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PubMed1990

[Research activity in the psychosomatic medicine/psychotherapy specialty at West German universities--a 1978-1988 status report].

The documentation of research activities in the discipline of psychosomatics/psychotherapy at the Federal German universities during the past 10 years includes scientific papers and monographs as well as research projects. In addition, a list of theses submitted by candidates wishing to qualify for lecturing at a German university ("Habi,-litationsschrift") has been set up for the same period. The emphasis is on psychosomatic/psychotherapeutic care, specific psychosomatic diseases and the management of chronic diseases, whereas less research activity was seen in the areas of psychophysiology and epidemiology. The data represent considerable research activity in this discipline, but it would be advisable to see to it that in the future such data are better documented and coordinated.

Germany, West↗

PubMed1981

[Appearance and frequency of mental diseases. Epidemiological investigations (author's transl)].

After a survey of the earlier psychiatric epidemiological studies carried out in Munich, particularly the work of Brugger, three investigations carried out by the Munich Psychiatric Hospital in the last decade are described: a study to determine the administrative prevalence and incidence in the afflux area of the Gabersee District Hospital, an investigation to determine the frequency of psychic disorders among the patients of doctors in private practise and finally a field study which served to establish the true morbidity in the population. For mental disorders needing therapy a prevalence of 18.5% was found which is primarily based diagnostically on neurotic and psychosomatic diseases. To cover the need for treatment it is not proposed that specialist care should be extended but rather that the competence of the practising physician with regard to psychiatric diseases be considerably strengthened.

Adolescent↗

PubMed1984

Endocrine influence on disease outcome: experimental findings and implications.

The psychosocial environment may impose stressor effects on animal and man. Adaptation to these environmental changes requires behavioural, autonomic, neuroendocrine, metabolic, etc. processes. The neuroendocrine system plays a key role in the integration of these processes. Experimental evidence obtained in the rat suggests that neuropeptides related to ACTH, endogenous opioids and their fragments, vasopressin, etc., but also oestrogens may selectively influence the form and magnitude of acute cardiac response to emotional stressors. Dichotomies between the behavioural and cardiac responses may occur too. It is suggested that neuroendocrine action on brain mechanisms that are involved in the organization of behavioural and bodily responses to stressors are important in physiological adaptation. Neuroendocrine disturbances (two much or too little neuropeptides and other hormones) may thereby contribute to the outcome of psychosomatic diseases.

Adrenocorticotropic Hormone↗

PubMed2006

[Cognitive impairment, depression, and work capacity of 50-59-year-old psychosomatic inpatients].

Due to aging of the population and a possible rise in retirement age, the cognitive capacity of older people is gaining great importance. As evidenced by the increase in early retirement due to psychosomatic disease, many employees are not capable of working at a higher age. Decreasing cognitive abilities have usually been studied in subjects over 65 years based on the heterogeneous construct of mild cognitive impairment (MCI). This study investigates the prevalence of cognitive impairments in the age group from 50 to 59 years and their reflections in subjective vocational achievement and social medical evaluation. Having been assigned to inpatient rehabilitation due to decreasing work performance, these patients could be considered a risk group for developing MCI. A battery of standardized cognitive tests was conducted with patients at a psychosomatic hospital (Termine Test, CVLT, Block Design, TAP, and Tower of Hanoi). The MCI was defined by performance below the average age norm in at least two of five functional areas. Depression was assessed by the Beck Depression Inventory. Cognitive impairment was observed in 24% of participants. These patients also described vocational difficulties. Cognitive impairments of older employees could possibly be compensated for by specific training programs in order to maintain or rebuild their work capacity.

Cognition Disorders↗

PubMed1983

[Psychiatric patients in the internal medicine hospital--results of a survey].

According to the results of an inquiry in Niedersachsen, more than one quarter of patients in internal wards need at least a psychiatric co-treatment, most of them suffering from gerontopsychiatric and psychosomatic diseases and alcoholism. Internal specialists inform about this demand; the special treatment that ought to follow can mostly not be realized. The usual cooperation as well as psychiatric wards or hospitals mostly not within easy reach can hardly improve the situation. A special ward integrated in the general hospital is considered helpful for patients of this very house. As there will hardly be a chance of building up special new wards in the next few years, considering the present financial situation of the health care system, it is discussed, in which way an effective psychiatric-psychosomatic care might be created.

