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PubMed2005

[Dropped head syndrome: report of two cases].

PURPOSE: The dropped head syndrome is characterized by an abnormal bending of the head to the body, mainly affecting old people. It corresponds to an alteration of the cervical extensor muscles, revealing in some cases a neuromuscular disease. In some cases, the etiology of this syndrome remains unknown. EXEGESIS: We report here two cases with dropped head syndrome. The first clinical case concerned a 78-year old man, presenting a dropped head syndrome revealing a myasthenia. The syndrome disappeared with specific therapy. The second clinical case was a dropped head syndrome developed in the context of severe depressive syndrome in a 71-year old woman. The etiological screening did not reveal any underlying disease. Counteracting the syndrome was successfully obtained with early physiotherapy. CONCLUSION: The dropped head syndrome can reveal a general disease such as myasthenia or amyotrophic lateral sclerosis. Therefore, investigation needs first to eliminate underlying diseases. If no etiology is found, the dropped head syndrome is considered of an unknown neuromuscular origin or a psychosomatic disease. In this latter case, physiotherapy may be beneficial.

Aged↗
PubMed1998

[Psychotherapy in the day clinic].

Recently, the importance of psychiatric day hospital treatment is increasing in German psychiatry, as the regionalization and community-orientation of care advance and catchment areas become smaller. When a psychiatric department of a local general hospital is within easy reach of the patient's residence, the means for intensive treatment, as is available in a hospital, can be utilized during the day, while the patient spends a considerable amount of time (in fact, two thirds) in the familiar surroundings of his/her own home. This is applicable for many psychiatric conditions, including neuroses, personality disorders and psychosomatic diseases. As compared to conventional individual outpatient psychotherapy on the one hand and a distinct limited stay in a psychosomatic sanatorium far from home on the other hand, psychotherapy in a day hospital offers a promising additional way to provide effective and lasting professional help early and with a low threshold. The article summarizes the experience gained in a newly founded department of psychiatry and psychotherapy at a general hospital in one district of eastern Germany, where the staff is struggling to meet the needs of the catchment area in spite of a too small number of hospital beds.

Adult↗
PubMed2006

Psychosomatic disorders in developing countries: current issues and future challenges.

PURPOSE OF REVIEW: This paper focuses on understanding of the concept, recent advances, and challenges to be faced in the field of psychosomatic disorders by the developing countries. RECENT FINDINGS: Changing health scenario in developing countries has led to imminent epidemic of noncommunicable diseases along with the unmet agenda of controlling infectious diseases. Psychosomatic medicine has a role to play in curtailing the upcoming epidemic. Research studies on psychosomatic disorders from developing countries are very few. Most of the publications are in nonpsychiatric medical journals covering explorative to intervention studies. Traditional, complementary, and alternative medicines such as ayurveda are already playing their role in the area of psychosomatic disorders in developing countries. SUMMARY: The role and responsibility of the psychiatrist is changing from treating major mental disorders to preventing and treating psychosomatic disorders. In this regard, developing countries have to meet various challenges such as development of manpower, training of medical and paramedical staff, funding resources for clinical practice and research, coordinating with complementary and alternative medicines, and networking with policy makers in combating the imminent epidemic.

Developing Countries↗
PubMed1985

Ferritin concentration in cerebrospinal fluid.

15 patients with psychosomatic disease, 26 patients with miscellaneous neurological diseases, and 16 patients with cerebrovascular disease were investigated with regard to concentrations of ferritin in serum and cerebrospinal fluid (CSF). The mean CSF ferritin concentration in the psychosomatic group was 6.2 micrograms/l +/- 2.4 (1 S.D.). Patients with recent cerebral infarction had similar values while 2 patients with intracerebral hematomas had very high CSF ferritin concentrations. There was a positive correlation between serum and CSF ferritin levels and between CSF total protein and ferritin in patients with a damaged blood-CSF barrier only. At present, the practical value of analysing ferritin in the CSF is very small.

