability of western concepts should be tested locally, and adaptations should be undertaken where necessary. The revised curriculum forms the basis of training in psychosomatic medicine and psychotherapy for medical students and postgraduate doctors in China, Vietnam and Laos.

Recording of dissimulation and denial in the context of the psychosomatic evaluation at living kidney transplantation using the Minnesota Multiphasic Personality Inventory (MMPI)

PubMed Central

Wutzler, Uwe; Venner, Margit; Villmann, Thomas; Decker, Oliver; Ott, Undine; Steiner, Thomas; Gumz, Antje

2009-01-01

Objective: Living organ donation involves interference with a healthy organism. Therefore, most transplantation centres ascertain the voluntariness of the donation as well as its motivation by means of a psychosomatic evaluation. The circumstance that the evaluation is compulsory and not a primary concern of the donor-recipient pair may occasion respondents to present only what they consider innocuous and socially adequate. Thus, the information value of the results can be considerably affected. Methods: In the context of a psychosomatic evaluation prior to living kidney transplantation, 71 donor-recipient pairs were screened at the transplantation centre of Friedrich Schiller University, Jena. Using the validity scales of the Minnesota Multiphasic Personality Inventory (MMPI) (“infrequency” (F), “lie” (L) and “correction-scales” (K)) and the Dissimulation Index according to Gough (“F-K”), we tried to find traits of dissimulation and denial. Results: About 50% of the participants showed an infrequency raw score of zero. This means that at least half of the sample is apprehensive which may cause a cautious and controlled attitude towards the examination. The K-value (T≥59) and the Dissimulation Index (F-K≤–15) indicated dissimulation in 29% and 26% of the overall sample. Moreover, it affects the score of 11 respondents (8%) so profoundly that any significance regarding the personality traits is lost. Conclusion: In the setup of the examination situation as well as in the interpretation of test-psychological findings, the occurrence and possible influence of dissimulation should be considered. The validity scale of the MMPI can help to obtain an objective clinical impression of dissimulation in problem cases. PMID:19911073

An Investigation of the Causes of the Coronary-Prone (Type A) Behavior Pattern and Coronary Heart Disease.

DTIC Science & Technology

1983-09-01

experiences. Uncontrollable Stress Uncontrollable stress arises when an individual’s outcome is not determined by his/her response to a situation. Seligman ... Linda Hervig, and Ray H. Rosenman. "Heritability of Type A Behavior," Psychosomatic Medicine, 40, No. 6 (1978), pp. 478-486. , Robert T. Rubin, and...Performance, 25 (1980), pp. 184-215. Seligman , M. E. P. Helplessness: On Depression, Develop- ment, and Death. San Francisco: Freeman, 1975. Tamir, I., G

An Anonymous Survey of Psychosomatic Medicine Fellowship Directors regarding Breaches of Contracts and a Proposal for Prevention

ERIC Educational Resources Information Center

Levenson, James L.; Bialer, Philip

2010-01-01

Objective: The authors studied how often applicants accept positions at more than one program, or programs offer positions to applicants who have already signed contracts with other programs. Methods: An anonymous survey was distributed to all psychosomatic medicine fellowship program directors. Results: It is fairly common for applicants to sign…

Longitudinal Analysis of Links between Bullying Victimization and Psychosomatic Maladjustment in Swedish Schoolchildren

ERIC Educational Resources Information Center

Hellfeldt, Karin; Gill, Peter Edward; Johansson, Björn

2018-01-01

Cross-sectional studies of bullying mask variability in categories of and persistence of bullying victimization. Longitudinal, individual-level data offers a greater insight into schoolchildren's psychosomatic maladjustment as a consequence of bullying. Swedish schoolchildren (n = 3,349), with unique identifiers, in 44 schools (4th-9th grade),…

Development of Self-Perceived Risk Behaviour and Psychosomatic Symptoms in Adolescents: A Longitudinal Approach.

ERIC Educational Resources Information Center

Choquet, M.; Menke, H.

1987-01-01

Investigated health and behavior problems in cohort samples of 327 high school students between 1983 and 1985. Showed that psychosomatic, depressive, and behavioral problems appeared to be common during adolescence. Found sex differences in that boys experienced behavioral problems such as alcohol or drug use, smoking, and violence, while girls…

School-Related Stress and Psychosomatic Symptoms among Norwegian Adolescents

ERIC Educational Resources Information Center

Murberg, Terje A.; Bru, Edvin

2004-01-01

This study examines the relationships between school-related stress, gender and psychosomatic symptoms in a sample of 531 adolescent pupils in years (grades) 8, 9 and 10 (aged 13-16 years) from two compulsory schools in Norway. Results showed that 18.1 percent reported being very much affected by at least one of the assessed psychosomatic…

Bullying in Context: An Analysis of Psychosomatic Complaints among Adolescents in Stockholm

ERIC Educational Resources Information Center

Modin, Bitte; Låftman, Sara Brolin; Östberg, Viveca

2015-01-01

Using multilevel modeling, this study examined how different types of bullying, involving both peers and teachers, relate to psychosomatic health complaints. Data were obtained via the Stockholm School Survey from 41,032 ninth- and eleventh-grade students in the years 2004, 2006, 2008, and 2010. Results showed that students involved in bullying as…

Affective disorders and endocrine disease. New insights from psychosomatic studies.

PubMed

Fava, G A

1994-01-01

This is a review of psychosomatic interactions between affective disorders (depressive and anxiety disturbances, irritable mood) and endocrine disease. Particular reference is made to stressful life events in the pathogenesis of endocrine disease, psychopathology of hormonal disturbances, and pathophysiology of hypothalamic-pituitary-adrenal axis function in depression and Cushing's disease. These psychosomatic interactions may lead to appraisal of common etiological mechanisms in endocrine and psychiatric disorders, of the value of retaining the category of organic affective syndromes in psychiatric classification, and of the need for research on quality-of-life measures in endocrine disease. The establishment of "psychoendocrine units," where both endocrinologists and psychiatrists should work, is advocated. Such psychoendocrine units may serve and benefit clinical populations who currently defy traditional medical subdivisions.

Multilevel Modeling in Psychosomatic Medicine Research

PubMed Central

Myers, Nicholas D.; Brincks, Ahnalee M.; Ames, Allison J.; Prado, Guillermo J.; Penedo, Frank J.; Benedict, Catherine

2012-01-01

The primary purpose of this manuscript is to provide an overview of multilevel modeling for Psychosomatic Medicine readers and contributors. The manuscript begins with a general introduction to multilevel modeling. Multilevel regression modeling at two-levels is emphasized because of its prevalence in psychosomatic medicine research. Simulated datasets based on some core ideas from the Familias Unidas effectiveness study are used to illustrate key concepts including: communication of model specification, parameter interpretation, sample size and power, and missing data. Input and key output files from Mplus and SAS are provided. A cluster randomized trial with repeated measures (i.e., three-level regression model) is then briefly presented with simulated data based on some core ideas from a cognitive behavioral stress management intervention in prostate cancer. PMID:23107843

[Evaluation of Contextual Factors in Psychosomatic Rehabilitation].

PubMed

Bülau, N I; Kessemeier, F; Petermann, F; Bassler, M; Kobelt, A

2016-12-01

Objectives: Although individualized and ICF-oriented implementation of rehabilitation treatment requires knowledge of relevant contextual factors, there is a lack of operationalized documentation and measurement tools to evaluate these factors. Therefore, an ICF-oriented semi-structured interview was designed. Methods: 20 contextual factors were externally assessed whether they negatively affected mental functioning and participation of psychosomatic patients. Additionally, psychometric scales were applied. Results: Six relevant impairing contextual factors were identified. Contextual factors significantly correlated with psychometric scales. Patients with higher contextual impairment showed significantly higher psychological stress levels. Conclusions: Anamnesis of contextual factors at the beginning of psychosomatic rehabilitation yields important information for therapy planning. Further research on contextual factors in medical rehabilitation is needed. © Georg Thieme Verlag KG Stuttgart · New York.

Group therapy for somatization disorders in primary care: maintenance of treatment goals of short cognitive-behavioural treatment one-and-a-half-year follow-up.

PubMed

Lidbeck, J

2003-06-01

The objective of this study was to evaluate the maintenance of treatment goals of a short cognitive-behavioural group treatment programme for the management of somatization disorders in primary care. In a previous controlled 6-month follow-up study, patients with somatization disorders (n=32) improved with respect to illness and somatic preoccupation, hypochondriasis, and medication usage. In the present report the same group of patients were also investigated one-and-a-half year after initial treatment. The long-term follow-up manifested maintained improvement with respect to hypochondriasis. There was additional reduction of anxiety and psychosocial preoccupation, whereas somatization and depression-anxiety scores improved progressively. A short cognitive-behavioural group treatment of psychosomatic patients can be useful in primary care and may manifest maintained or progressive beneficial outcome.

[A Concept Analysis for Mind-Body Interaction].

PubMed

Chen, Hsing-Wen; Yeh, Mei-Ling; Rong, Jiin-Ru

2015-08-01

Mind-body interaction (MBI) refers the holistic association and interactive process between wisdom, thinking, belief, and physiological reaction, which critically affects health. The main goal of nursing is to maintain mind and body in a healthy state of well being. Few reports in the literatures have addressed the evaluation and application of MBI. Thus, a conceptual analysis of this subject is worth exploring in depth. This paper analyzes the MBI concept step by step based on the procedures of Walker and Avant. The result defines the characteristics of MBI as (1) being aware of psychosomatic effects, (2) interacting between psychology, neurology, immunology and others, and (3) turning out a bio-psycho-social status. Antecedents include geography, culture, race, gender, age, education, profession, values, personality, experience, and health status. Consequences of MBI include well-being, illness, and death. This paper provides new information on MBI that clarifies its meaning, provides comprehensive cognition, and suggests useful applications.

Frontal Lobe Epilepsy: A Primer for Psychiatrists and a Systematic Review of Psychiatric Manifestations.

PubMed

Gold, Jessica A; Sher, Yelizaveta; Maldonado, José R

2016-01-01

Frontal lobe epilepsy (FLE) can masquerade as a primary psychiatric condition, be misdiagnosed in-lieu of a true psychiatric disorder, or may be comorbid with psychiatric illness. To (1) qualitatively review psychiatric manifestations of FLE and (2) to systematically review the cases/case series of psychiatric manifestations of FLE presented in the literature to date. A systematic review of the literature was performed following the PRISMA guidelines and using PubMed/Medline, PsychInfo, and Cochrane database of systematic reviews to identify cases and case series of psychiatric manifestations of FLE. A total of 35 separate articles were identified. Further, 17 patients primarily presented with psychosis, 33 with affective symptoms, and 16 with personality changes. Also, 62% of cases were males and 38% were females. Ages ranged from 2-83 years with the average age of 32.7. Prior psychiatric history was reported in 27.3% of cases. Causes of seizure were known in 53%, with the most common causes being dysplasia and tumor. Only 6 cases (<10%) did not have electroencephalographic correlations. Psychiatric manifestations were primarily ictal in 74.3% of the cases. Associated manifestations included motor (63.6%), cognitive (34.8%), and medical (9.0%) findings. Surgery was required in 31.8% of the cases, whereas others were treated with medications alone. All, but 3, patients were seizure free and saw an improvement in symptoms with treatment. Given the complexity and multifunctionality of the frontal lobes, FLE can present with complex, psychiatric manifestations, with associated motor, cognitive, and medical changes; thus, psychiatrists should keep FLE on the differential diagnosis of complex neuropsychiatric cases. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Stressful Life Events and Psychosomatic Symptoms among Students Smokers and Non-smokers

ERIC Educational Resources Information Center

Dodaj, Arta; Simic, Natasa

2012-01-01

The objective of this study is to analyze the rate of stressful life events and psychosomatic symptoms among students smokers and non-smokers and examine the predictive contribution of stress and smoking to subjective health status. Methods were conducted on a convenience sample of 200 students from the University of Mostar, with a median age of…

Medical Student Experiences on Consultation-Liaison Psychiatry Rotations: A Nationwide Survey.

PubMed

Meyer, Fremonta; Abbasi, Omair; Kasick, David; Lee, Kewchang; Pelic, Christine; Zinser, Jennifer; Harris, Thomas; Funk, Margo

Consultation-liaison (C-L) psychiatry clerkship rotations may improve medical students' understanding of psychiatric principles relevant to the settings in which they will ultimately practice. This study aimed to characterize students' experiences on C-L rotations. This cross-sectional survey study, sponsored by the Academy of Psychosomatic Medicine Subcommittee on Medical Student Education, was conducted at 5 US medical schools between 2012 and 2016. After the C-L rotation, students completed a voluntary 17-item survey. A total of 235 surveys were collected (mean response rate = 92%). The most frequently endorsed benefit of C-L was learning to manage psychiatric disorders in the context of medical illness (89%). The most frequently endorsed drawback was inconsistent/excessively variable workload (40%). Overall, 82% of respondents recommended C-L to other students; 80% reported that the ideal clerkship would include exposure to both C-L and inpatient psychiatry. Overall, 38% reported that their C-L experience increased their interest in psychiatry as a career. Effect of C-L on interest in psychiatry did not differ by study site, age, sex, clerkship length, or time spent on C-L. Respondents who noted more positive role-modeling on C-L compared to other clerkship rotations were more likely to report increased interest in a psychiatry career (odds ratio = 2.70). Most medical students perceive C-L rotations favorably. Positive role modeling may increase their consideration of psychiatry specialization. The findings that C-L rotation length did not correlate with attitudes and that most students preferred exposure to both inpatient and C-L psychiatry suggest that C-L exposure can beneficially be integrated into core clerkships containing other elements. Copyright © 2018 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Family functioning and illness perception of parents of children with atopic dermatitis, living without skin symptoms, but with psychosomatic symptoms.

PubMed

Rodríguez-Orozco, Alain R; Kanán-Cedeño, E G; Guillén Martínez, E; Campos Garibay, M J

2011-03-01

Emotional factors and a recurrent psychosomatic environment, have been implicated in the evolution of atopic dermatitis. These, in turn, affect the disease. This study was under taken to evaluate the functioning of families with a child that has atopic dermatitis without skin symptoms and the parents' perceptions of their child's disease.Semi-quantitative and cross-sectional study in which questionnaires were applied: one to study family functioning (Espejel et al. scale) and the second to determine aspects of parental perception of their child's atopic dermatitis. Pearson's correlation was used to analyze the correlation between the categories of the Family Function Scale.The most affected categories of family functioning were authority, handling of disruptive conduct, communication, and negative affect. The most significant positive correlations between the categories of family functioning were: authority and support, r=0.867, p<.001; disruptive conduct and communication, r=0.798, p<.001; and support and communication, r=0.731, p<.001. Of the parents, 66.4% thought that the pharmacotherapy used for their child's atopic dermatitis was not effective, and 33.3% of parents stated that the disease had affected their child's daily activities.In families of children with atopic dermatitis, various family environment factors facilitate the recurrence of symptoms even when no cutaneous lesions have been found on the child. The identification and use of family resources to face this disease are aspects that should be taken into consideration during the psychotherapeutic management of these families, putting emphasis on the most affected functional categories of these families in a strategy that should be implanted in a multi-disciplinary context.

[Psychosomatic stress factors in compensated and decompensated tinnitus].

PubMed

Stobik, Corinna; Weber, Rainer K; Münte, Thomas F; Frommer, Jörg

2003-08-01

In modern medical practice, chronic decompensated tinnitus is defined as a complex psychosomatic process in which mental and social factors are considered to have a determining effect on the patient's subjective response to the impairment of otological or other somatic functions attributed to tinnitus. What is still largely unknown is the interaction of the individual factors and their impact on the patient's ability to cope with tinnitus. The impact of psycho-social and somatic factors on the subjective experience of patients with compensated and decompensated tinnitus is evaluated. 53 patients with chronic tinnitus were divided into two groups, compensated and decompensated, on the basis of their subjective experience of the disorder, established according to the tinnitus questionnaire published by Goebel and Hiller. Self-assessment instruments and a survey of symptoms of somatic stress disorders were used to compare the two groups in terms of differences in the patients' mental and psycho-social behaviour, in their strategies for coping with tinnitus and in the incidence of co-morbidity. The patients with decompensated tinnitus suffered from more pronounced mental and social disabilities, were more prone to depression and used less effective techniques to cope with their illness. The principal difference between the two groups, however, appeared to lie in a significantly higher degree of somatic multi-morbidity, where a particularly strong correlation was found between tinnitus and the incidence of cardiovascular diseases and hypacusis. 81 percent of the total sample of patients suffered from impaired hearing. Patients with decompensated tinnitus experienced greater communication difficulties as a result of their auditory impairment. In the diagnosis and therapy of tinnitus, in addition to psychic and psycho-social aspects greater attention ought to be paid to somatic factors, influencing the patient's ability to cope with the disorder.

How to Reach Emotions with Psychosomatic Patients: A Case Report.

PubMed

Colaianni, Gwenaëlle; Poot, Francoise

2016-08-23

Alopecia areata (patchy hairloss) often indicates to the dermatologist the existence of psychological disorders, mostly anxiety and depression. Psychosomatic conditions are usually associated with difficulty in expressing emotions, as is the case in alexithymia, and this difficulty is often seen in patients with alopecia areata. This case study aims to show how to help these patients connect with their emotions and how the somatic symptom can become meaningful by using a unifying approach, which challenges the beliefs, the rules and the interactions of both the individual and the family, as well as the emotions expressed or suppressed. In this particular case we used a systemic family therapy tool, "the family blazon" that helped to discover the unconscious myth of unity and the fear of family disaggregation that is involved in psychosomatic families.

Rationale, design and conduct of a randomised controlled trial evaluating a primary care-based complex intervention to improve the quality of life of heart failure patients: HICMan (Heidelberg Integrated Case Management)

PubMed Central

Peters-Klimm, Frank; Müller-Tasch, Thomas; Schellberg, Dieter; Gensichen, Jochen; Muth, Christiane; Herzog, Wolfgang; Szecsenyi, Joachim

2007-01-01

Background Chronic congestive heart failure (CHF) is a complex disease with rising prevalence, compromised quality of life (QoL), unplanned hospital admissions, high mortality and therefore high burden of illness. The delivery of care for these patients has been criticized and new strategies addressing crucial domains of care have been shown to be effective on patients' health outcomes, although these trials were conducted in secondary care or in highly organised Health Maintenance Organisations. It remains unclear whether a comprehensive primary care-based case management for the treating general practitioner (GP) can improve patients' QoL. Methods/Design HICMan is a randomised controlled trial with patients as the unit of randomisation. Aim is to evaluate a structured, standardized and comprehensive complex intervention for patients with CHF in a 12-months follow-up trial. Patients from intervention group receive specific patient leaflets and documentation booklets as well as regular monitoring and screening by a prior trained practice nurse, who gives feedback to the GP upon urgency. Monitoring and screening address aspects of disease-specific self-management, (non)pharmacological adherence and psychosomatic and geriatric comorbidity. GPs are invited to provide a tailored structured counselling 4 times during the trial and receive an additional feedback on pharmacotherapy relevant to prognosis (data of baseline documentation). Patients from control group receive usual care by their GPs, who were introduced to guideline-oriented management and a tailored health counselling concept. Main outcome measurement for patients' QoL is the scale physical functioning of the SF-36 health questionnaire in a 12-month follow-up. Secondary outcomes are the disease specific QoL measured by the Kansas City Cardiomyopathy questionnaire (KCCQ), depression and anxiety disorders (PHQ-9, GAD-7), adherence (EHFScBS and SANA), quality of care measured by an adapted version of the Patient Chronic Illness Assessment of Care questionnaire (PACIC) and NT-proBNP. In addition, comprehensive clinical data are collected about health status, comorbidity, medication and health care utilisation. Discussion As the targeted patient group is mostly cared for and treated by GPs, a comprehensive primary care-based guideline implementation including somatic, psychosomatic and organisational aspects of the delivery of care (HICMAn) is a promising intervention applying proven strategies for optimal care. Trial registration Current Controlled Trials ISRCTN30822978. PMID:17716364

Rationale, design and conduct of a randomised controlled trial evaluating a primary care-based complex intervention to improve the quality of life of heart failure patients: HICMan (Heidelberg Integrated Case Management).

PubMed

Peters-Klimm, Frank; Müller-Tasch, Thomas; Schellberg, Dieter; Gensichen, Jochen; Muth, Christiane; Herzog, Wolfgang; Szecsenyi, Joachim

2007-08-23

Chronic congestive heart failure (CHF) is a complex disease with rising prevalence, compromised quality of life (QoL), unplanned hospital admissions, high mortality and therefore high burden of illness. The delivery of care for these patients has been criticized and new strategies addressing crucial domains of care have been shown to be effective on patients' health outcomes, although these trials were conducted in secondary care or in highly organised Health Maintenance Organisations. It remains unclear whether a comprehensive primary care-based case management for the treating general practitioner (GP) can improve patients' QoL. HICMan is a randomised controlled trial with patients as the unit of randomisation. Aim is to evaluate a structured, standardized and comprehensive complex intervention for patients with CHF in a 12-months follow-up trial. Patients from intervention group receive specific patient leaflets and documentation booklets as well as regular monitoring and screening by a prior trained practice nurse, who gives feedback to the GP upon urgency. Monitoring and screening address aspects of disease-specific self-management, (non)pharmacological adherence and psychosomatic and geriatric comorbidity. GPs are invited to provide a tailored structured counselling 4 times during the trial and receive an additional feedback on pharmacotherapy relevant to prognosis (data of baseline documentation). Patients from control group receive usual care by their GPs, who were introduced to guideline-oriented management and a tailored health counselling concept. Main outcome measurement for patients' QoL is the scale physical functioning of the SF-36 health questionnaire in a 12-month follow-up. Secondary outcomes are the disease specific QoL measured by the Kansas City Cardiomyopathy questionnaire (KCCQ), depression and anxiety disorders (PHQ-9, GAD-7), adherence (EHFScBS and SANA), quality of care measured by an adapted version of the Patient Chronic Illness Assessment of Care questionnaire (PACIC) and NT-proBNP. In addition, comprehensive clinical data are collected about health status, comorbidity, medication and health care utilisation. As the targeted patient group is mostly cared for and treated by GPs, a comprehensive primary care-based guideline implementation including somatic, psychosomatic and organisational aspects of the delivery of care (HICMAn) is a promising intervention applying proven strategies for optimal care.

Relaxation - Induced by Vibroacoustic Stimulation via a Body Monochord and via Relaxation Music - Is Associated with a Decrease in Tonic Electrodermal Activity and an Increase of the Salivary Cortisol Level in Patients with Psychosomatic Disorders.

PubMed

Sandler, Hubertus; Fendel, Uta; Buße, Petra; Rose, Matthias; Bösel, Rainer; Klapp, Burghard F

2017-01-01

Vibroacoustic stimulation by a Body Monochord can induce relaxation states of various emotional valence. The skin conductance level (SCL) of the tonic electrodermal activity is an indicator of sympathetic arousal of the autonomic nervous system and thus an indicator of the relaxation response. Salivary cortisol is considered to be a stress indicator of the HPA-axis. The effects of the treatment with a Body Monochord and listening to relaxation music (randomized chronological presentation) on SCL and salivary cortisol in relation to the emotional valence of the experience were examined in patients with psychosomatic disorders (N = 42). Salivary cortisol samples were collected immediately before and after the expositions. Subjective experience was measured via self-rating scales. Overall, both the exposure to the Body Monochord as well as the exposure to the relaxation music induced an improvement of patients' mood and caused a highly significant reduction of SCL. A more emotionally positive experience of relaxation correlated with a slightly stronger reduction of the SCL. Both treatment conditions caused a slight increase in salivary cortisol, which was significant after exposure to the first treatment. The increase of salivary cortisol during a relaxation state is contrary to previous findings. It is possible that the relaxation state was experienced as an emotional challenge, due to inner images and uncommon sensations that might have occurred.

[Psychosomatic aspects of expert judgement in gastro-intestinal disease (author's transl)].

PubMed

Freyberger, H; Wellmann, W

1980-06-01

Psychosomatic aspects in expert judgement about gastro-intestinal disease are important in regard to 3 particular problems: (1) establishing physical fitness for prison confinement, (2) establishing causal relationships between disease and military service, (3) judging the fitness for work, when annuities are demanded from the state insurance agencies. The point last mentioned is most important nowadays and is discussed therefore in more detail.

Psychiatric comorbidity in adult eczema.

PubMed

Schmitt, J; Romanos, M; Pfennig, A; Leopold, K; Meurer, M

2009-10-01

Atopic eczema (AE) is a common dermatological condition that causes significant problems in everyday life and high levels of illness-related stress in substantial proportions of patients. The extent to which adult AE is associated with clinically relevant psychiatric morbidity is unclear. To investigate the association between adult AE and major psychiatric/psychosomatic disorders. Case-control study utilizing the GKV database Saxony, an interdisciplinary administrative outpatient database from Germany. All patients documented as having AE at least twice within the study period (2003-2004) (n = 3769, mean age 44 years) were individually matched by age and sex to 3769 controls without AE. Logistic regression models were fitted to investigate the relationship of AE with affective, stress-related, behaviour and schizophrenic disorders, considering sociodemographic characteristics, consulting behaviour and allergic comorbidities as potential confounding factors. Eczema was independently associated with affective [adjusted odds ratio (OR) 1.42, 95% confidence interval (CI) 1.13-1.79], stress-related (OR 1.55, 95% CI 1.35-1.77), behaviour (OR 1.52, 95% CI 1.03-2.23) and schizophrenic disorders (OR 2.12, 95% CI 1.22-3.71). For each psychiatric condition the likelihood of being affected significantly increased with each physician visit due to AE, suggesting that the risk of psychiatric comorbidity increases with the severity of AE. This study indicates psychiatric comorbidity of adults with AE. Collaboration between dermatologists and mental health specialists may optimize medical care for a significant subgroup of patients with AE.

The Relationship of Hypochondriasis to Anxiety, Depressive, and Somatoform Disorders.

PubMed

Scarella, Timothy M; Laferton, Johannes A C; Ahern, David K; Fallon, Brian A; Barsky, Arthur

2016-01-01

Though the phenotype of anxiety about medical illness has long been recognized, there continues to be debate as to whether it is a distinct psychiatric disorder and, if so, to which diagnostic category it belongs. Our objective was to investigate the pattern of psychiatric comorbidity in hypochondriasis (HC) and to assess the relationship of health anxiety to anxiety, depressive, and somatoform disorders. Data were collected as part of a clinical trial on treatment methods for HC. In all, 194 participants meeting criteria for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) HC were assessed by sociodemographic variables, results of structured diagnostic interviews, and validated instruments for assessing various symptom dimensions of psychopathology. Most of the individuals with HC had comorbid psychiatric illness; the mean number of comorbid diagnoses was 1.4, and 35.1% had HC as their only diagnosis. Participants were more likely to have only comorbid anxiety disorders than only comorbid depressive or somatoform disorders. Multiple regression analysis of continuous measures of symptoms revealed the strongest correlation of health anxiety with anxiety symptoms, and a weaker correlation with somatoform symptoms; in multiple regression analysis, there was no correlation between health anxiety and depressive symptoms. Our findings suggest that the entity of health anxiety (HC in DSM-IV and illness anxiety disorder in DSM-5) is a clinical syndrome distinct from other psychiatric disorders. Analysis of comorbidity patterns and continuous measures of symptoms suggest that its appropriate classification is with anxiety rather than somatoform or mood disorders. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

[Stress and the molecular basis of psychosomatics].

PubMed

Peters, E M J

2013-06-01

Stress and skin-an inseparable pair, this is how many of our patients perceive it and even clinicians are willing to integrate psychosomatic aspects into their recommendations if nothing from the somatic repertoire provides sufficient treatment. How the stress reaches the skin however is still an enigmatic matter to most lay people and professionals alike. Interestingly, psychoneuroimmunological research since the 1970s has produced a flood of valuable data. We now know that stressors, be it biochemical or psychoemotional, always elicit a neuroendocrine stress reaction with consequences for the immune response and therefore especially chronic inflammatory skin diseases. Here we employ allergic inflammation/atopic dermatitis and psoriasis as instructive model diseases to discuss basic mechanisms of molecular psychosomatic effects on chronic inflammation. The aim is to enhance pathogenetic understanding and open the door for the development and employment of integrated therapeutic concepts in dermatology.

Psychosomatic symptoms as biomarkers: transcending the psyche-soma dichotomy.

PubMed

Neuman, Yair

2010-01-01

Following the advancement in understanding dynamical systems, the author presents a novel metaphor of psychosomatic symptoms as low-dimensional biomarkers. This metaphor, which transcends the old binary of psyche-soma, resonates with classical psychoanalytic concepts and with Matte-Blanco's idea of repetition as indicative of dimensionality reduction. The relevance of this metaphor for explanation, diagnosis, and treatment is illustrated through a case study of a male patient suffering from hyperprolactinemia.

Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes

PubMed Central

França, Elisabeth; Teixeira, Renato; Ishitani, Lenice; Duncan, Bruce Bartholow; Cortez-Escalante, Juan José; de Morais, Otaliba Libânio; Szwarcwald, Célia Landman

2014-01-01

OBJECTIVE To propose a method of redistributing ill-defined causes of death (IDCD) based on the investigation of such causes. METHODS In 2010, an evaluation of the results of investigating the causes of death classified as IDCD in accordance with chapter 18 of the International Classification of Diseases (ICD-10) by the Mortality Information System was performed. The redistribution coefficients were calculated according to the proportional distribution of ill-defined causes reclassified after investigation in any chapter of the ICD-10, except for chapter 18, and used to redistribute the ill-defined causes not investigated and remaining by sex and age. The IDCD redistribution coefficient was compared with two usual methods of redistribution: a) Total redistribution coefficient, based on the proportional distribution of all the defined causes originally notified and b) Non-external redistribution coefficient, similar to the previous, but excluding external causes. RESULTS Of the 97,314 deaths by ill-defined causes reported in 2010, 30.3% were investigated, and 65.5% of those were reclassified as defined causes after the investigation. Endocrine diseases, mental disorders, and maternal causes had a higher representation among the reclassified ill-defined causes, contrary to infectious diseases, neoplasms, and genitourinary diseases, with higher proportions among the defined causes reported. External causes represented 9.3% of the ill-defined causes reclassified. The correction of mortality rates by the total redistribution coefficient and non-external redistribution coefficient increased the magnitude of the rates by a relatively similar factor for most causes, contrary to the IDCD redistribution coefficient that corrected the different causes of death with differentiated weights. CONCLUSIONS The proportional distribution of causes among the ill-defined causes reclassified after investigation was not similar to the original distribution of defined causes. Therefore, the redistribution of the remaining ill-defined causes based on the investigation allows for more appropriate estimates of the mortality risk due to specific causes. PMID:25210826

Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes.

PubMed

França, Elisabeth; Teixeira, Renato; Ishitani, Lenice; Duncan, Bruce Bartholow; Cortez-Escalante, Juan José; Morais Neto, Otaliba Libânio de; Szwarcwald, Célia Landman

2014-08-01

OBJECTIVE To propose a method of redistributing ill-defined causes of death (IDCD) based on the investigation of such causes. METHODS In 2010, an evaluation of the results of investigating the causes of death classified as IDCD in accordance with chapter 18 of the International Classification of Diseases (ICD-10) by the Mortality Information System was performed. The redistribution coefficients were calculated according to the proportional distribution of ill-defined causes reclassified after investigation in any chapter of the ICD-10, except for chapter 18, and used to redistribute the ill-defined causes not investigated and remaining by sex and age. The IDCD redistribution coefficient was compared with two usual methods of redistribution: a) Total redistribution coefficient, based on the proportional distribution of all the defined causes originally notified and b) Non-external redistribution coefficient, similar to the previous, but excluding external causes. RESULTS Of the 97,314 deaths by ill-defined causes reported in 2010, 30.3% were investigated, and 65.5% of those were reclassified as defined causes after the investigation. Endocrine diseases, mental disorders, and maternal causes had a higher representation among the reclassified ill-defined causes, contrary to infectious diseases, neoplasms, and genitourinary diseases, with higher proportions among the defined causes reported. External causes represented 9.3% of the ill-defined causes reclassified. The correction of mortality rates by the total redistribution coefficient and non-external redistribution coefficient increased the magnitude of the rates by a relatively similar factor for most causes, contrary to the IDCD redistribution coefficient that corrected the different causes of death with differentiated weights. CONCLUSIONS The proportional distribution of causes among the ill-defined causes reclassified after investigation was not similar to the original distribution of defined causes. Therefore, the redistribution of the remaining ill-defined causes based on the investigation allows for more appropriate estimates of the mortality risk due to specific causes.

[Psychosomatic Consultation in the Workplace--Description and Modelling of a New Health-Related Service].

PubMed

Preiser, C; Wittich, A; Rieger, M A

2015-11-01

In Germany, mental disorders have increasing importance for disability and early retirement. However, patients may have to wait several months before becoming an appointment with a psycho(somatic) therapist. Accordingly, several companies initiated a "psychosomatic consultation in the workplace" (PCIW). This concept has been explored. Qualitative data analysis (expert interviews with stakeholders, focus group interviews with occupational health physicians; Mayring's content analysis) focussed on the question of how the concept of a PCIW can be tailored to meet the employees' needs. Concepts and implementation of PCIW differed with regard to the aspects dissemination of information about the consultation, gatekeeping, place of the consultation, and number of appointments with the psycho(somatic) therapist. The concepts of PCIW may be described as more or less "restrictive" or "liberal". The interviewees emphasised the need for PCIW and discussed the involvement of the occupational health physician within this approach. PCIW proved of value. Yet, the interviewees were ambivalent regarding the fact that companies offer and pay for treatment which should be provided within standard health care. Shaping company-based elements of standard health care should respect setting-specific needs and involve in-company stakeholders into the process. © Georg Thieme Verlag KG Stuttgart · New York.

Effects of Twenty-four Move Shadow Boxing Combined with psychosomatic relaxation on Depression and Anxiety in Patients with Type-2 Diabetes.

PubMed

Zheng, Yingying; Zhou, Yiyi; Lai, Qiujia

2015-06-01

The aim of the current study was to observe the effects of Twenty-four Move Shadow Boxing combined with psychosomatic relaxation on depression and anxiety in patients with Type-2 Diabetes. One hundred and twenty (120) patients with Type-2 Diabetes and depressive/anxious symptoms were divided into intervention group (60 cases) and control group (60 cases) according to the minimum distribution principle of unbalanced indicators. Twenty-four Move Shadow Boxing group used this intervention combined with psychosomatic relaxation. Control group underwent conventional treatment. All the patients in the two groups completed the Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after treatment. Among the 52 people included in the statistical analysis, the recovery rate was 13.3%. The differences between depression and anxiety scores in the intervention group before and after treatment were statistically significant (P<0.001), whereas these differences were non-significant in the control group (P=0.123). After the treatment, the glycated hemoglobin reduction in the intervention group was greater than that of the control group (t=2.438, P=0.016). The combination of Twenty-four Move Shadow Boxing and psychosomatic relaxation has a beneficial auxiliary therapeutic effect on depression and anxiety accompanying Type-2 Diabetes.

Teaching psychosomatic medicine using problem-based learning and role-playing.

PubMed

Heru, Alison M

2011-01-01

Problem-based learning (PBL) has been implemented in medical education world-wide. Despite its popularity, it has not been generally considered useful for residency programs. The author presents a model for the implementation of PBL in residency programs. The author presents a description of a PBL curriculum for teaching psychosomatic medicine to PGY 2 members in a psychiatry training program. The goals of PBL are to encourage self-directed learning; enhance curiosity, using case-based, contextualized learning; promote collaborative practice; and support patient-centered care. The addition of role-playing exercises helps PGY 2 residents to develop their skills from simply developing a differential diagnosis to being able to construct biopsychosocial formulations, and it provides these residents an opportunity to practice presenting case formulations to the patient and family. Residents and faculty enjoyed the PBL role-playing sessions. Residents wanted the learning objectives given to them rather than generating their own learning objectives, to move through the cases faster, and to receive more information and more cases. Teaching psychosomatic medicine, using PBL and role-playing, allows many of the proposed Academy of Psychosomatic Medicine residency core competencies to be met. However, further refinement of the PBL method needs to take place in order to adapt its use to residency programs.

Posttraumatic stress disorder among preschoolers exposed to ongoing missile attacks in the Gaza war.

PubMed

Kaufman-Shriqui, Vered; Werbeloff, Nomi; Faroy, Michal; Meiri, Gal; Shahar, Danit R; Fraser, Drora; Novack, Yelena; Bilenko, Natalya; Vardi, Hillel; Elhadad, Naama; Pietrzak, Robert H; Harpaz-Rotem, Ilan

2013-05-01

The prevalence and manifestation of posttraumatic stress symptoms in young children may differ from that observed in adults. This study examined sociodemographic, familial, and psychosomatic correlates of posttraumatic stress disorder (PTSD) among preschool children and their mothers who had been exposed to ongoing missile attacks in the Gaza war. One hundred and sixty-seven mothers of preschoolers (aged 4.0-6.5 years) were interviewed regarding PTSD and psychosomatic symptomatology of their children, as well as their own reactions to trauma. Fourteen mothers (8.4%) and 35 children (21.0%) screened positive for PTSD. Sociodemographic characteristics were not associated with PTSD among mothers or children. Among children, the only significant risk factor was having a mother with PTSD (OR = 12.22, 95% CI 2.75-54.28). Compared to children who did not screen positive for PTSD, those who did screen positive displayed significantly higher rates of psychosomatic reactions to trauma, most notably constipation or diarrhea (OR = 4.36, 95% CI 1.64-11.60) and headaches (OR = 2.91, 95% CI 1.07-7.94). Results of this study add to the burgeoning literature on child PTSD, emphasizing the important role of maternal anxiety and the psychosomatic reactions associated with exposure to ongoing traumatic experiences in young children. © 2013 Wiley Periodicals, Inc.

Attitudes of U.S. Psychiatry Residents and Fellows towards Mental Illness and its Causes: a Comparison Study with Medical Students.

PubMed

Chiles, Catherine; Stefanovics, Elina; Rosenheck, Robert

2018-01-13

Stigma towards people with mental illness remains a burden for patients and healthcare providers. This study at a large US university examined the attitudes of psychiatry residents and fellows towards mental illness and its causes, and whether their attitudes differed from the medical student attitudes previously studied utilizing the same survey method. An electronic questionnaire examining attitudes toward people with mental illness, causes of mental Illness, and treatment efficacy was used to survey the attitudes of psychiatry residents and fellows. Exploratory factor analysis derived from the authors' medical student survey was used to examine attitudinal factors. The study response rate was 54.2% (n = 94). Factor analysis employed three factors previously identified reflecting social acceptance of mental illness, belief in supernatural causes, and belief in biopsychosocial causes. Residents and fellows reporting more personal experiences with mental illness, both as a group and when compared with medical students, were significantly more willing to socialize with the mentally ill. Respondents who had more professional (work) experience other than medical school or post-graduate training were less likely to believe in supernatural causes of mental illness. Female residents and fellows were more willing to socialize with the mentally ill, and were less likely to believe in supernatural causes for mental illness than their male counterparts. In our study, increased social acceptance of the mentally ill relates to having personal experiences, advanced training in psychiatry, and female gender. Both professional experiences outside of training and female gender reduced the belief in supernatural causes.

Belief in supernatural causes of mental illness among Malay patients: impact on treatment.

PubMed

Razali, S M; Khan, U A; Hasanah, C I

1996-10-01

The concept of aetiology of mental illness in 134 Malay patients was investigated by means of a 20-item checklist. About 53% of the patients attributed their illnesses to supernatural agents. Witchcraft and possession by evil spirits were regarded as common causes of illness. The number of patients who believed in supernatural causes of their mental illness was significantly higher among those who had consulted bomohs (Malay traditional healers) than among those who had not consulted them. The belief that mental illness is caused by supernatural agents is firmly held by bomohs, who reinforce this notion in those who seek their advice. Belief in supernatural causes of mental illness was not significantly associated with age, gender, level of education or occupation of the patients. Patients who believed in supernatural causes of mental illness were also found to show poor drug compliance, and the number of such patients at 6 months follow-up was significantly lower than the corresponding figure for those who did not believe in supernatural causes. The importance of understanding the patients' cultural background when treating psychiatric patients is highlighted.

Hysteria and mourning--a psychosomatic case.

PubMed

Sklar, Jonathan

2008-01-01

Freud early in the history of analysis viewed hysteria in relation to trauma. This became a subject of great interest to Ferenczi particularly in his clinical activities in trying to find the balance between fantasy and trauma. The enactment in the body, as a psychosomatic symptom, is a way of unconsciously drawing attention to that which cannot be processed emotionally. A young man with a long-standing obsessional character had a sudden onset of motor disturbance. A recent set of family calamities triggered a psychosomatic defence against his having to be affectively in touch with a breakdown, which first occurred when he was 2 years old, and which he had never mourned. It was only after the development of a severe body tic following the family disruption that the possibility of finding lost affect and the capacity for an integration of the psychic and somatic became available through the analytic process.

Psychosomatic factors in pruritus

PubMed Central

Tey, Hong Liang; Wallengren, Joanna; Yosipovitch, Gil

2013-01-01

Pruritus and psyche are intricately and reciprocally related, with psychophysiological evidence and psychopathological explanations helping us to understand their complex association. Their interaction may be conceptualized and classified into 3 groups: pruritic diseases with psychiatric sequelae, pruritic diseases aggravated by psychosocial factors, and psychiatric disorders causing pruritus. Management of chronic pruritus is directed at treating the underlying causes and adopting a multidisciplinary approach to address the dermatologic, somatosensory, cognitive, and emotional aspects. Pharmcotherapeutic agents that are useful for chronic pruritus with comorbid depression and/or anxiety comprise selective serotonin reuptake inhibitors, mirtazapine, tricyclic antidepressants (amitriptyline and doxepin), and anticonvulsants (gabapentin, pregabalin); the role of neurokinin receptor-1 antagonists awaits verification. Antipsychotics are required for treating itch and formication associated with schizophrenia and delusion of parasitosis (including Morgellons disease). PMID:23245971

[The relationship between depression, anxiety and heart disease - a psychosomatic challenge].

