[The significance of psychosomatic medicine for medical practice. Basic problems of psychosomatic medicine. (III)].
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The Bioethics Subcommittee of The Academy of Psychosomatic Medicine developed a survey to assess the involvement of psychosomatic-medicine psychiatrists in bioethics and the extent of their participation on bioethics committees and in the teaching of bioethics. Of 599 Academy members surveyed, 122 (20.4%) responded. The majority of respondents reported that the management of bioethical dilemmas had a significant impact on their work in psychosomatic medicine. Many respondents were involved in teaching bioethics and in serving on ethics committees. The majority of respondents reported psychiatry-resident involvement on ethics committees. Bioethics work is an integral part of the fabric of psychosomatic medicine.
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In psychosomatic medicine the indication of tiapridal may appear incomplete if it is based only on symptoms. This study takes into account certain psychopathological tendancies of the patient which are always present in a more or less attenuated form. Numerous psychosomatic manifestations are thus found to be episodic expressions of minor depression or moderate psychoneurotic disorders. Tiapridal is remarkably effective in resolving these symptoms.
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This practice guideline seeks to provide guidance to psychiatrists who regularly evaluate and manage patients with medical illnesses. The guideline is intended to delineate the knowledge base, professional expertise, and integrated clinical approach necessary to effectively manage this complex and diverse patient population. This guideline was drafted by a work group consisting of psychiatrists with clinical and research expertise in the field, who undertook a comprehensive review of the literature. The guideline was reviewed by the executive council of the Academy of Psychosomatic Medicine and revised prior to final approval. Some of the topics discussed include qualifications of C-L consultants, patient assessment, psychiatric interventions (e.g., psychotherapy, pharmacotherapy), medicolegal issues, and child and adolescent consultations.
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In 1970 new directions for the training of medical students in Germany have been issued. They include for the first time several compulsory lectures and courses on psychological-medicine, which covers: psychosomatic medicine, psychotherapy, psychoanalysis and medical psychology. Our paper puts to dicussion a new teaching model for psychological medicine that proved to be useful and effective many terms. The standards for our "practical course in psychosomatic medicine and psychotherapy" have been derived from the post-graduate training courses for psychoanalysis as offered in Germany for the last 25 years by the two psychoanalytical societies of the DGPPT (German Society for Psychotherapy, Psychosomatic Medicine and Deep Psychology).
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BACKGROUND: The psychosomatic evidence that has consolidated over the past decades provides the ideal background for dealing with the new needs that emerge in current medical practice. METHOD: A review of the psychosomatic literature, using both MEDLINE and manual searches, was performed. Search terms were psychosomatic, psychosomatic medicine, mind-body medicine, and biopsychosocial. Medical journals and books in English were also searched manually. Articles, with particular reference to review articles, which were judged to be relevant to clinical practice, were selected. RESULTS: The following aspects were found of particular clinical interest: assessment of psychosocial factors affecting individual vulnerability (life events, chronic stress and allostatic load, well-being, and health attitudes), evaluation of psychosocial correlates of medical disease (psychiatric disturbances, psychological symptoms, illness behavior, and quality of life), application of psychological therapies to medical disease (lifestyle modification, treatment of psychiatric comorbidity, and abnormal illness behavior). CONCLUSION: A psychosomatic approach may be crucial in managing patients with unexplained somatic symptoms and in identifying psychological distress that cannot be diagnosed by psychiatric categories. Furthermore, it may contribute to recovery and rehabilitation by specific interventions.
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