Blood-Brain Barrier↗
PubMedDate not supplied

[Biophysical concept of the human autodiagnostic system].

A possible neurophysiological mechanism of the therapeutic effect of weak influences was proposed, which is based on the following assumptions: 1. In the organism, there is an autodiagnostic system, which serves for the accumulation and processing of information on the state of the organs to diagnose a desease. 2. The autodiagnostic disease is a recognizing system, i. e., a neuronet, which is constructed and functions according to the paradigms of neurocomputing. 3. Systemic (psychosomatic) diseases appear to result from erroneous diagnosis due to the defects of the autodiagnostic system. The influence of puncture on biologically active points corrects these defects, providing a positive therapeutic effect. A theoretical model for the structure and functioning of the autodiagnostic system is discussed. It is shown that the structure of the model autodiagnostic system coincides with that of Rexede plates forming the gray substance of the spinal cord. The experimental data on Rexede plates and their connections with organs and corresponding biologically active points are discussed. A relationship between the concept of the autodiagnostic system and the basic principles of alternative eastern medicine is discussed. It is shown that the Chinese model of puncture therapy represents a verbal description of the topological features of the phase space of the mathematical model for the recognizing neuroprocessor.

Acupuncture Therapy↗
PubMed1997

Periodic syndrome and migraine in children and adolescents.

Many reports in the literature seem to confirm the hypothesis that the symptoms of periodic syndrome are precursors or the equivalent of migraine: the aim of this study was to assess the prevalence of periodic syndrome in a group of children and adolescents suffering from migraine in comparison with that observed in various control groups. We considered seven symptoms: recurrent vomiting and abdominal pain, migrating limb pain, vertigo, recurrent hyperthermia with no visible cause, sleep disturbances and eating disorders. The study involved 171 children divided into four groups; 42 migraineurs; 37 subjects with chronic nervous pathologies but no psychosomatic symptoms; 46 subjects with a known psychosomatic disease, and 46 healthy subjects. The prevalence of the symptoms in the different control groups was different, although the pattern was more similar in the migraineurs and psychosomatic patients than in the other control groups. The development continuum of the syndrome may support the view that periodic syndrome is predictive of the subsequent development of a psychosomatic pathology.

Adolescent↗
PubMed2002

[Psyche - soma - delinquency. Empirical and clinical datas of psychosomatic disturbed delinquents: discussion and survey].

Psychosomatic disorders of delinquents are current clinical phenomena, but they are rarely examined and discussed. The contribution presents empirical-statistical results of a field-study with n = 202 unselected forensic patients in disciplinary measures. Psychosomatic diseases have been diagnosed in n = 48 cases. The interpretation of multi- and bivariate statistics hints at an iatrogene influence on detainees: Their psychosomatic disorders can be described as forms of autoplastic defence which must be considered in the context of specific basic personality structures and corresponding disturbed ego functions (control of impulses and anxiety, competence of communication and sublimation). This psychosomatic structure can be differentiated from perverse structured personalities. Characterised as an autoplastic and auto-aggressive reaction, the psychosomatic symptom can be distinguished from alloplastic and hetero-aggressive acting. Nevertheless these psychodynamics seem to be forensic-psychological predicators for anticipated delinquent relapses.

Adolescent↗
PubMed1982

Locus of control among psychosomatically and chronically ill children and adolescents.

In a matched group design, two groups of children suffering from a psychosomatic disease (bronchial asthma and ulcerative colitis) were compared with two groups of children suffering from other chronic illnesses affecting the same organ (cystic fibrosis and Crohn's disease) and with healthy subjects with regard to locus of control. With the exception of bronchial asthma, all clinical groups were characterized by greater internal locus of control. There were no significant relationships between the IE-dimension and further clinical parameters specific to each disease. Furthermore, there was an indication that psychiatric disturbance in general is related to external locus of control. The IE dimension did not contribute to a differentiation between the types of psychosomatic and chronic illness.