PubMed

Kapfhammer, Hans-Peter

2011-12-01

Depressive and cardiological disorders present a major comorbidity. Their manifold interrelations may be best analysed within a biopsychosocial model of disease. A systematic research was done on empirical studies published during the last 15 years and dealing with epidemiological, etiopathogenetic and therapeutic dimensions of the comorbidity of depression, anxiety and heart disease. From an epidemiological perspective recurrent depressions are associated with a significantly increased risk of coronary heart disease. Depressive disorders play a major role in triggering critical cardiac events, e.g. myocardial infarction. The prevalence rates of depressive disorders in various cardiological conditions are significantly higher than the frequencies that can be expected in healthy general population. Depression shows a negative impact on the somatic morbidity and mortality during the further course of illness. Anxiety and posttraumatic stress disorders seem to be interrelated with cardiological conditions in quite a similar way, probably contributing even more negatively to critical and lethal cardiological events than depression. From an etiopathogenetic perspective some clusters of depressive symptoms seem to be linked to cardiotoxicity more closely than other, vital exhaustion, anhedonia, and hopelessness probably mediating a special risk. In any case, postmyocardial infarct depression that proves treatment-resistent indicates a negative prognosis of the prevailing cardiological condition. On a level of psychological and psychosocial constructs type-A personality, anger/hostility, type-D personality, and alexithymia have been explored regarding its proper pathogenetic role. Psychological and psychopathological variables have to be set into a context of psychosocial stressors on the one hand, and have to be simultaneously analysed with various underlying psycho- and neurobiological variables on the other. Above all, HPA- and sympathicomedullary dysfunctions, reduced heart rate variability, altered functions of thrombocytes, and increased proinflammatory processes have to be recognized as significantly contributing to the pathophysiology both of depression and of heart condition. Neurobiological aspects of anxiety and posttraumatic stress disorders must be interlinked with these underpinnings of depression. Differential effects on critical cardiological events must be supposed. From a therapeutic perspective several RCTs demonstrate that SSRIs may safely and efficiently treat depressive disorders in cardiological conditions, and may even improve the general somatic prognosis. Cognitive-behavioural psychotherapies have been empirically validated in treating depression and anxiety with cardiological patients. So far, however, a differential indication of psychopharmacological versus psychotherapeutic approaches has not been proved yet. Depression and anxiety disorders in patients with heart disease paradigmatically define a psychosomatic-somatopsychic challenge to any health delivery system. A psychosomatic perspective may best be practised within a Consultation-Liaison psychiatric service that cooperates continuously and closely with cardiological departments and experts.

Humor in psychiatric healing.

PubMed

Saper, B

1988-01-01

The oft-quoted aphorism that "laughter is the best medicine" is examined. Specifically, three big drops in the shower of claims regarding the benefits of humor in treating physical and mental disorders are evaluated. First, studies of the effects of mirth and laughter on the physiology of the body reveal both good and bad news. The meager evidence of the salutary effects of positive emotions on the cardiovascular, respiratory, immune and neuroendocrine systems, though apparently supportable on more or less scientific, rational and subjective grounds, needs much better verification from more extensive, replicable, and empirical research. Second, despite numerous claims, in the context of behavioral or psychosomatic medicine, that a joyful, optimistic, or humorous attitude can render a salubrious effect, almost to the extent of preventing illness and curing physical disease, the jury is still out and issuing dire warnings regarding too ready acceptance of this largely anecdotal evidence. Much careful "clinical trial" research needs to be mounted to determine the conditions under which humor works best, if at all. The type of patient, the kind of humor, the type and severity of illness, the psychosocial contexts-all of these factors should be considered. Third, the infusion of humor into psychotherapy is great news for some therapists and awful news for others. A number of more balanced approaches point up the probability that when mirth is incorporated into therapy judiciously, appropriately, and meaningfully it can be of value.

From somatic pain to psychic pain: The body in the psychoanalytic field.

PubMed

Hartung, Thomas; Steinbrecher, Michael

2017-03-24

The integration of psyche and soma begins with a baby's earliest contact with his or her parents. With the help of maternal empathy and reverie, β-elements are transformed into α-elements. While we understand this to be the case, we would like to enquire what actually happens to those parts of the affect which have not been transformed? For the most part they may be dealt with by evacuation, but they can also remain within the body, subsequently contributing to psychosomatic symptoms. This paper describes how the body serves as an intermediate store between the psychic (inner) and outer reality. The authors focuses on the unconscious communicative process between the analyst and the analysand, and in particular on how psychosomatic symptoms can spread to the analyst's body. The latter may become sensitive to the analysand's psychosomatic symptoms in order to better understand the psychoanalytical process. Sensory processes (visual and auditory) and psychic mechanisms such as projective identification can serve as a means for this communication. One of the first analysts to deal with this topic was Wilhelm Reich. He described one kind of psychosomatic defence like a shell, the character armour, comparing the armour formed by muscle tension with another, more psychical type of armour. This concept can be linked to Winnicott's contribution of the false self and later on to Feldman's concept of compliance as a defence. The authors links further details of the clinical material with theoretical concepts from Joyce McDougall, Piera Aulagnier, and Ricardo Rodulfo and Marilia Aisenstein. With the aid of the complex concept of projective identification, as described by Heinz Weiss, the authors discusses the important question of how the analyst gets in touch with the patient's current psychosomatic state, and describes a specific communication between the body of the psychoanalyst and the body of the patient. A vignette illustrates in greater detail the relationship between this theoretical understanding and an actual clinical example. In the session described, the analyst reacts to the patient with an intense body-countertransference, taking on the patient's symptoms for a short time. The patient, who had been unable to integrate psyche and soma (whose psyche did not indwell (Winnicott) in his body), projected the untransformed β-elements into his body, where they emerged as bodily symptoms. The body became a kind of intermediate store between inner and outer reality. By internalizing the patient's symptoms in his own body, the analyst created a bodily communication - something in between concerning the inner and the outer reality of both participants of the analytic dyad. The analyst was able to recognize his psychosomatic experience as the fear of dying, and to work through his bodily countertransference. This is described in detail. The emerging understanding of the countertransference helped the analyst to contribute to the patient's process of transforming his symptoms. The analyst was able to help the patient get in touch emotionally with many traumatic situations experienced during his life. The function of the psychosomatic symptoms was to contain the patient's fear of death. These frightening feelings could now be worked through on a psychical level; they could enter into a process of symbol formation so that the psychosomatic symptoms were no longer necessary and disappeared. Copyright © 2017 Institute of Psychoanalysis.

Illness Attitudes Scale dimensions and their associations with anxiety-related constructs in a nonclinical sample.

PubMed

Stewart, S H; Watt, M C

2000-01-01

The Illness Attitudes Scale (IAS) is a self-rated measure that consists of nine subscales designed to assess fears, attitudes and beliefs associated with hypochondriacal concerns and abnormal illness behavior [Kellner, R. (1986). Somatization and hypochondriasis. New York: Praeger; Kellner, R. (1987). Abridged manual of the Illness Attitudes Scale. Department of Psychiatry, School of Medicine, University of New Mexico]. The purposes of the present study were to explore the hierarchical factor structure of the IAS in a nonclinical sample of young adult volunteers and to examine the relations of each illness attitudes dimension to a set of anxiety-related measures. One-hundred and ninety-seven undergraduate university students (156 F, 41 M; mean age = 21.9 years) completed the IAS as well as measures of anxiety sensitivity, trait anxiety and panic attack history. The results of principal components analyses with oblique (Oblimin) rotation suggested that the IAS is best conceptualized as a four-factor measure at the lower order level (with lower-order dimensions tapping illness-related Fears, Behavior, Beliefs and Effects, respectively), and a unifactorial measure at the higher-order level (i.e. higher-order dimension tapping General Hypochondriacal Concerns). The factor structure overlapped to some degree with the scoring of the IAS proposed by Kellner (1986, 1987), as well as with the factor structures identified in previously-tested clinical and nonclinical samples [Ferguson, E. & Daniel, E. (1995). The Illness Attitudes Scale (IAS): a psychometric evaluation on a nonclinical population. Personality and Individual Differences, 18, 463-469; Hadjistavropoulos, H. D. & Asmundson, G. J. G. (1998). Factor analytic investigation of the Illness Attitudes Scale in a chronic pain sample. Behaviour Research and Therapy, 36, 1185-1195; Hadjistavropoulos, H. D., Frombach, I. & Asmundson, G. J. G. (in press). Exploratory and confirmatory factor analytic investigations of the Illness Attitudes Scale in a nonclinical sample. Behaviour Research and Therapy; Speckens, A. E., Spinhoven, P., Sloekers, P. P. A., Bolk, J. H. & van Hemert, A. M. (1996). A validation study of the Whitley Index, the Illness Attitude Scales and the Somatosensory Amplification Scale in general medical and general practice patients. Journal of Psychosomatic Research, 40, 95-104]. The Fears, Beliefs and Effects lower-order factors and the General Hypochondriacal Concerns higher-order factor, were shown to be strongly associated with anxiety sensitivity, even after accounting for trait anxiety and panic history. Implications for understanding the high degree of comorbidity between the diagnoses of panic disorder and hypochondriasis, as well as future research directions for exploring the utility of various IAS dimensions in predicting responses to lab-based bodily symptom-induction procedures, are discussed.

Witchcraft and Biopsychosocial Causes of Mental Illness: Attitudes and Beliefs About Mental Illness Among Health Professionals in Five Countries.

PubMed

Stefanovics, Elina A; He, Hongbo; Cavalcanti, Maria; Neto, Helio; Ofori-Atta, Angelo; Leddy, Meaghan; Ighodaro, Adesuwa; Rosenheck, Robert

2016-03-01

This study examines the intercorrelation of measures reflecting beliefs about and attitudes toward people with mental illness in a sample of health professionals (N = 902) from five countries: Brazil, China, Ghana, Nigeria, and the United States, and, more specifically, the association of beliefs in supernatural as contrasted with biopsychosocial causes of mental illness. Factor analysis of a 43-item questionnaire identified four factors favoring a) socializing with people with mental illness; b) normalizing their roles in society; c) belief in supernatural causes of mental illness (e.g., witchcraft, curses); and d) belief in biopsychosocial causes of mental illness. Unexpectedly, a hypothesized negative association between belief in supernatural and biopsychosocial causation of mental illness was not found. Belief in the biopsychosocial causation was weakly associated with less stigmatized attitudes towards socializing and normalized roles.

Recreational Waterborne Illnesses: Recognition, Treatment, and Prevention.

PubMed

Perkins, Allen; Trimmier, Marirose

2017-05-01

Illness after recreational water activities can be caused by a variety of agents, including bacteria, viruses, parasites, algae, and even chlorine gas. These illnesses are more common in summer. Waterborne illnesses are underreported because most recreational activity occurs in unsupervised venues or on private property, and participants tend to disperse before illness occurs. Symptoms of waterborne illness are primarily gastrointestinal, but upper respiratory and skin manifestations also occur. Gastrointestinal symptoms are usually self-limited, and supportive treatment may be all that is necessary. However, some infections can cause significant morbidity and mortality. Cryptosporidium and Giardia intestinalis are the most common cause of gastrointestinal illness and have partial chlorine resistance. Respiratory infections are typically mild and self-limited. However, if legionnaires' disease develops and is unrecognized, mortality may be as high as 10%. Cellulitis caused by Vibrio vulnificus can result in serious illness, amputation, and death. Early and appropriate antibiotic treatment is important. Chronically ill and immunocompromised persons are at high risk of infection and should be counseled accordingly.

Parvovirus B19 and Other Illnesses

MedlinePlus

... Cheek Rash Parvovirus B19 and Other Illnesses References Parvovirus B19 and Other Illnesses Recommend on Facebook Tweet Share ... disease is the most common illness caused by parvovirus B19 infection. Learn More Parvovirus B19 infection can cause ...

[Multifaceted body. 3. The contextualised body].

PubMed

Bourquin, C; Wykretowicz, H; Saraga, M; Stiefel, F

2015-02-11

The human body is the object upon which medicine is acting, but also lived reality, image, symbol, representation and the object of elaboration and theory. All these elements which constitute the body influence the way medicine is treating it. In this series of three articles, we address the human body from various perspectives: medical (1), phenomenological (2), psychosomatic and socio-anthropological (3). This third and last article focuses on the psychosomatic and socio-anthropological facets of the body and their contribution to its understanding.

Proceedings of the User’s Workshop on Combat Stress; Lessons Learned in Recent Operational Experiences (4th) Held at Sam Houston, Texas on 18-21 September 1984

DTIC Science & Technology

1985-01-01

Acute and chronic psychiatric and psychosomatic reactions in concentration camp survivors, in Society, Stress, and Disease. Edited by Levi, L. New York...healthier than males with non-stress diagnoses. Because the sample contained relatively few women, the more complex analyses were not very effective...among inept leaders, frpquently in static defense positions. In 1863, by directive, there were no more psychiatric diagnoses. Psychosomatic

Activation of latent Graves' disease in children. Review of possible psychosomatic mechanisms.

PubMed

Morillo, E; Gardner, L I

1980-03-01

In some children, psychological events have appeared to be important in the triggering of Graves' disease. This report examines the case histories of three children in whom the appearance of symptomatology of Graves' disease was associated with depression following the death of a loved one. An analysis of neuroendocrine and immunologie pathways suggests that depression, set off by bereavement, causes low levels of norepinephrine in the brain. The latter in turn may mediate an increase in ACTH and cortisol, leading to reductions in immune surveillance and resultant production of thyroid-stimulating immunoglobulins, hence the development of Graves' disease.

Treating childhood asthma in Singapore: when West meets East.

PubMed Central

Connett, G. J.; Lee, B. W.

1994-01-01

Though Western medicines and ideas about asthma have become popular in many Asian nations, local beliefs about treatment prevail. The multiracial society of Singapore shows a variety of beliefs about causes of asthma attacks (for example, the balance of yin and yang) and types of treatment--herbal remedies, inhaled versus eaten medicines, the influence of Ramadan. Many of the cultural practices mentioned are probably preserved among south east Asian minorities residing in the United Kingdom. Eastern treatments typically take a holistic approach to asthma and do not ignore the psychosomatic component of the disorder. Images p1282-a PMID:8205023

Defining Older Adults' Perceived Causes of Hypertension in the Brief Illness Perception Questionnaire

ERIC Educational Resources Information Center

Duwe, Elise A. G.; Koerner, Kari M.; Madison, Anna M.; Falk, Nikki A.; Insel, Kathleen C.; Morrow, Daniel G.

2014-01-01

Objectives: This study sought to make the Brief Illness Perception Questionnaire (BIPQ) to be more informative about illness representation among older adults with hypertension. The authors developed categories for coding the open-ended question regarding cause of illness in the BIPQ--a pervasive quantitative measure for illness representation.…

The Singaporean public beliefs about the causes of mental illness: results from a multi-ethnic population-based study.

PubMed

Pang, S; Subramaniam, M; Lee, S P; Lau, Y W; Abdin, E; Chua, B Y; Picco, L; Vaingankar, J A; Chong, S A

2017-04-03

To identify the common causal beliefs of mental illness in a multi-ethnic Southeast Asian community and describe the sociodemographic associations to said beliefs. The factor structure to the causal beliefs scale is explored. The causal beliefs relating to five different mental illnesses (alcohol abuse, depression, obsessive-compulsive disorder (OCD), dementia and schizophrenia) and desire for social distance are also investigated. Data from 3006 participants from a nationwide vignette-based study on mental health literacy were analysed using factor analysis and multiple logistic regression to address the aims. Participants answered questions related to sociodemographic information, causal beliefs of mental illness and their desire for social distance towards those with mental illness. Physical causes, psychosocial causes and personality causes were endorsed by the sample. Sociodemographic differences including ethnic, gender and age differences in causal beliefs were found in the sample. Differences in causal beliefs were shown across different mental illness vignettes though psychosocial causes was the most highly attributed cause across vignettes (endorsed by 97.9% of respondents), followed by personality causes (83.5%) and last, physical causes (37%). Physical causes were more likely to be endorsed for OCD, depression and schizophrenia. Psychosocial causes were less often endorsed for OCD. Personality causes were less endorsed for dementia but more associated with depression. The factor structure of the causal beliefs scale is not entirely the same as that found in previous research. Further research on the causal beliefs endorsed by Southeast Asian communities should be conducted to investigate other potential causes such as biogenetic factors and spiritual/supernatural causes. Mental health awareness campaigns should address causes of mental illness as a topic. Lay beliefs in the different causes must be acknowledged and it would be beneficial for the public to be informed of the causes of some of the most common mental illnesses in order to encourage help-seeking and treatment compliance.

"Head take you": causal attributions of mental illness in Jamaica.

PubMed

Arthur, Carlotta M; Whitley, Rob

2015-02-01

Causal attributions are a key factor in explanatory models of illness; however, little research on causal attributions of mental illness has been conducted in developing nations in the Caribbean, including Jamaica. Explanatory models of mental illness may be important in understanding illness experience and be a crucial factor in mental health service seeking and utilization. We explored causal attributions of mental illness in Jamaica by conducting 20 focus groups, including 16 community samples, 2 patient samples, and 2 samples of caregivers of patients, with a total of 159 participants. The 5 most commonly endorsed causal attributions of mental illness are discussed: (a) drug-related causes, including ganja (marijuana); (b) biological causes, such as chemical imbalance, familial transmission, and "blood"; (c) psychological causes, including stress and thinking too much; (d) social causes, such as relationship problems and job loss; and (e) spiritual or religious causes, including Obeah. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Children's conceptions of mental illness: a naïve theory approach.

PubMed

Fox, Claudine; Buchanan-Barrow, Eithne; Barrett, Martyn

2010-09-01

This paper reports two studies that investigated children's conceptions of mental illness using a naïve theory approach, drawing upon a conceptual framework for analysing illness representations which distinguishes between the identity, causes, consequences, curability, and timeline of an illness. The studies utilized semi-structured interviewing and card selection tasks to assess 6- to 11-year-old children's conceptions of the causes and consequences (Study 1) and the curability and timeline (Study 2) of different mental and physical illnesses/ailments. The studies revealed that, at all ages, the children held coherent causal-explanatory ideas about the causes, consequences, curability, and timeline of both mental and physical illnesses/ailments. However, while younger children tended to rely on their knowledge of common physical illnesses when thinking about mental illnesses, providing contagion and contamination explanations of cause, older children demonstrated differences in their thinking about mental and physical illnesses. No substantial gender differences were found in the children's thinking. It is argued that children hold coherent conceptions of mental illness at all ages, but that mental illness only emerges as an ontologically distinct conceptual domain by the end of middle childhood.

[Kurt Goldstein's understanding of amnesic aphasia and its underlying disorder - an early model of the pensée opératoire of the French psychosomatic school?].

PubMed

Danzer, G; Eisenblätter, A; Belz, W; Schulz, A; Klapp, B F

2002-07-01

Kurt Goldstein's understanding of amnesic aphasia in some regards anticipated the model of the pensée opératoire, a concept developed during the 60's and 70's by the French psychoanalytical school of psychosomatics. Goldstein interpreted amnesic aphasia within the framework of a "basic disorder". Closely following the philosopher Ernst Cassirer, Goldstein described amnesic aphasia as an expression of a general alteration following localized or generalised brain damage. Due to various historical events (world war, fascism, the holocaust) as well as developments during the 20(th) century (dominance of the English language in many areas of science), these connections were forgotten or were no longer recognised as such. Without wanting to determine the extent to which the concept of pensée opératoire possesses validity, one can interpret Goldstein's reflections on aphasia as a heretofore unreceived preliminary model of the psychosomatic concept of the French School.

[Unhealthy lifestyle in patients of a psychosomatic outpatient and consultation-liaison clinic].

PubMed

Beutel, Till F; Weiser, Prisca; Zwerenz, Rüdiger; Wiltink, Jörg; Subic-Wrana, Claudia; Michal, Matthias

2014-09-01

Patients with mental disorders have an increased risk for somatic diseases. Especially life style risk factors contribute to this increased risk. In order to identify targets for preventive measures, we aimed to determine the prevalence of an unhealthy lifestyle in a clinical sample and to analyze associations with severity of mental disorders and somatic complaints. We analyzed the medical records of n=1 919 outpatients, who were treated between 2009-2011 in the Department of Psychosomatic Medicine and Psychotherapy of the University Medical Center Mainz. 62.4% of the patients were physically inactive, 33.2% were smokers and 17.4% were obese. Lifestyle risk factors were associated with increased symptom burden and impairment. Smoking was strongly associated with more previous psychiatric or psychosomatic inpatient treatments. These results indicate an urgent need for targeting health behavior more rigorously in the treatment of patients with common mental disorders. © Georg Thieme Verlag KG Stuttgart · New York.

[Motivational and Volitional Determinants of Applying for Psychosomatic Rehabilitation: Findings of a Cohort Study].

PubMed

Bethge, M; Peters, E; Michel, E; Radoschewski, F M; Spanier, K

2016-12-01

Objective: Analyses of motivational and volitional determinants of applying for psychosomatic rehabilitation Methods: Determinants of a rehabilitation request were assessed by a questionnaire in 2013. Applications for psychosomatic rehabilitation measures until the end of 2014 were extracted from administrative data records. Included were employees with mental disorders. Results: Only 55 of 974 persons requested a rehabilitation measure. The intention to apply for a rehabilitation measure was strongest determined by self-efficacy and family and professional support. Planning was explained by intention and to a lesser extent by family and physician support. Persons with higher planning scores were more likely to apply for a rehabilitation measure. Physician support also increased the likelihood of a rehabilitation request. Conclusion: The analyses identified determinants of rehabilitation claims that are modifiable. This gives opportunities to support rehabilitation claims. However, the contribution of these factors to explain rehabilitation requests is only limited. © Georg Thieme Verlag KG Stuttgart · New York.

The relevance of the philosophical 'mind-body problem' for the status of psychosomatic medicine: a conceptual analysis of the biopsychosocial model.

PubMed

Van Oudenhove, Lukas; Cuypers, Stefaan

2014-05-01

Psychosomatic medicine, with its prevailing biopsychosocial model, aims to integrate human and exact sciences with their divergent conceptual models. Therefore, its own conceptual foundations, which often remain implicit and unknown, may be critically relevant. We defend the thesis that choosing between different metaphysical views on the 'mind-body problem' may have important implications for the conceptual foundations of psychosomatic medicine, and therefore potentially also for its methods, scientific status and relationship with the scientific disciplines it aims to integrate: biomedical sciences (including neuroscience), psychology and social sciences. To make this point, we introduce three key positions in the philosophical 'mind-body' debate (emergentism, reductionism, and supervenience physicalism) and investigate their consequences for the conceptual basis of the biopsychosocial model in general and its 'psycho-biological' part ('mental causation') in particular. Despite the clinical merits of the biopsychosocial model, we submit that it is conceptually underdeveloped or even flawed, which may hamper its use as a proper scientific model.

Attitudes of Students at a US Medical School Toward Mental Illness and Its Causes.

PubMed

Chiles, Catherine; Stefanovics, Elina; Rosenheck, Robert

2017-06-01

Stigma among health care providers toward people with mental illness is a worldwide problem. This study at a large US university examined medical student attitudes toward mental illness and its causes, and whether student attitudes change as they progress in their education. An electronic questionnaire focusing on attitudes toward people with mental illness, causes of mental illness, and treatment efficacy was used to survey medical students at all levels of training. Exploratory factor analysis was used to establish attitudinal factors, and analysis of variance was used to identify differences in student attitudes among these factors. Independent-samples t tests were used to assess attitudes toward efficacy of treatments for six common psychiatric and medical conditions. The study response rate was 42.6 % (n = 289). Exploratory factor analysis identified three factors reflecting social acceptance of mental illness, belief in supernatural causes, and belief in biopsychosocial causes. Stages of student education did not differ across these factors. Students who had completed the psychiatry clerkship were more likely to believe that anxiety disorders and diabetes could be treated effectively. Students reporting personal experiences with mental illness showed significantly more social acceptance, and people born outside the USA were more likely to endorse supernatural causes of mental illness. Sociocultural influences and personal experience with mental illness have a greater effect than medical education on attitudes toward people with mental illness. Psychiatric education appears to have a small but significant effect on student attitudes regarding treatment efficacy.

Psychosomatic factors in pruritus.

PubMed

Tey, Hong Liang; Wallengren, Joanna; Yosipovitch, Gil

2013-01-01

Pruritus and psyche are intricately and reciprocally related, with psychophysiological evidence and psychopathological explanations helping us to understand their complex association. Their interaction may be conceptualized and classified into 3 groups: pruritic diseases with psychiatric sequelae, pruritic diseases aggravated by psychosocial factors, and psychiatric disorders causing pruritus. Management of chronic pruritus is directed at treating the underlying causes and adopting a multidisciplinary approach to address the dermatologic, somatosensory, cognitive, and emotional aspects. Pharmcotherapeutic agents that are useful for chronic pruritus with comorbid depression and/or anxiety comprise selective serotonin reuptake inhibitors, mirtazapine, tricyclic antidepressants (amitriptyline and doxepin), and anticonvulsants (gabapentin, pregabalin); the role of neurokinin receptor-1 antagonists awaits verification. Antipsychotics are required for treating itch and formication associated with schizophrenia and delusion of parasitosis (including Morgellons disease). Copyright © 2013 Elsevier Inc. All rights reserved.

[The role of cognitive emotional self-regulation in adolescence in levels of depression, psychosomatic symptoms and subjective well-being].

PubMed

Kriston, Pálma; Pikó, Bettina

More and more studies suggest that mental health may be determined by processes of emotional self-regulation. Emotion regulation is a complex concept which can be explicit and implicit and includes different cognitive and behavioral processes: evaluation, modifying of emotional reaction to accomplish goals. Our research aim was to explore the use of cognitive emotional self-regulation strategies related to mental health indicators among adolescents. The youth study was performed with a sample size of 1245 participants in Makó, in 2016. Data collection was based on self-administrated questionnaries that contained items on mental health, subjective well-being and background of sociodemographics. The data were compared on the basis of gender differences and tested by multiple linear regression analysis to map associations between the regulation strategies and mental health indicators: depression, psychosomatic symptoms, satisfaction with life. Girls reported higher levels of depression and psychosomatic symptoms and lower satisfaction with life than boys. Significant differences were observed between boys and girls in using rumination, positive refocusing, selfblame, others-blame and putting into perspective regulation strategy. In addition the nonadaptive strategies were proved to be related to higher depression and psychosomatic symptom scores, whereas adaptive strategies to higher level of satisfaction with life in both boys and girls. The study draws attention to the importance of cognitive emotion regulation strategies from the point of view of mental health and to explore the background factors of cognitive processes of emotional self-regulation.

[Current status of job burnout in clinical nurses in a grade A tertiary hospital and related influencing factors].

PubMed

Ye, L Y; Fan, C L; Wang, L G; Tao, T; Gao, W B; Li, Y H

2017-10-20

Objective: To investigate the current status of job burnout in clinical nurses in a grade A tertiary hospitalin Shaoxing,China and related influencing factors. Methods: In October 2016, the Nursing Burnout Scale (NBS)was used for the investigation of 304 clinical nurses in a grade A tertiary hospital.The contents of the investigation included general data(including age,education background,working years,marital status, frequency of night shifts,professional title, and way of employment), characteristics of working environment,burnout, personality characteristics,coping strategy,and psychosomatic symptoms.SPSS 18.0 was used to conduct Pearson correlation analysis of the scores of each dimension of NBS. A multivariate regression analysis was performed with the demographic features of clinical nurses as the independent variable and the scores of each dimension of NBS as the dependent variable. Results: Among the clinical nurses in this grade A tertiary hospital, the incidence rate of severe burnout was 74%.The Pearson correlation analysis showed that burnout,pessimistic personality,negative coping,and psychosomatic symptoms were positively correlated with working environment( r =0.530,0.316,0.116,and 0.502); pessimistic personality and psychosomatic symptoms were positively correlated with burnout( r =0.618 and 0.675); psychosomatic symptoms were positively correlated withpessimistic personality( r =0.540); negative coping was negatively correlated with pessimistic personality( r =-0.145).The multivariate linear regression analysis showed that department(Department of Internal Medicine or Department of Surgery, B =-0.364 and -0.428)and frequency of night shifts(<6 times/month and 6 - 10 times/month, B =0.199 and 0.256)were influencing factors for the score of working environment; department(Department of Internal Medicine or Department of Surgery, B =-0.350 and -0.360)was an influencing factor for the score of burnout; 1 - 3 working years( B =-0.238)was an influencing factor for the score of pessimistic personality; married state,1 - 3 working years,and department (Department of Internal Medicine or Department of Surgery)were influencing factors for the score of psychosomatic symptoms( B =0.263,-0.301,-0.322,and -0.391). Conclusion: There is a high incidence rate of job burnout among clinical nurses in this grade A tertiary hospital,which is associated with burnout,working environment, pessimistic personality,and psychosomatic symptoms.Marital status,working years,department,and frequency of night shifts are major influencing factors for job burnout.

Psychosocial approach to endocrine disease.

PubMed

Sonino, Nicoletta; Tomba, Elena; Fava, Giovanni A

2007-01-01

In recent years, there has been growing interest in the psychosocial aspects of endocrine disease, such as the role of life stress in the pathogenesis of some conditions, their association with affective disorders, and the presence of residual symptoms after adequate treatment. In clinical endocrinology, exploration of psychosocial antecedents may elucidate the temporal relationships between life events and symptom onset, as it has been shown to be relevant for pituitary (Cushing's disease, hyperprolactinemia) or thyroid (Graves' disease) conditions, as well as the role of allostatic load, linked to chronic stress, in uncovering a person's vulnerability. After endocrine abnormalities are established, they are frequently associated with a wide range of psychological symptoms: at times, such symptoms reach the level of psychiatric illness (mainly mood and anxiety disorders); at other times, however, they can only be identified by the subclinical forms of assessment provided by the Diagnostic Criteria for Psychosomatic Research (DCPR). Indeed, in a population study, the majority of patients suffered from at least one of the three DCPR syndromes considered: irritable mood, demoralization, persistent somatization. In particular, irritable mood was found to occur in 46% of 146 patients successfully treated for endocrine conditions, a rate similar to that found in cardiology and higher than in oncology and gastroenterology. Long-standing endocrine disorders may imply a degree of irreversibility of the pathological process and induce highly individualized affective responses. In patients who showed persistence or even worsening of psychological distress upon proper endocrine treatment, the value of appropriate psychiatric interventions was underscored. As it happened in other fields of clinical medicine, a conceptual shift from a merely biomedical care to a psychosomatic consideration of the person and his/her quality of life appears to be necessary for improving effectiveness in endocrinology. The DCPR have been demonstrated to be a valuable tool for psychological assessment in the various phases of endocrine disease from diagnostic to follow-up periods.

Gulf War illnesses are autoimmune illnesses caused by reactive oxygen species which were caused by nerve agent prophylaxis.

PubMed

Moss, J I

2012-08-01

Gulf War illnesses (GWI share many of the features of chronic fatigue syndrome (CFS) and both CFS and GWI may be the result of chronic immune system processes. The main suspected cause for GWI, the drug pyridostigmine bromide (PB), has been shown to cause neuronal damage from reactive oxygen species (ROS). ROS have been associated with IgM mediated autoimmune responses against ROS induced neoepitopes in depressed patients and this may also apply to CFS. It therefore follows that the drug used in the Gulf War caused ROS, the ROS modified native molecules, and that this trigged the autoimmune condition we refer to as Gulf War illnesses. Similar mechanisms may apply to other autoimmune illnesses. Copyright © 2012 Elsevier Ltd. All rights reserved.

Analysis of causes of death for all decedents in Ohio with and without mental illness, 2004-2007.

PubMed

Sherman, Marion E; Knudsen, Kraig J; Sweeney, Helen Anne; Tam, Kwok; Musuuza, Jackson; Koroukian, Siran M

2013-03-01

This study compared causes of death, crude mortality rates, and standardized mortality ratios (SMRs) between decedents with mental illness in Ohio's publicly funded mental health system ("mental illness decedents") and all Ohio decedents. Ohio death certificates and Ohio Department of Mental Health service utilization data were used to assess mortality among decedents from 2004 to 2007. Age-adjusted SMRs and age-adjusted mortality rates were calculated across race and sex strata. Mental illness decedents accounted for 3.3% of all 438,749 Ohio deaths. Age-adjusted SMRs varied widely across the race and sex strata and by cause of death. Nonblacks with or without mental illness showed higher SMRs than blacks. Nonblack females with mental illness showed the highest SMRs in injury-related deaths. Higher SMRs were found for deaths associated with substance abuse; mental illness; diabetes; issues related to the nervous, cardiovascular, or respiratory systems; and injury. With and without mental illness, the top cause of death was violence for youths and cardiovascular disease for adults >35. Deaths from injury and violence, especially among those <35, should be specifically addressed to reduce excess mortality for persons with mental illness. Mental health care should be integrated with primary care to better manage chronic disease, especially cardiovascular disease. Methodological contributions included use of linked files to compare SMR and leading causes of death between mental illness decedents and all Ohio decedents. More research is needed on patterns in cause of death and any interactions from demographic characteristics and mental illness. Health care data silos must be bridged between private and public sectors and the Departments of Veterans Affairs and Defense.

Psychosomatic aspects of end-stage renal failure.

PubMed

Sensky, T

1993-01-01

End-stage renal failure (ESRD) is more than a typical chronic disease. Its treatment includes features which arguably make this condition unique. Selected psychosomatic aspects of ESRD are reviewed, including psychiatric morbidity, patients' adherence to their treatments, quality of life and the emotional impact on staff involved in treating patients with ESRD. Rather than presenting a comprehensive review of the results of published research, particular emphasis is laid on the critical appraisal of the methodology of published studies, to examine the extent to which these have provided answers to clinically important questions.

[Repetitive work and psychosomatic complaints].

PubMed

Liebrich, J; Geiger, L; Rupp, M

1978-08-01

200 workers of the Swiss watch industry were examined in an interdisciplinary study on the effect of repetitive work on the wellbeing of the worker. Women doing repetitive work with little autonomy complained more often about psychosomatic problems than the male workers doing non-repetitive work. This difference is interpreted as a difference of sexe rather than one of the work situation. However, there is a significant difference in the complaint about nervosity between women being paid monthly and women who were paid by piece or by hour with a premium.

Causal Beliefs and Effects upon Mental Illness Identification Among Chinese Immigrant Relatives of Individuals with Psychosis.

PubMed

Yang, Lawrence H; Wonpat-Borja, Ahtoy J

2012-08-01

Identifying factors that facilitate treatment for psychotic disorders among Chinese-immigrants is crucial due to delayed treatment use. Identifying causal beliefs held by relatives that might predict identification of 'mental illness' as opposed to other 'indigenous labels' may promote more effective mental health service use. We examine what effects beliefs of 'physical causes' and other non-biomedical causal beliefs ('general social causes', and 'indigenous Chinese beliefs' or culture-specific epistemologies of illness) might have on mental illness identification. Forty-nine relatives of Chinese-immigrant consumers with psychosis were sampled. Higher endorsement of 'physical causes' was associated with mental illness labeling. However among the non-biomedical causal beliefs, 'general social causes' demonstrated no relationship with mental illness identification, while endorsement of 'indigenous Chinese beliefs' showed a negative relationship. Effective treatment- and community-based psychoeducation, in addition to emphasizing biomedical models, might integrate indigenous Chinese epistemologies of illness to facilitate rapid identification of psychotic disorders and promote treatment use.

Cultural diversity in causal attributions for illness: the role of the supernatural.

PubMed

Landrine, H; Klonoff, E A

1994-04-01

We investigated cultural diversity in beliefs about the causes of illness and assessed the possibility that popular free-form methodologies (asking subjects to generate causes) inhibit minorities from expressing their belief in supernatural causes. As predicted, when asked to generate causes of illness and rate these in terms of their importance, whites and minorities did not differ in the number or type (natural vs supernatural) of causes they generated or in the importance rating they assigned to these. However, when these same subjects were provided with natural and supernatural causes to rate in terms of importance, minorities rated supernatural causes significantly more important than did whites, and more minorities than whites endorsed such causes. Cultural differences in causal attributions for illness are examined, and the role of methodology in determining such attributions is highlighted.

Illness causal beliefs in Turkish immigrants

PubMed Central

Minas, Harry; Klimidis, Steven; Tuncer, Can

2007-01-01

Background People hold a wide variety of beliefs concerning the causes of illness. Such beliefs vary across cultures and, among immigrants, may be influenced by many factors, including level of acculturation, gender, level of education, and experience of illness and treatment. This study examines illness causal beliefs in Turkish-immigrants in Australia. Methods Causal beliefs about somatic and mental illness were examined in a sample of 444 members of the Turkish population of Melbourne. The socio-demographic characteristics of the sample were broadly similar to those of the Melbourne Turkish community. Five issues were examined: the structure of causal beliefs; the relative frequency of natural, supernatural and metaphysical beliefs; ascription of somatic, mental, or both somatic and mental conditions to the various causes; the correlations of belief types with socio-demographic, modernizing and acculturation variables; and the relationship between causal beliefs and current illness. Results Principal components analysis revealed two broad factors, accounting for 58 percent of the variation in scores on illness belief scales, distinctly interpretable as natural and supernatural beliefs. Second, beliefs in natural causes were more frequent than beliefs in supernatural causes. Third, some causal beliefs were commonly linked to both somatic and mental conditions while others were regarded as more specific to either somatic or mental disorders. Last, there was a range of correlations between endorsement of belief types and factors defining heterogeneity within the community, including with demographic factors, indicators of modernizing and acculturative processes, and the current presence of illness. Conclusion Results supported the classification of causal beliefs proposed by Murdock, Wilson & Frederick, with a division into natural and supernatural causes. While belief in natural causes is more common, belief in supernatural causes persists despite modernizing and acculturative influences. Different types of causal beliefs are held in relation to somatic or mental illness, and a variety of apparently logically incompatible beliefs may be concurrently held. Illness causal beliefs are dynamic and are related to demographic, modernizing, and acculturative factors, and to the current presence of illness. Any assumption of uniformity of illness causal beliefs within a community, even one that is relatively culturally homogeneous, is likely to be misleading. A better understanding of the diversity, and determinants, of illness causal beliefs can be of value in improving our understanding of illness experience, the clinical process, and in developing more effective health services and population health strategies. PMID:17645806

Illness causal beliefs in Turkish immigrants.

PubMed

Minas, Harry; Klimidis, Steven; Tuncer, Can

2007-07-24

People hold a wide variety of beliefs concerning the causes of illness. Such beliefs vary across cultures and, among immigrants, may be influenced by many factors, including level of acculturation, gender, level of education, and experience of illness and treatment. This study examines illness causal beliefs in Turkish-immigrants in Australia. Causal beliefs about somatic and mental illness were examined in a sample of 444 members of the Turkish population of Melbourne. The socio-demographic characteristics of the sample were broadly similar to those of the Melbourne Turkish community. Five issues were examined: the structure of causal beliefs; the relative frequency of natural, supernatural and metaphysical beliefs; ascription of somatic, mental, or both somatic and mental conditions to the various causes; the correlations of belief types with socio-demographic, modernizing and acculturation variables; and the relationship between causal beliefs and current illness. Principal components analysis revealed two broad factors, accounting for 58 percent of the variation in scores on illness belief scales, distinctly interpretable as natural and supernatural beliefs. Second, beliefs in natural causes were more frequent than beliefs in supernatural causes. Third, some causal beliefs were commonly linked to both somatic and mental conditions while others were regarded as more specific to either somatic or mental disorders. Last, there was a range of correlations between endorsement of belief types and factors defining heterogeneity within the community, including with demographic factors, indicators of modernizing and acculturative processes, and the current presence of illness. Results supported the classification of causal beliefs proposed by Murdock, Wilson & Frederick, with a division into natural and supernatural causes. While belief in natural causes is more common, belief in supernatural causes persists despite modernizing and acculturative influences. Different types of causal beliefs are held in relation to somatic or mental illness, and a variety of apparently logically incompatible beliefs may be concurrently held. Illness causal beliefs are dynamic and are related to demographic, modernizing, and acculturative factors, and to the current presence of illness. Any assumption of uniformity of illness causal beliefs within a community, even one that is relatively culturally homogeneous, is likely to be misleading. A better understanding of the diversity, and determinants, of illness causal beliefs can be of value in improving our understanding of illness experience, the clinical process, and in developing more effective health services and population health strategies.

[The assessment of the general functional status and of the psychosomatic complaints of workers at hydroelectric power plants].

PubMed

Danev, S; Dapov, E; Pavlov, E; Nikolova, R

1992-01-01

Evaluation of the general functional status and psychosomatic complaints of 61 workers from the hydroelectric power stations is made. The following methods are used: 1. Assessment of the general functional state, by means of computer analysis of the cardiac variability, analysing the changes in the values of the following indices: average value of the cardiac intervals (X), their standard deviation (SD), coefficient of variation (CV), amplitude of the mode (AMO), index of stress (IS), index of the vegetative balance (IVB), homeostatic index (HI). The last 3 indices serve for determination of the complex evaluation of chronic fatigue and work adaptation (ChFWA). 2. Evaluation of the psychosomatic complaints, by the use of a questionnaire for the subjective psychosomatic complaints. 3. Studying the systolic and diastolic blood pressure. The average values received in workers from HPS were compared with the average values of the population of the country and with the average values of a similar working activity of a group of operators from the thermal power station HPS. In conclusion it could be noted that concerning ChFWA the received values in workers from HPS are not more unfavourable generalized values from that measured in workers, occupied with similar type of work in other industrial branches of the country. However, they are with more unfavourable data in comparison with the workers from HPS. The subjective evaluation of the operators concerning their psychic and body health status is moderately worse, both in comparison with the values of the index for the country, and in comparison with those of the operators from HPS.

Organizational Wellbeing among Workers in Mental Health Services: A Pilot Study.

PubMed

Sancassiani, Federica; Campagna, Marcello; Tuligi, Francesco; Machado, Sergio; Cantone, Elisa; Carta, Mauro Giovanni

2015-01-01

Organizational wellbeing in mental health services influences the outcomes of users and their families. Workers should be motivated, have a positive morale and be able to recognize values and the deep meaning of their work. This survey aims to examine the organizational wellbeing of the services provided by the Department of Mental Health (DSM) in Lanusei (Italy) and the correlations between job satisfaction and the psychosomatic health of its workers. Descriptive-correlational study on a population of 43 mental health workers. Organizational wellbeing, as well as workers' job satisfaction and psychosomatic health, were measured using the "Multidimensional Organizational Health Questionnaire" (MOHQ). It is a self-report questionnaire able to examine 14 dimensions of organizational wellbeing, 14 indicators about individual discomfort, 12 indicators about individual wellbeing, 8 psychosomatic symptoms related to job distress. 31 workers (72%) participated in the survey. Regarding the organizational wellbeing of DSM, the general profile mean±sd was 2.66±0.28 (values from 1 to 4: 1=never, 4=often). Job satisfaction was negatively correlated with headaches and concentration difficulties (R=-.584, p=0.001), nervousness, restlessness, anxiety (R=-.571, p=0.001), sense of excessive fatigue (R=-.634, p=0.000) and sense of depression (R=-.558, p=0.001) reported by workers. Data denoted an overall healthy state of the DSM. There were significant correlations between workers' job satisfaction and their psychosomatic health. The recognition and restitution about the weakness and strengths of the services could be useful to point out some organizational development perspectives.

Psychosomatic disorders of gravida status: false and denied pregnancies.