Alcoholism↗

PubMedDate not supplied

[Psychophysiologic approaches in the etiology and therapy of psychosomatic disorders].

Psychosomatic phenomena were considered within the framework of psychophysiology and general stress research. Startingpoint for an adequate understanding and interpretation of etiology and symptom-specifity of psychosomatic diseases are neurophysiologic-endocrinologic and psychodynamic findings. The familiarity with the concept of the specifity-of-attitude-hypotheses is important, too. Concerning the described etiologic hypotheses three psychotherapeutic procedures are demonstrated: 1) Relaxation trainings combined with biofeedback techniques, 2) rational-emotive therapy, 3) social-skill training. Furthermore it is referred to the clinical importance of slow cortical potentials (contingent negative variation--CNV) as central nervous correlates of information processes in the treatment of anxiety and hyperactivation of the autonomous system in stress situations. Prognostic criteria and indication for different treatment procedures of psychosomatic disorders were discussed.

Adrenal Cortex Hormones↗

PubMed1978

Circulatory effect of jet noise, with special reference to cerebral circulation.

The circulatory effect of jet noise on heart rate, systolic blood pressure and cerebral blood flow was investigated by means of the on-line Doppler ultrasonic technique devised by the author in 20 normal young males, normal elderly males and elderly patients with cerebral vascular disease. The jet noise ranged from 60 dBA to 110 dBA. Heart rate and systolic blood pressure showed slight and transient increase at the level of over 90 dBA. Although the cerebral blood flow was increased at the level of 90--110 dBA, conspicuous dissociation was observed between the vertebral artery and internal carotid artery. The vertebral artery dominant type was more frequent than the internal carotid artery dominant type. Headache and discomfort due to the noise were observed in all the subjects. The above facts suggest that the jet noise induces dysfunction of the autonomic nervous system and various kinds of psychosomatic diseases.

Adult↗

PubMed2004

[History of the discovery of Helicobacter pylori].

The discovery of Helicobacter pylori is one of the greatest achievements in the modern history of gastroenterology, which led to fundamental changes in our approach to the pathogenesis and treatment of peptic ulcer disease. However, the road towards accepting the role of these spiral bacteria in the pathogenesis of certain diseases of the upper digestive tract was long and marked with repeated false interpretations and misunderstandings, even when--in retrospect--many times several researchers were very near to the discovery. The first observations concerning the presence of bacteria in animal/human stomachs dates from the dawn of medical microbiology, when the bacterial etiology of some other diseases (tuberculosis, cholera, dysentery, syphilis) was ascertained. In spite of many bacteriological, experimental, biochemical and therapeutic observations, the causative role of the microorganism in the pathogenesis of peptic ulcer was not recognised even in the case of most elegant demonstrations. Sometimes, head-strong thinking and excessive belief in opinion leaders statements set back the bacterial research. The identification of Helicobacter pylori by Barry J. Marshall and J. Robert Warren in 1983 can not be, in any case, considered as serendipitous: without the endeavour, youthful curiosity, talent and ambition of the former and solid classical knowledge in pathology of the latter, peptic ulcer might be considered even today as an acid-related or psychosomatic disease, as it was during the past century.

Australia↗

PubMed1991

Patterns of self-definition of asthma patients and normal persons in the Freiburg Personality Inventory.