Adolescent↗
PubMed2004

Proof of the mysterious efficacy of ginseng: basic and clinical trials: clinical effects of medical ginseng, korean red ginseng: specifically, its anti-stress action for prevention of disease.

We are exposed to many external and internal stresses in this day and age. Stress weakens the function of immune systems in living organisms and disturbs homeostasis. As a result, stress induces various psychosomatic diseases. Thus, ways of reducing stress and thus protecting humans from disease must be developed. One such method is called "the prevention of Mibyou" in Kampo, the Chinese traditional medicine. Many studies have reported the direct effects of medical ginseng on damaged target organs and recovery from disease. It also increases immune potential and may maintain homeostasis of living organisms through the autonomic-endocrine systems. It is also thought to prevent the development of disease. We studied and considered the action of medical ginseng on living organisms that were exposed to various stresses such as cold environment and industrial work. Furthermore, we confirmed the preventive effects of medical ginseng on the common cold symptom complex, including flu, by clinical observation. Here, we report our experiences.

Cold Temperature↗
PubMed1993

Endocrine correlates of stress vulnerability.

Psychological stress is implicated as one element in a constellation of risk factors for the development and maintenance of psychosomatic disease. Endocrine responses to stressful experience vary widely among individuals, and may account for some of the individual variability in vulnerability to development of psychosomatic symptoms under stress. Endocrine stress responsiveness probably has a large genetic component, but is also known to be modifiable by prolonged and/or profound stressful experience. Social and cognitive factors influence the pituitary-adrenal response to stress, and sex differences may also be significant. It may be possible to develop specific tests of endocrine responsiveness, perhaps incorporating psychological and pharmacological challenges, that may serve as markers of chronic stress experience or of vulnerability to psychosomatic disorders.

Adjustment Disorders↗
PubMed1975

The psychosomatic approach in the practice of medicine.

The psychosomatic approach requires of the practitioner broad knowledge and skills relevant to the psychosocial, metabolic and physical responses of patients. The approach, being holistic, becomes appropriate in many different clinical situations (and should not be restricted to a few so-called psychosomatic diseases). Wise physicians and perceptive laymen have recognized the validity of an holosomatic approach for over 4000 years. Although the prevalence and incidence of psychosomatic disturbances are difficult to estimate (and probably underestimated in many surveys), data support the statement that family physicians should employ a psychosomatic approach in at least 15 per cent of cases. The general internist will probably encounter primarily psychosomatic disturbances in about 30 per cent of his patients; for example, many common presenting symptoms such as fatigue and chest pain arise in a setting of psychological stress. Apart from a sound knowledge of the genesis and manifestations of metabolic and structural changes, the physician must be familiar with the causes and symptoms of psychological disorders. Skillful interviewing and histroy-taking provide the data necessary to analyze and unravel psychosomatic interplay. Psychotherapeutic interviews often enable both the patient and the physician to understand the clinical problem: this understanding appears to aid recovery.

Behavior Therapy↗
PubMed1976

The use of psychotropic drugs in rheumatology.

The possible role of various psychotropic drugs in the management of rheumatic diseases is considered--tranquillizers, sedatives, tricyclic antidepressants and monoamine oxidase inhibitors. The dilemma of which anti-depressant for which patient is considered. The possible association between rheumatoid disease and disorders of the brain, brain-stem and autonomic nervous system is discussed. Psychotropic drugs may effect the disease itself as well as the patient's mood. The author is opposed, however, to the idea that rheumatoid arthritis may be regarded as a psychosomatic disease.

Anti-Anxiety Agents↗
PubMed1996

[Debatable issues in the problem of somatoform and related disorders].