PubMed

Kenner, William D; Nicolson, Stephen E

2015-01-01

The authors review the literature on two dramatic psychosomatic disorders of reproduction and offer a potential classification of pregnancy denial. Information on false and denied pregnancies is summarized by comparing the descriptions, differential diagnoses, epidemiology, patient characteristics, psychological factors, abdominal tone, and neuroendocrinology. Pregnancy denial's association with neonaticide is reviewed. False and denied pregnancies have fooled women, families, and doctors for centuries as the body obscures her true condition. Improvements in pregnancy testing have decreased reports of false pregnancy. However, recent data suggests 1/475 pregnancies are denied to 20 weeks, and 1/2455 may go undiagnosed to delivery. Factors that may contribute to the unconscious deception include abdominal muscle tone, persistent corpus luteum function, and reduced availability of biogenic amines in false pregnancy, and posture, fetal position, and corpus luteum insufficiency in denied pregnancy. For each condition, there are multiple reports in which the body reveals her true pregnancy status as soon as the woman is convinced of her diagnosis. Forensic literature on denied pregnancy focused on the woman's rejection of motherhood, while psychiatric studies have revealed that trauma and dissociation drive her denial. False pregnancy has firm grounding as a classic psychosomatic disorder. Pregnancy denial's association with neonaticide has led to misleading forensic data, which obscures the central role of trauma and dissociation. A reappraisal of pregnancy denial confirms it as the somatic inverse of false pregnancy. With that perspective, clinicians can help women understand their pregnancy status to avoid unexpected deliveries with tragic outcomes. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Organizational Wellbeing among Workers in Mental Health Services: A Pilot Study

PubMed Central

Sancassiani, Federica; Campagna, Marcello; Tuligi, Francesco; Machado, Sergio; Cantone, Elisa; Carta, Mauro Giovanni

2015-01-01

Introduction: Organizational wellbeing in mental health services influences the outcomes of users and their families. Workers should be motivated, have a positive morale and be able to recognize values and the deep meaning of their work. This survey aims to examine the organizational wellbeing of the services provided by the Department of Mental Health (DSM) in Lanusei (Italy) and the correlations between job satisfaction and the psychosomatic health of its workers. Materials and Methodology: Descriptive-correlational study on a population of 43 mental health workers. Organizational wellbeing, as well as workers’ job satisfaction and psychosomatic health, were measured using the “Multidimensional Organizational Health Questionnaire” (MOHQ). It is a self-report questionnaire able to examine 14 dimensions of organizational wellbeing, 14 indicators about individual discomfort, 12 indicators about individual wellbeing, 8 psychosomatic symptoms related to job distress. Results: 31 workers (72%) participated in the survey. Regarding the organizational wellbeing of DSM, the general profile mean±sd was 2.66±0.28 (values from 1 to 4: 1=never, 4=often). Job satisfaction was negatively correlated with headaches and concentration difficulties (R=-.584, p=0.001), nervousness, restlessness, anxiety (R=-.571, p=0.001), sense of excessive fatigue (R=-.634, p=0.000) and sense of depression (R=-.558, p=0.001) reported by workers. Conclusions: Data denoted an overall healthy state of the DSM. There were significant correlations between workers’ job satisfaction and their psychosomatic health. The recognition and restitution about the weakness and strengths of the services could be useful to point out some organizational development perspectives. PMID:25767557

Psychological factors in ulcerative colitis.

PubMed

Murray, J B

1984-04-01

Almost 50 years ago ulcerative colitis was included among the seven classical psychosomatic diseases. The psychodynamics and personality structures specific to ulcerative colitis sufferers were sought and the main-stay of treatment was psychotherapy. However, for the past decade the psychogenic approach to this disorder has been replaced by physiological and immunological explanations and treatments. The history of medical and psychogenic explanations and treatments of ulcerative colitis has been traced to the present. Ulcerative colitis remains a "riddle," as it was described almost 50 years ago, a complex disorder whose pattern is to flare up and subside, its cause and cure still unknown despite almost 100 years of study.

Adjusting health spending for the presence of comorbidities: an application to United States national inpatient data.

PubMed

Dieleman, Joseph L; Baral, Ranju; Johnson, Elizabeth; Bulchis, Anne; Birger, Maxwell; Bui, Anthony L; Campbell, Madeline; Chapin, Abigail; Gabert, Rose; Hamavid, Hannah; Horst, Cody; Joseph, Jonathan; Lomsadze, Liya; Squires, Ellen; Tobias, Martin

2017-08-29

One of the major challenges in estimating health care spending spent on each cause of illness is allocating spending for a health care event to a single cause of illness in the presence of comorbidities. Comorbidities, the secondary diagnoses, are common across many causes of illness and often correlate with worse health outcomes and more expensive health care. In this study, we propose a method for measuring the average spending for each cause of illness with and without comorbidities. Our strategy for measuring cause of illness-specific spending and adjusting for the presence of comorbidities uses a regression-based framework to estimate excess spending due to comorbidities. We consider multiple causes simultaneously, allowing causes of illness to appear as either a primary diagnosis or a comorbidity. Our adjustment method distributes excess spending away from primary diagnoses (outflows), exaggerated due to the presence of comorbidities, and allocates that spending towards causes of illness that appear as comorbidities (inflows). We apply this framework for spending adjustment to the National Inpatient Survey data in the United States for years 1996-2012 to generate comorbidity-adjusted health care spending estimates for 154 causes of illness by age and sex. The primary diagnoses with the greatest number of comorbidities in the NIS dataset were acute renal failure, septicemia, and endocarditis. Hypertension, diabetes, and ischemic heart disease were the most common comorbidities across all age groups. After adjusting for comorbidities, chronic kidney diseases, atrial fibrillation and flutter, and chronic obstructive pulmonary disease increased by 74.1%, 40.9%, and 21.0%, respectively, while pancreatitis, lower respiratory infections, and septicemia decreased by 21.3%, 17.2%, and 16.0%. For many diseases, comorbidity adjustments had varying effects on spending for different age groups. Our methodology takes a unified approach to account for excess spending caused by the presence of comorbidities. Adjusting for comorbidities provides a substantially altered, more accurate estimate of the spending attributed to specific cause of illness. Making these adjustments supports improved resource tracking, accountability, and planning for future resource allocation.

Parents' labour market participation as a predictor of children's health and wellbeing: a comparative study in five Nordic countries.

PubMed

Reinhardt Pedersen, C; Madsen, M

2002-11-01

To study the association between parents' labour market participation and children's health and wellbeing. Parent reported data on health and wellbeing among their children from the survey Health and welfare among children and adolescents in the Nordic countries, 1996. A cross sectional study of random samples of children and their families in five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden). A total of 10 317 children aged 2-17 years. Children in families with no parents employed in the past six months had higher prevalence of recurrent psychosomatic symptoms (odds ratio 1.67, 95% confidence intervals 1.16 to 2.40), chronic illness (odds ratio 1.35, 95% confidence intervals 1.00 to 1.84), and low wellbeing (odds ratio 1.47, 95% confidence intervals 1.12 to 1.94). Social class, family type, parents' immigrant status, gender and age of the child, respondent, and country were included as confounders. When social class, family type and the parents' immigrant status (one or more born in the Nordic country versus both born elsewhere) were introduced into the model, the odds ratios were reduced but were still statistically significant. Health outcomes and parents' labour market participation were associated in all five countries. Children in families with no parents employed in the past six months had higher prevalence of ill health and low wellbeing in the five Nordic countries despite differences in employment rates and social benefits.

Assembly work in Indonesia and in Sweden--ergonomics, health and satisfaction.

PubMed

Waluyo, L; Ekberg, K; Eklund, J

1996-02-01

Work conditions in industrial production vary substantially between different cultures. In the present study the aims were to identify differences between Swedish and Indonesian assembly industry workers regarding work environment factors, health and job satisfaction, and to find associations between work environment factors, and the health measures. Data were collected by a questionnaire from 326 Swedish and 136 Indonesian assembly industry workers, interviews and from company documents. The prevalence of musculoskeletal symptoms was high in both groups. Stress and psychosomatic symptoms had higher prevalences in the Swedish group, which also rated their work conditions as worse in most respects. Work tasks were physically heavier in Indonesia, but less monotonous and with lower demands on productivity. The Indonesians were more satisfied with their jobs. Physical job demands were associated with musculoskeletal symptoms. Competence development was associated with increased job satisfaction. Conflicts and harassments at work were associated with stress and psychosomatic symptoms. Job pressure, especially deficient planning of the jobs was associated with lower job satisfaction, psychosomatic and stress symptoms in the Swedish group. Implications for job design in the two cultures are presented.

Do Work Beliefs Moderate the Relationship Between Work Interruptions, Wellbeing and Psychosomatic Symptoms?

PubMed Central

Zoupanou, Zoi(e); Rydstedt, Leif W.

2017-01-01

The purpose of this study was to explore the moderating effects of work beliefs in the relationship between work interruptions and general health, wellbeing and reports of psychosomatic symptoms. Self-report data were gathered from 310 employees from different occupational sectors. Results revealed that beliefs in hard work and morality ethic moderated the positive appraisal of work interruptions and acted as protective factors on impaired general health and wellbeing. The relationship was stronger among employees who endorsed strong beliefs in hard work and did not have regard for morality/ethics as a value. Likewise, beliefs in delay of gratification and morality/ethics moderated positive appraisal of work interruptions and reduced psychosomatic complaints. More specifically, the relationship was stronger among employees who had strong belief in the values of delayed gratification and weaker morality/ethics. These findings indicate that organisations should adopt work ideology or practices focused on work values particularly of hard work, delay of gratification and conformity to morality as protective factors that reduce the impact of work interruptions on employees’ general health and wellbeing. PMID:28580023

[The process and effect of heaviness exercise in autogenic training: factor analytical study of subjective response induced by the concentration upon and formal language of the sense of heaviness in the arm].

PubMed

Ikezuki, M; Sasaki, Y

1996-02-01

The present study examined the subjective response induced by the concentration upon and repetition of the formal language expressing the sense of heaviness--"The arm is heavy." As a result of the factor analysis of the experiment using 60 subjects, the following five factors emerged. (1) Overall sense of improvement; (2) awareness of the sensation of the arm; (3) change to less nervousness; (4) awareness of positive aspects; (5) understanding of the formal language. Also, those who were aware of psychosomatic symptoms felt their change to less nervousness more significantly, and their understanding of the formal language was significantly higher than those who were not aware of psychosomatic symptoms. The result of the experiment suggests one possibility that excessive concentration upon the body concerning psychosomatic symptoms may have changed to the concentration upon the sense of heaviness, or that the reduction of the stress thereof may have brought the change to less nervousness.

Do biogenetic causal beliefs reduce mental illness stigma in people with mental illness and in mental health professionals? A systematic review.

PubMed

Larkings, Josephine S; Brown, Patricia M

2018-06-01

Viewing mental illness as an 'illness like any other' and promoting biogenetic causes have been explored as a stigma-reduction strategy. The relationship between causal beliefs and mental illness stigma has been researched extensively in the general public, but has gained less attention in more clinically-relevant populations (i.e. people with mental illness and mental health professionals). A systematic review examining whether endorsing biogenetic causes decreases mental illness stigma in people with mental illness and mental health professionals was undertaken using the preferred reporting items for systematic reviews and meta-analyses guidelines. Multiple databases were searched, and studies that explored the relationship between biogenetic causal beliefs and mental illness stigma in people with mental illness or mental health professionals were considered. Studies were included if they focussed on depression, schizophrenia, or mental illness in general, were in English, and had adult participants. The search identified 11 journal articles reporting on 15 studies, which were included in this review. Of these, only two provided evidence that endorsing biogenetic causes was associated with less mental illness stigma in people with mental illness or mental health professionals. The majority of studies in the present review (n = 10) found that biogenetic causal beliefs were associated with increased stigma or negative attitudes towards mental illness. The present review highlights the lack of research exploring the impacts of endorsing biogenetic causes in people with mental illness and mental health professionals. Clinical implications associated with these results are discussed, and suggestions are made for further research that examines the relationship between causal beliefs and treatment variables. © 2017 Australian College of Mental Health Nurses Inc.

Quantum-holographic and classical Hopfield-like associative nnets: implications for modeling two cognitive modes of consciousness

NASA Astrophysics Data System (ADS)

Rakovic, D.; Dugic, M.

2005-05-01

Quantum bases of consciousness are considered with psychosomatic implications of three front lines of psychosomatic medicine (hesychastic spirituality, holistic Eastern medicine, and symptomatic Western medicine), as well as cognitive implications of two modes of individual consciousness (quantum-coherent transitional and altered states, and classically reduced normal states) alongside with conditions of transformations of one mode into another (considering consciousness quantum-coherence/classical-decoherence acupuncture system/nervous system interaction, direct and reverse, with and without threshold limits, respectively) - by using theoretical methods of associative neural networks and quantum neural holography combined with quantum decoherence theory.

Comparative Analysis of the Clinical Significance of Oscillatory Components in the Rhythmic Structure of Pulse Signal in the Diagnostics of Psychosomatic Disorders in School Age Children.

PubMed

Desova, A A; Dorofeyuk, A A; Anokhin, A M

2017-01-01

We performed a comparative analysis of the types of spectral density typical of various parameters of pulse signal. The experimental material was obtained during the examination of school age children with various psychosomatic disorders. We also performed a typological analysis of the spectral density functions corresponding to the time series of different parameters of a single oscillation of pulse signals; the results of their comparative analysis are presented. We determined the most significant spectral components for two disordersin children: arterial hypertension and mitral valve prolapse.

On the validity of the Middlesex Hospital Questionnaire: a comparison of diagnostic self-ratings in psychiatric out-patients, general practice patients, and 'normals' based on the Hebrew version.

PubMed

Dasberg, H; Shalif, I

1978-09-01

The short clinical diagnostic self-rating scale for psycho-neurotic patients (The Middlesex Hospital Questionnaire) was translated into everyday Hebrew and tested on 216 subjects for: (1) concurrent validity with clinical diagnoses; (2) discriminatory validity on a psychoneurotic gradient of psychiatric out-patients, general practice patients, and normal controls; (3) validity of subscales and discrete items using matrices of Spearman rank correlation coefficients; (4) construct validity using Guttman's smallest space analysis based on coefficients of similarity. The Hebrew MHQ was found to retain its validity and to be easily applicable in waiting-room situations. It is a useful method for generating and substantiating hypotheses on psychosomatic and psychosocial interrelationships. The MHQ seems to enable the expression of the 'neurotic load' of a general practice subpopulation as a centile on a scale, thereby corroborating previous epidemiological findings on the high prevalence of neurotic illness in general practice. There is reason to believe that the MHQ is a valid instrument for the analysis of symptom profiles of subjects involved in future drug trials.

Psychosocial factors, psychiatric illness and functional gastrointestinal disorders: a historical perspective.

PubMed

Van Oudenhove, Lukas; Vandenberghe, Joris; Demyttenaere, Koen; Tack, Jan

2010-01-01

A new classification of functional gastrointestinal disorders (FGID) became available recently, based on consensus in expert committees ('Rome III process'). It is widely accepted that these frequent disorders, although their pathophysiology remains incompletely understood, result from a complex reciprocal interaction between biological, psychological and social factors that can be predisposing, precipitating and/or perpetuating. Comorbidity with psychiatric disorders, especially mood and anxiety disorders, is high. Modern epidemiologic, psychophysiological and functional neuroimaging studies have partially elucidated the mechanisms underlying the relation between cognitive-affective processes on the one hand and GI function and symptom reporting on the other. The aim of this article is to provide a noncomprehensive historical review of the literature on FGID up to the mid-20th century, with special emphasis on the role of psychosocial factors and psychiatric comorbidity. We can conclude from this review that a lot of the knowledge that became available recently through modern research methodology can also be found in the historical psychosomatic and neuroscience literature, though obviously less empirically grounded. This provides further support for an integrative, multidisciplinary biopsychosocial approach to FGID.

Influence of physical activity on psychosomatic health in obese women.

PubMed

Menzyk, K; Cajdler, A; Pokorski, M

2008-12-01

It is unclear to what extent the known psychosomatic benefits of exercise hold true for the obese. In the present study, we investigated the hypothesis that the psychosomatic health and components of general intelligence, such as the capacity for logical-deductive tasks, would be better in regularly exercising than non-exercising obese women. We addressed the issue in a self-reported survey study, comprising two groups of middle-aged obese women (age 30-50 years, BMI >30 kg/m(2)) of 25 persons each. The criterion for the group division was regular exercise, minimum twice a week, for at least 2 months. The following psychometric tools were used: Physical Fitness and Exercise Scale, Patient Health Questionnaire-9 for depression, Life Satisfaction Scale, General Health Inventory-28, Raven's Matrices Test for intelligence, and a test for selfcontentment with one's body figure shape. The exercising obese women scored significantly better in Life Satisfaction Scale (17.1 +/- 1.2 vs.12.0 +/- 0.9), had a lower level of depression (8.1 +/- 0.6 vs. 13.4 +/- 0.7), and a better assessment of the health status (24.6 +/- 1.6 vs. 36.4 +/- 2.2) (reversed score) compared with non-exercising ones (P<0.05). The exercising obese women also appreciably better assessed their bodily looks. Interestingly, if depression was present in exercising women, it had more detrimental health effects than in physically inactive ones. The study failed to substantiate appreciable changes in general intelligence between active and non-active obese women. In conclusion, physical activity is of benefit for the psychosomatic health in obese women, which should be considered in behavioral counseling.

The state of the service: a survey of psychiatry resident education in psychosomatic medicine.

PubMed

Heinrich, Thomas W; Schwartz, Ann C; Zimbrean, Paula C; Wright, Mark T

2013-01-01

Although required by the Accreditation Council for Graduate Medical Education, training of general psychiatry residents in Psychosomatic Medicine (PM) varies significantly between programs. In 1996, the Academy of Psychosomatic Medicine (APM) developed guidelines for residency training in PM. Since then, there has been no assessment of the status of PM training during psychiatry residency. Assessment of the current state of PM training in U.S. psychiatry residency programs. A 46-item questionnaire was sent via e-mail to 206 residency directors. Four major areas were assessed: the timing and duration of the PM rotation, level of faculty supervision, didactic curriculum, and role (or potential role) of the APM in residency education. Ninety-two surveys were returned (response rate 45%). Forty-four (54%) of the general psychiatry residencies reported the total duration of the C-L rotation as being between 3 and 6 months (including both full- and part-time rotation). Only 38 (46%) programs' residents complete their PM experience in 1 year of residency. The average Full-Time Equivalent of teaching faculty per service was 1.74 (standard deviation 0.92). Sixty-four (77%) programs have a formal didactic curriculum in C-L. Eighty-one (98%) respondents were aware of the APM. Fifty-eight (70%) had APM members among faculty. The most popular responses on how the APM could best serve training programs were the creation of a subspecialty curriculum (73%) as well as the development of a competency-based evaluation tool (66%). There is significant variation in how residents are taught PM during their training. The APM is a well-recognized organization that may define what constitutes adequate residency training in PM and may help programs fulfill the educational needs of residents. © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Somali Refugees' Perceptions of Mental Illness.

PubMed

Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie

2015-01-01

Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.

Cross-National Analysis of Beliefs and Attitude Toward Mental Illness Among Medical Professionals From Five Countries.

PubMed

Stefanovics, Elina; He, Hongbo; Ofori-Atta, Angela; Cavalcanti, Maria Tavares; Rocha Neto, Helio; Makanjuola, Victor; Ighodaro, Adesuwa; Leddy, Meaghan; Rosenheck, Robert

2016-03-01

This quantitative study sought to compare beliefs about the manifestation, causes and treatment of mental illness and attitudes toward people with mental illness among health professionals from five countries: the United States, Brazil, Ghana, Nigeria, and China. A total of 902 health professionals from the five countries were surveyed using a questionnaire addressing attitudes towards people with mental illness and beliefs about the causes of mental illness. Chi-square and analysis of covariance (ANCOVA) were used to compare age and gender of the samples. Confirmatory factor analysis was employed to confirm the structure and fit of the hypothesized model based on data from a previous study that identified four factors: socializing with people with mental illness (socializing), belief that people with mental illness should have normal roles in society (normalizing), non-belief in supernatural causes (witchcraft or curses), and belief in bio-psycho-social causes of mental illness (bio-psycho-social). Analysis of Covariance was used to compare four factor scores across countries adjusting for differences in age and gender. Scores on all four factors were highest among U.S. professionals. The Chinese sample showed lowest score on socializing and normalizing while the Nigerian and Ghanaian samples were lowest on non-belief in supernatural causes of mental illness. Responses from Brazil fell between those of the U.S. and the other countries. Although based on convenience samples of health professional robust differences in attitudes among health professionals between these five countries appear to reflect underlying socio-cultural differences affecting attitudes of professionals with the greater evidence of stigmatized attitudes in developing countries.

Physics of Intrinsic and Extrinsic Factors that Cause the Onset of the Deadliest Illness of Mankind and are Important for Diagnostics and Treatment

NASA Astrophysics Data System (ADS)

Saxena, Arjun

One of the most important topic of research in the field of Physics of Behavior is the deadliest illness of mankind which is the group of illnesses called mental illnesses. They are getting attention increasingly worldwide by the medical communities and their respective governments, because of the following fact. It is now well established that these illnesses cause more loss of human lives, destruction of families, businesses and overall economy than all the other illnesses combined. The purpose of this paper is to identify and provide solutions to two fundamental issues of such illnesses which still remain as problems. One is the stigma associated with them because of their name ``mental''. The patients are regarded as less than normal because their illness is only ``mental'' in origin. The second is that it is still not widely recognized that they are caused by medical problems in their ``brain'' which afflict their ``mind''. This paper explains this and gives an improved 3-D model using the physics of intrinsic and extrinsic factors of both ``brain'' and ``mind''. It leads to an important new name, ``BAMI'' (Brain and Mind Illness), which eliminates the stigma and gives quantitative parameters to diagnose the illness and monitor medicines to treat such illnesses.

Attitudes of Brazilian Medical Students Towards Psychiatric Patients and Mental Illness: A Quantitative Study Before and After Completing the Psychiatric Clerkship.

PubMed

da Rocha Neto, Helio Gomes; Rosenheck, Robert A; Stefanovics, Elina A; Cavalcanti, Maria Tavares

2017-06-01

The authors evaluated whether a psychiatric clerkship reduces stigmatized attitudes towards people with mental illness among medical students. A 56-item questionnaire was used to assess the attitudes of medical students towards patients with mental illness and their beliefs about its causes before and after their participation in their psychiatric clerkship at a major medical school in Rio de Janeiro. Exploratory factor analysis identified four factors, reflecting "social acceptance of people with mental illness," "normalizing roles for people with mental illness in society," "non-belief in supernatural causes for mental illness," and "belief in bio-psychosocial causes for mental illness." Analysis of variance was used to evaluate changes in these factors before and after the clerkship. One significant difference was identified with a higher score on the factor representing social acceptance after as compared to before the clerkship (p = 0.0074). No significant differences were observed on the other factors. Participation in a psychiatric clerkship was associated with greater social acceptance but not with improvement on other attitudinal factors. This may reflect ceiling effects in responses before the clerkship concerning supernatural and bio-psychosocial beliefs about causes of mental illness that left little room for change.

[Psychosomatics and psychotraumatology of refugees and migrants : A Challenge for the Internist].

PubMed

Schellong, J; Epple, F; Weidner, K

2016-05-01

Many refugees experience severely stressful events in their home countries, during migration and occasionally even after arrival in the country of destination. The individual reactions not only influence the mental health but also somatic well being. Traumatic events may have an essential impact on psychosocial functioning; moreover, the social circumstances during the integration process influence mental stability. Physicians play an important role in identifying possible traumatization and subsequently guiding towards adequate treatment; hence, the healthcare of refugees should regularly include psychosomatic and psychotraumatological aspects. Knowledge of screening instruments, trauma-informed care and interpreter-assisted communication are necessary to meet required standards.

Tackling the global mental health challenge: a psychosomatic medicine/consultation-liaison psychiatry perspective.

PubMed

Bauer, Amy M; Fielke, Ken; Brayley, John; Araya, Mesfin; Alem, Atalay; Frankel, Bernard L; Fricchione, Gregory L

2010-01-01

Consultation-liaison (C-L) psychiatry, informed by principles of psychosomatic medicine, is well-positioned to address the global impact of mental disorders through primary care C-L models. The authors review the international burden of mental disorders, highlighting medical comorbidity, undertreatment, and the rationale for enhancing primary-care management. C-L psychiatry fosters the skills required for global mental health work. The authors describe successful C-L models developed in a low-income country (Ethiopia) and an under-resourced region of a high-income country (Australia). C-L psychiatrists have the potential to marshal their unique skill-set to reduce the global burden of mental disorders.

Macro-level determinants of young people's subjective health and health inequalities: a multilevel analysis in 27 welfare states.

PubMed

Rathmann, Katharina; Ottova, Veronika; Hurrelmann, Klaus; de Looze, Margarethe; Levin, Kate; Molcho, Michal; Elgar, Frank; Gabhainn, Saoirse Nic; van Dijk, Jitse P; Richter, Matthias

2015-04-01

Cross-national studies have rarely focused on young people. The aim of this study is to investigate whether macro-level determinants are associated with health and socioeconomic inequalities in young people's health. Data were collected from the Health Behaviour in School-aged Children (HBSC) study in 2006, which included 11- to 15-year old adolescents from 27 European and North American countries (n=134,632). This study includes national income, health expenditure, income inequality, and welfare regime dummy-variables as macro-level determinants, using hierarchical regression modelling. Psychosomatic health complaints and socioeconomic inequalities in psychosomatic health complaints. Adolescents in countries with higher income inequality and with liberal welfare tradition were associated with more health complaints and a stronger relationship between socioeconomic status and macro-level determinants compared to adolescents from countries with lower income inequality or the Social Democratic regime. National income and health expenditure were not related to health complaints. Countries with higher national income, public health expenditure and income inequality showed stronger associations between socioeconomic status and psychosomatic health complaints. Results showed that macro-level characteristics are relevant determinants of health and health inequalities in adolescence. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Perceived job-anxiety and general psychosomatic symptom load and perceived social support - Is there a relationship?

PubMed

Muschalla, Beate; Markova, Mariya; Linden, Michael

2010-01-01

Job-related distress has often been found to be related with low social support at work. The question is whether dimensions of social support outside work have a similar relation with job-anxiety or whether they are independent. A sample of 154 employed inpatients from a psychosomatic rehabilitation center (70% women) participated in this study. Participants completed self-rating questionnaires on perceived symptom load in the domain of work (job-anxiety) and in general life (general psychosomatic symptom load), and on perceived social support at work and outside work. Job-anxiety showed moderate correlations with the perceived level of social support through colleagues. Thereby the social support dimensions of "consolation and encouragement" and "criticism, overload, rejection" were more strongly related to job-anxiety than the dimension of "practical support". There were no significant correlations between job-anxiety and social support through household members, leisure time partners or neighbors. Social support is in a specific way important in the context of work other than concerning general mental health outside the work-context. Job-anxiety is a domain-specific clinical phenomenon and independent from perceived social support outside the workplace.

The Cartesian doctor, François Bayle (1622-1709), on psychosomatic explanation.

PubMed

Easton, Patricia

2011-06-01

There are two standing, incompatible accounts of Descartes' contributions to the study of psychosomatic phenomena that pervade histories of medicine, psychology, and psychiatry. The first views Descartes as the father of "rational psychology" a tradition that defines the soul as a thinking, unextended substance. The second account views Descartes as the father of materialism and the machine metaphor. The consensus is that Descartes' studies of optics and motor reflexes and his conception of the body-machine metaphor made early and important contributions to physiology and neuroscience but otherwise his impact was minimal. These predominately negative assessments of Descartes' contributions give a false impression of the role his philosophy played in the development of medicine and psychiatry in seventeenth-century France and beyond. I explore Descartes' influence in the little-known writings of a doctor from Toulouse, François Bayle (1622-1709). A study of Bayle gives us occasion to rethink the nature and role of psychosomatic explanation in Descartes' philosophy. The portrait I present is of a Cartesian science that had an actual and lasting effect on medical science and practice, and may offer something of value to practitioners today. Copyright © 2010 Elsevier Ltd. All rights reserved.

Does the density of the health workforce predict adolescent health? A cross-sectional, multilevel study of 38 countries.

PubMed

Riehm, Kira E; Latimer, Eric; Quesnel-Vallée, Amélie; Stevens, Gonneke W J M; Gariépy, Geneviève; Elgar, Frank J

2018-06-11

Scant evidence exists on the relation between the availability of health professionals and adolescent health, and whether the size of the health workforce equally benefits adolescents across socioeconomic strata. We conducted a cross-sectional analysis of adolescent health in 38 countries. Data from 218 790 adolescents were drawn from the 2013/2014 Health Behavior in School-aged Children survey. We used multilevel regression analyses to examine the association between the density of the health workforce and psychosomatic and mental health symptoms with differences in country wealth and income inequality controlled. A higher density of psychologists was associated with better self-reported mental health in adolescents (P = 0.047); however, this finding was not robust to sensitivity analyses. The densities of physicians and psychiatrists were not significantly associated with better adolescent psychosomatic or mental health. Cross-level interactions between the health workforce and socioeconomic status did not relate to health, indicating that larger health workforces did not reduce socioeconomic differences in adolescent health. This study found that adolescents in countries with a higher density of health providers do not report better psychosomatic or mental health. Other social or structural factors may play larger roles in adolescent health.

[Psychosomatic symptoms in somatic diseases - open-angle glaucoma for example].

PubMed

Emmerich, G M

2010-08-01

Psychological aspects exist in somatic diseases like tumours and even fractures, not only in the beginning but also in the management of disease. Somatic diseases give rise to signs of a special constellation of life and management of these diseases is important for the psychological constellation of the individual. Studies on open-angle glaucoma have shown that many patients suffering from this disease are anxious, hypochondric, perfectionist and emotional instable. Chronic diseases are demanding processes of flexibility and defense, and define how the individual can deal with the diseases and what place in life the disease will occupy in the future. In the holistic view of medicine even psychological conflicts should be treated. In many situations, these conflicts are not consciously experienced by the individual. Therapeutically, 2 different tools can be used: symbolic stories can bring forces to manage the conflict and to solve the conflict (2 examples in the text). The method of positive psychotherapy describes the reasons for psychosomatic diseases in three parts: psychosomatic in the traditional understanding, in further and comprehensive understanding. Especially the psychosomatic effects in comprehensive understanding are embedded in the individual's sociocultural environment and provide tips on reasons for the diseases in those parts of life. The "positive balance model" gives an example of life-management and conflict-therapy. In ophthalmology, fear is often more important for the patient than pain. To avoid this, the patients develop techniques to deny, to cover or to suppress the fear. In the article questions are presented like those the ophthalmologist should be able to ask patients in the office concerning open-angle glaucoma. Tips for the therapy and management for neurotic stress are offered and some special anamnestic questions for the ophthalmologist are presented. Unsolved conflicts and denied desires as neurotic symptoms can be focused in symptoms of eye diseases. Macrotraumata and microtraumata may be reason for changes of the hormonal situation and subsequent destabilisation of the metabolism, hypertonic disease and variation of the intraocular pressure. This article gives an example of the therapeutic possibilities in somatic diseases, to discuss the psychic situation with the patient and to be able to give tips for self-help. Finally, the therapeutic procedere in patients with somatic and psychosomatic diseases is discussed and a 5-step model is presented. Georg Thieme Verlag KG Stuttgart, New York.

Increased rate of depression and psychosomatic symptoms in Jewish migrants from the post-Soviet-Union to Germany in the 3rd generation after the Shoa.

PubMed

Ullmann, E; Barthel, A; Licinio, J; Petrowski, K; Bornstein, S R; Strauß, B

2013-03-12

The mental health status of persons with Jewish background living in Germany is discussed with special regard to social exclusion like anti-Semitism and overprotective parental rearing behavior, as a transmissional factor of the KZ-Syndrome. These stressors are considered in the context of a higher risk for depression/fear and psychosomatic disorders and also abnormal cortisol levels. The present sample (N=89) is derived from the Jewish population currently living in the German region of Saxony aged between 17-36 years that emigrated from the post-Soviet-Union areas. The mean age was 22.9 years. Two questionnaires to detect psychosomatic symptoms (Giessen complaint list (GBB)-24, hospital anxiety and depression scale) and one questionnaire addressing parental rearing behavior (FEE) were employed. Comparisons were drawn with normative data from the literature about the German residential population. In addition, questions were asked concerning the experience of anti-Semitism in Germany and in the post-Soviet-Union areas. A higher prevalence of depression/fear (10.3% versus 18.2%) and psychosomatic symptoms (M=14.03 versus 17.8; t=2.42; P<0.05) was observed in Jewish migrants to Germany as compared with non-Jewish German residents. Furthermore, anti-Semitic experiences in Germany correlated positively with depression (r=0.293; P<0.01) and fear (r=0.254; P<0.05). The anti-Semitic experiences in the post-Soviet-Union areas also correlated positively with limb pain (r=0.41, P<0.01), fatigue symptoms (r=0.296, P<0.01) and psychocardial symptoms (r=0.219, P<0.05). It was also confirmed that the male respondents recalled a controlling and overprotecting maternal rearing behavior more frequently than the German standard random sample (M=15.39 versus 18.6; t=2.68; P<0.01). The latter also correlated significantly positive with epigastric pain (r=0.349; P<0.01). The present results show that depression, fear and psychosomatic problems are common in Jewish residents with a background of migration from the post-Soviet-Union areas to Germany. Apart from the transgenerational passing of psychological traumata and the Holocaust experiences, other stressors like anti-Semitism, control and overprotection as parental rearing measures appear to be important factors specifically contributing to the pathogenesis of the attributed symptoms.

Increased rate of depression and psychosomatic symptoms in Jewish migrants from the post-Soviet-Union to Germany in the 3rd generation after the Shoa

PubMed Central

Ullmann, E; Barthel, A; Licinio, J; Petrowski, K; Bornstein, S R; Strauß, B

2013-01-01

The mental health status of persons with Jewish background living in Germany is discussed with special regard to social exclusion like anti-Semitism and overprotective parental rearing behavior, as a transmissional factor of the KZ-Syndrome. These stressors are considered in the context of a higher risk for depression/fear and psychosomatic disorders and also abnormal cortisol levels. The present sample (N=89) is derived from the Jewish population currently living in the German region of Saxony aged between 17–36 years that emigrated from the post-Soviet-Union areas. The mean age was 22.9 years. Two questionnaires to detect psychosomatic symptoms (Giessen complaint list (GBB)-24, hospital anxiety and depression scale) and one questionnaire addressing parental rearing behavior (FEE) were employed. Comparisons were drawn with normative data from the literature about the German residential population. In addition, questions were asked concerning the experience of anti-Semitism in Germany and in the post-Soviet-Union areas. A higher prevalence of depression/fear (10.3% versus 18.2%) and psychosomatic symptoms (M=14.03 versus 17.8; t=2.42; P<0.05) was observed in Jewish migrants to Germany as compared with non-Jewish German residents. Furthermore, anti-Semitic experiences in Germany correlated positively with depression (r=0.293; P<0.01) and fear (r=0.254; P<0.05). The anti-Semitic experiences in the post-Soviet-Union areas also correlated positively with limb pain (r=0.41, P<0.01), fatigue symptoms (r=0.296, P<0.01) and psychocardial symptoms (r=0.219, P<0.05). It was also confirmed that the male respondents recalled a controlling and overprotecting maternal rearing behavior more frequently than the German standard random sample (M=15.39 versus 18.6; t=2.68; P<0.01). The latter also correlated significantly positive with epigastric pain (r=0.349; P<0.01). The present results show that depression, fear and psychosomatic problems are common in Jewish residents with a background of migration from the post-Soviet-Union areas to Germany. Apart from the transgenerational passing of psychological traumata and the Holocaust experiences, other stressors like anti-Semitism, control and overprotection as parental rearing measures appear to be important factors specifically contributing to the pathogenesis of the attributed symptoms. PMID:23481628

[The multiple interactions between infertility and sexuality].

PubMed

Mimoun, S

1993-03-01

After investigating into literature and clinical experience, we shall line out in this study 4 types of interactions between sexuality and infertility: sexual causes to feminine (vaginism, with and without heavy dyspareunia) or masculine (impotency, ante-portas ejaculation, anejaculation, dysejaculation), infertility; influence of tests and of treatments for infertility on sexual life; influence of infertility on sexuality focusing on the various ambiguous feelings (of culpability, inferiority, aggressivity, passivity); and last, the psychological and sexual interactions with medical assisted procreation, reinforcing the sexual separation of man and woman if the body is considered a machine. Psychosomatic guidance of the couple during these steps (with reassurance as the being helped conception) will allow maintaining on removing sexual attraction.

Self-reported workplace perception as indicators of work anxieties.

PubMed

Muschalla, B; Fay, D; Linden, M

2016-03-01

Work anxiety is a potentially disabling mental health problem, which can cause (long-term) sickness absence. In many cases patients do not openly report their anxieties and tend to give externalizing explanations of inner problems. Therefore people with work anxiety may perceive their workplace more negatively than those without such anxiety. To investigate the relation between subjective work description and work anxiety. Work anxiety was investigated with a standardized interview in a sample of employed psychosomatic rehabilitation inpatients suffering from common mental disorders. We assessed their subjective perception and evaluation of workplace conditions with the 'Short Questionnaire for Job Analysis' (KFZA) and compared their results with those from a sample of employees in the general population. There were 148 inpatient participants and 8015 general population controls. Patients with work anxiety described their workplace significantly more negatively than patients without work anxiety and employees in the general population, with no differences in workplace descriptions between psychosomatic patients without work anxiety and the general population sample. The type of complaint about work conditions was related to the specific type of work anxiety. Reports about workplace burdens can be indicative of work anxiety and should prompt further in-depth assessments. The content of complaints about work conditions may point to the type of underlying work anxiety. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Care seeking and beliefs about the cause of mental illness among Nigerian psychiatric patients and their families.

PubMed

Aghukwa, Chikaodiri Nkereuwem

2012-06-01

This study examined treatment seeking by 219 psychiatric patients at a teaching hospital in Kano, Nigeria. Patients or their families were interviewed about the types of mental health healers that patients saw before seeking conventional psychiatric treatment and beliefs about the causes of the illness. The length of illness before the psychiatric consultation was 4.5 years, and 99 (45%) respondents reported that patients had previously sought religious healing. A majority of respondents (N=128, 59%) attributed the illness to supernatural forces. Up to 68% and 75% of respondents who believed in a medical or genetic cause of illness, respectively, reported seeking a psychiatric consultation within six months of onset, and about 70% who believed in supernatural forces reported seeking psychiatric consultation five years after onset or later (p<.05). Mental health planners should educate alternative mental health healers and integrate them in the care of mental illness.

[Illness caused by water-based paints?].

PubMed

Birkeland, G; Zahlsen, K; Aas, K

1994-08-20

Illness caused by the indoor environment is a challenging and complicated field to investigate. Emissions from paints may contribute to the problems. Several components of water-based paints evaporate for a long time after painting, and some of them may affect human biology. We describe one patient who has experienced symptoms caused by water-based paint. Different reaction mechanisms may be involved, and these are discussed. Components which may elicit biological effects are listed and discussed. Physicians should be aware of the possibility that a few patients may suffer from illness caused by emissions from modern paints.

Into Darkness and Silence: What Caused Helen Keller's Deafblindness?

PubMed

Gilsdorf, Janet R

2018-05-05

In 1882, at 19 months of age, Helen Keller developed a febrile illness that left her both deaf and blind. Historical biographies attribute the illness to rubella, scarlet fever, encephalitis, or meningitis. This analysis of her illness suggests she likely had bacterial meningitis, caused by N. meningitidis or possibly H. influenzae.

Descriptive survey about causes of illness given by the parents of children with cancer.

PubMed

Matteo, Bernardi; Pierluigi, Badon

2008-04-01

When a doctor diagnoses a child's illness as cancer, parents very often react by creating wrong and unrealistic theories about the origins of their child's illness which in turn generates self-blame in the parents, who take responsibility for the disease. To find what are the parents' beliefs about the origins of their children's illness. Descriptive study. Seventy-two couples of parents whose children with cancer are under treatment in the haemato-oncology paediatric ward of the Padova hospital. They have been collected by a no probabilistic method of sampling. A questionnaire was used, based on current literature, which investigates the beliefs of the parents as to what are the causes of illness, whether the parents research information about the illness and the origins of cancer and what are the information sources they use in order to establish if there is a connection between these factors. Eighty-seven percent of the sample group thinks that there is a specific origin of their child's illness: 27% believes the cause is environmental pollution, 26% believes it is due to radiation emissions, 26% believes it is due to genetic factors and 8% believes it is due to other causes. Eighty six percent and 70% of the sample search for information about the illness and its causes; 64% of the parents state that the first meeting with the medical staff, in which the illness is explained and they are informed that there are no known causes that produce it, does not clarify their doubts. The sources more often used to search for more information and explanations are the physicians in the ward, internet and medical books. This survey confirms the importance of an "advocacy" role of the nurse in educating the caregiver and the need to create instruments which guide the parents in the informative process and the research for good information. Nurses need to be cognizant that their care is crucial not just for the child, but for the entire family.

[The first Mental Health Act in China 2013 : An historical step towards human rights].

PubMed

Zhao, X

2017-05-01

In the past, the mentally ill used to be relentlessly stigmatized and their basic needs grossly neglected in China. Only the coastal cities with their Western oriented universities provided Western type mental healthcare. In general, traditional Chinese medicine (TCM) embracing medicinal herbs and acupuncture was practiced. Mental hospitals were non-existent before 1889 and care of the chronically mentally ill rested with their families and the community; however, the prevalence and spectrum of mental disorders were similar to those in Western countries. After the establishment of the People's Republic of China old-fashioned mental hospitals were founded. The "Great Leap Forward" starting in 1958 envisaged the creation of a mental healthcare system based on Soviet Union standards. Psychiatry had a strong biological orientation, and psychotherapy did not exist. Psychology was rejected as not being science and was not taught at universities before 1978. With the Reform and Opening Policy in 1978 the education of psychology was stepped up. Psychology was introduced as an academic discipline in 1978 and psychotherapy and psychosomatic medicine were established in mental healthcare. The current mental healthcare in China resembles the standard in Germany before the "Psychiatrie-Enquete" (expert commission official report). With the Mental Health Act adopted in 2013 after 27 years of planning, China has laid the legal foundation for planning and establishing a humane system of mental healthcare. The Act safeguards patients' human and individual rights and increases trust in psychiatric institutions. It guarantees the right to optimal treatment and provides legal protection in cases of malpractice.

Attitudes toward People with Disabilities Caused by Illness or Injury: Beyond Physical Impairment

ERIC Educational Resources Information Center

Shiloh, Shoshana; Heruti, Irit; Berkovitz, Tamar

2011-01-01

This study examined differences in attitudes toward and reactions to individuals with comparable disabilities caused by injury or illness. Participants were students and healthcare professionals randomly assigned to read one of eight vignettes constructed in a between-subjects, full-factorial design: 2 (illness/injury)x2 (male/female)x2…

Attitudes to Mental Illness in the U.K. Military: A Comparison With the General Population

PubMed Central

Forbes, Harriet J.; Boyd, Caroline F. S.; Jones, Norman; Greenberg, Neil; Jones, Edgar; Wessely, Simon; Iversen, Amy C.; Fear, Nicola T.

2016-01-01

Objectives To compare attitudes to mental illness in the U.K. military and in the general population in England. Methods Using data from a cross-sectional survey of 821 U.K. military personnel and a separate cross-sectional survey of 1,729 members of the general population in England, levels of agreement with five statements about mental illness were compared in the military and the general population. Results The majority of respondents from both populations showed positive attitudes toward mental illness. The general population showed slightly more positive attitudes toward integrating people with mental illness into the community (68.0% [65.7%–70.1%] agreed that “People with mental illness have the same rights to a job as everyone else,” vs. 56.7% [51.5%–61.7%] of the military). However, the general population showed more negative attitudes about the causes of mental illness (62.4% [60.1%–64.6%] disagreed that “One of the main causes of mental illness is a lack of self-discipline and willpower,” vs. 81.3% [77.0%–84.9%] of the military). Conclusions Overall, attitudes toward mental illness are comparable in the general population in England and the U.K. military. Differences included the military holding more positive attitudes about the causes of mental illness, but more negatives attitudes about job rights of those with mental illness. Strategies aiming to improve attitudes toward mental illness could focus particularly on personnel’s concerns around mental illness impacting on their career. PMID:24005543

Powassan encephalitis and Colorado tick fever.