The concept of the specificity of psychosomatic diseases (Alexander) is being differentiated at the time. In order to clarify some aspects of this problem, we want to investigate whether types of self-rating of normal persons differ from those of patients with bronchial asthma. In a second step we shall examine whether those types of self-rating can be found also in expert rating and third the differences between the two groups concerning their help-seeking behavior. For the purpose of this investigation the data of 135 patients with bronchial asthma (who had been investigated at the Heidelberg University Medical Department between 1979 and 1982) and of 330 persons of the Mannheim Cohort Study (who are a representative sample of the average urban population) have been reanalyzed. By means of the Freiburg Personality Inventory (FPI) data cluster analyses have been done. Evaluated by a group of 5 (5-cluster solution) the patterns of self-rating of patients with bronchial asthma do not differ significantly from those of normal persons. They had a high correlation to the expert rating and to other social-medically important outer criteria. The results indicate that the specificity of psychosomatic patients in relation to normal persons is not very convincing in a pattern of self-rating on the level of the FPI. Therefore, further research in this field seems to be necessary.

Adult↗

PubMed1996

Mental distress, obesity and body fat distribution in middle-aged men.

Previous epidemiological studies have suggested that psychiatric symptoms are associated with obesity and abdominal distribution of body fat in women. The aim of the present study was to examine this in middle-aged men. In 1992 a cluster selected cohort of 1040 men born in 1944 (participation rate 79.9%) was examined. Registrations of symptoms of depression and anxiety, sleep disturbances, psychosomatic disease as well as degree of life satisfaction were analyzed in relation to body mass index (BMI) and the waist/hip circumference ratio (WHR). In univariate analyses both BMI and WHR correlated with these factors. BMI and WHR were, however, closely interrelated (p = 0.61), necessitating analyses of separate, independent relationships in multivariate analyses. When adjusted for WHR all the significant relationships with BMI disappeared. In contrast the WHR, adjusted for BMI, showed remaining significant associations with the use of anxiolytics (p = 0.018), hypnotics (p = 0.029), antidepressive drugs (p = 0.008), degree of melancholy (p = 0.002), and life satisfaction (p = 0.002, negative), difficulties to sleep (p = 0.014) and fall asleep (p = 0.047), tendency to wake up from sleep (borderline, p = 0.070) and dyspepsia (p < 0.001). Since smoking and alcohol are known to influence on the WHR, these factors were, in addition to BMI, entered into the analyses as confounding variables. The mentioned associations then remained statistical significant (use of hypnotics borderline, p = 0.074) except difficulties to fall asleep and tendency to wake up. It was concluded that in contrast to BMI, the WHR is associated with symptoms of depression and anxiety with associated sleep disturbances, as well as psychosomatic symptoms and dissatisfaction. It was hypothesized that the mechanism involved might be increased secretion of cortisol, directing storage fat to central adipose tissue depots.

Adipose Tissue↗

PubMed1987

The psychophysiology of confession: linking inhibitory and psychosomatic processes.

A theory of inhibition and psychosomatic disease suggests that the failure to confide traumatic events is stressful and associated with long-term health problems. We investigated the short-term autonomic correlates of disclosing personal and traumatic experiences among two samples of healthy undergraduates. In Experiment 1, subjects talked into a tape recorder about extremely stressful events that had occurred in their lives, as well as what they planned to do following the experiment. Skin conductance, blood pressure, and heart rate were continuously measured. Based on judges' ratings of subjects' depth of disclosure, subjects were classified as high or low disclosers. Talking about traumatic events was associated with decreased behavioral inhibition, as measured by lower skin conductance levels among high disclosers. Disclosing traumatic material was also associated with increased cardiovascular activity. In Experiment 2, subjects both talked aloud and thought about a traumatic event and about plans for the day. Half of the subjects were alone in an experimental cubicle and talked into a tape recorder; the remaining subjects talked to a silent "confessor" who sat behind a curtain. Among high disclosers, both talking and thinking about traumatic events produced lower skin conductance levels than did thinking or talking about plans for the day. The presence of a confessor inhibited subjects' talking. Implications for understanding the nature of confession and the development of an inhibitory model for psychosomatic processes are discussed.

Arousal↗

PubMed1982

Insula of the old world monkey. I. Architectonics in the insulo-orbito-temporal component of the paralimbic brain.

