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[Pediatric psychosomatic medicine. Liminal proposals].

Psychosomatic disorders are part of the pediatrician's everyday practice. However, they have only lately become a field for systematic investigations, based on diverse methods and concepts. The viewpoints supported by the authors originate in studies carried out in the pediatric department of a hospital which deals only with psychosomatics. The following points are considered successively: 1) definition and peculiarities of psychosomatic disorders in children; 2) susceptible emotional organizations, which carry a high risk of psychosomatic disease; 3) depression, which is a key mental mechanism in psychosomatic disruption. One of the main purposes of research is description of a specific semiology of childhood psychosomatic disease. Its ambition is to be both open to medical practice and acknowledged in its specificity, so as to be used in psychological disciplines, i.e., sufficiently clear but without oversimplification. Further developments can be found in "L'enfant du désordre psychosomatique" (Privat 1981) and "La psychosomatique de l'enfant" (PUF 1983).

Child↗

Behçet's disease and psychosomatic patterns of thinking. A single case study.

BACKGROUND: A single case of Behçet's disease was studied throughout several consultations during a period of 15 years. METHODS: The evolution of the disease was related to important events in the subject's life, cognitive patterns, psychopathological features and, particularly, his relationships to women and to his family. RESULTS: Some interesting complex correlations between illness course and psychosocial events and states were highlighted. CONCLUSIONS: Future prospective studies could better elucidate this multiple feedback.

Adult↗

Fasting therapy for psychosomatic disorders in Japan.

It has been well known in Japan that fasting therapy has an excellent effect on various kinds of psychosomatic diseases. From 1967 to 1977 the therapy was carried out on about 382 cases of psychosomatic diseases in our clinic with an efficacy rate of 87%. The following diseases were considered as suitable indications for the therapy; irritable colon, behavioral disturbance of eating, functional disorders of the G-I tract, neurocirculatory asthenia, labile hypertension, variable psychosomatic symptoms of puberty, conversion hysteria and many kinds of neurosis with somatic complaints. The mechanism of effectiveness of the therapy is discussed from the psychological and biological aspects. It is concluded that the regulating mechanisms of the autonomic nervous system and endocrine system may change the whole functioning of the body including the brain, resulting in a spontaneous deconditioning of maladaptive bodily and mental behavior and an improved homeostatic adjustment to life.

Electroencephalography↗

[Experience in the correction of the internal picture of the disease in psychosomatic practice].

Psychotherapeutic correction activated compensatory abilities in patients with schizophrenia and augmented antipsychotic effect of medicamentous treatment. Correction of the inner picture of disease and cultivation of sanogenetic intentions increased considerably the efficacy of therapeutic and rehabilitative measures both in psychosomatic and schizophrenic patients, shortened stay in hospital by 5-10 days, reduced morbidity with temporary loss of capacity for work by 10-15%.

Attitude to Health↗

[Stress ulcer in a patient with a subacute subdural hematoma].

During the onset and development of pathologic events, numerous changes occur in the body as the result of an attempt of dynamic equilibrium maintenance. Results of such sequence of events may lead to organic, as well as psychic impairment of the body that is often referred to as the onset of psychosomatic disease. This paper deals with the disorder that could provide better insight in the possible physiopathologic mechanisms of psychosomatic disease or disorders. In a patient, chronic alcoholic subdural hematoma was diagnosed. Peptic ulcer hemorrhage occurred after surgical removal of the hematoma. Possible physiopathologic mechanisms in the origin of this disorder have been described.

Alcohol-Induced Disorders, Nervous System↗

[Psychosomatic personality structure--fact or fiction?].

This article describes the different approaches to explaining psychosomatic disease according to the gradual scientific development of this concept in the course of medical history. Whereas Freud and also some of the later psychoanalytical authors considered psychosomatic disease as a special form of neurosis, recent efforts are directed at working out a specific psychosomatic personality structure which can be differentiated against that of the neurotic or psychotic personality. Besides the concept of the "infantile personality" formulated as early as 1948 by Ruesch in respect of the psychosomatic patient, specific characteristics of a psychosomatic personality have been outlined during the sixties by a French working team as part of a concept which they called "operative thinking"; independent of this development, American authors have also defined such specific characteristics under the designation "alexithymia". The central aspect of these definitions concerns a disturbance of affective perception and of the ability to psychic or affective working-over. The critical discussion of these approaches is carried out both on a theoretical and on a methodical empirical level. Basing on an empirical study conducted by the author himself, methodical drawbacks of previous studies are discovered and pointed out.

Affect↗

[A treated case of facial tic caused by a psychological factor. Successful case approached by psychosomatic dentistry].

As the oral psychosomatic diseases of infants appear connected with a predisposition of their environment, environmental adjustment and psychotherapy on the basis of psychosomatic dentistry are necessary in the treatment. We encountered a 9-year-old boy who seemed to be suffering from a facial tic caused by psychological factors. An attempt of therapy on the basis of psychosomatic dentistry was made in this case. The results as follows were obtained: 1. Intake interview to a mother was carried out regarding a cause of the tic. It was shown that the attitude of the mother will bring up the child and her meddling as well as the stress of school life caused his facial tic. 2. With our guidance, the mother reconsidered her meddling attitude toward the patient. And she was able to handle the patient with a kind attitude. 3. After play therapy as preparation, catharsis was carried out on the patient, the tic decreased rapidly. 4. Finally a token economy method was used. 5. It was thought that sufficient correspondence on the basis of psychosomatic dentistry was beneficial in the therapy of patient with psychosomatic disease in pedodontics.

Child↗

[Factors of significance for short or prolonged duration of physiotherapeutic treatment from private practicing physiotherapists].

The aim of the study was to determine factors of importance for the duration of treatment of physiotherapy patients. A material of 363 patients answered questions about personal and social data and their disease. The following was related to prolonged treatment (greater than 47 days): 1) young, unmarried students. There was twice as many boys as girls. 2) Patients with psychosomatic disease. The ratio between men and women was 1, and the main symptom was headache. 3) Patients with generalized disease. This study did not reveal whether prolonged treatment is due to an ineffective treatment or whether other factors are of importance. However, we doubt the effect of physiotherapy in patients with psychosomatic disease.

Adolescent↗

Interactions between psychosomatic conflicts and gonadotropin secretion.

This present paper represents an attempt to correlate hormonal patterns and psychoanalytical data in 30 patients with secondary amenorrhea. Based on psychoanalytical data and the maximal LH response to GnRH, which were obtained independently, the patients were divided into two groups presenting differing psychosomatic symptomatologies. Patients with severe psychosomatic disease (group A) complaining predominantly of somatic discomfort, exhibited a weak pituitary response to GnRH. Patients presenting mainly mental symptoms were found to be less affected by the psychosomatic disease (group B). The LH responses to GnRH were only moderately impaired in these patients. Seven patients of group A underwent psychotherapy, resulting in a resumption of regular menses in 4 patients. Eight untreated controls of this group who remained amenorrheic exhibited unaltered gonadotropin in levels. All patients of group B being treated by psychotherapy resumed regular menses, while 5 of 7 control patients developed spontaneous menstruation. The progress of sexual maturation in these patients is correlated with increasing pituitary LH response to GnRH. The present study provides evidence that the degree of a psychosomatic disturbance resulting in secondary amenorrhea is reflected by the pattern of plasma LH after GnRH stimulation.

Adult↗