PubMed

Romero, José R; Simonsen, Kari A

2008-09-01

This article discusses two tick-borne illnesses: Powassan encephalitis, a rare cause of central nervous system infection caused by the Powassan virus, and Colorado tick fever, an acute febrile illness caused by the Colorado tick fever virus common to the Rocky Mountain region of North America.

Myalgic encephalomyelitis, chronic fatigue syndrome: An infectious disease.

PubMed

Underhill, R A

2015-12-01

The etiology of myalgic encephalomyelitis also known as chronic fatigue syndrome or ME/CFS has not been established. Controversies exist over whether it is an organic disease or a psychological disorder and even the existence of ME/CFS as a disease entity is sometimes denied. Suggested causal hypotheses have included psychosomatic disorders, infectious agents, immune dysfunctions, autoimmunity, metabolic disturbances, toxins and inherited genetic factors. Clinical, immunological and epidemiological evidence supports the hypothesis that: ME/CFS is an infectious disease; the causal pathogen persists in patients; the pathogen can be transmitted by casual contact; host factors determine susceptibility to the illness; and there is a population of healthy carriers, who may be able to shed the pathogen. ME/CFS is endemic globally as sporadic cases and occasional cluster outbreaks (epidemics). Cluster outbreaks imply an infectious agent. An abrupt flu-like onset resembling an infectious illness occurs in outbreak patients and many sporadic patients. Immune responses in sporadic patients resemble immune responses in other infectious diseases. Contagion is shown by finding secondary cases in outbreaks, and suggested by a higher prevalence of ME/CFS in sporadic patients' genetically unrelated close contacts (spouses/partners) than the community. Abortive cases, sub-clinical cases, and carrier state individuals were found in outbreaks. The chronic phase of ME/CFS does not appear to be particularly infective. Some healthy patient-contacts show immune responses similar to patients' immune responses, suggesting exposure to the same antigen (a pathogen). The chronicity of symptoms and of immune system changes and the occurrence of secondary cases suggest persistence of a causal pathogen. Risk factors which predispose to developing ME/CFS are: a close family member with ME/CFS; inherited genetic factors; female gender; age; rest/activity; previous exposure to stress or toxins; various infectious diseases preceding the onset of ME/CFS; and occupational exposure of health care professionals. The hypothesis implies that ME/CFS patients should not donate blood or tissue and usual precautions should be taken when handling patients' blood and tissue. No known pathogen has been shown to cause ME/CFS. Confirmation of the hypothesis requires identification of a causal pathogen. Research should focus on a search for unknown and known pathogens. Finding a causal pathogen could assist with diagnosis; help find a biomarker; enable the development of anti-microbial treatments; suggest preventive measures; explain pathophysiological findings; and reassure patients about the validity of their symptoms.

Clinical trials validate the severity of persistent Lyme disease symptoms.

PubMed

Cameron, Daniel J

2009-02-01

Persistent Lyme Disease Symptoms (PLDS) have included fatigue, headaches, poor concentration and memory, lightheadedness, joint pain, and mood disturbances. Evidence-based guidelines committees disagree over the severity of PLDS. The 2004 International Lyme and Associated Diseases Society (ILADS) concluded that PLDS are severe. The 2006 Infectious Disease Society of America (IDSA) guidelines committee concluded that PLDS are nothing more than the "aches and pains of daily living" and an ad hoc International Lyme group concluded that PLDS are "symptoms common in persons who have never had Lyme disease." Clinical trials validate the severity of persistent Lyme disease symptoms. There are 22 standardized instruments used to measure the severity of PLDS among the four published National Institutes of Health (NIH) sponsored double-blind randomized placebo-controlled trials (RCTs). VALIDATING THE HYPOTHESIS: All four NIH sponsored RCTs validate the severity of PLDS. PLDS are as severe as symptoms seen in other serious chronic illnesses, and result in a quality of life lower than for the general population as determined by 22 standardized measures of QOL, including fatigue, pain, role function, psychopathology, and cognition. None of the four RCTs support the IDSA hypothesis that PLDS are nothing more than "the aches and pains of daily living" nor the ad hoc International Lyme group conclusion that PLDS are "symptoms common in persons who have never had Lyme disease." If the QOL of life for these patients is as poor as for patients with other serious chronic diseases, their symptoms need to be addressed by their doctors. Studies differ as to the precise cause of PLDS, the most effective treatments, and whether a cure is possible. But the fact that there is disagreement is not a license for physicians to ignore or turn away patients complaining of PLDS, or to dismiss their symptoms as purely psychosomatic. For physicians, the goal or purpose of treating PLDS should be the same as their purpose in treating other chronic illnesses that result in a poor QOL: vigorous pursuit of a cure, and where a cure proves impossible, amelioration of patients' symptoms and suffering. Even if this hypothesis fails to be apply to more than a fraction of the total Lyme disease population, this still represents a significant number of patients, and these findings could address a neglected aspect of caring for patients with Lyme disease.

Commitment to Celibacy in German Catholic Priests: Its Relation to Religious Practices, Psychosomatic Health and Psychosocial Resources.

PubMed

Baumann, Klaus; Jacobs, Christoph; Frick Sj, Eckhard; Büssing, Arndt

2017-04-01

We aimed to investigate Catholic priests' commitment to celibacy and its relation to their religious practices, life and work satisfaction, and psychosomatic health. Results of our cross-sectional study of 2549 priests show that the majority finds living in celibacy helpful to minister more effectively. Nevertheless, a large proportion see it as a burden and would not choose celibate life again. Commitment to celibacy was predicted best by the frequency of religious practices (liturgy), work engagement and personal relation with God, explaining 39 % of variance. These resources are predictors for maintaining a celibate lifestyle and facilitate priests' satisfaction with life and commitment to their ministry.

Workplace mobbing and effects on workers' health.

PubMed

Meseguer de Pedro, Mariano; Soler Sánchez, María Isabel; Sáez Navarro, María Concepción; García Izquierdo, Mariano

2008-05-01

In this work, we analyze various consequences of the phenomenon of mobbing on the health of a work sector with special characteristics: the agro fruit sector. For this purpose, we collected data from a sample of 396 workers (61 men and 331 women) belonging to this sector in the Region of Murcia (Spain). A questionnaire with the following measurement instruments was administered: a Spanish adaptation of the revised Negative Acts Questionnaire (Sáez, García, & Llor, 2003), the Psychosomatic Problems Questionnaire (Hock, 1988), and a measure of absenteeism. The results revealed a significant and positive relation between workplace mobbing and psychosomatic symptoms, but not with absenteeism. The implications of the results for future research are discussed.

Computational Psychosomatics and Computational Psychiatry: Toward a Joint Framework for Differential Diagnosis.

PubMed

Petzschner, Frederike H; Weber, Lilian A E; Gard, Tim; Stephan, Klaas E

2017-09-15

This article outlines how a core concept from theories of homeostasis and cybernetics, the inference-control loop, may be used to guide differential diagnosis in computational psychiatry and computational psychosomatics. In particular, we discuss 1) how conceptualizing perception and action as inference-control loops yields a joint computational perspective on brain-world and brain-body interactions and 2) how the concrete formulation of this loop as a hierarchical Bayesian model points to key computational quantities that inform a taxonomy of potential disease mechanisms. We consider the utility of this perspective for differential diagnosis in concrete clinical applications. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Diagnosis of Parasitic Diseases

MedlinePlus

... that cause diarrhea, loose or watery stools, cramping, flatulence (gas) and other abdominal illness. CDC recommends that ... that cause diarrhea, loose or watery stools, cramping, flatulence (gas) and other abdominal illness. This test is ...

Lay perceptions of current and future health, the causes of illness, and the nature of recovery: explaining health and illness in Malaysia.

PubMed

Swami, Viren; Arteche, Adriane; Chamorro-Premuzic, Tomas; Maakip, Ismail; Stanistreet, Debbi; Furnham, Adrian

2009-09-01

This study examined beliefs about the causes and determinants of health, illness, and recovery in an opportunistic sample from Malaysia. In all, 371 women and 350 men completed the Health and Illness Scale, a 124-item scale that examined beliefs about current and future health, and beliefs about the causes of illness and recovery. Each of the four subscales of the Health Illness Scale were factor analysed to reveal the underlying structure. Results showed the emergence of a number of distinct factors in the case of each subscale, of which environmental, life-style, psychological, religious, and fate-related factors were fairly stable across subscales. Results also showed a number of differences in beliefs between religious groups, and that religiosity and sex were the strongest predictors of beliefs across the four subscales. The results are discussed in terms of the available cross-cultural literature on lay beliefs about health.

[Influence of tendencies toward depression, neurosis and psychosomatic disorders on oral symptoms].

PubMed

Sasaki, Emi

2005-12-01

This study revealed that the tendencies towards depression, neurosis, and psychosomatic disorders have effects on oral symptoms. The total number of subjects was 102. The subjects were divided into two groups using the SDS (Self-rating Depression Scale): a control group of 66 subjects with an SDS value of less than 40, and a group of 36 subjects having depression tendencies with an SDS value of over 50. Most of the subjects in the depression tendency group showed symptoms of neurosis and psychosomatic disorders as well. The two groups were compared on the basis of their psychological characteristics, dosages of medicine taken, esthesis of mouth dryness, glossalgia, salivary flow rate, oral wettability, existence of dental cavities, and condition of the oral mucosa. No xerostomia at the mucobuccal fold was observed in the depression tendency group. However, there was an evident decrease of the resting salivary flow rate and the wettability of proglossis. It is considered that such a decrease resulted in an increase in the symptoms derived from xerostomia or esthesis of mouth dryness. The number of conservable but untreated dental cavities in the depression tendency group was larger than that in the control group with a significant difference, suggesting that both oral self-care and dental care management tended to be inadequate in the depression tendency group.

Effectiveness of an Internet-based preparation for psychosomatic treatment: Results of a controlled observational study.

PubMed

Zimmer, Benjamin; Moessner, Markus; Wolf, Markus; Minarik, Carla; Kindermann, Sally; Bauer, Stephanie

2015-11-01

Patients often have to sustain long waiting periods between the time they first apply for psychotherapy and the actual uptake of the treatment. To support patients who are on a wait-list for inpatient psychosomatic treatment an Internet-based preparatory treatment (VORSTAT) was developed. In a randomized controlled trial, VORSTAT proved to increase treatment motivation prior to intake and to accelerate the accommodation phase at the beginning of inpatient treatment. No impact of VORSTAT on inpatient treatment outcome was found. The aim of the present study was to investigate the effectiveness of VORSTAT after implementing the service into routine care. A large naturalistic observational study comparing VORSTAT participants (N=911) against non-participants (N=1721) was conducted. Propensity scores were used to control for potential confounding variables due to the non-randomized group allocation. Reliable improvement of self-reported impairment achieved during inpatient treatment was used as outcome measure. VORSTAT participants showed higher rates of reliable improvement in physical impairment (50.8% vs. 44.9%), psychological impairment (41.2% vs. 29.9%), and social problems (22.3% vs. 15.2%). An Internet-based preparation for psychotherapy is an effective approach to improve outcome of inpatient psychosomatic treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

[Working as a clinician-scientist in psychosomatic medicine: status, skills and research productivity].

PubMed

Hartmann, Mechthild; Wild, Beate; Herzog, Wolfgang; Nikendei, Christoph; Zipfel, Stephan; Henningsen, Peter; Löwe, Bernd

2008-06-01

Even though there is a high need of clinical research for the medical and psychotherapeutic practice in Germany, the interest in clinical research seems to be decreasing. The aim of this study was to assess the circumstances under which clinical research in psychosocial medicine is performed and to identify opportunities for improvement. n = 53 residents of the departments for Psychosomatic Medicine of the University Hospitals of Heidelberg and Tübingen and of the Technical University of Munich were asked about their research activities, their subjective research skills, and their productivity in clinical psychosocial research. In addition, objective research knowledge was investigated using a multiple-choice test. Both, subjective research skills and objective research knowledge were relatively low. The percentage of correct answers in the multiple choice test was 33 %. Subjective problems were predominately stated regarding "biostatistics" and "study design". In terms of research productivity, 33 % of residents had published as first authors of an original journal article, and 12 % had submitted a successful grant proposal. Altogether, there is a high need of training in the field of clinical psychosomatic research. We are presenting a training model that is adapted to the conditions of young clinicians and that addresses both general clinical research and specific psychosocial clinical research.

Self-perception of children with autism spectrum disorders.

PubMed

Nagai, Yukiyo; Uemura, Osamu; Kaneko, Tetsuji; Kanda, Yasushi; Gotoh, Yoshimitsu; Nakagawa, Mayuko; Uzuyama, Shiho; Nomura, Kayo; Iwasa, Mitsuji

2018-02-01

We aimed to evaluate self-perceived competence and self-esteem of primary school children with autism spectrum disorder (ASD) in Japan and compare to those of children with other chronic physical diseases and healthy controls. Data were collected from 227 children: ASD (N.=91), nephrotic syndrome (NS) (N.=52) and asthma (N.=84), using Children's Perceived Competence Scale (CPCS) in 2012-2014. CPCS measures perceived competence in cognitive, social and physical domains, and a general self-worth domain as self-esteem. Scores in the social domain of the ASD group were lower than those of all other groups after adjusting for school age grades and gender. Scores of the ASD group negatively correlated with psychosomatic symptoms in all domains and IQ in the physical domain. These findings are the first data set in Japan on self-perceived competence and self-esteem in primary school children with ASD. Those results were comparable to previous researches in adolescents with ASD. Low social domain scores in the ASD group indicate the CPCS may be one of the useful tools to evaluate difficulty in social competence from the children's point of view. Correlations between CPCS scores and psychosomatic symptoms in the ASD group suggest development of psychosomatic symptoms may be addressed early by attention to low scores, especially in general self-worth.

Behavioral medicine in China: history, current status, and future development.

PubMed

Bai, Bo; Ji, Feng

2014-08-01

Behavioral medicine in China has developed quickly in the last three decades. We briefly summarized the history, the main scope and achievements, and the future development of behavioral medicine in China. We did a literature search and discussed with senior scholars in behavioral medicine in China. The concept and main scope of behavioral medicine in China have been developed largely in accordance with the international perspective. Research in behavioral medicine in China significantly contributed to the better understanding of the relationship between various health behavioral factors and psychosomatic disorders and possible mechanisms of this relationship. The following aspects will be the main areas to be further developed in behavioral medicine in China: (1) Basic theories of behavioral medicine and theoretical mechanisms of higher nervous activities in human behavior regulation. (2) Etiology, pathogenesis, and mechanisms of common diseases that are closely related to human lifestyle behaviors. (3) Assessment criteria for unhealthy and disease-related behaviors. (4) Behavioral therapy of psychosomatic disorders, and rehabilitation technologies of disability. (5) Application of major findings from research of behavioral medical science in clinical practice and in health promotion of the whole society. Behavioral medicine in China, as a multidisciplinary subject, plays a relevant role in preventing behavior-related psychosomatic diseases and in promoting health of the public.

Causes, coping, and culture: a comparative survey study on representation of back pain in three Swiss language regions.

PubMed

Schulz, Peter J; Hartung, Uwe; Riva, Silvia

2013-01-01

This study intends to contribute to a research tradition that asks how causal attributions of illnesses affect coping behavior. Causal attributions are understood as the most important element of illness representations and coping as a means to preserve quality of life. The issue is applied to a condition so far often neglected in research on illness representations-back pain-and a third concept is added to the picture: culture. The aim of this study is (a) to explore the causal factors to which persons with back pain attribute the further course of their illness, (b) to find out whether the attributed causes are predictors of coping maxims, and (c) to find out whether cultural factors affect attributions and coping and moderate the relationship between the two. A total of 1259 gainfully employed or self-employed persons with recent episodes of back pain were recruited in the three language regions of Switzerland. They were asked to complete a structured online interview, measuring among many other variables attributed causes, coping maxims, and affiliation to one of the Swiss micro-cultures (German-, French- or Italian-speaking). Attributed causes of the illness that can be influenced by a patient go along with more active coping styles. Cultural affiliation impacts on coping maxims independently, but culture moderates the relationship of attributed causes and coping maxims only in two of twenty possible cases. The results show that cultural differences can be analytically incorporated in the models of illness representations. Results may help to improve healthcare providers' communication with patients and plan public health campaigns. The approach to micro-cultural differences and the substantive relationships between alterability of causes and activity in coping may help the further development of models of illness representations.

Causes, Coping, and Culture: A Comparative Survey Study on Representation of Back Pain in Three Swiss Language Regions

PubMed Central

Schulz, Peter J.; Hartung, Uwe; Riva, Silvia

2013-01-01

Introduction This study intends to contribute to a research tradition that asks how causal attributions of illnesses affect coping behavior. Causal attributions are understood as the most important element of illness representations and coping as a means to preserve quality of life. The issue is applied to a condition so far often neglected in research on illness representations–back pain–and a third concept is added to the picture: culture. Aim The aim of this study is (a) to explore the causal factors to which persons with back pain attribute the further course of their illness, (b) to find out whether the attributed causes are predictors of coping maxims, and (c) to find out whether cultural factors affect attributions and coping and moderate the relationship between the two. Methods A total of 1259 gainfully employed or self-employed persons with recent episodes of back pain were recruited in the three language regions of Switzerland. They were asked to complete a structured online interview, measuring among many other variables attributed causes, coping maxims, and affiliation to one of the Swiss micro-cultures (German-, French- or Italian-speaking). Results Attributed causes of the illness that can be influenced by a patient go along with more active coping styles. Cultural affiliation impacts on coping maxims independently, but culture moderates the relationship of attributed causes and coping maxims only in two of twenty possible cases. Implications The results show that cultural differences can be analytically incorporated in the models of illness representations. Results may help to improve healthcare providers’ communication with patients and plan public health campaigns. The approach to micro-cultural differences and the substantive relationships between alterability of causes and activity in coping may help the further development of models of illness representations. PMID:24223756

Differences in patients' perceptions of Schizophrenia between Māori and New Zealand Europeans.

PubMed

Sanders, Deanna; Kydd, Robert; Morunga, Eva; Broadbent, Elizabeth

2011-06-01

Māori (the Indigenous people of New Zealand) are disproportionately affected by mental illness and experience significantly poorer mental health compared to New Zealand Europeans. It is important to understand cultural differences in patients' ideas about mental illness in treatment settings. The aim of the present study was to investigate differences in illness perceptions between Māori and New Zealand Europeans diagnosed with schizophrenia. A total of 111 users of mental health services (68 Māori, 43 New Zealand European) in the greater Auckland and Northland areas who had been diagnosed with schizophrenia or other psychotic disorder were interviewed using the Brief Illness Perception Questionnaire and the Drug Attitude Inventory. District Health Board staff completed the Global Assessment of Functioning for each patient. Māori with schizophrenia believed that their illness would continue significantly less time than New Zealand European patients did. Chance or spiritual factors were listed as causes of mental illness by only five Māori patients and no New Zealand European patients. Other illness perceptions, as well as attitudes towards medication, were comparable between groups. Across groups, the top perceived causes were drugs/alcohol, family relationships/abuse, and biological causes. Illness perceptions provide a framework to assess patients' beliefs about their mental illness. Differences between Māori and New Zealand European patients' beliefs about their mental illness may be related to traditional Māori beliefs about mental illness. Knowledge of differences in illness perceptions provides an opportunity to design effective clinical interventions for both Māori and New Zealand Europeans.

Estimates of Foodborne Illness in the United States -- Burden of Foodborne Illness: Findings

MedlinePlus

... Pathogens causing the most foodborne illnesses, hospitalizations, and deaths each year Eight known pathogens are estimated to ... majority of domestically acquired foodborne illnesses, hospitalizations, and deaths. The tables below list the top five pathogens ...

Ethnicity and excess mortality in severe mental illness: a cohort study.

PubMed

Das-Munshi, Jayati; Chang, Chin-Kuo; Dutta, Rina; Morgan, Craig; Nazroo, James; Stewart, Robert; Prince, Martin J

2017-05-01

Excess mortality in severe mental illness (defined here as schizophrenia, schizoaffective disorders, and bipolar affective disorders) is well described, but little is known about this inequality in ethnic minorities. We aimed to estimate excess mortality for people with severe mental illness for five ethnic groups (white British, black Caribbean, black African, south Asian, and Irish) and to assess the association of ethnicity with mortality risk. We conducted a longitudinal cohort study of individuals with a valid diagnosis of severe mental illness between Jan 1, 2007, and Dec 31, 2014, from the case registry of the South London and Maudsley Trust (London, UK). We linked mortality data from the UK Office for National Statistics for the general population in England and Wales to our cohort, and determined all-cause and cause-specific mortality by ethnicity, standardised by age and sex to this population in 2011. We used Cox proportional hazards regression to estimate hazard ratios and a modified Cox regression, taking into account competing risks to derive sub-hazard ratios, for the association of ethnicity with all-cause and cause-specific mortality. We identified 18 201 individuals with a valid diagnosis of severe mental illness (median follow-up 6·36 years, IQR 3·26-9·92), of whom 1767 died. Compared with the general population, age-and-sex-standardised mortality ratios (SMRs) in people with severe mental illness were increased for a range of causes, including suicides (7·65, 95% CI 6·43-9·04), non-suicide unnatural causes (4·01, 3·34-4·78), respiratory disease (3·38, 3·04-3·74), cardiovascular disease (2·65, 2·45-2·86), and cancers (1·45, 1·32-1·60). SMRs were broadly similar in different ethnic groups with severe mental illness, although the south Asian group had a reduced SMR for cancer mortality (0·49, 0·21-0·96). Within the cohort with severe mental illness, hazard ratios for all-cause mortality and sub-hazard ratios for natural-cause and unnatural-cause mortality were lower in most ethnic minority groups relative to the white British group. People with severe mental illness have excess mortality relative to the general population irrespective of ethnicity. Among those with severe mental illness, some ethnic minorities have lower mortality than the white British group, for which the reasons deserve further investigation. UK Health Foundation and UK Academy of Medical Sciences. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Children's understanding of mental illness: an exploratory study.

PubMed

Fox, C; Buchanan-Barrow, E; Barrett, M

2008-01-01

This study aimed to investigate children's thinking about mental illness by employing a well-established framework of adult illness understanding. The study adopted a semistructured interview technique and a card selection task to assess children's responses to causes, consequences, timeline and curability of the different types of mental illness. The children were aged between 5 and 11 years. Results indicated a developmental trend in the children's thinking about mental illness; there was an increase in the children's understanding of the causes, consequences, curability and timeline of mental illness with age. The older children demonstrated a more sophisticated and accurate thinking about mental illness compared with the younger children, who tended to rely on a medical model in order to comprehend novel mental illnesses. Furthermore, the girls exhibited more compassion, showing greater social acceptance compared with the boys. The Leventhal model provides a useful framework within which to investigate children's knowledge and understanding of mental illness. Limitations of the study and implications for future research are discussed.

Rate and predictors of negative effects of psychotherapy in psychiatric and psychosomatic inpatients.

PubMed

Rheker, Julia; Beisel, Sylvia; Kräling, Svenja; Rief, Winfried

2017-08-01

Studies examining the rates of negative effects of psychotherapy are rare and the reported rates differ widely. To be able to calculate adequate benefit-cost ratios in conjunction with different samples and settings, we need a deeper understanding of these effects. We therefore investigated whether different treatment settings would reveal varying rates and kinds of negative effects by recruiting patients from a psychiatric (n=93) and a psychosomatic rehabilitation (n=63) hospital. Negative effects of psychotherapy were assessed with the Inventory for the Assessment of Negative Effects of Psychotherapy post-treatment. To investigate whether patients' pre-treatment expectations have an influence on reported negative effects, patients filled in the Patient Questionnaire on Therapy Expectation and Evaluation prior to treatment begin. Patients from the psychiatric hospital reported an average 1.41 negative effects, with 58.7% reporting at least one negative effect. Those from the psychosomatic hospital reported 0.76 negative effects on average, with 45.2% of patients reporting at least one negative effect. The differences between these samples are significant. The two samples' top three reported types of negative effects are that patients had experienced more downs during or just before the end of the therapy, that patients had difficulty making important decisions without the therapist, and that patients were concerned that colleagues or friends might find out about the therapy. A regression analysis revealed that the clinical setting (psychosomatic rehabilitation hospital vs. psychiatric hospital) and expectations in the form of hope of improvement were significant predictors for negative effects of psychotherapy. Our study highlights the need to examine the negative effects of psychotherapy in different settings and samples to better evaluate the benefit-cost ratios of treatments for different patient groups. It also shows that we need guidelines for assessing and reporting negative effects. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

[Motivation for psychosomatic-psychotherapeutic treatment of vocational stresses -- development and validation of a questionnaire].

PubMed

Zwerenz, R; Knickenberg, R J; Schattenburg, L; Beutel, M E

2005-02-01

There is a lack of questionnaires assessing the motivation of inpatients to scrutinize occupational stresses and deal with them as part of their psychotherapeutic treatment. Work-related stress contributes significantly to the development of mental disorders. Vocational reintegration is an outcome criterion for the success of vocational rehabilitation. Patients are often not motivated for dealing with occupational stresses during inpatient medical rehabilitation. Therefore it is necessary to assess patient motivation at the beginning of treatment, in order to assign them to specific interventions, e. g. promoting motivation. A questionnaire (Fragebogen zur berufsbezogenen Therapiemotivation -- FBTM) consisting of 84 items was developed, based on published questionnaires for psychotherapy motivation. 283 psychosomatic rehabilitation inpatients were administered the FBTM, subsequently analyzed by item and factor analyses. Based on a second sample (n = 282) confirmatory factor analyses and validation of the questionnaire were executed. Item and factor analyses revealed a four factor structure. 24 items constituted the subscales that could be described as "intention to change", "wish for pension", "negative treatment expectations" and "active coping". Reliability (Cronbach's Alpha) was satisfactory with coefficients between 0.69 and 0.87, and only low correlations could be found between the four subscales. Correlations with other measures were most pronounced for the subscale "intention to change". Some significant but low correlations could be reported between the FBTM and a standardized questionnaire of psychotherapy motivation (FMP). Confirmatory factor analyses of a second sample (n = 282) confirmed the original four factors. First evidence of sensitivity could be observed in a sample of patients who took part in an intervention promoting work-related therapy motivation during psychosomatic inpatient rehabilitation. The FBTM is a reliable and valid instrument assessing work-related therapy motivation of inpatients, as a relevant therapeutic measure in psychosomatic rehabilitation. Further validation, especially the analysis of predictive validity is desirable.

Historical perspectives on music as a cause of disease.

PubMed

Kennaway, James

2015-01-01

The relationship between music and medicine is generally understood in the benign context of music therapy, but, as this chapter shows, there is a long parallel history of medical theories that suggest that music can cause real physical and mental illness. During the seventeenth and eighteenth centuries, the idea of music as an expression of universal harmony was challenged by a more mechanistic model of nervous stimulation. By the 1790s, there was a substantial discourse on the dangers of musical overstimulation to health in medicine, literature, and etiquette books. During the nineteenth century, the sense of music as a pathogenic stimulant gained in influence. It was often linked to fears about sexuality, female gynecological health, and theories of hypnosis and degeneration. In the twentieth century, the debate on the medical perils of the wrong kinds of music became overtly politicized in Germany and the Soviet Union. Likewise, the opponents of jazz, particularly in the United States, often turned to medicine to fend off its supposed social, moral, and physical consequences. The Cold War saw an extensive discourse on the idea of musical "brainwashing," that rumbled on into the 1990s. Today, regular media panics about pathological music are mirrored by alarming evidence of the deliberate use of music to harm listeners in the context of the so-called War on Terror. Can music make you ill? Music therapy is a common if perhaps rather neglected part of medicine, but its diametric opposite, the notion that music might lead to real mental and physical illness, may seem improbable. In fact, over the last two hundred years, there have been many times when as much was written about the medical dangers of music as about its potential benefits. Since the eighteenth century, fears about music's effects on the nerves and the mind have created a remarkably extensive discourse on pathological music based on a view of both music and the causation of disease as matters of nervous stimulation (Kennaway, 2010, 2012a). From concerns about young ladies fainting from excessive stimulation while playing the keyboard in the Georgian period and Victorian panics about Wagner to the Nazi concept of "degenerate music" and Cold War anxieties about musical brainwashing, the debate on the medical dangers of music has generally combined a theoretical and terminological basis in the medicine of the period concerned with broader agendas about gender, sexuality, race, and social order. Each generation has tended to regard the music it grew up with as the epitome of rationality and healthy mindedness while ascribing hair-raising medical consequences to newer music. This debate has continued right up to the present day, with the depressing difference that, with the systematic use of music in torture in the so-called War on Terror, the idea that music can be bad for you has become a much more realistic prospect. Although the debate about music's ill effects has largely been bogus, there are ways in which music can in fact adversely affect health. Most directly of all, there is of course the power of sheer volume to cause psychological strain and hearing damage. It was only really with the advent of the modern age, with its industrial noise, expanded orchestras, and amplified sound systems, that this became a widespread concern. Although the high-decibel sound can include music, it is not its character as music that causes health problems, so it falls rather outside our purview. Medical problems that do relate to specifically to music itself include the rare conditions of arousal-related arrhythmia and musicogenic epilepsy, but in both of these contexts, music is essentially a trigger rather than a fundamental cause of sickness (Sharp, 1997; Viskin, 2008; Wieser et al., 1997). There is a long history of medical accounts of musical hallucinations, which are certainly sometimes associated with serious medical conditions, but they are by no means always experienced as pathological (Berrios, 1990; Evers and Tanja, 2004). It should also be remembered that it is quite possible that many of the accounts of music causing disease refer to real physical symptoms and suffering, albeit generally with a psychosomatic rather than direct physiological explanation. This kind of psychological impact of music has meant it has been linked to a variety of culturally bound syndromes. Having said that, it is also clear that the most of the discourse on pathological music is basically fallacious. Over and over again, fundamentally moral objections to music relating to sexuality, gender, social order, and self-control have been clear beneath a veneer of medical language. © 2015 Elsevier B.V. All rights reserved.

MMPI for personality characteristics of patients with different diseases.

PubMed

Pop-Jordanova, N

2015-01-01

In the field of psychosomatic medicine the relationship between personality characteristics and diseases is supposed to be an important issue. The aim of this article is to present group's MMPI profiles obtained for patients with different chronic diseases and to discuss about possible specific features of these different groups. We summarized results obtained by psychological testing of following groups of patients: adult patients treated with chronic maintenance dialysis, patients with diabetic retinopathy, general anxiety group, attack panic syndrome, parents of children with rheumatoid arthritis, as well as adolescents with mental anorexia, cystic fibrosis, diabetes mellitus and leukemia. Two control groups comprised adults and adolescents, both without any health problems, selected randomly. As a psychometric test MMPI-201 was used. Statistic 10 package is used for statistical analysis. In our presentation it can be seen some typical personality characteristics for patients with chronic conditions. These findings could be helpful for clinicians concerning treatment planning and follow-up. In general, the MMPI helps us to obtain a global, factual picture from the self-assessment of the patient, explained in a psycho-technical language. Group's profile could be used in clinical practice for planning treatment and to suppose the prognosis of the illness.

Psychological comorbidity in patients with chronic tinnitus: analysis and comparison with chronic pain, asthma or atopic dermatitis patients.

PubMed

Zirke, N; Seydel, C; Szczepek, A J; Olze, H; Haupt, H; Mazurek, B

2013-03-01

To determine the prevalence and severity of psychological comorbidity in patients with chronic tinnitus in comparison with other chronic illnesses, namely chronic pain, chronic asthma and atopic dermatitis. Psychological diagnoses were done according to ICD-10 Chapter V(F). Subjective impairment was evaluated using 5 psychometric questionnaires: tinnitus questionnaire, Berlin mood questionnaire, sense of coherence (SOC-L9) and perceived stress questionnaire. Sleep disturbance was measured by the subdomain 'exhaustion' of the Giessen physical complaints inventory. Somatoform or affective disorders were most frequent in all disease groups. Patients with chronic tinnitus had a stronger SOC and better subjective mood, stronger commitment, and less anger and anxious depression than the patients with chronic pain, chronic asthma or atopic dermatitis. However, in patients with higher tinnitus annoyance, psychological comorbidity was similar to that found in patients with other chronic diseases. Besides collecting medical and social history, special psychometric instruments should be used for the diagnosis of tinnitus patients. Based on relative high frequency of psychological comorbidity, we recommend interdisciplinary cooperation between otorhinolaryngologists and other specialists (psychosomatic medicine, psychology or psychiatry) during the treatment of tinnitus patients, especially when high degree of tinnitus annoyance is involved.

The critical role of psychosomatics in promoting a new perspective upon health and disease.

PubMed

Dragoş, Dorin; Tănăsescu, Maria Daniela

2009-01-01

In an evolutionary model, health and disease are regarded as successful and respectively failed adaptation to the demands of the environment. The social factors are critical for a successful adaptation, while emotions are means of both signaling the organism's state and of adapting the physiological responses to environmental challenges. Hence the importance of a biopsychosocial model of health and disease. Psychoemotional distress generates and/or amplifies somatic symptoms. Somatization may be viewed as an altered cognitive process, inclining the individual to an augmented perception of bodily sensations and to an increased degree of complexity in reporting negative experiences (hence the greater cognitive effort allocated thereto). Somatosensory amplification and alexithymia are key elements in this process. The brain's right hemisphere is more involved in the generation of emotionally conditioned somatization symptoms. Somatic symptoms have various psychological and social functions and are strongly influenced by the particular belief system of the individual. Inappropriately perceiving the environment as an aggressor and excessively responding to it (by activating the cytokine system in correlation with the arousal of the psychic, nervous, and endocrine systems) may be a key element in the altered cognition conducive to ill health.

Love as sensory stimulation: physiological consequences of its deprivation and expression.

PubMed

Komisaruk, B R; Whipple, B

1998-11-01

For the present purpose, love is defined as one's having stimulation that one desires. The nature of the stimulation can range on a continuum from the most abstract cognitive, to the most direct sensory, forms. Thus, this definition of love encompasses having an emotional bond with a person for whom one yearns, as well as having sensory stimulation that one desires. We address some of the physiological and perceptual consequences both of having, and of not having, love. We propose a neural mechanism by which deprivation of love may generate endogenous, compensatory sensory stimulation that manifests itself as psychosomatic illness. In addition, we propose a neuroendocrine mechanism underlying sexual response and orgasm. The latter includes vaginocervical sensory pathways to the brain that can produce analgesia, release oxytocin, and/or bypass the spinal cord via the vagus nerve. We present evidence of the existence of non-genital orgasms, which suggests that genital orgasm is a special case of a more pervasive orgasmic process. Through recent studies, the mechanisms and manifestations of love and its deprivation are becoming better understood. The better is our understanding of love, the greater is our respect for the significance and potency of its role in mental and physical health.

[System-immanent incentives in the remuneration for psychiatry and psychosomatics : Analysis exemplified by treatment of alcohol-related disorders].

PubMed

Horter, H; Zapp, W; Driessen, M

2016-07-01

The German fixed rate remuneration system in psychiatry and psychosomatics (PEPP) has been criticized by many specialty associations because negative effects on mental healthcare are expected through economic incentives. Through analysis of performance data in the treatment of alcohol dependency at the Evangelical Hospital Bielefeld (Evangelisches Krankenhaus Bielefeld, EvKB) from 2014 and various simulations, the incentives of the PEPP (version 2015) were analyzed and its potential impact on patient care was evaluated. Groups of cases were created based on the clinical data. Various parameters were evaluated, such as duration of treatment, PEPP coding, loss of income by merging cases and case remuneration. Additionally, changes in the duration of treatment, the intensity of treatment and the intensity of care were simulated. In the simulations a reduction in the duration of treatment by 16.1 % led to additional revenues of 1.9 % per treatment day. The calculated additional costs of 1:1 care and intensive nursing care were not completely covered by the additional revenues, whereas psychotherapeutic inpatient treatment programs showed positive profit contributions. Complicated cases with increased merging of cases showed lower revenues but with above average expenditure of efforts. The current version of the PEPP leads to misdirected incentives in patient care. This is caused, for example, by the fact that higher profit contributions can be realized in some patient groups and intensive nursing care of patients is insufficiently represented. It is not clear whether these incentives will persist or can be compensated in subsequent versions of the system.

48 CFR 1852.223-75 - Major breach of safety or security.

Code of Federal Regulations, 2010 CFR

2010-10-01

... conditions that can cause death, injury, occupational illness, damage to or loss of equipment or property, or... conditions that can cause death, injury, occupational illness, damage to or loss of equipment or property, or...

Retrospective Validation of a Surveillance System for Unexplained Illness and Death: New Haven County, Connecticut

PubMed Central

Kluger, Michael D.; Sofair, Andre N.; Heye, Constance J.; Meek, James I.; Sodhi, Rajesh K.; Hadler, James L.

2001-01-01

Objectives. This study investigated retrospective validation of a prospective surveillance system for unexplained illness and death due to possibly infectious causes. Methods. A computerized search of hospital discharge data identified patients with potential unexplained illness and death due to possibly infectious causes. Medical records for such patients were reviewed for satisfaction of study criteria. Cases identified retrospectively were combined with prospectively identified cases to form a reference population against which sensitivity could be measured. Results. Retrospective validation was 41% sensitive, whereas prospective surveillance was 73% sensitive. The annual incidence of unexplained illness and death due to possibly infectious causes during 1995 and 1996 in the study county was conservatively estimated to range from 2.7 to 6.2 per 100 000 residents aged 1 to 49 years. Conclusions. Active prospective surveillance for unexplained illness and death due to possibly infectious causes is more sensitive than retrospective surveillance conducted through a published list of indicator codes. However, retrospective surveillance can be a feasible and much less labor-intensive alternative to active prospective surveillance when the latter is not possible or desired. PMID:11499106

Time to B. cereus about hot chocolate.

PubMed Central

Nelms, P K; Larson, O; Barnes-Josiah, D

1997-01-01

OBJECTIVE: To determine the cause of illnesses experienced by employees of a Minneapolis manufacturing plant after drinking hot chocolate bought from a vending machine and to explore the prevalence of similar vending machine-related illnesses. METHODS: The authors inspected the vending machines at the manufacturing plant where employees reported illnesses and at other locations in the city where hot chocolate beverages were sold in machines. Tests were performed on dry mix, water, and beverage samples and on machine parts. RESULTS: Laboratory analyses confirmed the presence of B. cereus in dispensed beverages at a concentration capable of causing illness (170,000 count/gm). In citywide testing of vending machines dispensing hot chocolate, 7 of the 39 licensed machines were found to be contaminated, with two contaminated machines having B. cereus levels capable of causing illness. CONCLUSIONS: Hot chocolate sold in vending machines may contain organisms capable of producing toxins that under favorable conditions, can induce illness. Such illnesses are likely to be underreported. Even low concentrations of B. cereus may be dangerous for vulnerable populations such as the aged or immunosuppressed. Periodic testing of vending machines is thus warranted. The relationship between cleaning practices and B. cereus contamination is an issue for further study. PMID:9160059

Time to B. cereus about hot chocolate.

PubMed

Nelms, P K; Larson, O; Barnes-Josiah, D

1997-01-01

To determine the cause of illnesses experienced by employees of a Minneapolis manufacturing plant after drinking hot chocolate bought from a vending machine and to explore the prevalence of similar vending machine-related illnesses. The authors inspected the vending machines at the manufacturing plant where employees reported illnesses and at other locations in the city where hot chocolate beverages were sold in machines. Tests were performed on dry mix, water, and beverage samples and on machine parts. Laboratory analyses confirmed the presence of B. cereus in dispensed beverages at a concentration capable of causing illness (170,000 count/gm). In citywide testing of vending machines dispensing hot chocolate, 7 of the 39 licensed machines were found to be contaminated, with two contaminated machines having B. cereus levels capable of causing illness. Hot chocolate sold in vending machines may contain organisms capable of producing toxins that under favorable conditions, can induce illness. Such illnesses are likely to be underreported. Even low concentrations of B. cereus may be dangerous for vulnerable populations such as the aged or immunosuppressed. Periodic testing of vending machines is thus warranted. The relationship between cleaning practices and B. cereus contamination is an issue for further study.

Psychosomatic symptoms in medical outpatients: an investigation of self-handicapping theory.

PubMed

Organista, P B; Miranda, J

1991-01-01

Investigated self-handicapping theory as it relates to somatization in medical patients. We predicted that medical outpatients (N = 113) would report psychosomatic symptoms in response to events that threaten their self-esteem. As predicted, results of hierarchical multiple regression indicated that high-perfectionism patients reported somatic symptoms positively related to the number of events that jeopardize their sense of accomplishment, whereas low-perfectionism patients' somatic symptoms were not related to these events (p = .005). Contrary to prediction, high-dependency patients did not differ significantly from low-dependency patients in the relationship of somatic symptoms and events that threatened their interpersonal relationships (p = .115). Implications of these findings and the utility of self-handicapping theory for predicting somatization in medical patients are discussed.

[Psychosomatic aspects of sudden deafness].

PubMed

Lamparter, U

1998-06-01

In a psychosomatic point of view in an overwhelming number of cases sudden deafness is a "response" to strain, which consciously or unconsciously is not assessed as tolerable. Special personal or situational circumstances seem to occur frequently, besides of psychomental strain above all high pressure of responsibility in situations of care, high sensibility and inhibition to show overt aggressive behaviour, which is suppressed by guilt feelings. These findings are used to develop a first idealtypic psychopathogenetic model of sudden deafness. Detecting and talking about the individual psychosocial strain of the patient is very important in the management of the disease and the social-medicine assessments, especially in determining duration of disablement and estimating grade of disability (GdB) in the case of persistent decrease of hearing and tinnitus.

The perspective of psychosomatic medicine on the effect of religion on the mind-body relationship in Japan.

PubMed

Nakao, Mutsuhiro; Ohara, Chisin

2014-02-01

Shintoism, Buddhism, and Qi, which advocate the unity of mind and body, have contributed to the Japanese philosophy of life. The practice of psychosomatic medicine emphasizes the connection between mind and body and combines the psychotherapies (directed at the mind) and relaxation techniques (directed at the body), to achieve stress management. Participation in religious activities such as preaching, praying, meditating, and practicing Zen can also elicit relaxation responses. Thus, it is time for traditional religions to play an active role in helping those seeking psychological stability after the Great East Japan Earthquake and the ongoing crisis related to the nuclear accident in Fukushima, Japan, to maintain a healthy mind-body relationship.

Magnitude and characteristics of acute paraquat- and diquat-related illnesses in the US: 1998-2013.

