Psychosomatic factors in periodontal disease.
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Animals↗
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Results for “PSYCHOSOMATIC DISEASES”
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Human psychoneuroimmunology today.
Studies in human psychoneuroimmunology began around 1919, but a systematic approach wasn't used until the work of Solomon in the 1960s. Recently, the new specialty has achieved relative independence due to considerable data acquisition. Stress research has revealed relationships between neuroendocrine and immune changes. In parallel, increasing evidence of immunological alterations in psychiatric diseases has expanded the field; presently, immunological correlates of psychosomatic diseases and personality are sought. On the other hand, while immunological disease has been psychologically assessed for many years, a clear-cut link between psyche and immunological changes has yet to be shown. This fact, along with the therapeutic implications of advancing knowledge, will influence strongly the future trends of psychoneuroimmunology. Concepts emerging from the study of this field will be of heuristic value to both psychiatry and immunology and will help define new and expanded limits for both disciplines.
Acquired Immunodeficiency Syndrome↗
[Psychosomatic treatment of irritable bowel syndrome].
Irritable bowel syndrome (IBS) may be defined as a psychosomatic disease. Most primary care physicians do not want to undertake psychosomatic treatment, but may find it necessary in refractory patients. Brief psychosomatic treatments, providing patients with betterways to cope with stress, reduce the symptoms. The literature on the psychosomatic treatment for IBS is summarized. Supportive therapy and autogenic training that produce relaxation response appear to be effective. Other special psychological therapies that require specialized training, such as hypnosis, biofeedback, cognitive therapy, transactional analysis may be used for IBS but adequately controlled trials are lacking. It is certain that psychosomatic treatment take part in the management of IBS. Additional studies are needed to verify the effectiveness of these treatment for IBS.
Autogenic Training↗
Placebo and its importance in medicine.
Placebo can be defined as "a therapeutic effect, drug or non-drug, or a part of it which, in the condition being treated, objectively does not have any specific pharmacodynamic action." Even today when powerful drugs are available placebo is important and present in therapy. Effective therapeutic agents are also sometimes used as placebo, mostly inadvertently. In clinical pharmacological investigations placebos are used deliberately to discriminate the pharmacodynamic action of drugs from psychic and other factors which can influence the objective of the drug evalution. The use of placebo in therapeutic trials is justified only when no effective treatment is available or the symptom or disease is trivial. Placebo effect is especially pronounced in diseases where pain is an important symptom as well as in psychosomatic diseases. The extent of placebo reaction depends on patient's characteristics (reactors and non-reactors), drug presentation, as well as on personality and attitudes of the prescriber. Deliberate use of placebo other than in clinical therapeutic investigation is justified in mild mental depression and in situations where the diagnosis is known, no drug is necessary, but the patient's pressure to get a prescription is irresistible (?). Every doctor should cultivate the induction of placebo reaction in treatment of his patient, but not to the extent that the belief of the former in the action of an inactive medication starts.
Ethics, Medical↗
[Essential testodynia].
Testodynia can be defined as long-lasting or recurrent testicular pain in younger men with no physical disease in their scrotal contents. The condition is suggested as a psychosomatic disease caused by any unrealized or unsolved existential problem leading to a chronic psychological stress reaction. The stress causes alpha 1-receptor mediated contraction of smooth muscle in the vas deferens and epididymis. The pain arises due to the muscle spasm or sperm obstruction. The therapy is a combination of psychotherapy and alpha 1-receptor blocking agents.
Adult↗
Computer tomography of the abdomen in patients with uncharacteristic abdominal disturbances.
Computer tomography (CT) was performed on 48 patients with uncharacteristic abdominal disturbances. Pathological CT findings were encountered in five patients, namely hepatic steatosis in three patients, liver metastases in one, and occlusion of the inferior vena cava in one. CT may be indicated in patients with uncharacteristic abdominal disorders when other investigations are negative. In some patients the negative result of the CT examination for organic disease was of great importance for the psychiatric approach to these patients' psychosomatic disease. In spite of this, the positive yield of abdominal CT seems to be highest when other less expensive examinations or tests have suggested abnormality of abdominal organs.
Gastrointestinal Diseases↗
[A prevalence study of the need for psychosomatic services at the general hospitals in Hamburg].
