Depression in the medically ill.
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Biomedical subjects
Publications and source records attributed to P G Stenn.
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Two patients underwent outpatient percutaneous liver biopsy under hypnosis without complications. One patient had severe anxiety about the procedure because of a previous adverse experience with liver biopsy and the other had a history of severe allergy to local anesthesia. Both patients had undergone a session of hypnosis at least once prior to the biopsy. One received no local anesthetic and the other received 1% lidocaine as a local anesthetic. Both patients were completely cooperative during the procedure with the required respiratory maneuvers. Both patients stated that they were aware of the procedure under hypnosis but described no pain and would be most willing to have the procedure done under hypnosis in the future. Hypnosis can be a useful method of preparing carefully selected patients for percutaneous liver biopsy.
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Clinical data are producted which appear to show that the response to therapy of myofascial pain dysfunction syndrome (MPDS) is much less favorable when the patient has been involved in a road traffic or similar accident which precipiated the condition. Reasons for this difference and the differences between postinjury MPDS and nonpostinjury MPDS patients may be a consequence of litigation and, in addition, may be due to the personality of the patient. Evidence to support this hypothesis is seen when the condition is compared with such disorders as low back pain. Further research is needed to explore the etiology and treatment implications of these differences.
The findings in 194 cases of myofascial pain dysfunction syndrome are summarized and the differential diagnosis of the condition is discussed. Conservative methods of treatment were used in all cases, and follow-up revealed complete or almost complete recovery in 75 per cent of the patients; this percentage was increased still further when relaxation and coping skills training were used. Those patients who had been involved in accidents with direct or indirect trauma to one or both joints showed a significantly higher proportion of nonresponse to therapy.
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