PubMed

Fortenberry, Gamola Z; Beckman, John; Schwartz, Abby; Prado, Joanne Bonnar; Graham, Lucia S; Higgins, Sheila; Lackovic, Michelle; Mulay, Prakash; Bojes, Heidi; Waltz, Justin; Mitchell, Yvette; Leinenkugel, Kathy; Oriel, Michel S; Evans, Elizabeth; Calvert, Geoffrey M

2016-04-01

Paraquat and diquat are among the most commonly used herbicides in the world. Determine the magnitude, characteristics, and root causes for acute paraquat- and diquat-related illnesses in the US METHODS: Illnesses associated with paraquat or diquat exposure occurring from 1998 through 2011 were identified from the Sentinel Event Notification System for Occupational Risks (SENSOR)-Pesticides Program, the California Department of Pesticide Regulation (CDPR) Pesticide Illness Surveillance Program (PISP), and the Incident Data System (IDS). Cases identified by the National Poison Data System (NPDS) were reviewed for the years 1998-2003 and 2006-2013. A total of 300 paraquat- and 144 diquat-related acute illnesses were identified by SENSOR, PISP, and IDS. NPDS identified 693 paraquat- and 2128 diquat-related acute illnesses. In SENSOR/PISP/IDS, illnesses were commonly low severity (paraquat=41%; diquat=81%); however, SENSOR/PISP/IDS identified 24 deaths caused by paraquat and 5 deaths associated with diquat. Nineteen paraquat-related deaths were due to ingestion, seven of which were unintentional, often due to improper storage in beverage bottles. In SENSOR/PISP/IDS, paraquat and diquat-related acute illnesses were work-related in 68% (n=203) and 29% (n=42) of cases, respectively. When herbicide application site was known, the vast majority of acute paraquat-related illnesses (81%) arose from agricultural applications. Common root causes of illness were failure to use adequate personal protective equipment (PPE), application equipment failure, and spill/splash of herbicide. Although the magnitude of acute paraquat/diquat-related illnesses was relatively low, several fatalities were identified. Many illnesses could be prevented through stricter compliance with label requirements (e.g. ensuring proper herbicide storage and PPE use), and through enhanced training of certified applicators. Published by Elsevier Inc.

Magnitude and characteristics of acute paraquat- and diquat-related illnesses in the US: 1998–2013

PubMed Central

Fortenberry, Gamola Z.; Beckman, John; Schwartz, Abby; Prado, Joanne Bonnar; Graham, Lucia S.; Higgins, Sheila; Lackovic, Michelle; Mulay, Prakash; Bojes, Heidi; Waltz, Justin; Mitchell, Yvette; Leinenkugel, Kathy; Oriel, Michel S.; Evans, Elizabeth; Calvert, Geoffrey M.

2016-01-01

Background Paraquat and diquat are among the most commonly used herbicides in the world. Objectives Determine the magnitude, characteristics, and root causes for acute paraquat- and diquat-related illnesses in the US Methods Illnesses associated with paraquat or diquat exposure occurring from 1998 through 2011 were identified from the Sentinel Event Notification System for Occupational Risks (SENSOR)-Pesticides Program, the California Department of Pesticide Regulation (CDPR) Pesticide Illness Surveillance Program (PISP), and the Incident Data System (IDS). Cases identified by the National Poison Data System (NPDS) were reviewed for the years 1998–2003 and 2006–2013. Results A total of 300 paraquat- and 144 diquat-related acute illnesses were identified by SENSOR, PISP, and IDS. NPDS identified 693 paraquat- and 2128 diquat-related acute illnesses. In SENSOR/PISP/IDS, illnesses were commonly low severity (paraquat=41%; diquat=81%); however, SENSOR/PISP/IDS identified 24 deaths caused by paraquat and 5 deaths associated with diquat. Nineteen paraquat-related deaths were due to ingestion, seven of which were unintentional, often due to improper storage in beverage bottles. In SENSOR/PISP/IDS, paraquat and diquat-related acute illnesses were work-related in 68% (n=203) and 29% (n=42) of cases, respectively. When herbicide application site was known, the vast majority of acute paraquat-related illnesses (81%) arose from agricultural applications. Common root causes of illness were failure to use adequate personal protective equipment (PPE), application equipment failure, and spill/splash of herbicide. Conclusions Although the magnitude of acute paraquat/diquat-related illnesses was relatively low, several fatalities were identified. Many illnesses could be prevented through stricter compliance with label requirements (e.g. ensuring proper herbicide storage and PPE use), and through enhanced training of certified applicators. PMID:26775000

Respiratory Illness in Saskatoon Infants: The Impact of Housing and Neighbourhood Characteristics

ERIC Educational Resources Information Center

Wright, Judith; Muhajarine, Nazeem

2008-01-01

Respiratory illness is an important childhood illness and a significant cause of infant mortality. This study examined the relationship between neighbourhood level variables and rates of respiratory illness for children less than 2 years of age, born in Saskatoon between 1992 and 1994. Rates of respiratory illness, as measured by proportion of…

Unexplained Deaths and Critical Illnesses of Suspected Infectious Cause, Taiwan, 2000–2005

PubMed Central

Wei, Kuo-Chen; Jiang, Donald Dah-Shyong; Chiu, Chan-Hsian; Chang, Shan-Chwen

2008-01-01

We report 5 years’ surveillance data from the Taiwan Centers for Disease Control on unexplained deaths and critical illnesses suspected of being caused by infection. A total of 130 cases were reported; the incidence rate was 0.12 per 100,000 person-years; and infectious causes were identified for 81 cases (62%). PMID:18826839

Children's Conceptions of Mental Illness: A Naive Theory Approach

ERIC Educational Resources Information Center

Fox, Claudine; Buchanan-Barrow, Eithne; Barrett, Martyn

2010-01-01

This paper reports two studies that investigated children's conceptions of mental illness using a naive theory approach, drawing upon a conceptual framework for analysing illness representations which distinguishes between the identity, causes, consequences, curability, and timeline of an illness. The studies utilized semi-structured interviewing…

Profiles of recreational activities of daily living (RADL) in patients with mental disorders.

PubMed

Linden, Michael; Gehrke, G; Geiselmann, B

2009-12-01

Activities of daily living, play a key role in the measurement of functional health as defined by the International Classification of Functioning, Disability and Health (ICF) and in prevention and treatment of mental or somatic illnesses. From a clinical context it is important to discriminate between basic "activities of daily living, ADL", "intentional activities of daily living, IADL", and "recreational activities of daily living, RADL". While ADL and IADL have gained much attention in dementia, the elderly, or severe somatic illnesses, there is a lack of research on RADL, which are important in depression, anxiety, or other neurotic disorders. 154 unselected inpatients of a department of behavioral and psychosomatic medicine filled in the "Check List of Recreational Activities" to assess the rates and profiles of RADL. Patients reported on average 19.3 (s.d. 7.0) activities (range 4 - 40), i.e. males 21.3 (s.d. 6.5, 9 - 34) and females 18.9 (s.d. 7.1, 4 - 40). Most frequent RADL were passive and unspecific activities like "watching tv" (93.4%). Least frequent were activities which need special skills or preparation like "horse back riding" (0.7%). Low rates were also found for activities which are in the centre of inpatient occupational therapy like "ceramics" (4.7%) or "silk-painting" (2.6%). There are differences between sexes but not in respect to age (18 to 60), sick leave and unemployment, or diagnostic status. When patients were asked what they would like to do in the future, the same activity profile emerged as when looking at what they had done in the last month The data give a reference profile for recreational activities, help to define what can be considered a normal frequency and spectrum of RADL, and, by this, can guide therapeutic interventions.

Downwards Vertical Attention Bias in Conversion Disorder vs Controls: A Pilot Study.

PubMed

Gazit, Sivan; Elkana, Odelia; Dawidowicz, Liraz; Yeshayahu, Liel; Biran, Iftah

Conversion disorder (CD) is a largely enigmatic disorder, one that requires a thorough ruling-out process. Prior research suggests that metaphors and conceptualization are rooted in physical experience, and that we interpret our affective world through metaphors. Spatial metaphors (interaction of affect and vertical space) are a prominent example of the grounding of metaphors. This is a relatively unpaved direction of research of CD. The present pilot study sought to explore this view by investigating the "healthy is up, sick is down" spatial metaphors (e.g., "fell ill" and "top shape") in patients with CD, examining the correlation between the processing of bodily-related words, CD, and vertical space. We hypothesized that patients with CD, who experience their bodies as ill, will demonstrate a downwards bias when processing bodily-related words; corresponding to the "healthy is up, sick is down" spatial metaphor. A total of 8 female patients (ages M-38.13 SD-10.44) and 42 female controls (ages M-36.4 SD-14.57) performed a visual attention task. Participants were asked to identify a spatial probe at the top or the bottom of a screen, following either a bodily related (e.g., arm) or non-bodily related (e.g., clock) prime word. As predicted, when processing bodily-related words, patients with CD demonstrated a downwards attention bias. Moreover, the higher the patient's level of somatization, the faster the patient detected lower (vs upper) spatial targets. This study suggests that the changed health paradigm of patients with CD is grounded in sensorimotor perception. Further research could propose new diagnostic and treatment options for CD. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Health Canada Warning on Citalopram and Escitalopram--Its Effects on Prescribing in Consultation-Liaison Psychiatry.

PubMed

Do, André; Noohi, Saeid; Elie, Dominique; Mahdanian, Artin A; Yu, Ching; Segal, Marilyn; Looper, Karl J; Rej, Soham

2016-01-01

Reports have suggested that citalopram and escitalopram may prolong the QTc interval, leading Health Canada to issue a warning to limit their dosages in 2012. Little is known about the effects of this warning and similar ones (e.g., by the Food and Drug Administration) on antidepressant prescribing in inpatients with acute medical illness, who are theoretically at high risk of QTc prolongation. The main objective of our study is to examine the effect of the Health Canada warning on citalopram/escitalopram prescribing patterns in the consultation-liaison (C-L) psychiatry setting. We performed a retrospective cohort study including 275 randomly selected inpatients with medical illness assessed by the psychiatric C-L team of a large Canadian academic hospital between 2008 and 2014. We grouped patients based on whether they were assessed by the C-L team before or after the citalopram Health Canada warning. Our primary outcome was change in citalopram/escitalopram prescribing patterns. We found that of patients seen before the Health Canada warning, a significantly higher number were prescribed citalopram/escitalopram (44.1% vs. 22.3%, χ(2) = 14.835, p < 0.001), even after controlling for confounders. However, the percentage of patients using a citalopram/escitalopram dose exceeding those recommended by the Health Canada warning was similar in both groups (8.9% vs. 12.1%, χ(2) = 0.233, p = 0.63). Overall, C-L psychiatrists were less likely to prescribe citalopram/escitalopram following the Health Canada warning, which did not translate into safer dosing. Clinicians should not avoid prescribing citalopram/escitalopram appropriately in medically vulnerable inpatients when benefits outweigh disadvantages. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Obstructive Sleep Apnea, Posttraumatic Stress Disorder, and Health in Immigrants

PubMed Central

Arnetz, Bengt B.; Templin, Thomas; Saudi, Waleed; Jamil, Hikmet

2013-01-01

Objective To determine whether obstructive sleep apnea mediates the relationship between posttraumatic stress disorder (PTSD) and psychosomatic and somatic disorders and its implications for self-rated health (SRH) among Iraqi immigrants in the United States. Methods A random sample of immigrants who had left Iraq before the 1991 Gulf War (n = 145) or after (n = 205) and are residing in metropolitan Detroit responded to a structured interview covering questions on sociodemographics, premigration trauma, SRH, physician-diagnosed and -treated obstructive sleep apnea, somatic disorders, and psychosomatic disorders. Structural equation modeling was used to evaluate the relationship between premigration trauma scores and health, as well as to explore mediating pathways between PTSD, obstructive sleep apnea, and health. Results The prevalence of obstructive sleep apnea among post-Gulf War immigrants (30.2%) was significantly higher than among pre-Gulf War immigrants (0.7%; p < .001). Premigration trauma scores were positively associated with depression and PTSD. Structural equation modeling supported a model in which obstructive sleep apnea mediated the relationship between PTSD and psychosomatic and somatic disorders. Premigration trauma also related directly to SRH. Conclusions Part of the PTSD-associated adverse health effects observed in Iraqi immigrants is mediated by obstructive sleep apnea. Because sleep apnea in the current study is based on medical history and current treatment, there is a need for future confirmatory polysomnographic studies. PMID:23023679

The Prevalence of and Factors Associated with Neck, Shoulder, and Low-Back Pains among Medical Students at University Hospitals in Central Saudi Arabia

PubMed Central

Al-Saran, Yazeed; Al-Moawi, Ahlam; Bin Dous, Abdullah; Al-Ahaideb, Abdulaziz

2017-01-01

Aim The study aim was to determine the prevalence of neck, shoulder, and low-back pains and to explore the factors associated with musculoskeletal pain (MSP) among medical students at university hospitals in central Saudi Arabia. Method This cross-sectional study was conducted at a government institution using an online self-administered, modified version of the Standardised Nordic Questionnaire in the English language. Results A total of 469 students responded to our survey. The prevalence of MSP in at least one body site at any time, in the past week, and in the past year was 85.3%, 54.4%, and 81.9%, respectively. Factors significantly associated with MSP in at least one body site at any time were being in the clinical year (P = 0.032), history of trauma (P  =  0.036), history of depressive symptoms (P < 0.001), and history of psychosomatic symptoms (P < 0.001). On multivariable regression analysis, factors associated with MSP were history of trauma (P = 0.016) and depressive (P = 0.002) or psychosomatic symptoms (P = 0.004). Conclusion MSP among Saudi medical students is high, particularly among those in the clinical years and those with history of trauma and with depressive or psychosomatic symptoms. Medical institutions should be aware of this serious health issue and preventive measures are warranted. PMID:29238618

The Prevalence of and Factors Associated with Neck, Shoulder, and Low-Back Pains among Medical Students at University Hospitals in Central Saudi Arabia.

PubMed

Algarni, Abdulrahman D; Al-Saran, Yazeed; Al-Moawi, Ahlam; Bin Dous, Abdullah; Al-Ahaideb, Abdulaziz; Kachanathu, Shaji John

2017-01-01

The study aim was to determine the prevalence of neck, shoulder, and low-back pains and to explore the factors associated with musculoskeletal pain (MSP) among medical students at university hospitals in central Saudi Arabia. This cross-sectional study was conducted at a government institution using an online self-administered, modified version of the Standardised Nordic Questionnaire in the English language. A total of 469 students responded to our survey. The prevalence of MSP in at least one body site at any time, in the past week, and in the past year was 85.3%, 54.4%, and 81.9%, respectively. Factors significantly associated with MSP in at least one body site at any time were being in the clinical year ( P = 0.032), history of trauma ( P   =  0.036), history of depressive symptoms ( P < 0.001), and history of psychosomatic symptoms ( P < 0.001). On multivariable regression analysis, factors associated with MSP were history of trauma ( P = 0.016) and depressive ( P = 0.002) or psychosomatic symptoms ( P = 0.004). MSP among Saudi medical students is high, particularly among those in the clinical years and those with history of trauma and with depressive or psychosomatic symptoms. Medical institutions should be aware of this serious health issue and preventive measures are warranted.

The Injury/Illness Performance Project (IIPP): A Novel Epidemiological Approach for Recording the Consequences of Sports Injuries and Illnesses

PubMed Central

Fuller, Colin; Jaques, Rod; Hunter, Glenn

2013-01-01

Background. Describing the frequency, severity, and causes of sports injuries and illnesses reliably is important for quantifying the risk to athletes and providing direction for prevention initiatives. Methods. Time-loss and/or medical-attention definitions have long been used in sports injury/illness epidemiology research, but the limitations to these definitions mean that some events are incorrectly classified or omitted completely, where athletes continue to train and compete at high levels but experience restrictions in their performance. Introducing a graded definition of performance-restriction may provide a solution to this issue. Results. Results from the Great Britain injury/illness performance project (IIPP) are presented using a performance-restriction adaptation of the accepted surveillance consensus methodologies. The IIPP involved 322 Olympic athletes (males: 172; female: 150) from 10 Great Britain Olympic sports between September 2009 and August 2012. Of all injuries (n = 565), 216 were classified as causing time-loss, 346 as causing performance-restriction, and 3 were unclassified. For athlete illnesses (n = 378), the majority (P < 0.01) resulted in time-loss (270) compared with performance-restriction (101) (7 unclassified). Conclusions. Successful implementation of prevention strategies relies on the correct characterisation of injury/illness risk factors. Including a performance-restriction classification could provide a deeper understanding of injuries/illnesses and better informed prevention initiatives. PMID:26464883

Illness beliefs and psychological outcome in people with Parkinson's disease.

PubMed

Simpson, Jane; Lekwuwa, Godwin; Crawford, Trevor

2013-06-01

Illness beliefs are important predictors of psychological outcome in people with chronic illness and evidence suggests these could also be significant in furthering our understanding of psychological functioning in people with Parkinson's disease. Illness beliefs are specific, dynamic representations of an illness and cover dimensions such as cause, identity, consequences and controllability. Eighty-one people with Parkinson's disease completed a series of questionnaires to provide demographic, clinical and psychosocial data, which were then used to assess the relative impact of illness beliefs on their psychological functioning. Psychological functioning was assessed by measuring levels of depression, anxiety, stress, positive affect and emotional well-being. Hierarchical block regression indicated that illness beliefs were important independent predictors across some but not all outcomes and the results emphasised the importance of testing new predictors against more established predictors of outcome such as physical functioning and self-esteem. The illness beliefs most important in psychological outcome in people with PD were causal beliefs (particularly in psychosocial causes) and illness coherence (the level of understanding of the illness). The therapeutic potential of psychosocial variables was discussed given that these can be modified during therapy and this change can positively influence psychological outcome.

[Work disability in public press professions].

PubMed

Akermann, S

2002-09-01

In this study more than 1,000 cases of long-term disability among members of the press and media were evaluated. Mental disorders were the main cause of disability in almost every fourth case. In women psychiatric illnesses were even more important. The most common diagnosis was that of a depressive disorder which accounted for more than half of all psychiatric cases. The causes of disability of other insurance systems such as the German social security scheme and the pension and disability plan for the medical profession were compared. Mental illnesses are the leading cause of disability in white collar workers and orthopaedic illnesses, especially disorders of the vertebral column, are the leading cause in blue collar workers, as one might have expected. In females mental disorders are even more common than in men whereas men tend to have more cardiovascular problems than women. In this study also some interesting features regarding disability caused by various illnesses after long-term follow-up were found. This opens unknown perspectives allowing new assessment of diseases and eventually will enable the actuary to price medical diagnoses for disability insurance.

How clean must our drinking water be: the importance of protective immunity.

PubMed

Frost, Floyd J; Roberts, Melissa; Kunde, Twila R; Craun, Gunther; Tollestrup, Kristine; Harter, Lucy; Muller, Tim

2005-03-01

Cryptosporidium parvum is an important cause of epidemic diarrhea. Few studies have assessed whether serological evidence of prior infection in adults is related to a reduced occurrence of enteric illness. Serum samples and enteric illness event data were obtained in 2000 and 2001 from 326 people served by 1 of 2 unfiltered surface sources or 1 groundwater source. In 2001, filtration was initiated at 1 of the surface sources. Poisson regression related illness episodes with serological responses to the 15/17- and 27-kDa Cryptosporidium antigen groups. Subjects with moderately strong responses to the 15/17-kDa antigen had <65% of the risk of all 1-3-day episodes of diarrheal or gastrointestinal illness and <40% of the risk of all >/=4-day episodes, compared with subjects without a moderately strong response. Water source, change in water treatment, and very weak responses were unrelated to illness events. Endemic Cryptosporidium infections are a common cause of diarrheal and gastrointestinal illness in persons without a moderately strong response to the 15/17-kDa antigen group. Users of surface-derived drinking water are more likely to have strong serological responses to this antigen group and may be at a lower risk of endemic gastrointestinal illness caused by Cryptosporidium infection.

Medication and Driving-Appropriate Interventions.

PubMed

Hitosugi, Masahito

2017-01-01

Sudden illness while driving has been identified as a major cause of vehicle collisions, accounting for approximately 1 in 10 collisions. Because most drivers who experience sudden illnesses while driving do not perform avoidance maneuvers, the improvement of drivers' health is being promoted as a traffic safety strategy. Although stroke, heart disease, and epilepsy are common causes of sudden illness, common symptoms, such as abdominal cramps, vertigo, and syncope can also cause problems during driving. We found that regular referral to physicians was significantly less common among drivers who experienced health-related vehicle collisions or incidents. Inadequate control of chronic disease might lead to unusual symptoms and the onset of major attacks. Medications are prescribed to patients to relieve their symptoms and/or bring their diseases under control. However, pharmacists and doctors should ensure that patients are treated with appropriate medications to avoid drivers being distracted due to adverse reactions to medications. The author suggests that it is important to keep drivers in good health and administer appropriate medications if necessary. Both pharmacists and doctors should warn drivers that sudden illness or medication-associated distractions can cause vehicle collisions. Such interventions might contribute to reducing the frequency of sudden illness-related vehicle collisions.

Beliefs about causation of schizophrenia: do Indian families believe in supernatural causes?

PubMed

Srinivasan, T N; Thara, R

2001-03-01

Beliefs about the causation of schizophrenia could influence the attitudes patients' families adopt towards the patient and may also influence their help-seeking behaviour. Indian families have been typically described as often believing in causes like supernatural forces and therefore seeking help from magico-religious healers. In the changing mental health scenario in India, this impression needs verification. Key relatives living with 254 chronic schizophrenia patients were interviewed and asked to name the causes they believed were behind the illness. A list of possible causes was provided for the families to select from, and relatives were also encouraged to mention other possible causes, not featured in the list. The possible causes identified and the factors related to attributions made were analysed. A supernatural cause was named by only 12% of the families and as the only cause by 5%. Psychosocial stress was most commonly cited cause, followed by personality defect and heredity. A small number of families (14%) could not name any cause and 39% named more than one cause. Patient gender and education, duration of illness and the key relative's education and the nature of relationship were related to the type of causal attributions made. Families living with patients suffering chronic schizophrenia receiving treatment in urban India rarely subscribe to the idea of supernatural causation of the illness. The causal attributions made by them are fairly rational and understandable, given the relative lack of exposure to proper information about the illness.

Public Stigma against People with Mental Illness in the Gilgel Gibe Field Research Center (GGFRC) in Southwest Ethiopia

PubMed Central

Girma, Eshetu; Tesfaye, Markos; Froeschl, Guenter; Möller-Leimkühler, Anne Maria; Müller, Norbert; Dehning, Sandra

2013-01-01

Background Public understanding about mental illnesses and attitudes towards people with mental illness (PWMI) play a paramount role in the prevention and treatment of mental illness and the rehabilitation of PWMI. The aim of this study was to measure public stigma against PWMI and the factors associated with stigma in the Gilgel Gibe Field Research Center (GGFRC) in Southwest Ethiopia. Methods This community-based, cross-sectional study was conducted from June to August 2012 among 845 randomly selected respondents by using the Community Attitudes towards the Mentally Ill (CAMI) scale, an interviewer-administered questionnaire. Data was entered with EPI-DATA and then exported to STATA for analysis. Simple descriptive and linear regression analyses were performed to identify predictors of stigma against PWMI. Results Of the total of 845 respondents, 68.17% were from rural districts. The mean stigma score was 2.62 on a 5-point score. The majority of the respondents (75.27%) believed that mental illness can be cured. Stress, poverty, and rumination were the most often perceived causes of mental illness. Rural residents had significantly higher stigma scores (std. β = 0.61, P<0.001). A statistically significant inverse relationship was found between the level of education and degree of stigma (std. β = −0.14, P<0.01), while higher income was significantly associated with more stigma (std. β = 0.07, P<0.05). Respondents with higher scores for perceived supernatural causes (std. β = −0.09, P<0.01) and perceived psychosocial and biological causes (std. β = −0.14, P<0.001) had significantly lower stigma levels. Conclusions The study found a more undermining but less avoidant attitude towards PWMI. Rural residents showed higher levels of stigma. Stigma against PWMI was lower in people with an explanatory concept about the causes of mental illness and a higher level of education. Information, education, and communication about the causes, signs, and nature of mental illnesses would help to reduce stigma. PMID:24324756

Public stigma against people with mental illness in the Gilgel Gibe Field Research Center (GGFRC) in Southwest Ethiopia.

PubMed

Girma, Eshetu; Tesfaye, Markos; Froeschl, Guenter; Möller-Leimkühler, Anne Maria; Müller, Norbert; Dehning, Sandra

2013-01-01

Public understanding about mental illnesses and attitudes towards people with mental illness (PWMI) play a paramount role in the prevention and treatment of mental illness and the rehabilitation of PWMI. The aim of this study was to measure public stigma against PWMI and the factors associated with stigma in the Gilgel Gibe Field Research Center (GGFRC) in Southwest Ethiopia. This community-based, cross-sectional study was conducted from June to August 2012 among 845 randomly selected respondents by using the Community Attitudes towards the Mentally Ill (CAMI) scale, an interviewer-administered questionnaire. Data was entered with EPI-DATA and then exported to STATA for analysis. Simple descriptive and linear regression analyses were performed to identify predictors of stigma against PWMI. Of the total of 845 respondents, 68.17% were from rural districts. The mean stigma score was 2.62 on a 5-point score. The majority of the respondents (75.27%) believed that mental illness can be cured. Stress, poverty, and rumination were the most often perceived causes of mental illness. Rural residents had significantly higher stigma scores (std. β = 0.61, P<0.001). A statistically significant inverse relationship was found between the level of education and degree of stigma (std. β = -0.14, P<0.01), while higher income was significantly associated with more stigma (std. β = 0.07, P<0.05). Respondents with higher scores for perceived supernatural causes (std. β = -0.09, P<0.01) and perceived psychosocial and biological causes (std. β = -0.14, P<0.001) had significantly lower stigma levels. The study found a more undermining but less avoidant attitude towards PWMI. Rural residents showed higher levels of stigma. Stigma against PWMI was lower in people with an explanatory concept about the causes of mental illness and a higher level of education. Information, education, and communication about the causes, signs, and nature of mental illnesses would help to reduce stigma.

[Clinical study of dermatoses as psychosomatic phenomena].

PubMed

Doucet, C

2000-06-01

The aim of this presentation is to introduce some aspects of the global problematics of our Phd research in psychopathology. This thesis shows that all the studies on the relations between body and mind agree to say that there are organic symptoms with a psychical etiology. Some of these symptoms can be called, under certain conditions, "psychosomatic phenomena". We are showing that, in case of a disease, a skin disease in the framework of this research, two questions must be raised: does the disease have a function in the psychical structure? which one? In this view, a case study enables us to examine the link between somatic pathology and psychical features of the subject who is affected by it, and that can be done only by examining the event which brought on the disease.

[Pastoral psychology, spiritual counseling in dentistry. Review of the literature].

PubMed

Fábián, Tibor Károly; Vértes, Gabriella; Fejérdy, Pál

2005-02-01

Although there were drastic changes in the XX-th century, still 70% of the Hungarian population believe in God, and 10-15% can be counted as active believer. A percentage of 44% of the hospitalised patients indicated a need of pastoral counseling during the treatment time. In the field of psychiatry and psychotherapy the percentage of the need of religious care (pastoral psychology, pastoral counseling) may be even higher. In the field of dentistry the increasing number of psychosomatic patients justify the introduction of such religious treatment methods into the dental care system as well. In this review authors try to collect the main points of this special, religious type of therapy to help dental professionals working in the field of psychosomatic dentistry in the orientation in this interesting and important field.

WATERBORNE OUTBREAKS CAUSED BY DISTRIBUTION SYSTEM DEFICIENCIES IN THE UNITED STATES

EPA Science Inventory

Distribution system contamination has caused a significant number of waterborne outbreaks in the United States. The number of illnesses in a distribution-system outbreak can be quite large, and illness can be severe resulting in hospitalization and sometimes death. During t...

Treatable Bacterial Infections Are Underrecognized Causes of Fever in Ethiopian Children

PubMed Central

Aarsland, Sara J.; Castellanos-Gonzalez, Alejandro; Lockamy, Kameron P.; Mulu-Droppers, Ruth; Mulu, Moges; White, A. Clinton; Cabada, Miguel M.

2012-01-01

Febrile illnesses remain a major cause of morbidity and mortality in resource-poor countries, but too often, tests are not available to determine the causes, leading to misdiagnosis and inappropriate treatment. To determine the cause of febrile illnesses, we recovered the malaria smears from 102 children presenting with fever to Soddo Christian Hospital in Wolaitta Soddo, Ethiopia. DNA was isolated from the smears and evaluated by real-time polymerase chain reaction. We identified pathogen DNA with probes for Plasmodium spp., Streptococcus pneumoniae, Rickettsia spp., Salmonella spp., and Borrelia spp. Overall, we showed that it is possible to isolate high-quality DNA and identify treatable pathogens from malaria blood smears. Furthermore, our data showed that bacterial pathogens (especially Pneumococcus, Rickettsia spp., and Borrelia spp.) are common and frequently unrecognized but treatable causes of febrile illnesses in Ethiopian children. PMID:22764303

[A Screening-Tool for Three Dimensions of Work-Related Behavior and Experience Patterns in the Psychosomatic Rehabilitation - A Proposal for a Short-Form of the Occupational Stress and Coping Inventory (AVEM-3D)].

PubMed

Beierlein, V; Köllner, V; Neu, R; Schulz, H

2016-12-01

Objectives: The assessment of work pressures is of particular importance in psychosomatic rehabilitation. An established questionnaire is the Occupational Stress and Coping Inventory (German abbr. AVEM), but it is quite long and with regard to scoring time-consuming in routine clinical care. It should therefore be tested, whether a shortened version of the AVEM can be developed, which is able to assess the formerly described three second-order factors of the AVEM, namely Working Commitment, Resilience, and Emotions, sufficiently reliable and valid, and which also may be used for screening of patients with prominent work-related behavior and experience patterns. Methods: Data were collected at admission from consecutive samples of three hospitals of psychosomatic rehabilitation ( N  = 10,635 patients). The sample was randomly divided in two subsamples (design and validation sample). Using exploratory principal component analyses in the design sample, items with the highest factor loadings for the three new scales were selected and evaluated psychometrically using the validation sample. Possible Cut-off values ought to be derived from distribution patterns of scores in the scales. Relationships with sociodemographic, occupational and diagnosis-related characteristics, as well as with patterns of work-related experiences and behaviors are examined. Results: The three performed principal component analyses explained in the design sample on the respective first factor between 31 % and 34 % of the variance. The selected 20 items were assigned to the 3-factor structure in the validation sample as expected. The three new scales are sufficiently reliable with values of Cronbach's α between 0,84 and 0,88. The naming of the three new scales is based on the names of the secondary factors. Cut-off values for the identification of distinctive patient-reported data are proposed. Conclusion: Main advantages of the proposed shortened version AVEM-3D are that with a considerable smaller number of items the three main dimensions of relevant work-related behavior and experience patterns can be reliably measured. The proposed measure is simple and economic to use and interpret. Based on the present sample we provide means and standard deviations as reference at admission of psychosomatic rehabilitation. As a limitation it should be mentioned that further evaluation of reliability, validity and sensitivity to change restricted to the items of the shortened version is necessary. The practicability and validity of the proposed cut-off values cannot yet be conclusively assessed. Finally, the validity of the AVEM-3D in groups of indications other than psychosomatic patients and in healthy persons remains to be examined. © Georg Thieme Verlag KG Stuttgart · New York.

Adults' Explanations and Children's Understanding of Contagious Illnesses, Non-Contagious Illnesses, and Injuries

ERIC Educational Resources Information Center

Toyama, Noriko

2016-01-01

The present study examined (1) whether children notice different causes for contagious illnesses, non-contagious illnesses, and injuries and (2) what information adults provide to children and to what extent this information is related to children's causal awareness. Studies 1 and 2 explored preschool teachers' and mothers' explanations of…

What Is Psychiatry?

MedlinePlus

... may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry Pain medicine ... American Association of Community Psychiatrists American Association for Geriatric Psychiatry Academy of Psychosomatic Medicine American Academy of ...

Beliefs about causes, symptoms, and stigma associated with severe mental illness among 'highly acculturated' Chinese-American patients.

PubMed

Lin, Susan Y

2013-12-01

Literature about experiences of mental illness among ethnic minority has tended to focus on first-generation migrants. This study fills that gap by exploring experiences among highly acculturated Chinese-American patients with mental illness. Twenty-nine participants completed semi-structured interviews based on Kleinman's explanatory model, which were audio-taped, transcribed and coded for qualitative analysis. Beliefs about the causes of mental illness included biological factors, head trauma and personal losses. Issues relating to stigma and shame were also discussed. Highly acculturated ethnic minority patients may ascribe to a biomedical model at the same time as ascribing to culture-specific beliefs.

Notes from the field: respiratory diphtheria-like illness caused by toxigenic Corynebacterium ulcerans --- Idaho, 2010.

PubMed

2011-01-28

On September 12, 2010, the Idaho Department of Health and Welfare was notified of a case of respiratory diphtheria-like illness in an Idaho man aged 80 years whose pharyngeal specimens yielded Corynebacterium ulcerans. Although C. ulcerans is zoonotic, the patient reported no animal contact or consumption of an unpasteurized dairy product. His vaccination history was unknown. Respiratory diphtheria-like illness from C. ulcerans is uncommon but has been reported in industrialized countries where respiratory diphtheria is rare. The last case of diphtheria-like illness caused by C. ulcerans in the United States was reported in 2005.

Illness associated with red tide--Nassau County, Florida, 2007.

PubMed

2008-07-04

A "red tide" is a harmful algal bloom that occurs when toxic, microscopic algae in seawater proliferate to a higher-than-normal concentration (i.e., bloom), often discoloring the water red, brown, green, or yellow. Red tides can kill fish, birds, and marine mammals and cause illness in humans. Florida red tide is caused by the dinoflagellate Karenia brevis, which produces toxins called brevetoxins and is most commonly found in the Gulf of Mexico; however, K. brevis blooms also can occur along the Atlantic coast. On September 25, 2007, a cluster of respiratory illnesses was reported to the Nassau County Health Department (NCHD) in northeastern Florida. All of the ill persons were employed at a beach restoration worksite by a dredging company operating at Fernandina Beach; they reported symptoms of eye or respiratory irritation (e.g., coughing, sneezing, sniffling, and throat irritation). NCHD and the Florida Department of Health promptly conducted epidemiologic and environmental investigations and determined the illnesses likely were associated with exposure to a red tide along the Atlantic coast. These actions highlight the importance of rapid investigation of health concerns with potential environmental causes to enable timely notification of the public and prevent further illness.

Potential virus detection and intervention methods for molluscan shellfish

USDA-ARS?s Scientific Manuscript database

Norovirus is the number one cause of foodborne illness in the Unites States, causing an estimated 9 million cases/yr. Hepatitis A is uncommon in the US but can result in serious illness. Bivalve shellfish are efficient bioconcentrators of these viruses from contaminated growing waters. Consequentl...

Childhood death rates declined in Sweden from 2000 to 2014 but deaths from external causes were not always investigated.

PubMed

Otterman, Gabriel; Lahne, Klara; Arkema, Elizabeth V; Lucas, Steven; Janson, Staffan; Hellström-Westas, Lena

2018-03-08

Countries that conduct systematic child death reviews report a high proportion of modifiable characteristics among deaths from external causes, and this study examined the trends in Sweden. We analysed individual-level data on external, ill-defined and unknown causes from the Swedish cause of death register from 2000 to 2014, and mortality rates were estimated for children under the age of one and for those aged 1-14 and 15-17 years. Child deaths from all causes were 7914, and 2006 (25%) were from external, ill-defined and unknown causes: 610 (30%) were infants, 692 (34%) were 1-14 and 704 (35%) were 15-17. The annual average was 134 cases (range 99-156) during the study period. Mortality rates from external, ill-defined and unknown causes in children under 18 fell 19%, from 7.4 to 6.0 per 100 000 population. A sizeable number of infant deaths (8.0%) were registered without a death certificate during the study period, but these counts were lower in children aged 1-14 (1.3%) and 15-17 (0.9%). Childhood deaths showed a sustained decline from 2000 to 2014 in Sweden and a quarter were from external, ill-defined or unknown causes. Systematic, interagency death reviews could yield information that could prevent future deaths. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Effect of direction of head movement on motion sickness caused by Coriolis stimulation.

PubMed

Woodman, P D; Griffin, M J

1997-02-01

During constant speed rotation of the body, head rotation about an axis other than the axis of rotation of the body (i.e., Coriolis is stimulation) induces motion sickness. The position of the body relative to the center of rotation will influence the sickness caused by Coriolis stimulation; the direction of head movement will not affect the sickness caused by Coriolis stimulation. There were 24 seated subjects (12 male, 12 female) who made 30 degrees pitch motions of the head every 30 s while rotating about a vertical axis at 10 r.p.m. on a turntable at two separate locations: a) at the center of rotation; and b) 0.75 m from the center of rotation. After each head movement the subjects gave ratings of motion illness. There was no significant difference between illness 0.75 m from the center of rotation and illness at the center of rotation, or between the illness ratings from male and female subjects. Moving the head up from the horizontal caused significantly fewer increases in ratings of motion illness than moving the head back down to the horizontal. Precise location of the body at the center of rotation is not critical during Coriolis stimulation, but the direction of head movement has a large effect on nausea. An influence of somatosensory information on sickness caused by Coriolis stimulation is suggested.

Trends in adolescent mental health during economic upturns and downturns: a multilevel analysis of Swedish data 1988-2008

PubMed Central

Kim, Yunhwan; Hagquist, Curt

2018-01-01

Background A long-term trend of increasing mental health problems among adolescents in many Western countries indicates a great need to investigate if and how societal changes have contributed to the reported increase. Using seven waves of repeated cross-sectional data collected between 1988 and 2008 in Sweden, the current study examined if economic factors at the societal level (municipality unemployment rate) and at the individual level (worry about family finances), and their interaction could explain a secular trend in mental health problems. Methods Participants were 17 533 students of age 15–16 years (49.3% girls), from 14 municipalities in a county of Sweden. Data on adolescents’ mental health (psychosomatic problems) and worry about family finances were obtained using a self-report questionnaire. A series of multilevel regression analyses were conducted in order to explain the trends in adolescents’ mental health. Results The results indicated that the individual-level predictor (worry about family finances) significantly explained the increasing rates of adolescents’ psychosomatic problems. This was particularly the case during the mid-1990s, which was characterised by a severe recession in Sweden with high unemployment rates. For example, after accounting for adolescents’ worry, a significant increase in psychosomatic symptoms between 1988 and 1998 among girls (b=0.112, P<0.05) disappeared (b=0.018, P>0.05) and a non-significant decrease between 1988 and 1995 among boys (b=−0.017, P>0.05) became significant (b=−0.142, P<0.05). Neither municipality unemployment rate nor its interaction with adolescents’ worry explained psychosomatic problems. Conclusions The findings demonstrate the effects of adolescents’ worry about family finances on a secular trend in mental health problems during an economically bleak period of time. The study highlights the need for repeated measurements including a large number of time points over a long time period in order to analyse time-specific putative explanatory factors for trends in adolescent mental health problems. PMID:29203524

Perceived mental stress in women associated with psychosomatic symptoms, but not mortality: observations from the Population Study of Women in Gothenburg, Sweden

PubMed Central

Hange, Dominique; Mehlig, Kirsten; Lissner, Lauren; Guo, Xinxin; Bengtsson, Calle; Skoog, Ingmar; Björkelund, Cecilia

2013-01-01

Purpose To investigate possible association between mental stress and psychosomatic symptoms, socioeconomic status, lifestyle, as well as incident mortality in a middle-aged female population followed over 37 years. Methods A prospective observational study initiated in 1968–1969, including 1462 women aged 60, 54, 50, 46, and 38 years, with follow-ups in 1974–1975, 1980–1981, and 2000–2001, was performed. Measures included self-reported mental stress as well as psychosomatic symptoms and smoking, physical activity, total cholesterol, S-triglycerides, body mass index, waist–hip ratio, blood pressure, socioeconomic status and mortality. Results Smoking, not being single, and not working outside home were strongly associated with reported mental stress at baseline. Women who reported high mental stress in 1968–1969 were more likely to report presence of abdominal symptoms (odds ratio [OR] = 1.85, 95% confidence interval [CI]: 1.39–2.46), headache/migraine (OR = 2.04, 95% CI: 1.53–2.72), frequent infections (OR = 1.75, 95% CI: 1.14–2.70), and musculoskeletal symptoms (OR = 1.70, 95% CI: 1.30–2.23) than women who did not report mental stress. Women without these symptoms at baseline 1968–1969, but with perceived mental stress were more likely to subsequently report incident abdominal symptoms (OR = 2.15, 95% CI: 1.39–3.34), headache/migraine (OR = 2.27, 95% CI: 1.48–3.48) and frequent infections (OR = 2.21, 95% CI: 1.12–4.36) in 1974–1975 than women without mental stress in 1968–1969. There was no association between perceived mental stress at baseline and mortality over 37 years of follow-up. Conclusion Women reporting mental stress had a higher frequency of psychosomatic symptoms than women who did not report these symptoms. Not working outside home and smoking rather than low socioeconomic status per se was associated with higher stress levels. Perception of high mental stress was not associated with increased mortality. PMID:23650451

Work-related stress and psychosomatic medicine.

PubMed

Nakao, Mutsuhiro

2010-05-26

This article introduces key concepts of work-related stress relevant to the clinical and research fields of psychosomatic medicine. Stress is a term used to describe the body's physiological and/or psychological reaction to circumstances that require behavioral adjustment. According to the Japanese National Survey of Health, the most frequent stressors are work-related problems, followed by health-related and then financial problems. Conceptually, work-related stress includes a variety of conditions, such as overwork, unemployment or job insecurity, and lack of work-family balance. Job stress has been linked to a range of adverse physical and mental health outcomes, such as cardiovascular disease, insomnia, depression, and anxiety. Stressful working conditions can also impact employee well-being indirectly by directly contributing to negative health behaviors or by limiting an individual's ability to make positive changes to lifestyle behaviors, such as smoking and sedentary behavior. Over the past two decades, two major job stress models have dominated the occupational health literature: the job demand-control-support model and the effort-reward imbalance model. In both models, standardized questionnaires have been developed and frequently used to assess job stress. Unemployment has also been reported to be associated with increased mortality and morbidity, such as by cardiovascular disease, stroke, and suicide. During the past two decades, a trend toward more flexible labor markets has emerged in the private and public sectors of developed countries, and temporary employment arrangements have increased. Temporary workers often complain that they are more productive but receive less compensation than permanent workers. A significant body of research reveals that temporary workers have reported chronic work-related stress for years. The Japanese government has urged all employers to implement four approaches to comprehensive mind/body health care for stress management in the workplace: focusing on individuals, utilizing supervisory lines, enlisting company health care staff, and referring to medical resources outside the company. Good communications between occupational health practitioners and physicians in charge in hospitals/clinics help employees with psychosomatic distress to return to work, and it is critical for psychosomatic practitioners and researchers to understand the basic ideas of work-related stress from the viewpoint of occupational health.