The insula of the rhesus monkey has a surface area of approximately 160 mm2 and can be divided into three architectonic sectors. The agranular sector is coextensive with prepiriform allocortex and is characterized by three agranular cellular strata, a zonal layer of myelinated fibers, and a high level of intracortical acetylcholinesterase (AChE). The dysgranular sector adjoins the agranular sector and shows first the emergence of a granular L4 and then a gradual differentiation of L2. Cortical myelin is low and mostly within deep layers; the AChE level is less than in the agranular sector. The third and granular sector covers the posterior aspect of the insula and contains granular L4 and L2, incipient sublamination of L3, increased cortical myelin with an emergent outer line of Baillarger, and a very low density of AChE. These observations indicate that AChE histochemistry can be used for the architectonic analysis of cortex. The lateral orbital cortex and the temporal pole can also be subdivided into agranular, dysgranular, and granular regions. In the insula as well as in lateral orbital and temporopolar areas, the agranular sector is directly contiguous with prepiriform cortex. When these three brain regions are considered jointly, they are seen to be organized in the form of increasingly more differentiated agranular, dysgranular, granular, and hypergranular sectors arranged concentrically around prepiriform allocortex. The term paralimbic is suggested as a generic term for all regions where such transitions occur from allocortex to granular isocortex. The insula, lateral orbital surface, and temporal pole are paralimbic areas with an olfactory allocortical focus. The parahippocampal, retrosplenial, cingulate, and subcallosal regions constitute a second group of paralimbic areas with a hippocampal-induseal focus. In the most general sense, the functional specilizations of paralimbic areas are predominantly for behaviors which require an integration between extrapersonal stimuli and the internal milieu. The human insula has a plan of organization virtually identical to that in the rhesus monkey. In the human, the insulo-orbito-temporopolar component of the paralimbic brain may become involved in conditions which range from epilepsy to psychosomatic disease.

Acetylcholinesterase↗

PubMed1979

[Studies on the psychopathology of adults with 4-5 c/s EEG rhythm (author's transl)].

Nineteen subjects (10 males and 9 females, aged between 18 and 61 years) with an occipital 4-5 c/s EEG rhythm were tested using a multidimensional psychological test program. The program consisted of the IST of Amthauer, the Raven Test, the German version of the MMPI ("MMPI Saarbrücken"), the Cattell 16-PF-questionnaire, Brickenkamp's d2-Test, and a test battery for psychomotor impairment. A group of normal persons with a regular alpha EEG, matched according to sex and age, was used to provide test norms for the 4-5 c/s EEG group. No difference in intelligence was found, but statistically significant differences were found in some personality traits in the MMPI and the 16-PF-questionnaire. Taking into consideration that the 4-5 c/s EEG group of the study is a subjective sample not randomly selected, this study showed that the male subjects with a 4-5 c/s rhythm as more sensitive, more tender and gentle, more anxious, and less tolerant of stress when compared with the control group; in terms of sex-specific personality traits, they tend to show more female features. Furthermore, the clinical observations of the psychological test date are discussed, i.e., that the subjects with 4-5 c/s rhythms suffer more frequently from functional somatic complaints (observed in 13 cases: 9 with neurovegetative disturbances, 4 with psychosomatic diseases) and/or show psychopathological features (observed in 12 cases: 8 with abnormal personality traits, 4 with neurotic personality development).

Adolescent↗

PubMed1991

Do antibody-coated bacteria prove bacterial prostatitis?

Using the immunofluorescence technique in 187 patients with bacteriologically proven prostatitis according to the Meares-Stamey test demonstrated a significant amount of antibody-coated bacteria (ACB) in their ejaculates. The ACB test was useful to discriminate between chronic bacterial prostatitis and prostatodynia with a sensitivity of 65% and a specifity of 92%; likewise the ACB test is superior to complement and coeruloplasmin estimation in the ejaculate by radial immunodiffusion usually recommended for the differential diagnosis of inflammatory and psychosomatic diseases of the prostate.

Adult↗

PubMed1979

[Are television cameramen and sound operators overstressed?].