Between 1981 and 1986 we took a random sample of patients in internal wards of 9 out of 11 General Hospitals. This study serves to determine the prevalence of psychosomatic diseases of in-patients and to ascertain the planned demand for psychosomatic care. We used a psychodynamically oriented half-standardized interview as well as questionnaires about the patients' opinion of the etiology respectively on their therapeutic expectations and on life events. 11.1% of the in-patients had been admitted due to psychiatric problems such as alcohol, suicidal tendencies. 38.4% of the thoroughly examined patients were identified as psychosomatic in accordance with the evaluation of the interview. Items of the lay-etiology and of the therapeutic expectations correlate with this identification; psychosomatic patients have more critical life events.
Adult↗
[A basic psychodiagnostic program for internists].
The increasing frequency of disturbances of the health, in which psychic and/or social influential factors are significant, reflects also in the number of patients of the specialist of internal medicine who is working in the outpatient department, the hospital and in a subspeciality. This requires from the specialists of internal medicine, if he will satisfy the claims of his patients for a comprehensive diagnostics and effective therapy, from the very beginning and in all phases of the care the involvement of a basic psychodiagnostics. Hereby the problem in question is an enhanced internal establishment of the anamnesis under psychodiagnostic aspect, which serves for the clarification of psychic and/or social influences on signs and symptoms, the experience of the and the course of the disease. An orientating systematization and a way to the positive diagnostics of neuroses, psychosomatic diseases or disturbances and further functional syndromes in the field of internal medicine are presented which demand the graduated psychotherapeutic measure.
Humans↗
[Psychosomatics of skin diseases].
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Humans↗
Psychological aspects. A series of 104 posttraumatic cases of reflex sympathetic dystrophy.
Over a period of 12 years, 104 cases of posttraumatic reflex sympathetic dystrophy have been diagnosed followed up and treated according to a standard protocol, including, among other clinical items, a psychiatric examination. Apart from the traditional clinical recordings, the following has been noted: 1. All patients were over 30 years of age; 2. No relationship was found between the significance of the trauma and the severity of the dystrophy; 3. The dystrophy nearly always emerged at the time of the primary healing of the injury; 4. On psychiatric examination, 96% of the patients showed signs of chronic depression; 5. Forty-nine percent had elevated gamma GT suggestive of alcohol abuse; 6. The socioprofessional context always revealed: either a state of inactivity (jobless persons, disabled persons, childless housewives, pensioners); or an opportunity for inactivity (work injury suffered by workers, lower-rank employees, bankrupt self-employed people). There were no tradesmen, executives, lawyers, physicians, consultants, artists, sportsmen or musicians in the series, and no housewives with young children. 7. In the second phase of the survey, we decided to complement the drug therapy by systematically adding antidepressant agents. This led to a significant improvement in the course of the disease. These elements have led us to consider whether traumatic algodystrophy could be a psychosomatic disease.
Adult↗
[The body in conversation with the patient].
The experience of the living body as condition of the human existence is evaluated according to the concept of the anthropological-integrative psychotherapy of D. Wyss. General ways of behavior towards the own body specially in psychosomatic diseases are subjected to research, including the possibilities of the therapist reactions. Models of psychosomatic methods are criticized under this aspect but also positive ways of approach discussed. Lacking integration of a bodily experienced approach with patients of psychosomatic disorders is pointed out--notably in clinical institutions--and new directions developed.
Body Image↗
[Ulcerative colitis and Crohn disease from the psychosomatic viewpoint].
Ulcerative colitis and Crohn's disease in childhood and adolescence are discussed from the psychosomatic point of view. To our up-to-date knowledge the psychic determinant is not a necessary but a promoting factor within the multifactorial aethiology. Premorbid conflict situations are described, which overstrain the physical and psychic endurance of the young patients and thus endanger an adequate adjustment to the illness. Since there have not been any control studies, there is no proof of advantageous effects of psychotherapy on the course of disease in children and adolescents. Up to now there are only a few positive case reports available. Nevertheless, there is no doubt that proper psychological care aids convalescence.
Adaptation, Psychological↗
Alexithymia: comparison with a patient's concept of the genesis of his disease and its relationship with depression.
The results of a three-direction investigation of the alexithymic phenomenon are presented. The first part of the investigation is a reduplication study of the first research of alexithymia; the second is devoted to the problem of relationship between depression and psychosomatic diseases. The relationship between the frequency of alexithymic responses in a particular psychosomatic patient and the concept which the patient himself has of the genesis of his disease represent the third part of the investigation.