Work-related stress and psychosomatic medicine

PubMed Central

2010-01-01

This article introduces key concepts of work-related stress relevant to the clinical and research fields of psychosomatic medicine. Stress is a term used to describe the body's physiological and/or psychological reaction to circumstances that require behavioral adjustment. According to the Japanese National Survey of Health, the most frequent stressors are work-related problems, followed by health-related and then financial problems. Conceptually, work-related stress includes a variety of conditions, such as overwork, unemployment or job insecurity, and lack of work-family balance. Job stress has been linked to a range of adverse physical and mental health outcomes, such as cardiovascular disease, insomnia, depression, and anxiety. Stressful working conditions can also impact employee well-being indirectly by directly contributing to negative health behaviors or by limiting an individual's ability to make positive changes to lifestyle behaviors, such as smoking and sedentary behavior. Over the past two decades, two major job stress models have dominated the occupational health literature: the job demand-control-support model and the effort-reward imbalance model. In both models, standardized questionnaires have been developed and frequently used to assess job stress. Unemployment has also been reported to be associated with increased mortality and morbidity, such as by cardiovascular disease, stroke, and suicide. During the past two decades, a trend toward more flexible labor markets has emerged in the private and public sectors of developed countries, and temporary employment arrangements have increased. Temporary workers often complain that they are more productive but receive less compensation than permanent workers. A significant body of research reveals that temporary workers have reported chronic work-related stress for years. The Japanese government has urged all employers to implement four approaches to comprehensive mind/body health care for stress management in the workplace: focusing on individuals, utilizing supervisory lines, enlisting company health care staff, and referring to medical resources outside the company. Good communications between occupational health practitioners and physicians in charge in hospitals/clinics help employees with psychosomatic distress to return to work, and it is critical for psychosomatic practitioners and researchers to understand the basic ideas of work-related stress from the viewpoint of occupational health. PMID:20504368

Individuals with currently untreated mental illness: causal beliefs and readiness to seek help.

PubMed

Stolzenburg, S; Freitag, S; Evans-Lacko, S; Speerforck, S; Schmidt, S; Schomerus, G

2018-01-16

Many people with mental illness do not seek professional help. Beliefs about the causes of their current health problem seem relevant for initiating treatment. Our aim was to find out to what extent the perceived causes of current untreated mental health problems determine whether a person considers herself/himself as having a mental illness, perceives need for professional help and plans to seek help in the near future. In a cross-sectional study, we examined 207 untreated persons with a depressive syndrome, all fulfilling criteria for a current mental illness as confirmed with a structured diagnostic interview (Mini International Neuropsychiatric Interview). The sample was recruited in the community using adverts, flyers and social media. We elicited causal explanations for the present problem, depression literacy, self-identification as having a mental illness, perceived need for professional help, help-seeking intentions, severity of depressive symptoms (Patient Health Questionnaire - Depression), and whether respondents had previously sought mental healthcare. Most participants fulfilled diagnostic criteria for a mood disorder (n = 181, 87.4%) and/or neurotic, stress-related and somatoform disorders (n = 120, 58.0%) according to the ICD-10. N = 94 (45.4%) participants had never received mental health treatment previously. Exploratory factor analysis of a list of 25 different causal explanations resulted in five factors: biomedical causes, person-related causes, childhood trauma, current stress and unhealthy behaviour. Attributing the present problem to biomedical causes, person-related causes, childhood trauma and stress were all associated with stronger self-identification as having a mental illness. In persons who had never received mental health treatment previously, attribution to biomedical causes was related to greater perceived need and stronger help-seeking intentions. In those with treatment experience, lower attribution to person-related causes and stress were related to greater perceived need for professional help. While several causal explanations are associated with self-identification as having a mental illness, only biomedical attributions seem to be related to increase perceived need and help-seeking intentions, especially in individuals with no treatment experiences. Longitudinal studies investigating causal beliefs and help-seeking are needed to find out how causal attributions guide help-seeking behaviour. From this study it seems possible that portraying professional mental health treatment as not being restricted to biomedical problems would contribute to closing the treatment gap for mental disorders.

Probiotics, prebiotics, and competitive exclusion for prophylaxis against bacterial disease

USDA-ARS?s Scientific Manuscript database

Bacteria that are pathogenic to animals and human consumers can exist in the gastrointestinal tract of our food animal species. The gastrointestinal tract of food animals can be inhabited by bacteria that cause foodborne illnesses in humans, but that do not cause detectable animal illnesses or a de...

An introduction to food and waterborne viruses: diseases, transmission, outbreaks, detection and control

USDA-ARS?s Scientific Manuscript database

Enteric viruses are the number one cause of foodborne illness throughout the world. In addition to foods, contaminated drinking water is another major cause of enteric viral illness. Among the enteric viruses are the noroviruses, hepatitis A and E viruses, enteric adenoviruses, rotavirus, and astro...

Factors affecting the dental erosion severity of patients with eating disorders.

PubMed

Otsu, Mitsuhiro; Hamura, Akira; Ishikawa, Yuiko; Karibe, Hiroyuki; Ichijyo, Tomoyasu; Yoshinaga, Yoko

2014-01-01

Intraoral disease is a common occurrence in patients with eating disorders, particularly dental erosion, which frequently becomes severe and may hinder daily life. The severity varies from patient to patient. Understanding the underlying mechanisms may help prevent dental erosion in these patients. Accordingly, we investigated the relationship between the severity of erosion and the behavior of patients with eating disorders, with a focus on daily diet and vomiting behavior. A total 71 female eating disorder outpatients from the Clinical Center of Psychosomatic Dentistry of Nippon Dental University Hospital and the Psychosomatic Internal Medicine Department of Kudanzaka Hospital or who were hospitalized at Hasegawa Hospital were enrolled. Dental erosion severity and location were determined by oral examination. Patients who induced vomiting were queried on their behavior during vomiting and on routine diet habits. Patients with dental erosion were further divided into mild and severe groups based on the lesion severity and the groups compared. Dental erosion was observed in 43 of 50 subjects who induced vomiting. Dental erosion was most frequent on the palatal side of the anterior maxillary teeth, occurring in 81.3% of the subjects. There were significant differences observed between the mild and severe groups according to post-vomiting oral hygiene. Significantly more subjects in the mild group consumed large amounts of water before vomiting, and significantly more subjects in the severe group routinely consumed carbonated beverages or sweetened food. While self-induced vomiting is the main cause of dental erosion in eating disorder patients, the erosion severity may be affected by behavior when inducing vomiting or by routine consumption of certain foods and beverages. Addressing these factors may help prevent severe dental erosion in patients who chronically induce vomiting.

The Chronic Illness Initiative: Supporting College Students with Chronic Illness Needs at DePaul University

ERIC Educational Resources Information Center

Royster, Lynn; Marshall, Olena

2008-01-01

College students with chronic illness find it difficult to succeed in traditional degree programs due to disruptions caused by relapses and unpredictable waxing and waning symptoms. College disability offices are often unable to help, both because their standard supports are not appropriate and because students with chronic illness frequently do…

[Illness and death of Wolfgang Amadeus Mozart (1756-1791). A contribution to the Mozart Year 2006].

PubMed

Franzen, Caspar

2006-09-15

In the Mozart year 2006 also medicine has to deal with the music genius W.A. Mozart. It has been intensely discussed for a long time whether Mozart was poisoned, whether he deceased from a certain illness, or by self-medication and/or medical procedures. Consequently, his death caused wild speculations and adventurous assertions. Many authors assume that Mozart was a chronically ill man all his life. However, most of Mozart's described illnesses were harmless, and his unbelievable amount of work proves his extraordinary efficiency. The exact cause of death remains speculative. The story of a tall stranger dressed in somber gray who assigned Mozart to write a Requiem Mass and the circumstances of Mozart's funeral have additionally contributed to the generation of legends. However, if one gathers all known facts, there is no evidence that Mozart was murdered, and the exact cause of his death remains unclear.

Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme.

PubMed

Shah, Arya; Wheeler, Lydia; Sessions, Kristen; Kuule, Yusufu; Agaba, Edwin; Merry, Stephen P

2017-10-11

To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Qualitative thematic analysis revealed two major themes: (1) belief that any given patient's metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness.

Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme

PubMed Central

2017-01-01

Objectives To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. Background A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Methods Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Results Qualitative thematic analysis revealed two major themes: (1) belief that any given patient’s metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. Conclusion As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness. PMID:29041798

[Death causes in 428 alcoholic patients: a descriptive study].

PubMed

Martínez Lanz, P; Días Coto, C

1992-12-01

Several studies have demonstrated either a direct or an indirect relationship between alcoholism and death causes. The present paper is a descriptive study about death causes in 428 alcoholic patients from San José, Costa Rica, metropolitan area, whose death occurred between 1978 and 1988. Sample subjects were males, under 90-year-old at death time. It was found out that basic death causes were: Traumatism and poisoning, 25%; circulatory system illnesses, 20%; digestive system illnesses, 18.5%, and tumors, 15%.

A psychoneuroendocrinology service.

PubMed

Sonino, Nicoletta; Peruzzi, Pio

2009-01-01

Research evidence has highlighted the relevance of endocrine/metabolic abnormalities in psychiatry and of psychosocial implications in endocrinology. However, the value of interdisciplinary expertise has not been implemented in clinical practice. We have therefore designed a new outpatient clinic, called the Psychoneuroendocrinology Service, to apply the principles of current psychosomatic medicine and report here on the first 100 referrals. Of the first 100 patients (74 females/26 males; mean age 44 +/- 13.8 years), the sources of referral were the Mental Health Center (n = 41), specialists (n = 37) and primary care physicians (n = 22). The main reasons for referral were endocrine assessment (n = 40), unexplained medical symptoms (n = 18) and poor response to treatment (n = 17). The most frequent medical diagnoses were obesity/overweight (n = 22), hypertension (n = 20) and hypothyroidism (n = 11). The most frequent psychiatric diagnoses were major depression (n = 15), schizophrenia/schizoaffective disorder (n = 13) and bipolar disorder (n = 12). Subclinical symptoms (Diagnostic Criteria for Psychosomatic Research) found were persistent somatization (n = 18), demoralization (n = 14) and irritable mood (n = 7). Therapeutic strategies included lifestyle modifications (n = 45), explanatory therapy (n = 30), low-dose clonazepam (n = 23) and modifications of existing treatment with psychotropic drugs (n = 16). In this highly selected population, several difficult patients could be appropriately managed by virtue of a holistic view. Such an approach must involve experienced clinicians with a broad-spectrum training in psychoneuroendocrinology and psychosomatic medicine. If confirmed in its efficacy and cost-effectiveness, this model might be further expanded. Copyright 2009 S. Karger AG, Basel.

[The new reimbursement for psychiatry and psychosomatics - challenges, opportunities and risks of the new financing system].

PubMed

Häring, B; Kutschis, M; Bleich, S

2014-01-01

With the implementation of § 17 d KHG which provides for the introduction of a new, much more performance-based and transparent reimbursement system for psychiatric and psychosomatic hospitals, the Federal Ministry of Health sends the psychiatric and psychosomatic facilities in Germany into a previously unexplored area. Since 2013, there is the possibility of voluntary participation in the new system. Valid from 2015, every other institution will have to deal with the new challenges, opportunities and risks coming along with the structural changes, even though this fact will not have any impact on the individual hospital revenue budget until the end of 2016. There is still some time left to get used to the new system. This paper summarises the key data on the new reimbursement system and explains its content as well as how it works. In addition to that this paper goes into the classification system and clarifies what is essential for a solid preparation. Finally, it comments on the most common criticisms emerging since 2009. How the new system will develop remains to be seen. The fact that it will evolve seems to be certain in terms of a "learning system". It is up to all parties to promote the learning process so as to make effective use of existing potential and keep risks to a minimum. © Georg Thieme Verlag KG Stuttgart · New York.

[Predictors of successful transfer to everyday live of a relaxation method acquired in psychosomatic rehabilitation].

PubMed

Bernardy, K; Krampen, G; Köllner, V

2008-12-01

The aim of the present study was to identify factors at the beginning and at the end of an inpatient psychosomatic rehabilitation predicting the successful transfer of Progressive Relaxation (PR) according to Jacobson three months after the stay. Eighty patients in a psychosomatic rehabilitation centre were studied in the beginning (T1), at discharge (T2) and three months after discharge (T3). Every patient participated in courses on PR. To evaluate the course, parts of the "Diagnostisches und evaluatives Instrumentarium für Entspannungstraining und Entspannungstherapie" were used. Transfer was defined as successful if patients practised PR at least once a week three months after their stay. Potential predictors were: diagnosis, age, symptoms, previous experiences, and motives at T1 and frequency of practising, adequateness of group size and change of symptoms at T2. Stepwise logistic regression analysis was used to identify predictors. Three months after the course 52,5% of the patients were able to transfer PR successfully into their daily lives. 68,8% of cases had been correctly classified by logistic regression through: participation motive "positive thoughts" (T1) and "frequency of practising PR outside the course" (T2). Intrinsic participation motives and practising independently are significant predictors of long-term transfer of PR. This indicates the necessity of discussing motives at the beginning as well as frequency of practising during the PR course. It would be particularly interesting to know whether specific encouraging of motivation would improve the transfer to everyday life.

Sphenopalatine (nasal) ganglion: remote effects including "psychosomatic" symptoms, rage reaction, pain, and spasm.

PubMed

Ruskin, A P

1979-08-01

Many articles implicate the nasal ganglion in the production of remote symptoms and discuss treatment. Symptoms are primarily spastic, involving both visceral and voluntary muscles including muscle spasm in the neck, shoulder, and low back; asthma, hypertension, intestinal spasm; diarrhea, angina pectoris, uterine spasm; intractable hiccup, and many others. All these symptoms appear to have 2 common denominators. They are mediated by the autonomic nervous system and at least in some instances can be "psychosomatic." The sphenopalatine ganglion (SPG) is a major autonomic ganglion located superficially in the pterygopalatine fossa, with major afferent distribution to the entire nasopharynx and important connections with the trigeminal nerve, facial nerve, internal carotid artery plexus of the sympathetic nervous system and, as shown in the rat, direct connection with the anterior pituitary gland. This paper presents arguments supporting the following hypotheses: 1. The SPG probably has a crucial role in lower animals in declenching the reflex responses known collectively as the rage reaction. 2. The SPG is a major point of entry to the autonomic system exposed to pathologic influences and readily accessible for therapeutic influences and readily accessible for therapeutic intervention. 3. A wide variety of symptoms are produced or maintained by alteration in autonomic system tonus and some of these may be affected by intervention on the SPG. 4. The possible relationship of some symptoms and "psychosomatic" conditions to the autonomic nervous system and the rage reaction must be considered.20

Somatization revisited: diagnosis and perceived causes of common mental disorders.

PubMed

Henningsen, Peter; Jakobsen, Thorsten; Schiltenwolf, Marcus; Weiss, Mitchell G

2005-02-01

The assessment of somatoform disorders is complicated by persistent theoretical and practical questions of classification and assessment. Critical rethinking of professional concepts of somatization suggests the value of complementary assessment of patients' illness explanatory models of somatoform and other common mental disorders. We undertook this prospective study to assess medically unexplained somatic symptoms and their patient-perceived causes of illness and to show how patients' explanatory models relate to professional diagnoses of common mental disorders and how they may predict the short-term course of illness. Tertiary care patients (N=186) with prominent somatoform symptoms were evaluated with the Structured Clinical Interview for DSM-IV, a locally adapted Explanatory Model Interview to elicit patients' illness experience (priority symptoms) and perceived causes, and clinical self-report questionnaires. The self-report questionnaires were administered at baseline and after 6 months. Diagnostic overlap between somatoform, depressive, and anxiety disorders occurred frequently (79.6%). Patients explained pure somatoform disorders mainly with organic causal attributions; they explained pure depressive and/or anxiety disorders mainly with psychosocial perceived causes, and patients in the diagnostic overlap group typically reported mixed causal attributions. In this last group, among patients with similar levels of symptom severity, organic perceived causes were related to a lower physical health sum score on the MOS Short Form, and psychosocial perceived causes were related to less severe depressive symptoms, assessed with the Hospital Anxiety and Depression Scale at 6 months. Among patients meeting criteria for comorbid somatoform with anxiety and/or depressive disorders, complementary assessment of patient-perceived causes, a key element of illness explanatory models, was related to levels of functional impairment and short-term prognosis. For such patients, causal attributions may be particularly useful to clarify clinically significant features of common mental disorders and thereby contribute to clinical assessment.

WHIPLASH INJURIES—Diagnosis and Treatment

PubMed Central

Huddleston, O. Leonard

1958-01-01

Whiplash injury may extend far beyond the neck, and may involve even the soft tissues of the pelvis. For permanent recovery, all the injuries must be evaluated and treated together. When impact from the rear snaps the head back and then forward, posterior subluxations in the cervical spine cause anterior-posterior narrowing of the intervertebral foramina, which may result in injury to the cervical nerve roots. Impact at the front, causing hyperflexion followed by hyperextension, has a similar effect although usually not as severe. Resulting symptoms may not appear until two or three weeks later, when irritative lesions have developed because of hemorrhage or swelling. Mild or progressive degenerative changes may cause no symptoms but may predispose the affected area to injury following some slight trauma. Capsular ligaments of the lateral intervertebral joints are especially liable to whiplash injury which may give rise to scars and adhesions that compress spinal nerves. Sympathetic system involvement may cause reflex and referred pain. Detailed neurologic, roentgen and electromyographic studies may be necessary for proper evaluation of injuries. Seemingly psychosomatic pain or disability is likely to have some physical basis in whiplash injuries. In 33 patients with whiplash injury, some recently injured and some chronically disabled with persistent symptoms, good results were observed following hydromassage, hot packs, joint mobilization exercises and, in a few, cervical or pelvic traction. PMID:13585155

[Rash and fever illness caused by herpes simplex virus type 1 needs to be distinguished from hand, foot and mouth disease].

PubMed

Zhu, Shuang-Li; Liu, Jian-Feng; Sun, Qiang; Li, Jing; Li, Xiao-Lei; Zhang, Yong; Chen, Ying; Wen, Xiao-Yun; Yan, Dong-Mei; Huang, Guo-Hong; Zhang, Bao-Min; Zhang, Bo; An, Hong-Qiu; Li, Hui; Xu, Wen-Bo

2013-06-01

An epidemic of rash and fever illnesses suspected of hand, foot and mouth disease (HFMD) occurred in Gansu Province of China in 2008, laboratory tests were performed in order to identify the pathogen that caused this epidemic. Eight clinical specimens collected from the 4 patients (each patient has throat swab and herpes fluid specimens) with rash and febrile illness, were inoculated onto RD and HEp-2 cells for virus isolation, and the viral nucleic acid was then extracted with the positive virus isolates, the dual-channel real-time reverse transcript-polymerase chain reaction (RT-PCR) was performed to detect the nucleic acid of human enterovirus (HEV) in the viral isolates at the same time. For the viral isolates with the negative results of HEV, a sequence independent single primer amplification technique (SISPA) was used for "unknown pathogen" identification. Totally, 6 viral isolates were identified as herpes simplex virus type 1 (HSV-1). Comprehensive analyses results of the clinical manifestations of the patients, epidemiological findings and laboratory test indicated that this epidemic of rash and febrile illness was caused by HSV-1. The differences among the gG region of 6 HSV-1 isolates at nucleotide level and amino acid level were all small, and the identities were up to 98. 8% and 97.9%, respectively, showing that this outbreak was caused by only one viral transmission chain of HSV-1. HSV-1 and other viruses that cause rash and febrile illnesses need differential diagnosis with HFMD. The etiology of rash and febrile illness is sometimes difficult to distinguish from the clinical symptoms and epidemiological data, the laboratory diagnosis is therefore critical.

Epidemiology of Foodborne Disease Outbreaks Caused by Clostridium perfringens, United States, 1998–2010

PubMed Central

Grass, Julian E.; Gould, L. Hannah; Mahon, Barbara E.

2015-01-01

Clostridium perfringens is estimated to be the second most common bacterial cause of foodborne illness in the United States, causing one million illnesses each year. Local, state, and territorial health departments voluntarily report C. perfringens outbreaks to the U.S. Centers for Disease Control and Prevention through the Foodborne Disease Outbreak Surveillance System. Our analysis included outbreaks confirmed by laboratory evidence during 1998–2010. A food item was implicated if C. perfringens was isolated from food or based on epidemiologic evidence. Implicated foods were classified into one of 17 standard food commodities when possible. From 1998 to 2010, 289 confirmed outbreaks of C. perfringens illness were reported with 15,208 illnesses, 83 hospitalizations, and eight deaths. The number of outbreaks reported each year ranged from 16 to 31 with no apparent trend over time. The annual number of outbreak-associated illnesses ranged from 359 to 2,173, and the median outbreak size was 24 illnesses. Outbreaks occurred year round, with the largest number in November and December. Restaurants (43%) were the most common setting of food preparation. Other settings included catering facility (19%), private home (16%), prison or jail (11%), and other (10%). Among the 144 (50%) outbreaks attributed to a single food commodity, beef was the most common commodity (66 outbreaks, 46%), followed by poultry (43 outbreaks, 30%), and pork (23 outbreaks, 16%). Meat and poultry outbreaks accounted for 92% of outbreaks with an identified single food commodity. Outbreaks caused by C. perfringens occur regularly, are often large, and can cause substantial morbidity yet are preventable if contamination of raw meat and poultry products is prevented at the farm or slaughterhouse or, after contamination, if these products are properly handled and prepared, particularly in restaurants and catering facilities. PMID:23379281

Causes of homelessness prevalence: Relationship between homelessness and disability.

PubMed

Nishio, Akihiro; Horita, Ryo; Sado, Tadahiro; Mizutani, Seiko; Watanabe, Takahiro; Uehara, Ryosuke; Yamamoto, Mayumi

2017-03-01

Many studies have reported that the prevalence of mental illness and cognitive disability is higher among homeless individuals compared to the general population, and the rates of mental illness among the homeless population have recently increased. This study: (i) compares causes of homelessness or barriers to escaping homelessness for people with/without mental illness/cognitive disability; (ii) reveals problems with the Japanese homeless policy; and (iii) proposes an effective and necessary support system. The participants were 114 homeless individuals. A psychiatric diagnostic interview and the Wechsler Adult Intelligence Scale, version III were used to measure participants' mental health and cognitive abilities. A questionnaire was administered comprising 17 items related to the causes of their homelessness and barriers to escaping from it. Participants were divided into four groups - with/without mental illness or cognitive disability - and Fisher's exact test was used to compare the questionnaire results. Individuals with cognitive disabilities considered bad relationships with their family members to be the cause of their homelessness. Conversely, normal individuals considered their homelessness to be the result of debt more so than did individuals with mental problems. Individuals with mental illness had more difficulties escaping homelessness than did either normal individuals or individuals with cognitive disability. This tendency was observed most strongly among individuals with both mental illness and cognitive disability. Most homeless individuals considered economic problems to be the cause of their homelessness; however, difficulties with human relationships were also important factors and were more difficult for participants to acknowledge. Furthermore, these difficulties were exacerbated among those individuals with mental problems. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

[Rehabilitation from the patient perspective--a qualitative analysis of the treatment beliefs of patients in inpatient orthopedic and psychosomatic rehabilitation].

PubMed

Heyduck, K; Glattacker, M; Meffert, C

2011-08-01

As the common sense self-regulation model (CSM) was further developed in the late 1990s, its focus was, along with subjective illness perceptions, the treatment representations of patients, in particular medication-related perceptions. However until now, only few studies have dealt with subjective concepts regarding non-medication treatment. The objective of this study was to explore the core content areas of the treatment concept of rehabilitation patients as a basis for developing a questionnaire to survey rehabilitation-related treatment beliefs. In 5 inpatient rehabilitation centres for psychosomatic and musculoskeletal diseases, guided focus groups were conducted with a total of n=25 rehabilitation patients. Some 56% of the participants were female; the average age was 52.8 years (SD=10.8). The interviews were transcribed and analyzed using the computer programme Atlas.ti based on the method recommended by Mayring in a multi-stage qualitative content analysis procedure. In the analysis of the discussion transcriptions, a total of 579 patient statements were categorized with 49 codes that were assigned to the areas (1) expectations and beliefs with respect to the rehabilitation process, (2) expectations of results, and (3) fears associated with rehabilitation. The process expectations were the most frequently discussed topic, constituting 58.2% of all patient statements. It was found that the patients associate not only numerous individual treatments with rehabilitation but also have concrete perceptions about the specific form rehabilitation should have, their own role in the rehabilitation process, and features of the overall rehabilitation concept. The outcome expectations are related to the areas activities of daily life and job, psyche, soma, and effectiveness of rehabilitation. Fears with respect to rehabilitation generally played only a subordinate role for those surveyed. The indication-specific analyses showed that the perceptions regarding the realization and form of rehabilitation differed among the various diagnosis groups, but the patients named similar categories for expectations of results and fears, with only some variation in importance. The focus groups allowed good insights into the patient perspectives of rehabilitation. Simultaneously, a good basis was created for generating contents of items for a questionnaire on the rehabilitative treatment concept, so that along with literature analyses, the qualitative method proved to be a suitable approach and good source for developing a questionnaire. © Georg Thieme Verlag KG Stuttgart · New York.

Surveillance for foodborne disease outbreaks - United States, 1998-2008.

PubMed

Gould, L Hannah; Walsh, Kelly A; Vieira, Antonio R; Herman, Karen; Williams, Ian T; Hall, Aron J; Cole, Dana

2013-06-28

Foodborne diseases cause an estimated 48 million illnesses each year in the United States, including 9.4 million caused by known pathogens. Foodborne disease outbreak surveillance provides valuable insights into the agents and foods that cause illness and the settings in which transmission occurs. CDC maintains a surveillance program for collection and periodic reporting of data on the occurrence and causes of foodborne disease outbreaks in the United States. This surveillance system is the primary source of national data describing the numbers of illnesses, hospitalizations, and deaths; etiologic agents; implicated foods; contributing factors; and settings of food preparation and consumption associated with recognized foodborne disease outbreaks in the United States. 1998-2008. The Foodborne Disease Outbreak Surveillance System collects data on foodborne disease outbreaks, defined as the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food. Public health agencies in all 50 states, the District of Columbia, U.S. territories, and Freely Associated States have primary responsibility for identifying and investigating outbreaks and use a standard form to report outbreaks voluntarily to CDC. During 1998-2008, reporting was made through the electronic Foodborne Outbreak Reporting System (eFORS). During 1998-2008, CDC received reports of 13,405 foodborne disease outbreaks, which resulted in 273,120 reported cases of illness, 9,109 hospitalizations, and 200 deaths. Of the 7,998 outbreaks with a known etiology, 3,633 (45%) were caused by viruses, 3,613 (45%) were caused by bacteria, 685 (5%) were caused by chemical and toxic agents, and 67 (1%) were caused by parasites. Among the 7,724 (58%) outbreaks with an implicated food or contaminated ingredient reported, 3,264 (42%) could be assigned to one of 17 predefined commodity categories: fish, crustaceans, mollusks, dairy, eggs, beef, game, pork, poultry, grains/beans, oils/sugars, fruits/nuts, fungi, leafy vegetables, root vegetables, sprouts, and vegetables from a vine or stalk. The commodities implicated most commonly were poultry (18.9%; 95% confidence interval [CI] = 17.4-20.3) and fish (18.6%; CI = 17.2-20), followed by beef (11.9%; CI = 10.8-13.1). The pathogen-commodity pairs most commonly responsible for outbreaks were scombroid toxin/histamine and fish (317 outbreaks), ciguatoxin and fish (172 outbreaks), Salmonella and poultry (145 outbreaks), and norovirus and leafy vegetables (141 outbreaks). The pathogen-commodity pairs most commonly responsible for outbreak-related illnesses were norovirus and leafy vegetables (4,011 illnesses), Clostridium perfringens and poultry (3,452 illnesses), Salmonella and vine-stalk vegetables (3,216 illnesses), and Clostridium perfringens and beef (2,963 illnesses). Compared with the first 2 years of the study (1998-1999), the percentage of outbreaks associated with leafy vegetables and dairy increased substantially during 2006-2008, while the percentage of outbreaks associated with eggs decreased. Outbreak reporting rates and implicated foods varied by state and year, respectively; analysis of surveillance data for this 11-year period provides important information regarding changes in sources of illness over time. A substantial percentage of foodborne disease outbreaks were associated with poultry, fish, and beef, whereas many outbreak-related illnesses were associated with poultry, leafy vegetables, beef, and fruits/nuts. The percentage of outbreaks associated with leafy vegetables and dairy increased during the surveillance period, while the percentage associated with eggs decreased. Outbreak surveillance data highlight the etiologic agents, foods, and settings involved most often in foodborne disease outbreaks and can help to identify food commodities and preparation settings in which interventions might be most effective. Analysis of data collected over several years of surveillance provides a means to assess changes in the food commodities associated most frequently with outbreaks that might occur following improvements in food safety or changes in consumption patterns or food preparation practices. Prevention of foodborne disease depends on targeted interventions at appropriate points from food production to food preparation. Efforts to reduce foodborne illness should focus on the pathogens and food commodities causing the most outbreaks and outbreak-associated illnesses, including beef, poultry, fish, and produce.

Exertional Heat Illness among Secondary School Athletes: Statewide Policy Implications

ERIC Educational Resources Information Center

Rodgers, Jill; Slota, Peggy; Zamboni, Beth

2018-01-01

Exertional heat illness (EHI) is a leading cause of preventable death among student athletes. While causes and preventative measures for EHI are known, school districts may not be implementing evidence-based practices. This descriptive, exploratory study explored school policies, resources, and practices of coaches in a mid-Atlantic state in the…

The Effects of Head Trauma and Brain Injury on Neuroendocrinologic Function

DTIC Science & Technology

1984-07-13

V., Lee, L.A., and Kelly, M. Apparent hypogonadism caused by critical illness: The " Hypogonadal Sick" syndrome. Submitted for publication. 2...Abstracts *Woolf, P.D., Hamill, R.W., McDonald, J.V., Lee, L.A., and Kelly, M. Apparent hypogonadism caused by critical illness: The " Hypogonadal Sick

Estimating the true global burden of mental illness.

PubMed

Vigo, Daniel; Thornicroft, Graham; Atun, Rifat

2016-02-01

We argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from associated causes. Using published data, we estimate the disease burden for mental illness to show that the global burden of mental illness accounts for 32·4% of years lived with disability (YLDs) and 13·0% of disability-adjusted life-years (DALYs), instead of the earlier estimates suggesting 21·2% of YLDs and 7·1% of DALYs. Currently used approaches underestimate the burden of mental illness by more than a third. Our estimates place mental illness a distant first in global burden of disease in terms of YLDs, and level with cardiovascular and circulatory diseases in terms of DALYs. The unacceptable apathy of governments and funders of global health must be overcome to mitigate the human, social, and economic costs of mental illness. Copyright © 2016 Elsevier Ltd. All rights reserved.

Injuries occurring in medical students during international medical rotations: a strategy toward maximizing safety.

PubMed

Galvin, Shannon; Robertson, Russell; Hargarten, Stephen

2012-06-01

The number of medical students traveling to nations outside the United States is steadily increasing. The Association of American Medical Colleges graduation questionnaire notes an increase from 2,838 students in 2001 to 3,799 students in 2009, the last year for which information is available. The risk of having any type of illness during international travel approaches 50%. Up to 19% of students will seek medical care on their return to the United States for illnesses. Most illnesses are benign and self limited. However, when deaths do occur, the leading causes are motor vehicle crashes and drownings. If air medical evacuation occurs, the most likely cause is an injury event. The authors review the literature to determine the risk of and type of illnesses and injuries suffered by travelers while overseas, especially medical volunteers. We describe the major categories of illness and injury risk and propose reasonable risk reduction and prevention strategies for prevention for injury, a relatively neglected area. We recommend that medical schools provide pre-travel training that includes injury prevention so that students are prepared not only for illness prevention but also for injury prevention. A focus on injury prevention, especially from motor vehicle crashes and drowning, is warranted given their role in causing death and serious injury to traveling students.

76 FR 19362 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-07

... contaminants that can cause health effects, including acute gastrointestinal and respiratory illness... risk for acute gastrointestinal or respiratory illness. This study would be, to our knowledge, the... gastrointestinal and respiratory illnesses. Study findings will inform the Environmental Protection Agency (EPA...

All-Cause, 30-Day Readmissions Among Persons With Intellectual and Developmental Disabilities and Mental Illness.

PubMed

Balogh, Robert; Lin, Elizabeth; Dobranowski, Kristin; Selick, Avra; Wilton, Andrew S; Lunsky, Yona

2018-03-01

Early hospital readmissions within 30 days of discharge are common and costly. This research describes predictors of all-cause, 30-day hospital readmissions among persons with intellectual and developmental disabilities (IDD), a group known to experience high rates of hospitalization. A cohort of 66,484 adults with IDD from Ontario, Canada, was used to create two subgroups: individuals with IDD only and those with IDD and mental illness. The rates of hospital readmission were determined and contrasted with a comparison subgroup of people without IDD who have mental illness. Compared with those with mental illness only, individuals with IDD and mental illness were 1.7 times more likely to experience a hospital readmission within 30 days. Predictors of their readmission rates included being a young adult and having high morbidity levels. The high rate of hospital readmission suggests that individuals with IDD and mental illness need attention regarding discharge planning and outpatient follow-up.

Estimated Annual Numbers of Foodborne Pathogen-Associated Illnesses, Hospitalizations, and Deaths, France, 2008-2013.

PubMed

Van Cauteren, Dieter; Le Strat, Yann; Sommen, Cécile; Bruyand, Mathias; Tourdjman, Mathieu; Da Silva, Nathalie Jourdan; Couturier, Elisabeth; Fournet, Nelly; de Valk, Henriette; Desenclos, Jean-Claude

2017-09-01

Estimates of the annual numbers of foodborne illnesses and associated hospitalizations and deaths are needed to set priorities for surveillance, prevention, and control strategies. The objective of this study was to determine such estimates for 2008-2013 in France. We considered 15 major foodborne pathogens (10 bacteria, 3 viruses, and 2 parasites) and estimated that each year, the pathogens accounted for 1.28-2.23 million illnesses, 16,500-20,800 hospitalizations, and 250 deaths. Campylobacter spp., nontyphoidal Salmonella spp., and norovirus accounted for >70% of all foodborne pathogen-associated illnesses and hospitalizations; nontyphoidal Salmonella spp. and Listeria monocytogenes were the main causes of foodborne pathogen-associated deaths; and hepatitis E virus appeared to be a previously unrecognized foodborne pathogen causing ≈68,000 illnesses in France every year. The substantial annual numbers of foodborne illnesses and associated hospitalizations and deaths in France highlight the need for food-safety policymakers to prioritize foodborne disease prevention and control strategies.

Estimated Annual Numbers of Foodborne Pathogen–Associated Illnesses, Hospitalizations, and Deaths, France, 2008–2013

PubMed Central

Le Strat, Yann; Sommen, Cécile; Bruyand, Mathias; Tourdjman, Mathieu; Da Silva, Nathalie Jourdan; Couturier, Elisabeth; Fournet, Nelly; de Valk, Henriette; Desenclos, Jean-Claude

2017-01-01

Estimates of the annual numbers of foodborne illnesses and associated hospitalizations and deaths are needed to set priorities for surveillance, prevention, and control strategies. The objective of this study was to determine such estimates for 2008–2013 in France. We considered 15 major foodborne pathogens (10 bacteria, 3 viruses, and 2 parasites) and estimated that each year, the pathogens accounted for 1.28–2.23 million illnesses, 16,500–20,800 hospitalizations, and 250 deaths. Campylobacter spp., nontyphoidal Salmonella spp., and norovirus accounted for >70% of all foodborne pathogen–associated illnesses and hospitalizations; nontyphoidal Salmonella spp. and Listeria monocytogenes were the main causes of foodborne pathogen–associated deaths; and hepatitis E virus appeared to be a previously unrecognized foodborne pathogen causing ≈68,000 illnesses in France every year. The substantial annual numbers of foodborne illnesses and associated hospitalizations and deaths in France highlight the need for food-safety policymakers to prioritize foodborne disease prevention and control strategies. PMID:28820137

Occurrence of injuries and illnesses during the 2009 IAAF World Athletics Championships.

PubMed

Alonso, Juan-Manuel; Tscholl, Philippe M; Engebretsen, Lars; Mountjoy, Margo; Dvorak, Jiri; Junge, Astrid

2010-12-01

To analyse the frequency and characteristics of sports injuries and illnesses incurred during the World Athletics Championships. Prospective recording of newly occurred injuries and illnesses. Twelfth International Association of Athletics Federations World Championships in Athletics 2009 in Berlin, Germany. National team physicians and physiotherapists and 1979 accredited athletes; Local Organising Committee physicians working in the Medical Centres. Incidence and characteristics of newly incurred injuries and illnesses. 236 injury incidents with 262 injured body parts and 269 different injury types were reported, representing an incidence of 135.4 injuries per 1000 registered athletes. Eighty percent affected the lower extremity. Thigh strain (13.8%) was the main diagnosis. Overuse (44.1%) was the predominant cause. Most injuries were incurred during competition (85.9%). About 43.8% of all injury events were expected to result in time-loss. 135 illnesses were reported, signifying an incidence of 68.2 per 1000 registered athletes. Upper respiratory tract infection was the most common condition (30.4%) and infection was the most frequent cause (32.6%). The incidence of injury and illnesses varied substantially among the events. The risk of injury varied with each discipline. Preventive measures should be specific and focused on minimising the potential for overuse. Attention should be paid to ensure adequate rehabilitation of previous injuries. The addition of the illness part to the injury surveillance system proved to be feasible. As most illnesses were caused by infection of the respiratory tract or were environmentally related, preventive interventions should focus on decreasing the risk of transmission, appropriate event scheduling and heat acclimatisation.

[Actual care and funding situation with regard to mother-child units for psychic disorders associated with pregnancy in Germany].

PubMed

Jordan, Wolfgang; Bielau, Hendrik; Cohrs, Stefan; Hauth, Iris; Hornstein, Christiane; Marx, Alexandra; Reck, Corinna; von Einsiedel, Regina

2012-07-01

CONCERN: The current care and financial situation of mother-child units for psychic disorders associated with pregnancies in Germany should be documented in preparation for the development of the new reimbursement system for psychiatry and psychosomatics. In accordance with the last survey of 2005, a brief questionnaire was developed and a nationwide poll was conducted. The survey revealed severe (10 fold) service deficits for severely and gravely mentally ill mothers, who require an inpatient treatment with specific professional competence. Compared with the last poll, these service deficits have increased. This is due to continued insufficient funding and unresolved financing in the new reimbursement system. With the establishment of an additional code for mother-child treatment the precondition for ensuring the funding of this important care form in the new reimbursement system was created. It is to be hoped that the decision-makers of health policy will finally face up to their social responsibility and ensure adequate funding of the additional diagnostic and therapeutic expenditure of mother-child treatment. The health care providers have an obligation to implement a transparent record of services of the additional expenditure and to augment the national evaluation approaches to inpatient mother-child treatments. © Georg Thieme Verlag KG Stuttgart · New York.

[Spirituality and ethics in psychosomatic medicine].

PubMed

Irmiš, Felix

2015-01-01

A patient has to cope with an illness on a physical, mental and spiritual level. There exists a difference between religiousness and spirituality even though the approach has a common foundation. Nonreligious spirituality relates to an inner experience, transcendent states of consciousness, meaningfulness, responsibility, sympathy, ethics, humanisation, faith. We encounter the spiritual point of view in humanistic psychotherapy, pastoral medicine, work of hospital chaplains, New Age, psychotherapies with religious and alternative aspects, transpersonal psychotherapy, psycho-spiritual crises, unusual states of consciousness, in meditation, Yoga, relaxation, kinesiology, ethicotherapy, reincarnation therapy, positive motivation, holotropic breathing, etc. There is description of different degrees of spiritual development, rational and irrational feeling of spirituality, Quantum Physics, spiritual intelligence, neuro-theology, physiological change, effects on improving adaptation during stress, drugs addiction, etc. Spirituality in relation with ethics is discussed in terms of socio-biology, evolution, emotions, aggressivity, genetics and social influence. The work analyses the effect of stressful situations on the deterioration of moral attitudes: during lack of time, obedience to authority and order. It is described how temperament and personality disorders can affect perception of spirituality, guilt feeling and conscience. Stressful situations, lack of time, relying only on the auxiliary objective methods leads to alienation of physician with a patient. Spirituality can partially improve the doctor-patient relationship, communication and sense of responsibility.

THE IMPORTANCE OF PLAY DURING HOSPITALIZATION OF CHILDREN

PubMed Central

Koukourikos, Konstantinos; Tzeha, Laila; Pantelidou, Parthenopi; Tsaloglidou, Areti

2015-01-01

Introduction: Play constitutes an essential parameter of the normal psychosomatic development of children, as well as their statutory right. It is also an important means of communication in childhood. Objective: To review, detect and highlight all data cited regarding the role of play during the hospitalization of children. Methodology: Literature review was achieved by searching the databases Scopus, PubMed, Cinhal in English, using the following key words: therapeutic play, play therapy, hospitalized child, therapist. Results: During hospitalization, play either in the form of therapeutic play, or as in the form of play therapy, is proven to be of high therapeutic value for ill children, thus contributing to both their physical and emotional well-being and to their recovery. It helps to investigate issues related to the child’s experiences in the hospital and reduce the intensity of negative feelings accompanying a child’s admission to hospital and hospitalization. Play is widely used in pre-operative preparation and invasive procedures, while its use among children hospitalized for cancer is beneficial. Conclusion: The use of play in hospital may become a tool in the hands of healthcare professionals, in order to provide substantial assistance to hospitalized children, as long as they have appropriate training, patience, and will to apply it during hospitalization. PMID:26889107

[Pleasure and pain in sexual relations. The basis and reasons for sex counseling by the general practitioner].

PubMed

Sohn, W

2003-11-13

An essential factor for successful sex counseling by the family doctor is an atmosphere of openness and trust between physician and patient. However, few patients will begin to talk about their sexual problems of their own accord. The physician should therefore allow himself sufficient time for such counseling, be aware of his own limitations, and develop an ear attuned to involuntary remarks by the patient. During talks, only sparse use should be made of technical terms, the better to encourage the patient. The problems most commonly described in the doctor's office are functional disorders with a psychosomatic cause, and triggering factors may vary considerably (a high level of stress at the workplace, social or financial crises, monotonous leisure activities). In view of this, a somatic investigation should always be preceded by careful history-taking.

The Attack on Psychosomatic Integrity: a Study of the Psychological Sequelae of Burn Trauma

PubMed Central

Cavaleri, V.; Epifanio, M.S.; Benigno, A.; Conte, F.; Di Pasquale, A.

2009-01-01

Summary Burns pathology is characterized not only by insidious damage to the patients' outward appearance but also by the equally painful emotional difficulties they encounter as they reorganize their identity and their personal history. This exploratory survey, combining research work with medical action, considers the cases of 41 outpatients who were hospitalized and subjected to skin grafting. The patients were recruited through the database of the Palermo Civic Hospital Plastic Surgery and Burns Therapy Operative Unit. The questionnaires were compiled 6 and 12 months post-burn (12 months' observation). The main objective of the research was to investigate the quality of life of burn patients in relation to the way they handled their condition on the emotional level, in order to cope with the stress caused by the burn. PMID:21991160

Public stigma associated with mental illnesses in Pakistani university students: a cross sectional survey

PubMed Central

Zubair, Muhammad; Ghulam, Hamzah; Wajih Ullah, Muhammad; Zubair Tariq, Muhammad

2014-01-01

Background. The objectives of the study were to explore the knowledge and attitudes of Pakistani university students toward mental illnesses. People with mental illnesses are challenged not only by their symptoms but also by the prejudices associated with their illness. Acknowledging the stigma of mental illness should be the first essential step toward devising an appropriate treatment plan. Methods. A cross-sectional survey was conducted at the University of Punjab, Lahore, CMH Lahore Medical and Dental College, Lahore, and University of Sargodha, Sub-campus Lahore, from February to May 2014. The self-administered questionnaire consisted of three sections: demographics, general knowledge of psychiatric illnesses, and Community Attitudes towards Mental Illnesses (CAMI) Scale. The questionnaire was distributed to 650 participants enrolled in different disciplines (Social Sciences, Medicine and Formal Sciences). Results. Response rate was 81% (527/650 respondents). Mean age was 20.98 years. Most of the students (331, 62.8%) had an urban background and studied Social Sciences (238, 45.2%). Four hundred and eighteen respondents (79.3%) considered religion very important and most respondents considered psychiatrists (334, 63.4%) and spiritual leaders (72, 13.7%) to be best able to treat mental illnesses. One hundred and sixty nine respondents (32.1%) considered black magic to be a cause of mental illness. Only 215 (41%) respondents had ever read an article on mental illnesses. Multiple regression analysis revealed study discipline, exposure, perceived causes of mental illnesses and superstitions to be significantly associated with attitudes towards mental illnesses (p < .05). Conclusion. Although low awareness and exposure were found in this sample of Pakistani university students, their attitude towards mental illnesses was generally positive. Most respondents gave supernatural explanations for mental illnesses but only a few believed that spiritual leaders can play a role in treatment. PMID:25548734

Valuing psychiatric patients' stories: belief in and use of the supernatural in the Jamaican psychiatric setting.