The questions of including into ICD-10 and DSM-III-R of extranosological category--somatoform disorders is discussed. Some positive moments were considered, but inexpediency of the limitation of somatoform disorders to psychological disturbances only, doubtfulness of both including psychosomatic diseases in this category and age limitations in beginning and duration of the disease were stressed. The concept of somatopsychic diseases was proposed with three main variations: 1) with relatively independent rise of somatic and psychic disorders, 2) with prevailing etiopathogenic role of psychic factor (psychosomatic disorders, somatized psychic disturbances, somatoform neurotic and psychosomatic disturbances), 3) with prevailing etiopathogenic role of somatic factors (somatogenic psychic disorders). The actual distribution of somatopsychic disturbances are presented on the syndromal, nosologic and personal levels using data of prophylactic medical examination of one big enterprise's employees.

Humans↗
PubMed2006

[Treatment for irritable bowel syndrome--psychotropic drugs, antidepressants and so on].

Irritable bowel syndrome (IBS) is a functional disease with good prognosis, which is diagnosed by exclusion of possible causative organic diseases. However, since the patients tend to have strong psychotic symptoms including anxiety, tension, depression, irritation and insomnia, this syndrome has to be elucidated as a psychosomatic disease. Although the symptoms are usually limited to gastrointestinal symptoms such as abdominal pain and abnormal bowel movements, many patients also manifest some kinds of psychiatric abnormalities such as hypochondria, depression, hysteria, panic disorder and posttraumatic stress disorder. Especially, the prevalence of depression is high. Therefore, use of psychotropic drugs is efficient in treating IBS. Antidepressant agents including tricyclic agents such as amitriptyline, trimipramine, imipramine, clomipramine, amoxapine and nortriptyline; tetracyclic antidepressant; antidepressants such as SSRI and SNRI; sulpiride; benzodiazepine class anxiolytic agents; tandospirone; and Chinese herbal medicine are being used. IBS is a stress-related disease. Therefore, in spite of the importance of pharmacotherapy, patients should also be instructed to avoid the stress that aggravates the symptoms in all aspects of daily life.

Antidepressive Agents↗
PubMed2000

[Retinopathia centralis serosa--stomach ulcer of ophthalmology?].

Centralis serosa retinopathy is regarded in ophthalmology as a psychosomatic disease, although this assumption has not been satisfactorily proven so far. With the use of the Freiburg Personality Inventory (FIP, [4]), the questionnaire for the evaluation of psychosomatic pathological processes [10], and by recording the affliction undergone by stressful events in the patients' lives, the question as to whether a psychogenic contributory cause existed was examined with a control group study (n = 11), parallelised according to age and sex. The results proved significantly that there was a psychosomatic connection, specifically a tendency to somatisation in patients with centralis serosa retinopathy. However, it was not possible to compile a typical personality profile, although it was possible to describe some conspicuous personality features. As a conclusion, the consequences for a subsequent study are being discussed.

Adult↗
PubMed1998

[A survey on condition of outpatients at prosthodontics II, University Hospital, Faculty of Dentistry, Tokyo Medical and Dental University].

The number of dental patients who have medical illnesses is increasing at the hospital of the Faculty of Dentistry, Tokyo Medical and Dental University. Although prosthodontic treatments are considered less invasive in all dental treatments, invasive procedures such as tooth extraction may be required occasionally. Therefore, it is necessary to treat patients in consideration of their condition. Under this situation, a clinical survey was conducted by health questionnaires answered by the patients who visited our clinic between October 1992 and March 1997. The number of patients whose illness was heart disease, hypertension, diabetes, nephritic disease, hepatitis, tuberculosis, hemodyscrasia, asthma, epilepsy, and so on during dental treatment was higher than the national average according to the Ministry of Health and Welfare. Dental psychosomatic diseases such as TMD and dental phobia were increased every year. These data reflect the contemporary disease structure in Japan characterized by the spreading of life-style related diseases and increase of neuropsychological and infectious diseases.

Adolescent↗