Sickness absences occurred between 1975 and 1977 among 29 cameramen and sound operators of the Swiss Television Corporation (in French language) in charge of outside reports have been compared with both those of a control group working in TV studio and with those of the staff of the Federal Administration. No significant difference was found between these three groups as regards absences for illnesses and injuries lasting one to three days and for injuries lasting more than three days. On the other hand, illnesses of more than three days were significantly more frequent among the cameramen and sound operators. This was mainly due to a very high rate of psychosomatic diseases and nervous breakdown. This difference has been attributed rather to professional fag than to attraction to these professions of more vulnerable people.

Absenteeism↗

PubMedDate not supplied

Search activity in the context of psychosomatic disturbances, of brain monoamines and REM sleep function.

The author discusses a number of controversial aspects of the search activity concept. This concept, based on an analysis of data cited by other researchers and the results of the author's own investigation, performed together with V. V. Arshavsky, postulates that search activity raises the body's resistance to stress and experimentally induced pathology whereas renunciation of search forms a nonspecific predisposition to somatic disturbances (e.g., psychosomatic disease). REM sleep is regarded as a specific form of search activity aimed at compensating for the state of renunciation of search in walking. In this paper the author argues that 1) renunciation of search can be accompanied either by anxiety or by depression, 2) REM sleep deprivation on a "small platform" raises the requirement in REM sleep by producing renunciation of search, 3) during search activity brain catecholamine synthesis is stimulated by catabolism whereas a state of renunciation of search upsets this feedback system. The actuation of the brain mechanisms of search in REM sleep necessitates a certain brain catecholamine level. If the brain catecholamine level is very high during waking behavior due to intensive search activity, the REM sleep requirement is low, REM sleep becoming reduced. After a moderate drop in the brain catecholamine level at the initial stage of renunciation of search the requirement in REM sleep rises and this phase grows longer. But at the late stage of renunciation of search the brain catecholamine level drops extremely, REM sleep shrinking in spite of the great appropriate requirement, and 4) the functional insufficiency of REM sleep invites various forms of pathology.

Animals↗

PubMed1998

The fibromyalgia syndrome as a manifestation of neuroticism?

After elucidating the components and theory of neuroticism (N) as well as of psychosomatic complaints and their relationships to personality dimensions and to psychosomatic diseases, comparisons are performed between patients suffering from fibromyalgia syndrome (FMS) or related pain diseases with healthy subjects scoring high on personality dimensions related to neuroticism. FMS and pain patients score high on depression, anxiety, and experience of stress although questionnaire scores on depression are higher in subjects not exhibiting somatic features of the disease. High subjective pain sensitivity and low thresholds for pain perception are also common features in high N subjects and FMS patients. On the endocrinological level cortisol responses to challenge tests with CRH as well as prolactin responses to TRH are higher in FMS patients than in high N healthy subjects indicating an endocrinological difference. A common feature, however, is the lack of adaptability in the two groups, since neurotics are in particular characterized by a low capacity to shift their behavior from one state to the other (waking-sleeping, working-relaxing), to re-adapt to baseline levels after endocrinological or physiological stress responses, or to adjust to conditions of shift work. This is reflected by chronobiological disturbances in FMS patients and could also explain their maintainance of pain perception, because they are incapable of correcting conditioned pain-producing muscle tension.

Adaptation, Psychological↗

PubMed1995

Alexithymia in essential hypertensive and psychiatric outpatients: a comparative study.

The purported association between alexithymia and essential hypertension was investigated in a sample of 114 hypertensive patients using the well-validated twenty-item Toronto Alexithymia Scale. Alexithymia was also assessed in a group of 113 general psychiatric outpatients and in a group of 130 normal adults. A rate of 55.3% of alexithymia was found in the hypertensive group compared with significantly lower rates of 32.7% in the psychiatric group and 16.3% in the normal controls. The results support the view that a high prevalence of alexithymia may be found among patients with disorders that were categorized in the past as "classical" psychosomatic diseases. It is hypothesized that a deficit in the cognitive processing and modulation of emotions may leave alexithymic individuals prone to states of heightened sympathetic arousal that are conducive to the development of essential hypertension.

Adult↗