PubMed

James, Caryl C A B; Carpenter, Karen A; Peltzer, Karl; Weaver, Steve

2014-04-01

The aim of this study was to examine illness presentation and understand how psychiatric patients make meaning of the causes of their mental illnesses. Six Jamaican psychiatric patients were interviewed using the McGill Illness Narrative Interview Schedule. Of the 6, 3 representative case studies were chosen. The hermeneutic phenomenological approach and the common sense model were used in the formulation of patients' explanatory models. Results indicate that psychiatric patients actively conceptualized the causes and resultant treatment of their mental illnesses. Patients' satisfaction and compliance with treatment were dependent on the extent to which practitioners' conceptualization matched their own, as well as practitioners' acknowledgement of patients' concerns about causation, prognosis, and treatment.

Know and Share the Facts about Flu Vaccination

ERIC Educational Resources Information Center

Grohskopf, Lisa

2012-01-01

Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. It can cause mild to severe illness, and sometimes can lead to death. Symptoms of flu can include fever or a feverish feeling, cough, sore throat, runny or stuffy nose, muscle or body aches, headache, fatigue, vomiting, and diarrhea. Flu…

Nonpeptidic mimics of host defense proteins as antimicrobial agents for E. coli O104:H4, campylobacter spp. and other foodborne pathogens

USDA-ARS?s Scientific Manuscript database

Background: Foodborne illness is a serious public health problem. According to the U.S. Food and Drug Administration Campylobacter jejuni is the leading cause of bacterial diarrheal illness in the United States, causing more disease than Shigella spp. and Salmonella spp. combined. The CDC estima...

Mistletoe hepatitis.

PubMed Central

Harvey, J; Colin-Jones, D G

1981-01-01

A 49-year-old woman presented with nausea, general malaise, and a dull ache in the right hypochondrium. Liver biopsy showed slight inflammatory-cell infiltration, and results of liver function tests suggested hepatitis. Hepatitis B surface antigen was not detected, and a cholecystogram was normal. Two years later she presented with similar symptoms, and both illnesses were found to have occurred after ingestion of a herbal remedy containing kelp, motherwort, skullcap, and mistletoe. A challenge test established this to be the cause of the illness. Mistletoe is the only constituent of the tablets known to contain any potential toxin and thus was probably the cause of the illness. Mistletoe is widely used in herbal remedies, whose ingestion may therefore cause hepatitis. Images FIG 1 FIG 2 PMID:6779941

Impact of Preexisting Mental Illness on All-Cause and Breast Cancer-Specific Mortality in Elderly Patients With Breast Cancer.

PubMed

Iglay, Kristy; Santorelli, Melissa L; Hirshfield, Kim M; Williams, Jill M; Rhoads, George G; Lin, Yong; Demissie, Kitaw

2017-12-20

Purpose Limited data are available on the survival of patients with breast cancer with preexisting mental illness, and elderly women are of special interest because they experience the highest incidence of breast cancer. Therefore, we compared all-cause and breast cancer-specific mortality for elderly patients with breast cancer with and without mental illness. Methods A retrospective cohort study was conducted by using SEER-Medicare data, including 19,028 women ≥ 68 years of age who were diagnosed with stage I to IIIa breast cancer in the United States from 2005 to 2007. Patients were classified as having severe mental illness if an International Classification of Diseases, Ninth Edition, Clinical Modification code for bipolar disorder, schizophrenia, or other psychotic disorder was recorded on at least one inpatient or two outpatient claims during the 3 years before breast cancer diagnosis. Patients were followed for up to 5 years after breast cancer diagnosis to assess survival outcomes, which were then compared with those of patients without mental illness. Results Nearly 3% of patients had preexisting severe mental illness. We observed a two-fold increase in the all-cause mortality hazard between patients with severe mental illness compared with those without mental illness after adjusting for age, income, race, ethnicity, geographic location, and marital status (adjusted hazard ratio, 2.19; 95% CI, 1.84 to 2.60). A 20% increase in breast cancer-specific mortality hazard was observed, but the association was not significant (adjusted hazard ratio, 1.20; 95% CI, 0.82 to 1.74). Patients with severe mental illness were more likely to be diagnosed with advanced breast cancer and aggressive tumor characteristics. They also had increased tobacco use and more comorbidities. Conclusion Patients with severe mental illness may need assistance with coordinating medical services.

Campylobacter.

PubMed

Fitzgerald, Collette

2015-06-01

Campylobacter continues to be one of the most common bacterial causes of diarrheal illness in the United States and worldwide. Infection with Campylobacter causes a spectrum of diseases including acute enteritis, extraintestinal infections, and postinfectious complications. The most common species of Campylobacter associated with human illness is Campylobacter jejuni, but other Campylobacter species can also cause human infections. This comprehensive review includes discussion of the taxonomy, clinical manifestations of infection, epidemiology and the different methods of laboratory detection of Campylobacter. Published by Elsevier Inc.

Appetite - decreased

MedlinePlus

Loss of appetite; Decreased appetite; Anorexia ... Any illness can reduce appetite. If the illness is treatable, the appetite should return when the condition is cured. Loss of appetite can cause weight ...

Social autopsy for identifying causes of adult mortality

PubMed Central

Gupta, Mamta; Kaur, Manmeet; Lakshmi, P. V. M.; Prinja, Shankar; Singh, Tarundeep; Sirari, Titiksha; Kumar, Rajesh

2018-01-01

Verbal autopsy methods have been developed to determine medical causes of deathforprioritizing disease control programs. Additional information on social causesmay facilitate designing of more appropriate prevention strategies. Use of social autopsy in investigations of causes of adult deaths has been limited. Therefore, acommunity-based study was conducted in NandpurKalour Block of Fatehgarh Sahib District in Punjab (India)for finding social causes of adult deaths. An integrated verbal and social autopsy toolwas developed and verbal autopsies of 600 adult deaths, occurring over a reference period of one year, were conducted in 2014. Quantitative analysis described the socio-demographic characteristics of the deceased, number and type of consultations from health care providers, and type of care received during illness. Qualitative data was analyzed to find out social causes of death by thematic analysis. The median duration of illness from symptom onset till death was 9 days (IQR = 1–45 days). At the onset of illness, 72 (12%) deceased utilized home remedies and 424 (70.7%)received care from a clinic/hospital, and 104 (17.3%) died withoutreceiving any care. The number of medical consultations varied from one to six (median = 2). The utilization of government health facilities and qualified allopathic doctor increased with each consultation (p value<0.05). The top five social causes of adult deaths in a rural area of Punjab in India. (1) Non availability of medical practitioner in the vicinity, (2) communication gaps between doctor and patient on regular intake of medication, (3) delayed referral by service provider, (4) poor communication with family on illness, and (5) perception of illness to be ‘mild’ by the family or care taker. To conclude, social autopsy tool should be integrated with verbal autopsy tool for identification of individual, community, and health system level factors associated with adult mortality. PMID:29851982

[Utilization of self-help groups and psychotherapy after psychosomatic-psychotherapeutic in-patient treatment].

PubMed

Höflich, Anke; Matzat, Jürgen; Meyer, Friedhelm; Knickenberg, Rudolf J; Bleichner, Franz; Merkle, Wolfgang; Reimer, Christian; Franke, Wolfram; Beutel, Manfred E

2007-05-01

Until now little is known about the role of participation in self-help groups alone or combined with psychotherapy in post-in-patient care. In the present study 2933 patients were questioned about their experience of self-help groups and psychotherapy after discharge from a clinic for psychosomatic medicine and psychotherapy. Nearly 8 % of them utilized self-help groups (mostly combined with out-patient psychotherapy), and altogether 68 % out-patient psychotherapy following in-patient treatment. Patients without out-patient treatment were psychologically less burdened and had better resources than participants of self-help groups or psychotherapy. Self-help group members differed from patients in out-patient psychotherapy by expressing a more positive opinion of groupwork and higher openness to new experiences. Additionly, they had discussed the topic of self-help groups more frequently with their therapists. This may be a starting-point for promoting more self-help activities of patients in the future.

No departure to "Pandora"? Using critical phenomenology to differentiate "naive" from "reflective" experience in psychiatry and psychosomatic medicine (A comment on Schwartz and Wiggins, 2010)

PubMed Central

2010-01-01

The mind-body problem lies at the heart of the clinical practice of both psychiatry and psychosomatic medicine. In their recent publication, Schwartz and Wiggins address the question of how to understand life as central to the mind-body problem. Drawing on their own use of the phenomenological method, we propose that the mind-body problem is not resolved by a general, evocative appeal to an all encompassing life-concept, but rather falters precisely at the insurmountable difference between "natural" and a "reflective" experience built into phenomenological method itself. Drawing on the works of phenomenologically oriented thinkers, we describe life as inherently "teleological" without collapsing life with our subjective perspective, or stepping over our epistemological limits. From the phenomenology it can be demonstrated that the hypothetical teleological qualities are a reflective reconstruction modelled on human behavioural structure. PMID:21040525

Sleep problems, depression, substance use, social bonding, and quality of life in professional firefighters.

PubMed

Carey, Mary G; Al-Zaiti, Salah S; Dean, Grace E; Sessanna, Loralee; Finnell, Deborah S

2011-08-01

Little attention has been given to factors contributing to firefighters' psychosomatic well-being. The purpose of this descriptive study was to examine such contributing factors in a sample of professional firefighters. Measures assessing sleep, depression, substance use, social bonding, and quality of life were examined in 112 firefighters. Overall, many firefighters reported sleep deprivation (59%), binge drinking behavior (58%), poor mental well-being (21%), current nicotine use (20%), hazardous drinking behavior (14%), depression (11%), poor physical well-being (8%), caffeine overuse (5%), or poor social bonding (4%). Small-to-medium correlations were identified between sleep deprivation, depression, physical/mental well-being, and drinking behaviors. High-risk behaviors that impact psychosomatic well-being are prevalent in professional firefighters, which require environmental and individual-based health promotion interventions. The inter-correlation relationships between such behaviors, therefore, need to be explored in further details.

Sleep Problems, Depression, Substance Use, Social Bonding, and Quality of Life in Professional Firefighters

PubMed Central

Carey, Mary G; Al-Zaiti, Salah S; Dean, Grace E; Sessanna, Loralee; Finnell, Deborah S

2011-01-01

Little attention has been given to factors contributing to firefighters' psychosomatic well-being. Objective The purpose of this descriptive study was to examine such contributing factors in a sample of professional firefighters. Methods Measures assessing sleep, depression, substance use, social bonding, and quality of life were examined in 112 firefighters. Results Overall, many firefighters reported sleep deprivation (59%), binge drinking behavior (58%), poor mental well-being (21%), current nicotine use (20%), hazardous drinking behavior (14%), depression (11%), poor physical well-being (8%), caffeine overuse (5%), or poor social bonding (4%). Conclusions Small-to-medium correlations were identified between sleep deprivation, depression, physical/mental well-being, and drinking behaviors. High-risk behaviors that impact psychosomatic well-being are prevalent in professional firefighters, which require environmental and individual-based health promotion interventions. The inter-correlation relationships between such behaviors, therefore, need to be explored in further details. PMID:21785370

[Features of oxygen utilization by the body of patients with arterial hypertension in the days of magnetic storms depending on the psychosomatic status and treatment options].

PubMed

Usenko, G A; Usenko, A G; Vasendin, D V

2015-01-01

During magnetic storms the observed increase in γ-background environment and the reduction of the rate of oxygen utilization by the tissues, but the increase in the number of angina attacks per day to magnetic storms the choleric, in the days of magnetic storms in sanguine, for 3-4 days at a phlegmatic, and 4-5 days in the melancholic especially in groups high anxiety phlegmatic and melancholic. Last-risk group severe arterial hypertension and ischemic heart disease. Antihypertensive therapy based on the blockade of the features of the psychosomatic status, significantly reduced the number of attacks and brought the values of the utilization of oxygen and coefficient of oxygen utilization bu the tissues of all the days to those in healthy individual relevant anxiety and temperament.

DOE Office of Scientific and Technical Information (OSTI.GOV)

MISAO, Tando; HATTORI, Kenichi; SHIRAKAWA, Mitsuru

Physical and psychosomatic examinations were performed on 356 A-bomb survivors during the 4-yr period complained of fatigue and vertigo, 118 of whom had had no corresponding explanation. There was no significant change in the blood and bone marrow other than a tendency to a higher incidence of either anemia, leukopenia, thrombocytopenia, or their combination, particularly in those who had been exposed at a small distance from the hypocenter. In psychosomatic aspects, almost all the survivors had some complaints such as anxiety, a feeling that their lives were hopeless, and fear of A-bomb effects on their descendants. Bodily complaints seemed tomore » stem from a neurotic basis. Since information on sequelae of A-bomb disease has come mainly from mass communication sources (67%) and also partially from physicians (21%), it should be emphasized that both mass communication sources and physicians must be very cautious in describing the morbid sequelae. (P.C.H.)« less

Work or welfare after cancer? Explorations of identity and stigma.

PubMed

Moffatt, Suzanne; Noble, Emma

2015-11-01

With increasing numbers of people living with cancer, a greater focus is required on the social consequences of the disease. This article explores the connections between cancer and employment and the constraints imposed by ill health and wider structural conditions. Narrative data from 23 people of working age with cancer in north-east England collected longitudinally over 16 months highlight the impact of financial strain caused by temporary or permanent interruption to employment, and the positive benefits of an upstream welfare rights intervention in enabling participants to claim benefit entitlements and boost incomes. Returning to work, for those who were able, helped repair the disruption caused by the illness. For those unable to work, reliance on welfare benefits, while necessary, conferred a stigmatised identity that compounded the disruption wrought by cancer. While stigma occurs at the individual level, the structural dimensions of stigma need to be acknowledged in order to analyse the forces that cause, maintain and perpetuate the stigma associated with claiming welfare while ill. We conclude that current UK policies and welfare reforms to reduce sickness-related welfare claims will lead to greater hardship during periods of ill health and increase inequalities. © 2015 Foundation for the Sociology of Health & Illness.

Gut Microbial Translocation in Critically Ill Children and Effects of Supplementation with Pre- and Pro Biotics

PubMed Central

Papoff, Paola; Ceccarelli, Giancarlo; d'Ettorre, Gabriella; Cerasaro, Carla; Caresta, Elena; Midulla, Fabio; Moretti, Corrado

2012-01-01

Bacterial translocation as a direct cause of sepsis is an attractive hypothesis that presupposes that in specific situations bacteria cross the intestinal barrier, enter the systemic circulation, and cause a systemic inflammatory response syndrome. Critically ill children are at increased risk for bacterial translocation, particularly in the early postnatal age. Predisposing factors include intestinal obstruction, obstructive jaundice, intra-abdominal hypertension, intestinal ischemia/reperfusion injury and secondary ileus, and immaturity of the intestinal barrier per se. Despite good evidence from experimental studies to support the theory of bacterial translocation as a cause of sepsis, there is little evidence in human studies to confirm that translocation is directly correlated to bloodstream infections in critically ill children. This paper provides an overview of the gut microflora and its significance, a focus on the mechanisms employed by bacteria to gain access to the systemic circulation, and how critical illness creates a hostile environment in the gut and alters the microflora favoring the growth of pathogens that promote bacterial translocation. It also covers treatment with pre- and pro biotics during critical illness to restore the balance of microbial communities in a beneficial way with positive effects on intestinal permeability and bacterial translocation. PMID:22934115

Emerging Causes of Arbovirus Encephalitis in North America: Powassan, Chikungunya, and Zika Viruses.

PubMed

Doughty, Christopher T; Yawetz, Sigal; Lyons, Jennifer

2017-02-01

Arboviruses are arthropod-borne viruses transmitted by the bite of mosquitoes, ticks, or other arthropods. Arboviruses are a common and an increasing cause of human illness in North America. Powassan virus, Chikungunya virus, and Zika virus are arboviruses that have all recently emerged as increasing causes of neurologic illness. Powassan virus almost exclusively causes encephalitis, but cases are rare, sporadic, and restricted to portions of North America and Russia. Chikungunya virus has spread widely across the world, causing millions of infections. Encephalitis is a rare manifestation of illness but is more common and severe in neonates and older adults. Zika virus has recently spread through much of the Americas and has been associated mostly with microcephaly and other congenital neurologic complications. Encephalitis occurring in infected adults has also been recently reported. This review will discuss the neuropathogenesis of these viruses, their transmission and geographic distribution, the spectrum of their neurologic manifestations, and the appropriate method of diagnosis.

Sports Injury and Illness Epidemiology: Great Britain Olympic Team (TeamGB) surveillance during the Sochi 2014 Winter Olympic Games

PubMed Central

Palmer-Green, Debbie; Elliott, Niall

2015-01-01

Background Sports injury and illness surveillance is the first step in injury and illness prevention, and is important for the protection of both athlete health and performance in major competitions. Aim To identify the prevalence, severity nature and causes of athlete injuries and illnesses in the Great Britain Olympic Team (TeamGB) during the Sochi 2014 Winter Olympic Games. Methods The observational prospective cohort study followed the Great Britain Injury/Illness Performance Project surveillance methodology and obtained information on injuries and illnesses that occurred during the Games between 30 January and 23 February 2014 in TeamGB athletes (n=56). Results Among the 56 TeamGB athletes, there were 27 injuries and 11 illnesses during the Olympic Games period. This equated to 39% sustaining at least one injury and 18% at least one illness, with an incidence of 48.2 injuries and 19.6 illnesses per 100 athletes, respectively. Of all injuries and illnesses, 9% and 7%, respectively, resulted in time loss. The risk of sustaining an injury was highest for freestyle skiing, skeleton and snowboarding; and lowest for curling, biathlon and Alpine skiing (with no reported injuries); with the lower limb being the most commonly injured location. Respiratory system illnesses were most frequently reported overall, and older female athletes were the ones most affected by illness. Conclusions The risk of injury was double the risk of illness for TeamGB athletes. Overall, the rate of time-loss issues was low. Methodological considerations are important when interpreting data, and prevention strategies should focus on those issues causing the greatest risk, in terms of prevalence and severity, to athlete health and performance. PMID:25425714

Ill-posedness in modeling mixed sediment river morphodynamics

NASA Astrophysics Data System (ADS)

Chavarrías, Víctor; Stecca, Guglielmo; Blom, Astrid

2018-04-01

In this paper we analyze the Hirano active layer model used in mixed sediment river morphodynamics concerning its ill-posedness. Ill-posedness causes the solution to be unstable to short-wave perturbations. This implies that the solution presents spurious oscillations, the amplitude of which depends on the domain discretization. Ill-posedness not only produces physically unrealistic results but may also cause failure of numerical simulations. By considering a two-fraction sediment mixture we obtain analytical expressions for the mathematical characterization of the model. Using these we show that the ill-posed domain is larger than what was found in previous analyses, not only comprising cases of bed degradation into a substrate finer than the active layer but also in aggradational cases. Furthermore, by analyzing a three-fraction model we observe ill-posedness under conditions of bed degradation into a coarse substrate. We observe that oscillations in the numerical solution of ill-posed simulations grow until the model becomes well-posed, as the spurious mixing of the active layer sediment and substrate sediment acts as a regularization mechanism. Finally we conduct an eigenstructure analysis of a simplified vertically continuous model for mixed sediment for which we show that ill-posedness occurs in a wider range of conditions than the active layer model.

Motivation for Psychotherapy and Illness Beliefs in Turkish Immigrant Inpatients in Germany: Results of a Cultural Comparison Study.

PubMed

Reich, Hanna; Bockel, Luisa; Mewes, Ricarda

2015-03-01

Some immigrant populations, for instance, Turkish immigrants, suffer from worse mental health than the general population. Moreover, psychotherapeutic treatment does not work well in this group. This might be explained by lower motivation for psychotherapy and particular illness beliefs as important early predictors of treatment outcome. We investigate differences in these predictors between Turkish immigrant inpatients and inpatients without a migration background and evaluate whether particular illness beliefs have a negative impact on motivation for psychotherapy. Turkish immigrant inpatients and inpatients without a migration background (N = 100), suffering from depressive disorder, somatoform disorder, and/or adjustment disorder, completed questionnaires assessing motivation for psychotherapy, depressive and somatic symptoms, illness perception, illness-related locus of control, and causal illness attributions. Despite a higher symptom burden, motivation for psychotherapy was lower in Turkish immigrant inpatients than in inpatients without a migration background (d = 0.54). This was fully explained by stronger beliefs in supernatural causes of illness and higher fatalistic-external illness-related locus of control in the Turkish immigrant sample (mediation analysis; R (2) = 0.27). Turkish immigrants believe in supernatural or fatalistic causes of illness and fatalistic-external locus of control to a greater extent than German inpatients without a migration background. These beliefs reduce motivation for psychotherapy and need to be addressed in psychotherapeutic treatment in order to secure positive treatment outcomes.

Emerging paradigms in medicine: implications for the future of psychiatry.

PubMed

Lake, James

2007-01-01

The causes of mental illness remain obscure in spite of rapid progress in the neurosciences. This is due in part to the fact that contemporary biomedical psychiatry rests on philosophically and scientifically ambiguous ground. In Western medicine paradigms, theories from physics, chemistry, and biology form the basis of an explanatory model of illness, including mental illness. Symptoms are conceptualized as subjective descriptions of effects caused by factors characterized in empirical terms. Conventional biomedicine asserts that all causes of illness, and by extension, mechanisms of action underlying legitimate treatment approaches, rest on biological processes that can be described in the reductionist language of Western science. However, in contemporary Western psychiatry, there is no single adequate explanatory model of the causes of mental illness. What remains are competing psychodynamic, genetic, endocrinologic, and neurobiological models of symptom formation reflecting disparate ideological positions and diverse clinical training backgrounds of mental health professionals. There is no unifying theory in psychiatry because no single explanatory model has been confirmed as more valid than any other. I hypothesize in this article that the synthesis of ideas and clinical approaches from Western biomedicine and non-Western systems of medicine based on understandings of human consciousness, the neurosciences, complexity theory, and quantum field theory, will lead to rapid evolution of conventional Western biomedical psychiatry toward truly integrative mental healthcare. The result will be the emergence of an integrative mental healthcare model that will more adequately address the disparate causes, conditions, and meanings of symptoms combining multimodal approaches from Western biomedicine and non-Western systems of medicine.

Dengue fever (image)

MedlinePlus

Dengue fever, or West Nile fever, is a mild viral illness transmitted by mosquitoes which causes fever, ... second exposure to the virus can result in Dengue hemorrhagic fever, a life-threatening illness.

Anorgasmia in Women

MedlinePlus

... of these areas can affect your ability to orgasm. Physical causes A wide range of illnesses, physical changes and medications can interfere with orgasm: Diseases. Serious illnesses, such as multiple sclerosis and ...

Charles Darwin's mitochondria.

PubMed

Hayman, John

2013-05-01

Charles Darwin's long-term illness has been the subject of much speculation. His numerous symptoms have led to conclusions that his illness was essentially psychogenic in nature. These diagnoses have never been fully convincing, however, particularly in regard to the proposed underlying psychological background causes of the illness. Similarly, two proposed somatic causes of illness, Chagas disease and arsenic poisoning, lack credibility and appear inconsistent with the lifetime history of the illness. Other physical explanations are simply too incomplete to explain the range of symptoms. Here, a very different sort of explanation will be offered. We now know that mitochondrial mutations producing impaired mitochondrial function may result in a wide range of differing symptoms, including symptoms thought to be primarily psychological. Examination of Darwin's maternal family history supports the contention that his illness was mitochondrial in nature; his mother and one maternal uncle had strange illnesses and the youngest maternal sibling died of an infirmity with symptoms characteristic of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS syndrome), a condition rooted in mitochondrial dysfunction. Darwin's own symptoms are described here and are in accord with the hypothesis that he had the mtDNA mutation commonly associated with the MELAS syndrome.

Ethnic differences in the knowledge, attitude and beliefs towards mental illness in a traditional fast developing country.

PubMed

Bener, Abdulbari; Ghuloum, Suhaila

2011-06-01

The aim of the study was to examine the ethnic differences in knowledge, attitude and practice towards mental illness in a sample of Qatari and non-Qatari Arabs. This is a cross sectional survey conducted in Primary Health Care centers, Qatar from October to June 2009. A representative sample of 3000 Qatari and non-Qatari Arabs above 20 years of age were approached and 2514 subjects (83.8%) gave consent to participate in this study. More than non-Qatari Arabs, a significant proportion of Qataris thought that mental illness can be a punishment from God (44.5% vs 50.6%; p=0.002) and that people with mental illness are mentally retarded (35.1% vs 45.1%; p<0.001). Qatari nationals had a poor knowledge about causes of mental illness compared to non-Qatari Arabs such as a belief that mental illness is due to possession of evil spirits (40.5% vs 37.6%) and psychiatric medication will cause addiction (61% vs 57.3%). The study revealed that there is an ethnic diversity within Arab societies in their knowledge, attitude and practice towards mental illness.

[Models of Mental Health Care for Vulnerable Refugees in the Community].

PubMed

Schellong, Julia; Epple, Franziska; Weidner, Kerstin; Möllering, Andrea

2017-04-01

A non-neglectable portion of people that have fled to Germany have been subjected to expulsion, violence, torture and grave human loss. In some of them, signs of secondary mental problems are obvious. In the light of the efforts at integration, these diseases must not be neglected. Outlined are the federal legal requirements and how the cost coverage, as well as the admission to health care system, is structured. Additionally, 2 exemplary regional models for psychosomatic health care are being introduced: Dresden's "Stepped Care Model for Psychologically Vulnerable Refugees" includes phased offers for prevention and treatment of acute mental crises, as well as somatoform disorders in refugees and their volunteer helpers. The PSZ in Bielefeld unites already existing expertise of social work and trauma therapy to form a shared project and favors, among other things, training courses and the instruction of language mediators. The local circumstances and differences lead to individual, sometimes totally new solutions. Already existing clinical care offers as well as concepts of trauma therapy are focal points for the development of a comprehensive health care provision. Most effective is a combination of medicinal care, psychosocial networking and psychosomatic treatment. For a working health care provision without parallel structures it is indispensible to use expertise in trauma therapy that is already in place. While being very resource-saving psychosomatic centers offer targeted applications in the network of all actors in refugee care especially when combined with well-trained volunteers and language mediators, informed on the issue of trauma. © Georg Thieme Verlag KG Stuttgart · New York.

Do health complaints in adolescence negatively predict the chance of entering tertiary education in young adulthood?

PubMed

Låftman, Sara B; Magnusson, Charlotta

2017-12-01

Self-reported psychological and psychosomatic health complaints, such as nervousness, sadness, headache and stomach-ache, are common among adolescents, particularly among girls, and studies suggest that the prevalence has risen among adolescent girls during the last few decades. However, only a limited number of studies have investigated the potential long-term consequences of such health complaints. The aim of the current study was to assess whether psychological and psychosomatic health complaints in adolescence predict the chance of entering tertiary education in young adulthood among women and men. The data used are from the Swedish Young-LNU, which is based on a nationally representative sample with self-reported survey information from adolescents aged 10-18 years in 2000 and from the same individuals at ages 20-28 in 2010 ( n=783). Information was also collected from parents and from official registers. Linear probability models showed that self-reported psychological complaints in adolescence were associated with a lower chance of having entered tertiary education 10 years later. This association was accounted for by differences in grade point average (GPA), suggesting that GPA may mediate the association between psychological complaints and later education. The pattern was similar for both genders. Furthermore, among men, psychosomatic complaints in adolescence were significantly associated with a lower likelihood of having entered tertiary education 10 years later when adjusting for GPA and social class in adolescence. A similar but non-significant tendency was found among women. The findings suggest that health complaints in adolescence may have long-term consequences in terms of lower educational attainment.

Playing music improves well-being of oncology nurses.

PubMed

Ploukou, Stella; Panagopoulou, Efharis

2018-02-01

Nurses experience high levels of stress associated with the demands of their workplace. Anxiety and depression symptoms are common in this occupational group and the necessity of supportive actions is vital. This is especially true for nurses working in high intensity and demanding settings such as oncology units. This study examined the effects of a music intervention on anxiety, depression, and psychosomatic symptoms of oncology nurses. Forty-eight oncology nurses, were randomized to either an intervention group (n = 22) attending four consecutive weekly 1-h music classes or a control group with no intervention (n = 26) who maintained their usual lifestyle habits, for one month. Intervention group played and improvised music using percussion instruments. Courses consisted of varied multitask exercises of progressive difficulty, sometimes involving team playing, or individual performances. Depression, anxiety, and physical symptoms were measured before and after the end of the intervention. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale. Psychosomatic symptoms were assessed with Pennebaker Inventory οf Limbic Languidness. Anxiety, depression and psychosomatic symptoms significantly reduced for the intervention group at the end of the study. No statistical significant change was observed for the control group in any of the three psychological indicators. The findings of our study highlight the fact that music can be a cost-effective resource in developing interventions to reduce stress and improve well-being. Playing music can be the next step for further investigation, since we already know that listening to music is beneficial. Copyright © 2017 Elsevier Inc. All rights reserved.

PubMed

Junne, Florian; Rieger, Monika; Michaelis, Martina; Nikendei, Christoph; Gündel, Harald; Zipfel, Stephan; Rothermund, Eva

2017-04-01

Psycho-mental stressors and increased perceived stress in workplace settings may determine the onset and course of stress-related mental and psychosomatic disorders. For the description of psycho-mental stressors three distinct models have widely been used in the analyses of the matter: the Demand-Control-Model by Karasek and Theorell, the Effort-Reward-Imbalance Model by Siegrist, and the Model of Organisational Justice.The interactional or social dimension in work-place settings can be seen as a cross-sectional dimension to the above mentioned models. Here, social conflicts and mobbing, as specific forms of interactional problems, are of importance.Besides measures of primary prevention which can be derived from applying the above mentioned models, attention is paid increasingly to secondary and tertiary preventive measures in work-place settings. Concepts such as the psychosomatic consultation-hour within the context of workplace showed to be effective measures for the early detection of people at risk or early stages of e. g. stress-related psychosomatic disorders.Furthermore, step-wise reintegration of members of the work-force play an important role within the effort to retain the ability to work and the workplace of individuals who suffered from stress-related mental disorders, as it has to be stressed that working and social interactions at the workplace may well be a resource that enhances and stipulates psycho-mental well-being and mental health.This CME-Article describes the above mentioned models and discusses selected perspectives of preventive measures to avoid stress-related mental disorders in members of the work-force. © Georg Thieme Verlag KG Stuttgart · New York.

Multivariable modeling of factors associated with spinal pain in young adolescence.

PubMed

Dolphens, Mieke; Vansteelandt, Stijn; Cagnie, Barbara; Vleeming, Andry; Nijs, Jo; Vanderstraeten, Guy; Danneels, Lieven

2016-09-01

To investigate the factors related to the 1-month period prevalence of low back pain (LBP), neck pain (NP) and thoracic spine pain (TSP) in young adolescents, thereby considering potential correlates from the physical, sociodemographic, lifestyle, psychosocial and comorbid pain domains. In this cross-sectional baseline study, 69 factors potentially associated with spinal pain were assessed among 842 healthy adolescents before pubertal peak growth. With consideration for possible sex differences in associations, multivariable analysis was used to simultaneously evaluate contributions of all variables collected in the five domains. A significantly higher odds of LBP was shown for having high levels of psychosomatic complaints (odds ratio: 4.4; 95 % confidence interval: 1.6-11.9), a high lumbar lordotic apex, retroversed pelvis, introverted personality, and high levels of negative over positive affect. Associations with a higher prevalence and odds of NP were found for psychosomatic complaints (7.8; 2.5-23.9), TSP in the last month (4.9; 2.2-10.8), backward trunk lean, high levels of negative over positive affect and depressed mood. Having experienced LBP (2.7; 1.3-5.7) or NP (5.5; 2.6-11.8) in the preceding month was associated with a higher odds of TSP, as were low self-esteem, excessive physical activity, sedentarism and not achieving the Fit-norm. Psychosomatic symptoms and pain comorbidities had the strongest association with 1-month period prevalence of spinal pain in young adolescents, followed by factors from the physical and psychosocial domains. The role that "physical factors" play in non-adult spinal pain may have been underestimated by previous studies.

A comparison of E. coli persistence on basil plants and soil using drip and overhead irrigation

USDA-ARS?s Scientific Manuscript database

Introduction: It is estimated that each year in the US there are 63,153 cases of foodborne illnesses caused by E.coli O157 serotypes and 112,752 illnesses caused by non-O157 shiga-toxin producing E.coli. Irrigation water is recognized as a pre-harvest contamination source and has been linked with o...

Hypnotherapy and Female Sexual Inadequacy

PubMed Central

Glick, Daniel

1972-01-01

Dr. Glick describes the use of hypnosis in the treatment of primary and secondary frigidity, dyspareunia and psychosomatic symptoms in female sexual inadequacy. He uses case histories to show the various techniques used and the results that can be expected. PMID:20468741

Antenatal psychosomatic programming to reduce postpartum depression risk and improve childbirth outcomes: a randomized controlled trial in Spain and France

PubMed Central

2014-01-01

Background Postpartum depression (PPD) and poor childbirth outcomes are associated with poverty; these variables should be addressed by an adapted approach. The aim of this research was to evaluate the impact of an antenatal programme based on a novel psychosomatic approach to pregnancy and delivery, regarding the risk of PPD and childbirth outcomes in disadvantaged women. Methods A multi-centre, randomized, controlled trial comparing a novel to standard antenatal programme. Primary outcome was depressive symptoms (using EPDS) and secondary outcome was preterm childbirth (fewer 37 weeks). The sample comprised 184 couples in which the women were identified to be at PPD risk by validated interview. The study was conducted in three public hospitals with comparable standards of perinatal care. Women were randomly distributed in to an experimental group (EG) or a control group (CG), and evaluated twice: during pregnancy (T1) and four weeks post-partum (T2). At T2, the variables were compared using the chi square test. Data analysis was based on intention to treat. The novel programme used the Tourné psychosomatic approach focusing on body awareness sensations, construction of an individualized childbirth model, and attachment. The 10 group antenatal sessions each lasted two hours, with one telephone conversation between sessions. In the control group, the participants choose the standard model of antenatal education, i.e., 8 to 10 two-hour sessions focused on childbirth by obstetrical prophylaxis. Results A difference of 11.2% was noted in postpartum percentages of PPD risk (EPDS ≥ 12): 34.3% (24) in EG and 45.5% (27) in CG (p = 0.26). The number of depressive symptoms among EG women decreased at T2 (intragroup p = 0.01). Premature childbirth was four times less in EG women: three (4.4%) compared to 13 (22.4%) among CG women (p = 0.003). Birth weight was higher in EG women (p = 0.01). Conclusions The decrease of depressive symptoms in women was not conclusive. However, because birth weight was higher and the rate of preterm childbirth was lower in the EG, our results suggest that the psychosomatic approach may be more helpful to the target population than the standard antenatal programs. PMID:24422605

[A retrospective study of expert opinions of a psychosomatic-psychotherapeutic university hospital for public and private customers over a period of 12 years].

PubMed

Uhlenbrock, Judith; Hinrichs, Jens; Heuft, Gereon

2017-09-01

A retrospective study of expert opinions of a psychosomatic-psychotherapeutic university hospital for public and private customers over a period of 12 years Objectives: Both the public and the legislative have developed an increasingly critical awareness for the fact that expert witnesses need to be independent. In contrast, to date there have been few studies concerning the quantity and the results of psychosomatic-psychotherapeutic expert opinions for public and private clients. In a retrospective study design, 285 expert opinions of a psychosomatic-psychotherapeutic university hospital stemming from consecutive, unselected random sampling over a 12-year time period (1990-2011) were analyzed using a predefined list of criteria. Besides client data, the study also noted the type and the objectives of the expertise, the sociodemographic data of the subjects, the biographic data of the subjects, the size of records, the particular psychopathological findings including conflict and structural diagnostics via the Operationalized Psychodynamic Diagnostics (OPD-2, Research Group 2006), syndromic diagnostics according to ICD-10 (WHO) including the related Impairment Scale Score (ISS, Schepank 1995), and the Global Assessment of Functioning-Scale (GAF, Heuft 2016). 54% of the subjects were men. All subjects were 46 years old at the time of examination; on average symptomatology had existed for 7 years, which made assessment of causality difficult. Most assignments referred to the effects of diseases or accidents in private contexts, followed by pension reports. Among the expert opinions related to possible implications of acts of violence, 95% were women. In 43.2% (n = 123) of the cases, the assessment had occurred in the context of legal action. In 65 cases at least one party had requested a supplemental written report during further procedure. In 17.8% (n = 22) of the cases sought by the courts, the expert witness was requested by at least one party to present the assessment verbally. It should be emphasized that OPD conflict and structural diagnostics appear indispensable also for assessing mental health prior to an external event (accident or assault). The use of the two severity ratings (ISS, GAF) is discussed. It is proposed that expert witnesses be requested to name all their clients fromthe last 5 years at the beginning or end of the expert opinion, so that their independence from possible conflicts of interest can be established.

Antenatal psychosomatic programming to reduce postpartum depression risk and improve childbirth outcomes: a randomized controlled trial in Spain and France.

PubMed

Ortiz Collado, Maria Assumpta; Saez, Marc; Favrod, Jérôme; Hatem, Marie

2014-01-15

Postpartum depression (PPD) and poor childbirth outcomes are associated with poverty; these variables should be addressed by an adapted approach. The aim of this research was to evaluate the impact of an antenatal programme based on a novel psychosomatic approach to pregnancy and delivery, regarding the risk of PPD and childbirth outcomes in disadvantaged women. A multi-centre, randomized, controlled trial comparing a novel to standard antenatal programme. Primary outcome was depressive symptoms (using EPDS) and secondary outcome was preterm childbirth (fewer 37 weeks). The sample comprised 184 couples in which the women were identified to be at PPD risk by validated interview. The study was conducted in three public hospitals with comparable standards of perinatal care. Women were randomly distributed in to an experimental group (EG) or a control group (CG), and evaluated twice: during pregnancy (T1) and four weeks post-partum (T2). At T2, the variables were compared using the chi square test. Data analysis was based on intention to treat. The novel programme used the Tourné psychosomatic approach focusing on body awareness sensations, construction of an individualized childbirth model, and attachment. The 10 group antenatal sessions each lasted two hours, with one telephone conversation between sessions. In the control group, the participants choose the standard model of antenatal education, i.e., 8 to 10 two-hour sessions focused on childbirth by obstetrical prophylaxis. A difference of 11.2% was noted in postpartum percentages of PPD risk (EPDS ≥ 12): 34.3% (24) in EG and 45.5% (27) in CG (p = 0.26). The number of depressive symptoms among EG women decreased at T2 (intragroup p = 0.01). Premature childbirth was four times less in EG women: three (4.4%) compared to 13 (22.4%) among CG women (p = 0.003). Birth weight was higher in EG women (p = 0.01). The decrease of depressive symptoms in women was not conclusive. However, because birth weight was higher and the rate of preterm childbirth was lower in the EG, our results suggest that the psychosomatic approach may be more helpful to the target population than the standard antenatal programs.

Treatment of Persons with Mental Illness in the Criminal Justice System: A Literature Review

ERIC Educational Resources Information Center

Brandt, Anna L. S.

2012-01-01

The number of mentally ill inmates in the criminal justice system has increased dramatically. This article evaluates the prevalence and causes of mental illness in the criminal justice system and describes the inadequate care that is provided, the effects of imprisonment, and the problem of rehabilitation. (Contains 4 notes.)

10 CFR 55.25 - Incapacitation because of disability or illness.

Code of Federal Regulations, 2010 CFR

2010-01-01

... § 55.25 Incapacitation because of disability or illness. If, during the term of the license, the licensee develops a permanent physical or mental condition that causes the licensee to fail to meet the... 10 Energy 2 2010-01-01 2010-01-01 false Incapacitation because of disability or illness. 55.25...

Foodborne illness: new developments concerning an old problem.

PubMed

Kasowski, Eric J; Gackstetter, Gary D; Sharp, Trueman W

2002-08-01

Foodborne illnesses continue to cause substantial morbidity and mortality in the United States, primarily as gastroenteritis but occasionally as other syndromes as well. Most of these illnesses are caused by a variety of widely known infectious agents, principally viruses, and are probably the result of common mistakes in food handling in the home or in restaurants. The epidemiology of foodborne illness is evolving. Major changes in food production, distribution, and consumption have created opportunities for new pathogens to emerge and for old ones to reemerge, and the potential for widespread outbreaks is increasing. Antibiotic resistance in bacterial pathogens resulting from the widespread use of antimicrobial agents in animal husbandry is also an important concern. Clinicians must be aware of the changing epidemiology of foodborne illness to recognize and manage these conditions in the clinical setting. In addition, clinicians are critical in the reporting of recognized or suspected foodborne illness, so that public health authorities are able to investigate, understand, and ultimately better control them. A number of new techniques have been employed, and others under development will improve our ability to recognize and cope with foodborne diseases.

Tardive Dyskinesia and Covert Dyskinesia with Aripiprazole: A Case Series.

PubMed

Patra, Suravi

2016-01-01

Aripiprazole, a dopamine stabilizing atypical antipsychotic is used in treatment of tardive dyskinesia caused by other neuroleptics. Tardive dyskinesia is rarely caused by Aripiprazole and has only been documented in high risk patients i.e., female gender, advanced age, affective illness, coexisting neurological disorders. Here the author describes two atypical cases of tardive dyskinesia associated with Aripiprazole. First case of tardive dyskinesia was observed in a neuroleptic naïve young adult male with paranoid illness after six months of treatment with Aripiprazole upon addition of Fluoxetine and the second case was a middle aged female with affective illness where dyskinetic movements appeared after stopping Aripiprazole. The role of Fluoxetine in causing tardive dyskinesia with Aripiprazole and covert dyskinesia due to Aripiprazole with appropriate management is discussed.

Illness Severity and Work Productivity Loss Among Working Adults With Medically Attended Acute Respiratory Illnesses: US Influenza Vaccine Effectiveness Network 2012–2013

PubMed Central

Petrie, Joshua G.; Cheng, Caroline; Malosh, Ryan E.; VanWormer, Jeffrey J.; Flannery, Brendan; Zimmerman, Richard K.; Gaglani, Manjusha; Jackson, Michael L.; King, Jennifer P.; Nowalk, Mary Patricia; Benoit, Joyce; Robertson, Anne; Thaker, Swathi N.; Monto, Arnold S.; Ohmit, Suzanne E.

