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Biomedical subjects

K Rodewig

Publications and source records attributed to K Rodewig.

5 recordsLinked to original sources
PubMed1995

Concepts of psychosomatic disorders in ICD-10: results of the Research Criteria Study.

The multicenter study with the research criteria in the field of psychotherapy/psychosomatic medicine considered nine cases. One patient with cardiac neurosis (F45.3) and one patient with a persistent somatoform pain disorder (F54.4) were diagnosed in category F45.x. The rater agreement was 63-68%. 54% of the correct diagnoses made for three cases of colitis ulcerosa and Crohn's disease concurred (28%, 50%, and 80%). The case of anorexia nervosa (F50.0) was coded correctly by all of the raters, while the agreement for bulimia (F50.2) was 82%. Only 50% of the raters correctly assigned the dissociative disorder (F44.4). The agreement achieved for factitious disorder (F68.1) was 54%. Across all the psychosomatic disorders in ICD-10 there was an agreement of 65%. This result is markedly lower than the overall agreement of the Research Criteria Study (78%). Cardiac neurosis and bulimia were given a favorable prognosis. A more reticent psychotherapeutic commitment was seen for the classical psychosomatic disorders, persistent pain disorder, and factitious disorder. Anorexia nervosa and dissociative disorder assumed an intermediate position.

Humans↗
PubMed1995

[Physical illness in the transference and countertransference].

The significance of severe physical illness in terms of the repercussions it may have on the course of psychoanalytic treatment is a topic that has received very little attention in the literature. The author approaches the problem from the point of view of transference and counter-transference on the one hand, and from a distinction between self and body-self on the other. Rodewig proceeds on the assumption that a physical ailment can have the character of an object and may thus attain the status of third object. Given the threat posed by dangerous physical illness, the ego has recourse to defence mechanisms such as splitting and separate projective identification of positive and negative object- and self-parts, projecting the omnipotent, idealizing desires onto the therapist and the negative desires onto the ailment itself. In a later stage a de-idealization of the therapist sets in and the latter is identified with the illness so that the illness is then bandied back and forth between patient and analyst. The most challenging technical problem for analysts is avoiding the projection of their own illness and death anxieties onto the patient with a view to resolving them there. Instead, they need to be worked in independently and then given back to the patient devoid of their original virulence. The author illustrates the various facets of the problem with brief reference to various case histories.

Attitude to Death↗
PubMed1993

[Psychosomatic aspects of hyperthyroidism with special reference to Basedow's disease. An overview].

The following paper deals with the current research in hyperthyroidism, with special accent to Graves' disease. Besides severe psychological trauma a breakdown of neurotic defense mechanism on the ground of a special personality structure was thought to be the trigger of the disease. The metabolic changes became the main point of interest. The influence of thyrostatic, surgical and radioactive therapies on psychological symptoms, was investigated. Thereby, the previously anticipated emotional factors became less significant in the aetiology of the disease. A recent study (Paschke 1990) suggests that patient with hyperthyroidism have, even in an euthyrotic state, an increased vulnerability to anxiety provoking situations. At this point it is not clear, due to the retrospective nature of the study, whether the vulnerability exists prior to the unset of the disease or is a result of the metabolic disorder. Both thyroxin and TRH are being successfully used in the treatment of major depression. TRH acts as a neurotransmitter in the autonomic nervous system and can be demonstrated in the peripheral lymphocytes. However, the exact mechanisms of action of thyroxin and TRH are still unknown. Graves' disease is an autoimmune disease, that can be caused by specific HLA antigens. Thereby, a changed subpopulation of lymphocytes can be demonstrated, as well as there disturbed functions. A correlation between high scores for anxiety and depression on one hand and the occurrence of an abnormal T4/T8 ratio on the other hand, have been reported in a small number of cases (Paschke 1990). The psychological symptoms in hyperthyroidism are similar to the symptomatology of neurotic anxiety and the anxious depressive syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1988

[The total person and the attitude of the physician in cancer therapy].

For us, the diagnosis of a cancer is now as before an extraordinary challenge. This is reflected in the great efforts we are making to search for the causes of this disease and to find new and better healing methods. Since its foundation, the German Cancer Research has raised enormous sums of money in order to finance this research. Within the last few decades, the science of psycho-oncology has been developing, too, and it has profited from this scientific impetus. Psycho-oncologic departments have been built at Heidelberg and other tumor centers, and extensive retrospective and prospective studies on epidemiology have been conducted in order to investigate the psychic background of the cancer disease. However, the personal behavior towards cancer patients is now as before a special and rather problematic task for the physician. The suffering caused by such a disease confronts us with our own anxieties and makes us aware of our helplessness in view of the psychic situation of the patient which is often characterized by hopelessness and a ceased dynamism.

Attitude to Health↗