Adolescent↗
[Study of two psychosomatic disorders of the gastrointestinal system (ulcer, colitis) using the Frustration Test].
By means of the frustration test (PFT) authors studied two psychosomatic diseases (ulcer and colitis) of the gastrointestinal tract. According to pertinent literature and pertinent literature and personal experiences the test will be helpful in revealing elaboration modalities of stress which are of decisive importance in the pathogenesis of the diseases. The study has been carried out on altogether 281 persons divided into following groups: psychosomatic patients in the "organic" and the "functional" stage, neurotics, and sine morbo controls, respectively. Statistical analysis and the paired t-test was used for the evaluation of results. It has been established that the particular psychosomatic type of reaction, the PFT-profile corresponding the "acting in", having been assessed by authors did exist. Nevertheless it permits no differentiation between patients in the "organic" and "functional" stage, as well as the neurotics with psychosomatic complaints, respectively. Some specific signs have been found however being characteristic for psychosomatic patients in the "organic" stage. According to authors disturbances of personality development lead in both, the neurotic and, they psychosomatic patients to disorders of adaptation, the ego integration, and inadequacy of mechanisms of stress elaboration. PFT is suitable to clear severity of the psychic anomaly.
Adaptation, Psychological↗
[Changes and diseases of mouth mucosa in the aged].
Natural changes in oral mucosa are influenced by disturbances of metabolism and many local injuries with the result of various appearances in the surface of the oral cavity in the elderly. There are less acute inflammations but more diseases with chronic inflammation and more degenerative and tumorous alterations. A special problem comes from psychosomatic diseases with their difficulties in diagnoses and therapeutic management.
Aged↗
[Psychosomatic aspects in orthopedic legal assessment].
AIM: Complaints in orthopaedics that are not sufficiently explainable can be caused (partly) by psychosomatic disorders. A manual psychosomatic disorders for legal assessment in orthopaedics will be supplied. METHOD: Diagnoses essential for orthopaedics are classified by DSM-IV and ICD-10 in consideration of the current literature; evaluation was performed under legal assessment criterions. RESULTS: The most important complaints that are often poorly explainable results in musculoskeletal pain. Since a sensorial perception of pain is combined with emotions, emotions and psychic disorders can be perceived as pain. The most important diagnoses for assessing not sufficiently explainable complaints by somatic cause are "somatoform pain disorder", "somatization disorder", "undifferentiated somatoform disorder", "conversion disorder", "hypochondriasis", "body dysmorphic disorder", "maior depression", "dysthymic disorder", "posttraumatic stress disorder", and "adjustment disorder". The relevance of psychosomatic comorbidity in legal assessment is possible in all affairs of civil and social law. Private accident insurances exclude psychic and psychosomatic diseases from all insurance benefits. CONCLUSION: When composing legal assessments in orthopaedics, especially on pain, the knowledge of psychosomatic (co)morbidity is necessary for meeting the different causes of the complaints. Under awareness of possible psychosomatic disorders, additional psychosomatic legal assessments can be recommended and understood as well.
Diagnosis, Differential↗
[Investigation in patients with central serous retinopathy with the MMPI Saarbrücken (author's transl)].
Patients with angiographically proven C.S.R. were investigated with the MMPI. They showed significantly higher scores on the hypochondria and hysteria-scale. The idea, that C.S.R. is an ocular psychosomatic disease is supported by the profile pattern, which shows an elevation of the "Neurotic Triad" with the characteristically depressed "Psychosomatic Valley".
Adolescent↗
[Anorexia nervosa from the aspect of psychoanalysis].
The author demonstrates the possibilities of therapeutic collaboration as regards treatment of anorexia nervosa by combined psychoanalytic and somatic treatment. He demonstrates this collaboration on a particularly severe course of the disease which was successfully reverted. The author indicates briefly the approach of modern psychoanalysis to this remarkable psychosomatic disease. The disease is conceived as the consequence of complete failure of feeding in the widest sense of the word during the period of preverbal childhood, caused by emotionally equivocal behaviour of the mother. This prevents satisfactory definition of the ego and non-ego of the child and interferes with the process of separation. This has then an impact on all further stages of development and the disorder leads to failure during adolescence. The mental anorectic symptomatology is then a persisting unconscious attempt to re-establish the lost unity with the mother which releases fear of the loss of self-limitation.
Adult↗