2016-01-01

Background. Influenza causes significant morbidity and mortality, with considerable economic costs, including lost work productivity. Influenza vaccines may reduce the economic burden through primary prevention of influenza and reduction in illness severity. Methods. We examined illness severity and work productivity loss among working adults with medically attended acute respiratory illnesses and compared outcomes for subjects with and without laboratory-confirmed influenza and by influenza vaccination status among subjects with influenza during the 2012–2013 influenza season. Results. Illnesses laboratory-confirmed as influenza (ie, cases) were subjectively assessed as more severe than illnesses not caused by influenza (ie, noncases) based on multiple measures, including current health status at study enrollment (≤7 days from illness onset) and current activity and sleep quality status relative to usual. Influenza cases reported missing 45% more work hours (20.5 vs 15.0; P < .001) than noncases and subjectively assessed their work productivity as impeded to a greater degree (6.0 vs 5.4; P < .001). Current health status and current activity relative to usual were subjectively assessed as modestly but significantly better for vaccinated cases compared with unvaccinated cases; however, no significant modifications of sleep quality, missed work hours, or work productivity loss were noted for vaccinated subjects. Conclusions. Influenza illnesses were more severe and resulted in more missed work hours and productivity loss than illnesses not confirmed as influenza. Modest reductions in illness severity for vaccinated cases were observed. These findings highlight the burden of influenza illnesses and illustrate the importance of laboratory confirmation of influenza outcomes in evaluations of vaccine effectiveness. PMID:26565004

Perphenazine

MedlinePlus

... used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of ... haloperidol (Haldol); ipratropium (Atrovent); medications for anxiety or mental illness, irritable bowel disease, motion sickness, Parkinson's disease, seizures, ...

Estimating the risk of communicable diseases aboard cargo ships.

PubMed

Schlaich, Clara C; Oldenburg, Marcus; Lamshöft, Maike M

2009-01-01

International travel and trade are known to be associated with the risk of spreading communicable diseases across borders. No international surveillance system for infectious diseases on ships exists. Outbreak reports and systematic studies mainly focus on disease activity on cruise ships. The study aims to assess the relevance of communicable disease occurrence on cargo ships. Retrospective analysis of all documented entries to 49 medical log books from seagoing cargo ships under German flag between 2000 and 2008. Incidence rates were calculated per 100 person-years at sea. Case series of acute respiratory illness, influenza-like illness, and infectious gastrointestinal illness affecting more than two persons within 1 successive week were classified as an outbreak. Attack rates were calculated based on number of entries to the medical log book in comparison to the average shipboard population during outbreak periods. During more than 1.5 million person-days of observation, 21% of the visits to the ship's infirmary were due to presumably communicable diseases (45.8 consultations per 100 person-years). As many as 33.9 patients per 100 person-years sought medical attention for acute respiratory symptoms. Of the 68 outbreaks that met predefined criteria, 66 were caused by acute respiratory illness with a subset of 12 outbreaks caused by influenza-like illness. Attack rates ranged between 3 and 10 affected seafarers per ship (12.5&-41.6% of the crew). Two outbreaks of gastrointestinal illness were detected. Respiratory illness is the most common cause of presumably communicable diseases aboard cargo ships and may cause outbreaks of considerable morbidity. Although the validity of the data is limited due to the use of nonprofessional diagnoses, missing or illegible entries, and restriction of the study population to German ships, the results provide guidance to ship owners and to Port Health Authorities to allocate resources and build capacities under International Health Regulations 2005.

Use of primary diagnosis during hospitalization in the Unified Health System (Sistema Único de Saúde) to qualify information regarding the underlying cause of natural deaths among the elderly.

PubMed

Cascão, Angela Maria; Jorge, Maria Helena Prado de Mello; Costa, Antonio José Leal; Kale, Pauline Lorena

2016-01-01

Ill-defined causes of death are common among the elderly owing to the high frequency of comorbidities and, consequently, to the difficulty in defining the underlying cause of death. To analyze the validity and reliability of the "primary diagnosis" in hospitalization to recover the information on the underlying cause of death in natural deaths among the elderly whose deaths were originally assigned to "ill-defined cause" in their Death Certificate. The hospitalizations occurred in the state of Rio de Janeiro, in 2006. The databases obtained in the Information Systems on Mortality and Hospitalization were probabilistically linked. The following data were calculated for hospitalizations of the elderly that evolved into deaths with a natural cause: concordance percentages, Kappa coefficient, sensitivity, specificity, and the positive predictive value of the primary diagnosis. Deaths related to "ill-defined causes" were assigned to a new cause, which was defined based on the primary diagnosis. The reliability of the primary diagnosis was good, according to the total percentage of consistency (50.2%), and fair, according to the Kappa coefficient (k = 0.4; p < 0.0001). Diseases related to the circulatory system and neoplasia occurred with the highest frequency among the deaths and the hospitalizations and presented a higher consistency of positive predictive values per chapter and grouping of the International Classification of Diseases. The recovery of the information on the primary cause occurred in 22.6% of the deaths with ill-defined causes (n = 14). The methodology developed and applied for the recovery of the information on the natural cause of death among the elderly in this study had the advantage of effectiveness and the reduction of costs compared to an investigation of the death that is recommended in situations of non-linked and low positive predictive values. Monitoring the mortality profile by the cause of death is necessary to periodically update the predictive values.

Haloperidol Injection

MedlinePlus

... release injection are used to treat schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of ... medications); medications for anxiety, depression, irritable bowel disease, mental illness, motion sickness, Parkinson's disease, seizures, ulcers, or urinary ...

Mental Illness in Children: Know the Signs

MedlinePlus

... the normal mood swings common in many people. Schizophrenia. This chronic mental illness causes a child to lose touch with reality (psychosis). Schizophrenia most often appears in the late teens through ...

Innate Immunity and the Pathogenicity of Inhaled Microbial Particles

PubMed Central

Wolff, C. Henrik J.

2011-01-01

Non-infectious inhaled microbial particles can cause illness by triggering an inappropriate immunological response. From the pathogenic point of view these illnesses can be seen to be related to on one hand autoimmune diseases and on the other infectious diseases. In this review three such illnesses are discussed in some detail. Hypersensitivity pneumonitis (HP) is the best known of these illnesses and it has also been widely studied in animal models and clinically. In contrast to HP Pulmonary mycotoxicosis (PM) is not considered to involve immunological memory, it is an acute self-limiting condition is caused by an immediate "toxic" effect. Damp building related illness (DBRI) is a controversial and from a diagnostic point poorly defined entity that is however causing, or attributed to cause, much more morbidity than the two other diseases. In the recent decade there has been a shift in the focus of immunology from the lymphocyte centered, adaptive immunity towards innate immunity. The archetypal cell in innate immunity is the macrophage although many other cell types participate. Innate immunity relies on a limited number of germline coded receptors for the recognition of pathogens and signs of cellular damage. The focus on innate immunity has opened new paths for the understanding of many chronic inflammatory diseases. The purpose of this review is to discuss the impact of some recent studies, that include aspects concerning innate immunity, on our understanding of the pathogenesis of inflammatory diseases associated with exposure to inhaled microbial matter. PMID:21448336

Perception of the etiology of illness: causal attributions in a heart patient population.

PubMed

Koslowsky, M; Croog, S H; La Voie, L

1978-10-01

This study examined perceived causes of myocardial infarction in a patient population of 345 men previously free from significant medical problems. Investigation of their perceptions following the life-threatening illness crisis indicated that stress and tension factors were the causes most commonly cited. Possible social and psychological correlates are analyzed using an attribution theory framework, and their implications are discussed.

The Young Offender.

ERIC Educational Resources Information Center

MacLeod, Hinson

1979-01-01

Looks at delinquency from the viewpoint of a training school chaplain and outlines factors believed to contribute to the development of delinquent behavior. Signs of maladjustment include overactivity, acute anxiety and fear, depression, psychosomatic disorders, unusual behavior, negative attitudes toward others and themselves, and resistance to…

Family Therapy Approach to Incapacitating Migraine.

ERIC Educational Resources Information Center

Rosenstock, Harvey A.; And Others

1979-01-01

The case of a nine-year-old boy suffering from psycosomatic migraine headaches is discussed. The main article presents the case study and discusses the family systems approach which was successfully used in therapy. The following discussion deals with the psychosomatic personality. (HMV)

On the Interpersonal and Intrapersonal Consequences of Expressing or Not Expressing Anger

ERIC Educational Resources Information Center

Holt, Robert R.

1970-01-01

Clinical and experimental data are cited to show that not expressing anger can also have maladaptive consequences: poisoning" of relationships, psychosomatic disorders, and impairment of cognitive functions. The article by Berkowitz is critically analyzed. (Author/EK)

Morningness-Eveningness and Satisfaction with Life

ERIC Educational Resources Information Center

Randler, Christoph

2008-01-01

Individual differences in diurnal preferences and circadian rhythms are viewed as an interesting dimension of human personality. Previous research has examined various psychological correlates of diurnal preference. Evening types reported psychological and psychosomatic disturbances more frequently and intensively than morning types and morning…

[Peculiarities of adaptation of servicemen service].

PubMed

Shelepov, A M; Smagulov, N K; Mukhametzhanov, A M

2012-09-01

Review of issues about the adaptation of servicemen in the process of military service is presented. Characteristics of military service, conditions and levels of official-military activity, peculiarities of adaptation, factors providing progression of psychosomatic diseases and dysaptation, concept "occupational health" are considered.

Psychosomatic treatment of phantom limb pain with post-traumatic stress disorder: a case report.

PubMed

Muraoka, M; Komiyama, H; Hosoi, M; Mine, K; Kubo, C

1996-08-01

The successful treatment of severe left lower limb phantom pain is reported. Hypnosis and antidepressant drugs were the basis for the treatment which controlled the phantom limb pain and an associated post-traumatic stress disorder.

It's Open Season on Ticks

MedlinePlus

... potentially fatal diseases like Lyme disease, ehrlichiosis and tularemia. Many of these illnesses can be treated effectively ... which can carry the organisms that cause ehrlichiosis, tularemia and the Southern Tick-Associated Rash Illness (STARI)), ...

Ashley, Two Born as One, and the Best Interests of a Child.

PubMed

Gillett, Grant

2016-01-01

What is in the best interests of a child, and could that ever include interventions that we might regard as prima facie detrimental to a child's physical well-being? This question is raised a fortiori by growth attenuation treatments in children with severe neurological disorders causing extreme developmental delay. I argue that two principles that provide guidance in generating a conception of best interests for each individual child yield the right results in such cases. The principles are as follows: the potentiality principle, whereby every child should be able to develop its potential and is entitled to receive certain help in doing so, and the principle of psychosomatic harmony, whereby every human being is entitled to treatment that is appropriate to or enables a life in which mind and body are in tune with each other. These principles indicate a certain response to what we can call Ashley-type cases and admit certain caveats.

[Influence of environmental noise on sleep quality and sleeping disorders-implications for health].

PubMed

Kohlhuber, M; Bolte, G

2011-12-01

Environmental noise is a well-known risk factor influencing sleep-wake behavior and sleep quality. Epidemiologic studies have shown that environmental noise is regarded as the most annoying environmental factor. Noise causes modifications in physiologic and mental functions and may result in health outcomes like elevated blood pressure and ischemic heart disease. Reactions to high sound levels during sleep are decreased sleep intensity, arousals, and increased stress hormone secretion. Effects of poor sleep quality are reduced cognitive performance, tiredness, and psychosomatic symptoms. Long-term consequences of recurrent sleep loss due to environmental noise may be heart disease and increased medication intake. Arousals occur especially due to single noise events and intermittent noise. Laboratory and field studies showed no habituation of physiologic parameters to high sound levels. Sleep is especially sensitive to noise; therefore, sound levels during nighttime should be much lower than during daytime.

Psychotherapy in an International Setting: A Malaysian Perspective.

ERIC Educational Resources Information Center

Kumaraswamy, N.

In spite of the development of medical services in Asian countries, mental illness and mental health services remain a stigma. An awareness of the causes and consequences of mental illness is also lacking. Since the 1990s, much work has been done in Malaysia to advance the people's concepts about the scientific approach to mental illness and to…

EXPOSURE TO SAND DURING BEACH RECREATION AND RISK OF ILLNESS: RESULTS FROM THE NATIONAL EPIDEMIOLOGICAL AND ENVIRONMENTAL ASSESSMENT OF RECREATIONAL (NEEAR) WATER STUDY

EPA Science Inventory

Recent studies found high levels of E. coli in sand, causing concern and media reports about risks of illness from sand during beach recreation. We summarize associations between sand exposure and illness [gastrointestinal (GI), respiratory, eye and ear infection, and rash] from...

Attitudes of Social Distance and Social Responsibility for Mental Illness: A Comparison of Teachers and the General Public

ERIC Educational Resources Information Center

Bentz, W. Kenneth; And Others

1970-01-01

The data suggests that much still must be done to instill a sense of social responsibility for mental illness in the community. The attitudes and feelings of the community regarding social responsibility for cause and cure of mental illness will be crucial in success or failure of programs. (Author)

Health and relationships with leisure time activities in Swedish children aged 2-17 years.

PubMed

Berntsson, Leeni T; Ringsberg, Karin C

2014-09-01

Three cross-sectional time series studies, randomised and stratified for age and gender, were performed on children aged 2-17, studying their health and well-being. The studies were performed in the Nordic countries in 1984, 1996 and 2011. Long-term illness (LTI) and psychosomatic complaints (PSC) increased during the period. Data were collected from mailed questionnaires. Data of 1461 Swedish children from 2011 were used and compared with data from 1984 and 1996. Relationships between the health indicators (the absence of LTI, 13 diagnoses, the absence of PSC, six symptoms, six items of well-being) and 12 activities were analysed. A total of 83.2% of the children were healthy and 16.8% had at least one LTI, boys 19.1% and girls 14.5%. PSC increased from 18.6% in 1996 to 23.1% in 2011. The distribution was higher in girls. Girls were more active than boys during leisure time. 'Reading books', 'visiting friends', 'listening to music' and 'activity in organisations' were related to an absence of PSC, LTI and well-being. 'Surfing/blogging on the Internet' was negatively related to LTI, PSC and well-being. Multiple regression showed that that 'visits or is visited by friends' was related with a low probability for LTI and also with a high probability for well-being. In the logistic regression analyses, the following variables were seen as promoting health most: 'visits or is visited by friends' and 'is active in organizations' for children aged 2-17 years, especially for boys and well-being. The health of Swedish children declined between 1984 and 2011. Positive relationships were found between some activities and health as well as other activities related to ill health. The results suggest an increased focus on the activities that have positive relationships with health in order to promote health among children. © 2013 Nordic College of Caring Science.

Severe Legionnaire's disease caused by Legionella longbeachae in a long-term renal transplant patient: the importance of safe living strategies after transplantation.

PubMed

Wright, A J; Humar, A; Gourishankar, S; Bernard, K; Kumar, D

2012-08-01

Legionella species are intracellular gram-negative bacilli that require specific culture media for growth. Transplant recipients with impaired cellular immunity are at particular risk for infection with this pathogen. Most human disease is caused by Legionella pneumophila; disease caused by non-L. pneumophila species is reported mainly in immunosuppressed patients with the exception of Legionella longbeachae. L. longbeachae is a common cause of Legionnaires' disease in Australia and New Zealand, and is associated with exposure to potting soil. We report the case of a patient, 26 years post kidney transplant, who presented with severe and rapidly progressive respiratory illness. L. longbeachae serogroup 1 was isolated from respiratory cultures. Further investigation revealed that she had significant soil exposure before the onset of illness. We highlight the importance of following safe living strategies to prevent exposure-related illness even in long-term transplant recipients. © 2012 John Wiley & Sons A/S.

Schizophrenia and Physical Comorbidity.

PubMed

Šimunović Filipčić, Ivona; Filipčić, Igor

2018-06-01

Schizophrenia is a severe psychiatric disorder increasingly recognized as a systemic disorder. In addition to the burden and suffering caused by the mental illness itself, individuals with schizophrenia have a high risk for physical illnesses. The life expectancy gap remains 13 to 30 years wider in people with schizophrenia compared to the general population. This premature mortality is caused largely by deaths due to cardiovascular disease, cancer, diabetes mellitus, and other natural causes, poor diagnosis and treatment, and insufficient prevention of modifiable risk factors. Although the links between schizophrenia and physical illnesses are well established, in clinical practice, physical illnesses in patients with schizophrenia are often overlooked, and the mortality gap between general population and people with schizophrenia continues to widen. The physical health of people with schizophrenia is commonly self-neglected but also ignored by people around them and by health systems, resulting in significant physical health disparities and limited access to health services. The root of the problem of insufficient healthcare appear to lie in interrelated contributory factors from illness, patients, and medical and mental healthcare system. Furthermore, a growing body of literature has been indicating the effect of the chronic physical illness on the treatment outcome of psychosis. Premature mortality and disability could be reduced if there was a greater focus on the implementation of strategies that effectively prevent modifiable risk factors from the first psychotic episode and enhance early recognition of physical illnesses, reduce the burden of physical comorbidity and lead to improved health outcomes. Ultimately, to improve treatment outcome and to reduce the suffering of people with schizophrenia, it is crucial to treat physical comorbidity promptly and assertively from the appearance of the first symptoms of the psychotic disorder. The integrative approach and collaborative care within all levels of healthcare providers should be the imperative in clinical practice.

Relationship of supernatural beliefs and first treatment contact in patients with obsessive compulsive disorder: an exploratory study from India.

PubMed

Grover, Sandeep; Patra, Bichitra N; Aggarwal, Munish; Avasthi, Ajit; Chakrabarti, Subho; Malhotra, Savita

2014-12-01

The etiology of mental illness has been attributed to many different causes by people of various cultural backgrounds, including supernatural beliefs. This in turn affects the help-seeking behavior. Aim of this study was to explore the supernatural belief and pathways of care in patients with obsessive compulsive disorder (OCD) attending a tertiary care hospital located in north India. In all, 89 consecutive patients diagnosed with OCD (according to the International Classification of Diseases-10th Revision (ICD-10)) and ≥ 15 years of age were evaluated for their supernatural belief and help seeking. More than half of the patients (54%) believed in supernatural causes and 57.3% attributed their illness to supernatural causes. In addition to supernatural causes, many patients also attributed their illness to stress (household/work-related stress) or chemical imbalance in the body and or mind. About two-thirds of the patients (n = 58; 65.2%) first contacted a psychiatrist for their symptoms of OCD. Those who first contacted faith healers believed in one of the supernatural causations. Patients with OCD hold multiple beliefs regarding the etiology and treatment of mental illness which can affect their pathways to care. © The Author(s) 2014.

Sports injury and illness epidemiology: Great Britain Olympic Team (TeamGB) surveillance during the Sochi 2014 Winter Olympic Games.

PubMed

Palmer-Green, Debbie; Elliott, Niall

2015-01-01

Sports injury and illness surveillance is the first step in injury and illness prevention, and is important for the protection of both athlete health and performance in major competitions. To identify the prevalence, severity nature and causes of athlete injuries and illnesses in the Great Britain Olympic Team (TeamGB) during the Sochi 2014 Winter Olympic Games. The observational prospective cohort study followed the Great Britain Injury/Illness Performance Project surveillance methodology and obtained information on injuries and illnesses that occurred during the Games between 30 January and 23 February 2014 in TeamGB athletes (n=56). Among the 56 TeamGB athletes, there were 27 injuries and 11 illnesses during the Olympic Games period. This equated to 39% sustaining at least one injury and 18% at least one illness, with an incidence of 48.2 injuries and 19.6 illnesses per 100 athletes, respectively. Of all injuries and illnesses, 9% and 7%, respectively, resulted in time loss. The risk of sustaining an injury was highest for freestyle skiing, skeleton and snowboarding; and lowest for curling, biathlon and Alpine skiing (with no reported injuries); with the lower limb being the most commonly injured location. Respiratory system illnesses were most frequently reported overall, and older female athletes were the ones most affected by illness. The risk of injury was double the risk of illness for TeamGB athletes. Overall, the rate of time-loss issues was low. Methodological considerations are important when interpreting data, and prevention strategies should focus on those issues causing the greatest risk, in terms of prevalence and severity, to athlete health and performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

An Internationally Comparative Study of Immigration and Adolescent Emotional and Behavioral Problems: Effects of Generation and Gender.

PubMed

Stevens, Gonneke W J M; Walsh, Sophie D; Huijts, Tim; Maes, Marlies; Madsen, Katrine Rich; Cavallo, Franco; Molcho, Michal

2015-12-01

Although the potential consequences of immigration for adolescent problem behaviors have been addressed in many former studies, internationally comparative research is scarce. This study investigated the impact of immigration on four indicators of adolescents' emotional and behavioral problems in 10 countries, taking into account gender and immigrant generation as moderating factors. Analyses were based on data from 11-, 13-, and 15-year-old adolescents participating in the Health Behavior in School-aged Children study in Denmark, Germany, Greece, Iceland, Ireland, Italy, the Netherlands, Spain, the United States, and Wales (total N = 53,218). Both first- and second-generation immigrant adolescents reported higher levels of physical fighting and bullying and a lower life satisfaction than native adolescents, whereas second-generation immigrant adolescents reported more psychosomatic symptoms than native adolescents. Effect sizes varied considerable for the different outcomes, and similar effects were found for first- and second-generation immigrant adolescents. Differences in these indicators of emotional and behavioral problems between immigrant and native adolescents did not vary significantly with the receiving country. With two exceptions, effects of immigrant status were similar for boys and girls. Although no differences in psychosomatic symptoms were found between first-generation immigrant and native girls, first-generation immigrant boys reported less psychosomatic symptoms than native boys. Furthermore, both second-generation immigrant boys and girls reported higher levels of physical fighting than their native peers, but differences were more pronounced for boys than for girls. Overall, the results of this study support a risk perspective on the impact of immigration on adolescent problem behaviors. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Transparency of outcome reporting and trial registration of randomized controlled trials in top psychosomatic and behavioral health journals: A systematic review.

PubMed

Milette, Katherine; Roseman, Michelle; Thombs, Brett D

2011-03-01

The most reliable evidence for evaluating healthcare interventions comes from well-designed and conducted randomized controlled trials (RCTs). The extent to which published RCTs reflect the efficacy of interventions, however, depends on the completeness and accuracy of published results. The Consolidated Standards of Reporting Trials statement, initially developed in 1996, provides guidelines intended to improve the transparency of published RCT reports. A policy of the International Committee of Medical Journal Editors, initiated in 2005, requires clinical trials published in member journals to be registered in publicly accessible registries prior to patient enrollment. The objective of this study was to assess the clarity of outcome reporting, proportion of registered trials, and adequacy of outcome registration in RCTs published in top behavioral health journals. Eligible studies were primary or secondary reports of RCTs published in Annals of Behavioral Medicine, Health Psychology, Journal of Psychosomatic Research, and Psychosomatic Medicine from January 2008 to September 2009. Data were extracted for each study on adequacy of outcome reporting and registration. Of 63 articles reviewed, only 25 (39.7%) had adequately declared primary or secondary outcomes, whereas 38 (60.3%) had multiple primary outcomes or did not define outcomes. Only 13 studies (20.6%) were registered. Only 1 study registered sufficiently precise outcome information to compare with published outcomes, and registered and published outcomes were discrepant in that study. Greater attention to outcome reporting and trial registration by researchers, peer reviewers, and journal editors will increase the likelihood that effective behavioral health interventions are readily identified and made available to patients. Copyright © 2011 Elsevier Inc. All rights reserved.

Comparison of self-citation by peer reviewers in a journal with single-blind peer review versus a journal with open peer review.

PubMed

Levis, Alexander W; Leentjens, Albert F G; Levenson, James L; Lumley, Mark A; Thombs, Brett D

2015-12-01

Some peer reviewers may inappropriately, or coercively request that authors include references to the reviewers' own work. The objective of this study was to evaluate whether, compared to reviews for a journal with single-blind peer review, reviews for a journal with open peer review included (1) fewer self-citations; (2) a lower proportion of self-citations without a rationale; and (3) a lower ratio of proportions of citations without a rationale in self-citations versus citations to others' work. Peer reviews for published manuscripts submitted in 2012 to a single-blind peer review journal, the Journal of Psychosomatic Research, were previously evaluated (Thombs et al., 2015). These were compared to publically available peer reviews of manuscripts published in 2012 in an open review journal, BMC Psychiatry. Two investigators independently extracted data for both journals. There were no significant differences between journals in the proportion of all reviewer citations that were self-citations (Journal of Psychosomatic Research: 71/225, 32%; BMC Psychiatry: 90/315, 29%; p=.50), or in the proportion of self-citations without a rationale (Journal of Psychosomatic Research: 15/71, 21%; BMC Psychiatry: 12/90, 13%; p=.21). There was no significant difference between journals in the proportion of self-citations versus citations to others' work without a rationale (p=.31). Blind and open peer review methodologies have distinct advantages and disadvantages. The present study found that, in reasonably similar journals that use single-blind and open review, there were no substantive differences in the pattern of peer reviewer self-citations. Copyright © 2015 Elsevier Inc. All rights reserved.

Racial and ethnic differences in depressive subtypes and access to mental health care in the United States.

PubMed

Lee, Su Yeon; Xue, Qian-li; Spira, Adam P; Lee, Hochang B

2014-02-01

Racial and ethnic minorities in the U.S. underutilize mental health service for mood disorders. This study sought to identify depressive subtypes associated with low use of mental health services across racial and ethnic groups based on a large, nationally representative sample of adults in the U.S. Based on latent class analysis, we identified the latent profile of depressive symptoms among those who endorsed lifetime depressed mood or anhedonia in the 2001-2002 National Epidemiological Survey on Alcohol and Related Condition (302 Asian Americans; 8602 Whites; 2266 Blacks; 2254 Hispanics). Proportions and types of lifetime mental health service use across depressive symptom subtypes were assessed and compared across the racial and ethnic categories. A four class model of depressive subtypes was examined across race and ethnicity ("mild," "cognitive," "psychosomatic," and "severe"). Asian Americans, blacks, and Hispanics with "severe" subtype of depression had significantly lower odds of mental health service use compared to whites with "severe" subtype of depression. While Asian Americans did not have higher proportion of "psychosomatic" subtype than other race and ethnic groups, Asian Americans with "cognitive" subtype of depression significantly underused mental health services compared to Asian Americans with "psychosomatic" subtype of depression (Odds ratio:0.34, 95% Confidence interval:0.13,0.91). We were unable to account for heterogeneity of the subethnic group compositions based on country of origin and other socio-demographic factors. A targeted outreach intervention to raise awareness among Asian Americans, blacks, and Hispanics with "severe" subtype and Asian Americans with "cognitive" subtype of depression may reduce disparity in mental health service utilization across racial and ethnic groups. Published by Elsevier B.V.

Psychophysiological stress in high school teachers.

PubMed

Ritvanen, Tiina; Louhevaara, Veikko; Helin, Pertri; Halonen, Toivo; Hänninen, Osmo

2003-01-01

The aim of this study was to follow psychophysiological stress over a year with four repeated measurements in full-time employed high school teachers and to compare their results with those obtained in the part-time retired teachers, gardeners and rescue workers. The subjects consisted of 17 (10 females, 7 males) full-time and 9 part-time employed teachers (7 females and 2 males) in three high schools, 12 female gardeners and 13 male rescue workers. The data on job conditions, well-being, and psychosomatic symptoms were obtained by a questionnaire. The perceived stress was recorded using a visual analogue scale. The neuroendocrine reactivity was assessed by determining the diurnal urine excretion of epinephrine and norepinephrine. Electromyography of the trapezius muscle was recorded during working days in all subjects and in full-time teachers on one day in the holiday season. Blood pressure and heart rate were measured in the morning and in the afternoon. Psychophysiological stress in the full-time employed teachers was at similar levels on all three working days in December, March and November. Recovery from psychophysiological stress of working period was observed on summer holidays. Blood pressure, static muscle tension, perceived strain, psychosomatic symptoms and epinephrine level decreased significantly during the summer holidays as compared to the working days. The full-time employed teachers reported more perceived stress and psychosomatic symptoms than the part-time retired teachers or gardeners and rescue workers. Also static muscle activity was higher in full-time teachers than in rescue workers on the working days. More emphasis should be given to prevent psychophysiolocigal stress among teachers as well as to develop stress coping methods, and part-time working systems to facilitate work ability of aging teachers.

On the validity of measuring change over time in routine clinical assessment: a close examination of item-level response shifts in psychosomatic inpatients.

PubMed

Nolte, S; Mierke, A; Fischer, H F; Rose, M

2016-06-01

Significant life events such as severe health status changes or intensive medical treatment often trigger response shifts in individuals that may hamper the comparison of measurements over time. Drawing from the Oort model, this study aims at detecting response shift at the item level in psychosomatic inpatients and evaluating its impact on the validity of comparing repeated measurements. Complete pretest and posttest data were available from 1188 patients who had filled out the ICD-10 Symptom Rating (ISR) scale at admission and discharge, on average 24 days after intake. Reconceptualization, reprioritization, and recalibration response shifts were explored applying tests of measurement invariance. In the item-level approach, all model parameters were constrained to be equal between pretest and posttest. If non-invariance was detected, these were linked to the different types of response shift. When constraining across-occasion model parameters, model fit worsened as indicated by a significant Satorra-Bentler Chi-square difference test suggesting potential presence of response shifts. A close examination revealed presence of two types of response shift, i.e., (non)uniform recalibration and both higher- and lower-level reconceptualization response shifts leading to four model adjustments. Our analyses suggest that psychosomatic inpatients experienced some response shifts during their hospital stay. According to the hierarchy of measurement invariance, however, only one of the detected non-invariances is critical for unbiased mean comparisons over time, which did not have a substantial impact on estimating change. Hence, the use of the ISR can be recommended for outcomes assessment in clinical routine, as change score estimates do not seem hampered by response shift effects.

New insights into the gut as the driver of critical illness and organ failure.

PubMed

Meng, Mei; Klingensmith, Nathan J; Coopersmith, Craig M

2017-04-01

The gut has long been hypothesized to be the 'motor' of multiple organ dysfunction syndrome. This review serves as an update on new data elucidating the role of the gut as the propagator of organ failure in critical illness. Under basal conditions, the gut absorbs nutrients and serves as a barrier that prevents approximately 40 trillion intraluminal microbes and their products from causing host injury. However, in critical illness, gut integrity is disrupted with hyperpermeability and increased epithelial apoptosis, allowing contamination of extraluminal sites that are ordinarily sterile. These alterations in gut integrity are further exacerbated in the setting of preexisting comorbidities. The normally commensal microflora is also altered in critical illness, with increases in microbial virulence and decreases in diversity, which leads to further pathologic responses within the host. All components of the gut are adversely impacted by critical illness. Gut injury can not only propagate local damage, but can also cause distant injury and organ failure. Understanding how the multifaceted components of the gut interact and how these are perturbed in critical illness may play an important role in turning off the 'motor' of multiple organ dysfunction syndrome in the future.

Point source outbreaks of Campylobacter jejuni infection--are they more common than we think and what might cause them?

PubMed Central

Gillespie, I. A.; O'Brien, S. J.; Adak, G. K.; Tam, C. C.; Frost, J. A.; Bolton, F. J.; Tompkins, D. S.

2003-01-01

Despite being the commonest bacterial cause of infectious intestinal disease (IID) in England and Wales, outbreaks of campylobacter infection are rarely reported. However, data from the Campylobacter Sentinel Surveillance Scheme suggested that outbreaks might be more common than was previously suspected, since a high proportion of cases reported other illness in the home or in the community at the same time as their illness. To identify factors that might lead to these apparent outbreaks, the exposures of cases of Campylobacter jejuni infection reporting other illness, either in the home or the community, were compared with those for cases not reporting other illness using case-case methodology. Illness in the home was associated with consuming organic meats in the winter, having contact with a pet suffering from diarrhoea or visiting a farm in the 2 weeks before the onset of symptoms. Illness in the community was associated with the consumption of foods in restaurants or drinking unpasteurized milk. Prevention of campylobacter infection requires that better methods of outbreak detection and investigation are developed, which in turn should lead to a better understanding of risk factors. PMID:12825720

Comorbidities and psychotic illness. Part 1: Philosophy and clinical consequences.

PubMed

Agius, Mark; Aquilina, Francesca Falzon

2014-11-01

This article aims at addressing the implications of defining 'comorbidity' within the field of psychiatry. We have looked at the standard definition of comorbidity and then discussed whether this definition can be applied to comorbidities in psychiatry. While comorbidities in physical illness are clearly the coexistence of two independent illnesses, Comorbidities in Mental illness are the result of the polygenic nature of mental illnesses, especially in psychotic illness whether schizophrenia or bipolar disorder. As a consequence, often the comorbidities of psychiatric illness are caused by two conditions which have in common the presence of particular single nucleotide polymorphisms (snps), which regulate the metabolism of neurotransmitters or the presence of neurotrophic factors . Thus inevitably, many such comorbidities are inextricably linked. We discuss the consequences of this form of comorbidity for the description, classification, and risk profile of mental illness.

Community Knowledge and Attitudes and Health Workers' Practices regarding Non-malaria Febrile Illnesses in Eastern Tanzania

PubMed Central

Chipwaza, Beatrice; Mugasa, Joseph P.; Mayumana, Iddy; Amuri, Mbaraka; Makungu, Christina; Gwakisa, Paul S.

2014-01-01

Introduction Although malaria has been the leading cause of fever for many years, with improved control regimes malaria transmission, morbidity and mortality have decreased. Recent studies have increasingly demonstrated the importance of non-malaria fevers, which have significantly improved our understanding of etiologies of febrile illnesses. A number of non-malaria febrile illnesses including Rift Valley Fever, dengue fever, Chikungunya virus infection, leptospirosis, tick-borne relapsing fever and Q-fever have been reported in Tanzania. This study aimed at assessing the awareness of communities and practices of health workers on non-malaria febrile illnesses. Methods Twelve focus group discussions with members of communities and 14 in-depth interviews with health workers were conducted in Kilosa district, Tanzania. Transcripts were coded into different groups using MaxQDA software and analyzed through thematic content analysis. Results The study revealed that the awareness of the study participants on non-malaria febrile illnesses was low and many community members believed that most instances of fever are due to malaria. In addition, the majority had inappropriate beliefs about the possible causes of fever. In most cases, non-malaria febrile illnesses were considered following a negative Malaria Rapid Diagnostic Test (mRDT) result or persistent fevers after completion of anti-malaria dosage. Therefore, in the absence of mRDTs, there is over diagnosis of malaria and under diagnosis of non-malaria illnesses. Shortages of diagnostic facilities for febrile illnesses including mRDTs were repeatedly reported as a major barrier to proper diagnosis and treatment of febrile patients. Conclusion Our results emphasize the need for creating community awareness on other causes of fever apart from malaria. Based on our study, appropriate treatment of febrile patients will require inputs geared towards strengthening of diagnostic facilities, drugs availability and optimal staffing of health facilities. PMID:24852787

Reducing absenteeism from gastrointestinal and respiratory illness in elementary school students: a randomized, controlled trial of an infection-control intervention.

PubMed

Sandora, Thomas J; Shih, Mei-Chiung; Goldmann, Donald A

2008-06-01

Students often miss school because of gastrointestinal and respiratory illnesses. We assessed the effectiveness of a multifactorial intervention, including alcohol-based hand-sanitizer and surface disinfection, in reducing absenteeism caused by gastrointestinal and respiratory illnesses in elementary school students. We performed a school-based cluster-randomized, controlled trial at a single elementary school. Eligible students in third to fifth grade were enrolled. Intervention classrooms received alcohol-based hand sanitizer to use at school and quaternary ammonium wipes to disinfect classroom surfaces daily for 8 weeks; control classrooms followed usual hand-washing and cleaning practices. Parents completed a preintervention demographic survey. Absences were recorded along with the reason for absence. Swabs of environmental surfaces were evaluated by bacterial culture and polymerase chain reaction for norovirus, respiratory syncytial virus, influenza, and parainfluenza 3. The primary outcomes were rates of absenteeism caused by gastrointestinal or respiratory illness. Days absent were modeled as correlated Poisson variables and compared between groups by using generalized estimating equations. Analyses were adjusted for family size, race, health status, and home sanitizer use. We also compared the presence of viruses and the total bacterial colony counts on several classroom surfaces. A total of 285 students were randomly assigned; baseline demographics were similar in the 2 groups. The adjusted absenteeism rate for gastrointestinal illness was significantly lower in the intervention-group subjects compared with control subjects. The adjusted absenteeism rate for respiratory illness was not significantly different between groups. Norovirus was the only virus detected and was found less frequently on surfaces in intervention classrooms compared with control classrooms (9% vs 29%). A multifactorial intervention including hand sanitizer and surface disinfection reduced absenteeism caused by gastrointestinal illness in elementary school students. Norovirus was found less often on classroom surfaces in the intervention group. Schools should consider adopting these practices to reduce days lost to common illnesses.

Premature mortality among people with severe mental illness - New evidence from linked primary care data.

PubMed

John, Ann; McGregor, Joanna; Jones, Ian; Lee, Sze Chim; Walters, James T R; Owen, Michael J; O'Donovan, Michael; DelPozo-Banos, Marcos; Berridge, Damon; Lloyd, Keith

2018-05-02

Studies assessing premature mortality in people with severe mental illness (SMI) are usually based in one setting, hospital (secondary care inpatients and/or outpatients) or community (primary care). This may lead to ascertainment bias. This study aimed to estimate standardised mortality ratios (SMRs) for all-cause and cause-specific mortality in people with SMI drawn from linked primary and secondary care populations compared to the general population. SMRs were calculated using the indirect method for a United Kingdom population of almost four million between 2004 and 2013. The all-cause SMR was higher in the cohort identified from secondary care hospital admissions (SMR: 2.9; 95% CI: 2.8-3.0) than from primary care (SMR: 2.2; 95% CI: 2.1-2.3) when compared to the general population. The SMR for the combined cohort was 2.6 (95% CI: 2.5-2.6). Cause specific SMRs in the combined cohort were particularly elevated in those with SMI relative to the general population for ill-defined and unknown causes, suicide, substance abuse, Parkinson's disease, accidents, dementia, infections and respiratory disorders (particularly pneumonia), and Alzheimer's disease. Solely hospital admission based studies, which have dominated the literature hitherto, somewhat over-estimate premature mortality in those with SMI. People with SMI are more likely to die by ill-defined and unknown causes, suicide and other less common and often under-reported causes. Comprehensive characterisation of mortality is important to inform policy and practice and to discriminate settings to allow for proportionate interventions to address this health injustice. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

[Psychosomatic troubles in cardiology].

PubMed

Renard, M

1996-10-01

Mental stress is a disagreeable feeling accompanied by sympathetic overactivity which may mimic heart disorder (panic attack, ...) induce angina pectoris in coronary patients or contribute to trigger acute myocardial infarction. It may be reproduced by mental stress tests (arithmetic test, ...) and used as diagnostic procedure in coronary patients.

Recurrent Vascular Headache: Home-Based Behavioral Treatment versus Abortive Pharmacological Treatment.

ERIC Educational Resources Information Center

Holroyd, Kenneth A.; And Others

1988-01-01

Compared the effectiveness of a home-based behavioral intervention (relaxation and thermal biofeedback training) with an abortive pharmacological intervention (with compliance training) for treating recurrent migraine and migraine/tension headaches. Both interventions yielded reductions in headache activity, psychosomatic symptoms, and daily life…

Emotional Strategies and Their Relationship to Complaints of Psychosomatic and Neurotic Symptoms.

ERIC Educational Resources Information Center

Ogden, Jenni A.; Von Sturmer, Guy

1984-01-01

Examined the emotional strategies people use and their psychological consequences. Adults (N=270 and 329) were classified into emotional strategy groups. Suppressed emotives had a significantly higher score on the Complaint Questionnaire than emotive and nonemotive groups, suggesting neurotic tendencies. (JAC)

USSR Report, Life Sciences Biomedical and Behavioral Sciences

DTIC Science & Technology

1985-01-07

Institute of General and Forensic Psychiatry imeni V. P. Serskiy; Psychosomatic Department, No 1 Municipalr Clinic imeni N. I. Pirogov [Abstract] A brief...and includes hypnosis and supportive measures. The personal, social and economic impact of this program is discussed. More than 1000 persons have

PSYCHOLOGICAL AND ALLERGIC ASPECTS OF ASTHMA.

ERIC Educational Resources Information Center

HIRT, MICHAEL L.

FOCUSED HISTORICALLY AND CHOSEN TO STIMULATE RESEARCH IN PSYCHOSOCIAL IMPLICATIONS OF ASTHMA, THE COLLECTION CONTAINS 18 PAPERS BY DIFFERENT AUTHORS. AREAS OF PSYCHOSOMATIC MEDICINE COVERED ARE (1) PRINCIPLES OF RESEARCH (ONE ARTICLE), (2) HISTORICAL DEVELOPMENTS, THEORETICAL MODELS, AND CORE PROBLEMS (THREE ARTICLES), AND (3) THE HYPOTHESIS,…

Association between oral malodour and psychological characteristics in subjects with neurotic tendencies complaining of halitosis.

PubMed

Suzuki, Nao; Yoneda, Masahiro; Naito, Toru; Inamitsu, Tetsuaki; Yamada, Kazuhiko; Okada, Ichizo; Hatano, Yuko; Iwamoto, Tomoyuki; Masuo, Yosuke; Fuijimoto, Akie; Hirofuji, Takao

2011-04-01

  To assess the psychosomatically subjective symptoms of subjects with neurotic tendencies complaining of halitosis.   Breath malodour was measured in 368 patients using organoleptic test and gas chromatography. Neurotic tendency and subjective symptoms were assessed using the Cornell Medical Index (CMI).   Of the 79 subjects who met the criteria for neurotic tendencies according to CMI scores, 58 (73.4%) had oral malodour, whereas 21 (26.6%) did not. Coated tongue, periodontal pocket, and daily drinking were significantly more common in subjects with oral malodour. On the CMI questionnaire, subjects with no oral malodour more frequently responded 'yes' to questions about fatigue and psychological problems in their families. Additionally, many answered that they had perceived their own bad breath.   Difficulties experienced by subjects with neurotic tendencies and oral malodour may manifest primarily in oral conditions, whereas those experienced by individuals with neurotic tendencies and no oral malodour may manifest primarily in psychosomatic symptoms. © 2011 FDI World Dental Federation.

Staying well and engaged when demands are high: the role of psychological detachment.

PubMed

Sonnentag, Sabine; Binnewies, Carmen; Mojza, Eva J

2010-09-01

The authors of this study examined the relation between job demands and psychological detachment from work during off-job time (i.e., mentally switching off) with psychological well-being and work engagement. They hypothesized that high job demands and low levels of psychological detachment predict poor well-being and low work engagement. They proposed that psychological detachment buffers the negative impact of high job demands on well-being and work engagement. A longitudinal study (12-month time lag) with 309 human service employees showed that high job demands predicted emotional exhaustion, psychosomatic complaints, and low work engagement over time. Psychological detachment from work during off-job time predicted emotional exhaustion and buffered the relation between job demands and an increase in psychosomatic complaints and between job demands and a decrease in work engagement. The findings of this study suggest that psychological detachment from work during off-job time is an important factor that helps to protect employee well-being and work engagement. Copyright 2010 APA, all rights reserved